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Off The Record – Veterans’ Disability – Why Some Claims Are Denied

Video Transcript

Hi, my name is Janet Santeramo and I’m a partner here at Turley Redmond & Rosasco. And I get a lot of calls from veterans asking questions about why they were denied a specific claim. And sometimes it’s not readily clear to the veteran, but I can tell you some reasons why some of these claims get denied usually if the veteran does not have a diagnosis. A diagnosis is important. You just can’t say, “Well, I think I have this, or I think I have that.” It’s always best to go in with a diagnosis. So, without a diagnosis, there’s a very good chance that your claim is gonna be denied. The next thing is proof of an in-service event or a nexus. Usually, the nexus is probably the most difficult hurdle to overcome for most veterans. Without a nexus, you can’t show that it’s service-connected and the VA is not gonna pay the claim.

Another issue that I see in a lot of veterans’ files is the lack of evidence. Now, evidence can be a couple of things. It’s great when I see a veteran who has something in their service treatment records that shows that an event took place and, you know, for instance, “I was marching up the hill, I felt my knee snap,” you know? And it’s documented somewhere, you know? That’s wonderful. But there are some situations when it comes to various conditions where it may not rear its ugly head till later on. That’s something that your representative and attorney or even you yourself can kind of mitigate a little bit by trying to find studies to substantiate, for instance, that a particular exposure caused this condition.

Another big issue is the failure to attend C&P examinations. Compensation and pension examinations are the VA’s way of trying to figure out if there is in fact a nexus between the condition that the veteran is alleging and their time in service. If a veteran doesn’t attend the C&P examination, you know, the VA will give you one shot to reschedule it. But if you don’t attend at all, that’s pretty much grounds for a denial right off the bat because you’ve not given them any proof or said much of anything.

Another issue is that veterans will submit things on the wrong form. If you’re submitting a brand-spanking new application, it needs to go on the application form. If it’s an appeal, you need to make sure that you’re using the right form as well. The VA much of the time will send you correspondence indicating that you’ve submitted the wrong form and they will ask you to submit the proper form. But a word to the wise, don’t rely on the VA to tell you that. Know what you’re doing because you don’t wanna be one of those veterans that fall between the cracks.

Another major issue with denials is missing the deadline. A lot of veterans or their representatives will submit an intent to file. An intent to file allows the veteran a year from the time that intent to file is submitted to actually submit a claim. So, you wanna make sure that you’re not missing any deadlines because if you file the day after that intent to file expires, you just lost potentially a whole year’s worth of benefits. So, it’s really important to pay attention to what’s going on with your claim. Your representative can do a lot for you, but you really want to keep your representative in the loop. In addition, you wanna monitor things on your end too. Keep copies of any correspondence between yourself and the VA so that if you do decide, if you don’t already have representation that you want representation, these things will be very helpful to your representative moving forward.

Should you have any questions, please don’t hesitate to reach out to us. You’ve got questions, we have answers. Thank you and have a great day.

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