Off The Record – Veteran’s Disability – Why Claims Get Denied

I get a lot of calls from veterans asking questions about why they were denied for a specific claim.

Sometimes the reason isn’t immediately clear to the veteran, but there are several common reasons why VA disability claims are denied.

The first reason is usually a lack of a diagnosis.

A diagnosis is extremely important. You can’t simply say, “I think I have this condition,” or “I believe I have that condition.”

It’s always best to have medical documentation showing an actual diagnosis before filing a claim.

Without a diagnosis, there is a very good chance your claim will be denied.

The next issue is proof of an in-service event or a nexus.

The nexus is often the most difficult hurdle for many veterans to overcome.

A nexus connects your current condition to your military service. Without that connection, you cannot establish that your condition is service-connected, and the VA is unlikely to approve your claim.

Another common problem I see in veterans’ files is a lack of evidence.

Evidence can come in many forms.

It’s always helpful when a veteran’s service treatment records document an event. For example, if a veteran was marching, felt their knee give out, and that injury was documented in their records, that can be valuable evidence.

However, some conditions do not appear until years after military service.

In those situations, a veteran, representative, or attorney may be able to strengthen the claim by finding medical studies or other evidence showing that a particular exposure or event can cause the condition being claimed.

Another major issue is failing to attend Compensation and Pension (C&P) examinations.

The VA uses these examinations to determine whether there is a connection between your current condition and your military service.

If a veteran does not attend a scheduled C&P examination, the VA may allow an opportunity to reschedule.

However, failing to attend without following up can result in a denial because the VA does not have the information needed to evaluate the claim.

Another issue I see is veterans submitting claims using the wrong forms.

If you are filing a brand-new claim, you need to use the correct application form.

If you are filing an appeal, you need to make sure you are using the proper appeal form.

The VA may send correspondence notifying you if the wrong form was submitted, but you should not rely on the VA to catch every mistake.

You need to understand the process and make sure your claim is submitted correctly.

Another major reason for claim problems is missing deadlines.

Many veterans or their representatives submit an Intent to File, which gives the veteran one year to submit the actual claim.

It is extremely important to keep track of that deadline.

If you submit your claim one day after your Intent to File expires, you could potentially lose an entire year of benefits.

Pay close attention to your claim and stay involved in the process.

Your representative can do a lot to help you, but you should always keep them updated and provide any new information they may need.

It’s also important to keep copies of all correspondence between you and the VA.

If you decide later that you need representation, those documents can be extremely helpful to your attorney or representative moving forward.