Top 10 Most Common Reasons Why VA Denies Claims
The Top 10 Most Common Reasons Why VA Denies Claims
You’ve been waiting for months to qualify for VA disability benefits, and then you get the news: the VA has denied your claim.
The VA denies around 30% of disability claims each year. It can be frustrating to learn that your claim for VA compensation was denied. You may feel like you did everything they asked of you and provided all the evidence necessary to get the disability compensation you deserve. Often, the VA does not give sufficiently specific reasons why you did not qualify, making the “claim denied” status even more confusing.
If your VA disability claim was denied, you can submit an appeal to the VA office. However, you must submit your appeal within one year of your denial. Before submitting an appeal, you will want to determine what went wrong in your initial application so you know specifically what evidence you should provide with your appeal.
Continue reading to learn the top 10 most common reasons why the VA denies disability claims. Then, find out more about how to appeal your claim on our website.
10. You Missed the Deadline
You must gather the evidence you need for your VA disability claim as quickly as possible, as the VA could take years to approve your application.
While there is no deadline to apply for benefits, you are only eligible for monthly payments to deal with current disabilities, so waiting until an injury has fully recovered may make you ineligible for compensation. For example, if you developed a knee problem, then went through years of rehabilitation until you made a full recovery, you would not be able to file for compensation after the fact.
In addition, you need to be aware of the deadlines to appeal the VA’s denial of a claim. From the time you are notified of a denial, a clock starts ticking for you to be able to appeal. If you do not appeal within the required period following an initial decision, you will need to refile your claim and start over.
9. You Did Not Submit Enough Evidence of Your Disability
To approve your application, the VA needs to have evidence of your service-related disability. This evidence comes in many different forms, such as medical records that you can usually get from your doctor for free.
If a Veteran does not submit enough proof about their disability in their VA claim , the VA will likely deny their claim. The VA has strict guidelines about what types of medical conditions qualify as disabilities and what level of compensation each veteran can receive based on the impact of the condition.
The next time you submit your application, you should include as much evidence as possible so that the VA does not doubt the legitimacy of your service-related disability. An attorney who works in Veterans law can help you gather all of the relevant evidence to include in your application.
8. Your Doctor Did Not Provide Enough Evidence
You can receive recommendations from your doctor as further evidence for your VA claim. However, if your doctor’s note is not adequately detailed and specific, the VA can exclude it from your application, making it useless.
Your doctor’s recommendation must include these elements to help it make an impact at the VA:
- Direct language: The VA looks for clear and conclusive language in doctors’ recommendations. Phrases like “it is possible,” or “it might” do not prove to the VA that your disability meets the requirements for compensation.
- Rationale: A medical professional should include their determination of whether your disability is service-connected as part of their recommendation, along with evidence to back it up.
- Review of your Claim file: Your doctor should review your claim file and any other relevant service information as part of their recommendation.
If your doctor did not meet these requirements, you may want to visit with them about the impact and history of your condition or possibly seek another doctor to write your next recommendation.
7. You Do Not Have a Specific Diagnosis
For the VA to approve your claim for disability compensation, you must have a diagnosed medical condition that is the result of your military service. This may seem obvious, but terms like “back pain” and “exposure to Agent Orange” are not diagnoses, as they do not point to specific disabling conditions.
Many veterans experience mental health problems after returning from service, but their symptoms do not seem severe enough to warrant a diagnosis. In this case, “mental health problems” on its own cannot serve as a sufficient claim for a disability. Instead a doctor needs to diagnose a specific impairment.
Similarly, VA compensation requires that the diagnosis be current. If a Veteran suffered from depression following service, but has made a full recovery from the view of their medical provider, then they are not entitled to get current compensation for that past issue.
Talk to your doctor about receiving a specific diagnosis for your disability, as this will improve your chances of qualifying for disability compensation.
6. You Didn’t Show Up to Your C&P Exam
The VA sets up Compensation and Pension (C&P) exams for veterans who file for disability claims. These exams determine the extent of the current disability, and whether your condition is service-connected, which qualifies you for compensation.
Sometimes, the VA sets up these appointments for veterans without adequately informing them. If the veteran misses the appointment, the VA can automatically deny their application.
If this happens, you should tell the VA that you never knew about the appointment and that you did not intentionally miss it. Then make sure to complete a C&P exam the next time you apply.
5. You Filled Out the Wrong Forms
Sometimes, the VA denies veterans their disability claims because they filled out the wrong forms. The application process is long and involves lengthy documentation. It is completely understandable that Veterans would sometimes make mistakes throughout the process.
Even the right form number may not be enough if you are using an outdated version. When new versions of forms are released, it makes the old version obsolete, and a Veteran may complete the old version without knowing that the VA will reject it.
Working with a competent lawyer for VA disability can help make sure you complete all of the necessary forms correctly.
4. Your Condition is Not Considered Service-Connected
To receive disability benefits, you have to prove that your disability is service-connected. This means that your disability is a direct result of your military service, or was clearly made worse by your service.
The VA may determine that your medical condition is independent of your time in the military, or that it may have been pre-existing, meaning they believe that it was present before your military service began and was made no worse during your time in the military.
For your disability to qualify as service-connected, you must undergo a C&P exam by a qualified VA doctor. The doctor will look at your medical records, examine your symptoms, and determine the origin of your disability. As long as they can determine that your condition was “at least as likely as not” to have begun or become worse as part of your military service, your disability should qualify as service-connected.
3. Your Disability Rating Does Not Qualify You for Benefits
Even if the VA accepts that you have a current diagnosis and it’s service-connected, the VA may have assigned you a disability rating that does not accurately reflect your medical condition. If a veteran receives a rating of less than 10%, they will not qualify for compensation, leading the VA to deny any financial compensation for their VA disability claim. Learn more about appealing a VA disability rating.
Providing more evidence of your disability and including other relevant information–such as notes from your doctor, buddy statements, medical bills, and extensive medical records–can lead the VA to increase your rating. You want to make it as easy as possible for the VA to understand the limitations of your condition. Getting a legal team on your side can make the process even smoother.
2. Your Claim is Still in Process
As a veteran, you may think that the VA has denied your claim because you haven’t received a response to your application in months, or even years. However, the VA is most likely still reviewing your application and processing your claim.
If you haven’t heard back about your application, you can check the current status on eBenefits, ask your legal representative or VSO, or directly contact the VA.
1. You Did Not Have Professional Representation
Most Veterans are not professionals at navigating the VA disability claims process. Simple mistakes such as missing deadlines or providing inadequate evidence can cost Veterans tens of thousands of dollars, and the claims process is not set up to help the Veteran.
You can arm yourself with the support of professionals throughout the process. For initial claims, you can work with an accredited VSO (such as the VFW or American Legion). When it comes to appealing a VA decision, you are entitled to the services of a professional law firm that can guide you through the appeals process, assist you in gathering evidence, and accurately present your request to the VA.
If the VA denied your disability claim, you may feel discouraged and tempted to give up. However, hiring experienced VA claims lawyers, like we have on our team at Berry Law, could be the step you need to overcome barriers and convince the VA to approve your claim. We’ll help you challenge the decision at the appropriate level, all the way up to the US Court of Appeals for Veterans Claims.
We’re a Veteran-owned law firm, and many of our staff have disability ratings, so we know the frustration that comes with not receiving the VA benefits you need after your military service. If the VA denied your claim for disability, we may be able to help. You can find out more about the appeals process on our website.
Please contact us today or visit our office to schedule a free case evaluation. Remember that appeals for Veterans’ claims must be filed within strict deadlines, so every day you wait may end up costing you money and benefits.
Established in 1965 by Vietnam War veteran and attorney John Stevens Berry Sr., Berry Law Firm is a team of veterans dedicated to defending, safeguarding, and fighting to protect the rights of veterans. Over the decades, thousands of veterans from across the country and all branches of the military have trusted our firm with their cases and, more importantly, their futures.