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VA Disability Claim Deferred: What This Means and What to Do Next

VA Disability Claim Deferred: What This Means and What to Do Next

The Department of Veterans’ Affairs (VA) offers tax-free monthly support to Veterans who qualify to receive disability benefits. In order to qualify for these monthly benefits, you need to be recognized by the VA as a Veteran who has a service-related disability. This means that you have a condition, either mental or physical, that significantly affects your quality of life and is directly connected to your time in the military.

Service-related disabilities can be a wide variety of conditions. From shrapnel wounds and back injuries to post-traumatic stress disorder and depression, the conditions recognized by the VA as disabilities cover a wide number of different injuries, disorders, and other issues that affect Veterans. The main criteria to receive support from the VA are sufficient medical evidence to back up your claim and a verifiable connection between your disability and your military service.

What Happens When You Apply to Receive Benefits From the VA?

When you apply to receive benefits from the VA, your regional Department of Veterans’ Affairs office will have you come in for a Compensation and Pension (C&P) exam. A C&P exam is the VA’s way of assessing the severity of your disability. It usually involves a basic physical checkup, a careful look at your military medical records, and any other necessary tests (bloodwork, x-rays, etc.) that might be relevant to your specific disability.

The VA will use the information they have gathered from your C&P exam to help them determine a fitting disability rating for you. 

The VA Rates Disabled Veterans on a Scale From 0 to 100.

The VA disability rating system works on a scale from 0 to 100. Each disability score given by the VA is a measure between 10% and 100%, going up by 10% with each rating. Veterans can receive a disability rating lower than 10%, but a disability rated at 0% does not qualify for monthly payments.

When the VA gives a disabled Veteran a specific rating, this rating directly corresponds to the amount of monthly compensation that the Veteran will receive. This compensation is often the only income source that Veterans have, especially Veterans who are so severely physically or mentally impaired that they cannot work. The higher the rating, the higher the benefits. As you can imagine, since the VA’s rating system works in increases of 10%, the difference between a 10% rating and a 100% rating’s benefits is staggering.

For a disabled Veteran, getting a rating that is an accurate reflection of their condition can be extremely important. For Veterans with severe mental or physical disabilities, finding work can range from extremely difficult to completely impossible. For these Veterans, anything less than a 100% disability rating can mean less financial support than they need to make ends meet for themselves and their loved ones. Without a high enough disability rating, many Veterans will end up struggling financially. 

Because disability benefits from the VA can be so crucial for many Veterans, getting an accurate rating from the VA is an absolute must. If a disabled Veteran ends up with a rating that is too low or if they are denied benefits altogether, they may have no other way to take care of themselves or any dependents they have. This outcome is sadly all too common for disabled Veterans.

What Happens When the VA Approves a Claim?

If a disabled Veteran applies to receive benefits and has their claim approved, the VA will give them a specific disability rating between 10% and 100% and start sending them monthly benefits. However, if a Veteran receives a disability rating from the VA that they view as too low, they can dispute the VA’s decision by requesting a decision review or making an appeal.

A Veteran has the right to dispute any VA decision by making an appeal or going through the decision review process. This means that even if a Veteran’s claim is approved, they can still fight for a higher rating if they believe they are not receiving the benefits they deserve.

If you find yourself with approval from the VA for disability benefits but still not enough monthly support to take care of yourself and your loved ones, it is well worth it to dispute the VA’s decision. With the help of an experienced attorney, you can appeal the VA’s decision and potentially get your rating raised to a point that more accurately reflects your disability status.

What Happens When the VA Denies a Claim?

When the VA denies a disabled Veteran’s claim, it typically means something was missing in the application process or that the C&P exam did not present enough evidence to qualify them for benefits. If you end up in this position, you can also dispute the VA’s decision and potentially get their ruling changed to an approval.

The VA will also deny your claim if you fail to show up for your required Compensation and Pension exam. The C&P exam is one of the most crucial parts of filing a claim for disability benefits. Without exam results, the VA won’t have enough data to accurately assess your condition. If you failed to take your C&P exam, your claim will be denied by default, but that does not mean the case is closed. You can reopen your claim by making another appointment for a C&P exam.

Not Approved, Not Denied – What Is a Claim Deferral? 

In some cases, the VA neither approves nor denies an application to receive benefits. In this case, the claim has been deferred. A VA deferral indicates that the Department is missing some critical information that they need to make a conclusive decision about your claim. If you are stuck at this point in the process, it does not necessarily mean that your claim is on the road to being rejected. Don’t panic – there are some effective steps you can take to get a good outcome after your claim has been deferred.

If the VA has deferred your claim, they have most likely done so based on a lack of sufficient medical evidence to support your application or a lack of confirmation that your disability was service-related. Without this information, the VA may not be able to rule conclusively and decide in favor of or against your claim. At this point in the process, the VA will request that you give them further evidence if you want to move forward.

How an IME Can Help You Get Approved by the VA

When you need to get more significant medical evidence to the VA to get approved for benefits, one way to do so is through an independent medical exam (IME). In an IME, a private doctor who is not connected to the VA will conduct an examination similar to the VA’s C&P exam. After the doctor has gotten results from this examination, they can compile a statement, which you can then show to the VA as evidence to support your claim.

If you are suffering from a psychological disability, you can still get an IME to help you move forward in the VA claims process. In an IME for a psychological problem, a mental health professional will evaluate you and, if possible, verify that your disability is legit – and that it is directly linked to your military service.

The VA needs to know that your disability is both diagnosable and verifiable and that it is objectively linked to an event or injury that occurred during your military service. An independent medical examination can help you confirm this to the VA, but there is more that you can do as well.

“Buddy Statements” Can Help, Too 

When you need to present further evidence to the VA to get your claim approved, one of the best ways to do so is by getting testimonials from the men and women who served with you in the military, or anyone familiar with your disability. Known as “buddy statements,” these testimonials serve as verification to the VA that there are eyewitnesses who can confirm that you are really suffering from a service-related disability.

The VA recognizes these types of testimonials as evidence that can change the outcome of a claim. An experienced attorney can help you gather information from your fellow soldiers and other trusted individuals that can help support your claim and get you closer to the outcome you deserve.

If you are struggling to get a decision from the VA in your favor, we can help. No soldier should ever have to fight alone, and that’s why the Berry Law team exists. We’re a group of Veterans helping Veterans, and we can help you navigate any aspect of disputing a VA claim, including a deferral. Contact Berry Law today for a free case evaluation.

Sources:

https://www.sciencedirect.com/science/article/pii/S0020748909000066

https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.156.12.1924

https://www.psych.theclinics.com/article/S0193-953X(18)30113-8/pdf

Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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