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What To Do If Your VA Disability Claim Was Denied

The Office of Veteran Affairs offers many benefits to veterans that can improve daily life. It’s not uncommon that the VA denied your initial claim for disability benefits and compensation, but the good news is that there are review and appeal options available to you. While many American veterans believe they can not appeal their denial, this is not always the case. It is worth exploring your options before giving up on your claim altogether, as it is not a complicated process once you are familiar with it.

As you work through the following steps, make sure to create physical copies of your documents, including military records, the rating decision, and the denial letter. If you have access to a private computer, you can also create a digital file of all of your documents. It is essential to make a paper trail to set yourself up for a successful appeal process. You can even use certified mail to confirm that the VA received all your documents. 

Why VA Claims Are Denied

The Office of Veteran Affairs denies claims for veterans’ disability for various reasons. Common reasons for denial include the veteran not providing all necessary documentation, submitting the wrong forms, not meeting eligibility requirements, or filing outside of required time frames. A percentage of claims may also be denied if there is incomplete or inaccurate information on VA claim forms. 

The best way to ensure that your claim for disability compensation is approved is by checking you meet the eligibility requirements. The baseline requirements included serving in the active naval, air, or military service and did not receive a dishonorable discharge. Before the claims process, you will want to gather all necessary paperwork, including service records, medical evidence, and disability rating. It is recommended you work closely with an accredited Veterans Service Officer. When filling out your claim forms, they can advise and collect any needed documents, like medical records. Failure to supply the required documentation may result in claim denial.

If you had a disability claim denial, there are several ways for you to respond. You can ask your local Veterans Affairs office to reconsider their decision by filing a formal appeal or submitting additional evidence with the VA. The VA should notify you if they take this action. Still, you can always follow up with VA representatives about your claim status.

Review Reasoning for VA Ratings Decision

After a denial, the first thing you should do is review the VA Ratings Decision letter. The VA will provide you with information about the initial decision and include your VA file number, the evidence, reasoning for the denial, references, and the decision date. The rating decision letter packet includes a rating sheet, providing a history of all the claims you have made.

Consider your Appeal Options

Under the Appeals Modernization Act (AMA), which began on February 19, 2019, you now have three options for appealing your claim. With these options, you can continue your pursuit of benefits and protect your retroactive benefits to the date you file your claim. You must act within 12 months of the date of the decision to preserve your back benefits.

File a Supplemental Claim

If your VA Claim was denied and you have additional evidence to provide, you can file a Supplemental Claim. You have the opportunity to add or identify new evidence to support your claim that the VA did not previously consider. A reviewer will decide if the supplemental evidence changes the prior decision. This claim includes additional evidence, like medical records, to support your original claim. You must submit this evidence to the VA at the same time you file your Supplemental Claim. 

You can file new and relevant evidence at any time. It should take about 125 days for this review to start the process. You can fill out the following form to submit supplemental information: Decision Review Request: Supplemental Claim (VA Form 20-0995). 

Request a Senior Reviewer (Higher Level Review)

If you do not have new evidence to support your claim but would like to have someone review your original claim, you will request a senior review. A senior reviewer or a senior claims adjudicator will reconsider your decision using the same evidence VA considered in the prior decision. They will assess if there’s an error in the preceding judgment. 

You can request an optional, one-time, informal conference with a senior reviewer to identify specific errors in the case, but ordering this conference may delay the review. Overall, the senior claims adjudicator process would take an average of 125 days. You can use this form to start the review process: Decision Review Request: Higher-Level Review (VA Form 20-0996). Disabled Veterans can request a Higher-Level Review online for disability compensation claims. 

Note, you cannot request a Higher Level Review of a decision by a Higher Level Reviewer. If your claim has been denied after an appeal, it is probably past time to speak with a Veterans’ Disability attorney. 

Board Appeal through Veteran Affairs

If you would like to have a Board review your benefits decision, you can request a direct review, evidence submission, or a hearing with a Veterans Law Judge at the Board of Veterans’ Appeals will review the original decision. 

Suppose you don’t have more documentation to add, like medical opinion evidence, nor do you want to have a hearing. In that case, you can request a direct review from aboard. If you wish to submit additional evidence of your medical conditions, you can file for evidence submission. Finally, you can request a hearing with a Veterans Law Judge. 

Requesting a hearing will take an average of 365 days. It may add additional time during the evidence submission or a hearing process. You can fill out the Decision Review Request: Board Appeal (VA Form 10182) form to start the process.

Prepare for Long Wait Times

Be prepared to wait on your appeal decision. The VA makes it easy to check the status of your claim online. An attorney will do their best to expedite the process. Still, there’s little that they can do aside from providing the pertinent information needed to decide on your case. 

The VA may prioritize your file if you are houseless, have advanced age, have a terminal illness, or are experiencing severe financial hardship. You may want to include these circumstances to expedite the appeals process. 

Initial Claim Denied for Veteran Disability Benefits? Take Action Now!

If you’re like most people following a denial, you probably feel frustrated. Maybe the VA stated that you didn’t qualify for benefits or that there’s no evidence of your service-related injury, or perhaps there is a legal error. Either way, it can be frustrating to get what you need only to find out that something is preventing it from happening. 

However, there are ways to appeal a VA denial, and our team has worked with thousands of veterans. We can help you get the disability benefits and compensation that you deserve. Contact us today for a free consultation to speak with a veterans benefits lawyer specializing in veterans’ disability claims. Our team has extensive experience in resolving disabled veterans’ cases so that you can have peace of mind knowing that it has been resolved successfully. 

Related Information:

  • VA Impairment Rating Chart
  • VA Medical Nexus Letter
  • Philadelphia Veterans Benefits Attorneys

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