Filing for disability compensation with the U.S. Department of Veteran Affairs (VA) is a tedious task and having your application denied can be disappointing. Although many VA claims get denied due to “bad paper” charges, others are the result of technicalities that applicants tend to avoid.
If you’re wondering what went wrong in your initial application that was denied or worried about filing a denial claim to the VA office, we’ve got you covered. This post will highlight some of the most common reasons for denied VA claims. We’ll also discuss how a veteran disability attorney can help you fill the missing gaps and navigate the complex VA claims and review process.
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1. Proving Your Disability Came From Service
The VA follows strict guidelines to determine eligibility for veterans’ disability benefits. It can deny your claim if you fail to establish the credibility of your service-related disability. To maximize your chances of claim approval, furnish legitimate medical evidence and prove at least one of these events leading to your injury/illness:
- Stemmed from active military service (in-service disability claim)
- Got worse while serving military (preservice disability claim)
- Didn’t appear until after the service ended (post-service disability claim)
2. Missing Your C&P exam
The VA conducts Compensation and Pension (C&P) exams, and you could end up with a denied claim if you miss the appointment. The exam isn’t mandatory, but the VA will approach you if they need more information to decide your claim. The physicians should include the condition’s diagnosis, nature, test measurements, and results in the C&P exam report. The purpose of these exams is to ascertain:
- Disability rating — this will be based on the severity of your symptoms and will determine your compensation amount
- Compensation — this may include things like monthly payments and enrollment in the VA health-care program
3. Filling Out The Wrong Forms
You’re likely to face a claim denial if you submit incorrect/incomplete forms. You need to completely fill out a set of base forms, and some of you may need to turn in additional forms to support the disability claim. For instance, those claiming post-traumatic stress disorder (PTSD) must also fill out VA Form 21-0781.
4. No Legal Representation
If you’re an eligible VA claimant, it’s always good to seek out help from a veteran disability attorney who’ll help you avoid any mistakes that can lead to claim denial. When it comes to appealing a VA decision, an experienced legal representation can help you potentially win your appeal by:
- Collating evidence and medical records
- Accurately presenting your case, and filling all the required forms
- Seeking ways to maximize your compensation and disability ratings
5. Doctor Showed No Proof of Disability
Credible medical evidence is essential to claiming your VA disability benefits. You’re likely to face a claim denial if your doctor is unable to do the following:
- Provide a concrete diagnosis of your disability, its symptoms, and why it should be considered for VA disability compensation
- Share clear and conclusive medical observations
- Accurately fill out all the required forms
- Furnish the proof that your injury or illness is service-related
6. No Specific Diagnosis
Your VA disability claim must include a diagnosed medical condition related to your military service for it to be approved. The VA may deny compensation if a diagnosis doesn’t adequately confirm the existence of a debilitating illness or injury. Consult your doctor about receiving a specific diagnosis for your disability, as this improves your chances of receiving compensation. You may be able to get VA disability benefits for conditions such as:
- Chronic (long-lasting) back pain resulting in a current diagnosed back disability
- Breathing problems resulting from a current lung condition or lung disease
- Severe hearing loss
- Scar tissue
- Loss of range of motion (problems moving your body)
- Ulcers
- Cancers caused by contact with toxic chemicals or other dangers
- Traumatic brain injury (TBI)
- Post-traumatic stress disorder (PTSD)
- Depression
- Anxiety
7. Your Claim Is Part of the Ongoing Backlog
You may think your VA claim has been denied because you haven’t received a response in months. It’s possible, however, that your disability claim hasn’t yet been denied and the VA is still reviewing/processing it.
According to the Department of Veterans Affairs, there are 639,496 pending claims and 152,572 rating-related claims backlogged as of 9/10/2022. There are several reasons for the delay in processing the VA claims backlog. As the VA can only process 500 to 1,000 hearings per week, scheduling and processing hearings can take a long time.
How a VA lawyer can help
You need an experienced veteran lawyer that understands the appeal process, knows the reasons behind claim denials, and is aware of the winning tactics. The FY2020 Board of Veterans’ Appeals report shows veterans with attorneys won 41 percent of their appealed cases within the last fiscal year. Here’s how a veteran disability attorney can help you win the disability benefits you deserve:
- Provide a detailed explanation of why your claim was denied the first time
- Appeal VA claim decision you disagree with
- Suggest tips and tricks to fill the gaps and win the appeal
- Help you request a higher-level claim review by an experienced reviewer or file a supplemental claim with new evidence
- Find ways to increase your disability ratings (you do not qualify for compensation if you earn a rating of less than 10 percent)
- Review your medical records, paperwork, and proofs
If you have VA disability claim questions, LegalASAP can help you connect with a VA lawyer in your area. Contact us today to get started.