When a Veteran makes a claim through the VA to receive benefits, there is no guarantee that the VA will accept it. Sadly, the VA often makes denials. A denial can be based on several reasons, but it often has to do with a lack of evidence required for the VA to accept a claim.
If the VA denies your claim, there is no reason to worry. As a Veteran, you can appeal a decision made by the VA. Though the process may require more work and a team of people to help you gather everything you need, it can prove a fruitful endeavor.
This article will go over all you need to know to appeal a VA disability decision.
As a Veteran with a disability, you may be wondering why a claim would be denied in the first place. The VA has many reasons as to why it denies claims.
The first reason, and the most common, is a lack of evidence to prove the Veteran’s current disability. If the Veteran does not provide medical records and a current diagnosis, the VA will likely deny the claim. If the claim is not made for a disability that the VA recognizes, they will also likely deny that claim. This does not mean that the denial was proper.
Medical and service records are essential in establishing what caused the disability and how debilitating it currently is, so you want to make sure you have all the possible information gathered before you make a claim.
The VA has an obligation to help you in the initial development of your claim. This includes obtaining all records from any VA where you received care, obtaining your service medical records, and possibly scheduling you for a compensation and pension examination.
Another reason the VA denies claims is that they cannot find a reasonable service connection through the evidence you provided. The claim must show that an event during a Veteran’s military service caused or worsened their current condition.
This is where service and medical records, as we stated above, come into play. The VA must assist you in obtaining this information. But, it is ultimately your responsibility to make sure the VA has the information it needs. If you cannot obtain this information, the information doesn’t exist, or the information was destroyed, you can reach out to others who know of your condition well enough to write up a buddy statement.
These statements are written by fellow service members, family members, friends, or anyone who knows the details of your condition and how it was caused. This can stand in the place of any missing records that would give information on your disability.
A third reason the VA would deny a claim is that the Veteran failed to go to a compensation and pension examination (C&P exam). The VA schedules these exams when they lack the necessary medical records to make a decision.
The Veteran must attend these exams because they will receive a professional medical opinion on whether their service caused or aggravated their current condition. The medical professional will also provide an opinion on the severity of the condition for rating purposes. If the Veteran fails to go to this exam, the VA will deny the claim. Even if you are already service connected, if you apply for an increase or if the VA determines it needs to reevaluate your condition, you must attend your examination.
If the Veteran’s medical examination was not adequate, the VA may deny the claim. The doctor will have to rationally explain why and how they came to their decision. At Berry Law, we know what an adequate examination should look like. We can ensure that your examination was adequate and contains the necessary language.
Finally, it is possible that though you have a disability, the VA does not find it severe enough to give you a rating. This is possible even if they grant a service connection.
The VA works within 10% increments when they give ratings for disabilities. If your disability is less than the initial 10% rating, you will receive a 0%, making you ineligible to receive benefits.
When you are ready to appeal a decision made by the VA, you have three options. Each one is tailored for different claims.
The first one is the supplemental claim review. This is for Veterans who have gathered new evidence that was previously not a part of the claim. New evidence can help in a few aspects. Whether you want to get a higher rating or benefits in general, new evidence will allow the VA to review their initial decision and possibly change it. The more evidence you can gather to help prove your claim, the better.
You can also appeal so that a higher-level senior in the VA will look at your claim. In these cases, a more seasoned professional will look over all the details. Newer VA employees who initially look at a claim may make mistakes and overlook some factors that keep you from getting a certain ranking or benefits. If you feel that having a higher-level official in the VA would get you the results you want, think about this option.
Finally, you can appeal to the board and have a Veterans law judge look at your claim. A Veterans law judge is an expert in making VA decisions. To do this, you will need to fill out the VA form 10182. From there, you may get a hearing with a Veterans law judge to look over your claim and get the benefits you deserve.
Overall, it is best to consult with your legal team when making these decisions. They will guide you to the best option. Some appeal decisions are better for certain cases than others, so you want to choose the right one to get the best result.
Yes, you can appeal any claim that you find incorrect. How you appeal will make all the difference.
When you appeal, you must supply the necessary evidence and legal arguments. Know ahead of time what the VA will be looking for when they review your claim. Doing this can ensure that you will not miss anything that might cause them to deny your claim again.
The best way to ensure that you have everything you need is by working with an experienced team, like our team here at Berry Law. The process of making a claim and appealing can be long and tedious. It also takes knowledge that might be beyond what most people are familiar with. Because of all of the VA’s requirements, you will want to have people that will take away some of the burden.
Berry Law is also accredited by the VA. Our team has years of experience in helping people make claims and appeal decisions by the VA.
We also have a list of people we can refer you to for medical examinations. These medical professionals are familiar with VA requirements and can get you all of the necessary evidence you need to appeal. They particularly deal with those who have had previous inadequate experiences with medical examinations. Our contacts will make sure that this does not happen.
The VA claims process can be long and tedious. The last thing that any VA wants is a denial and to have to start working on an appeal process.
However, though it is extra work, it can prove beneficial for the Veteran. When going through the appeal process, remember that you need to have all the necessary information to understand why the VA denied you in the first place. If you work with a team of professionals, they will help you locate what the issue is and gather the material you need to make a compelling appeal.
For any more information on the appeal process for a VA disability decision or any questions, please visit our website.
Sources:
VA Decision Reviews And Appeals | Veterans Affairs
VA Claim Exam (C&P Exam) | Veterans Affairs
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