Common reasons why the VA denies disability claims in Georgia
The volume of unresolved veterans affairs (VA) disability claims in the U.S. is significant, with over 425,000 pending cases left without a verdict. Of these, roughly 7 percent of the cases were resolved after an average waiting time of 7 years.
It is one thing to wait that long for compensation, but it’s another thing for your claim to be rejected altogether. By understanding the common reasons behind claim denials, you can avoid being denied your rightful VA disability benefits.
Common reasons why VA disability claims are denied
The Department of Veterans Affairs is responsible for approving military veteran disability benefits towards illness, injury or disability incurred during service. However, guaranteeing monthly compensation isn’t easy. They may refuse your request if you fail to adhere to the appropriate protocols when filing your claim.
Veterans with rejected claims will be issued with claim denial codes indicating the particular reason for their denial. They are allowed to file an appeal, but following through with an appeal can be a lengthy and confusing process.
To minimize your chances of receiving a VA disability claim denial, here are the common reasons most veteran disability benefits get rejected.
Misinformation or incomplete form
As with any other benefits application, failing to include accurate information on the forms can severely hinder your claim’s success. With VA disability forms, veterans are required to fill in detailed information about:
- Themselves, including contact information and family details
- Previous military service
- Medical history
- Evidence proving disability, such as records and pictures
Failing to provide the appropriate information or skipping out on a particular document section will limit the VA’s ability to approve your claim. To increase your favor with the VA, make sure that you have a fully developed claim with supporting documents or VA claim forms.
Your condition doesn’t qualify as a disability
In order to receive disability benefits, you first need to prove that your disability is diagnosable. Symptoms like back pain or exposure to Agent Orange and TCE are not enough to formulate a diagnosis. However, if exposure to the chemical compound results in a medical illness, then your condition is diagnosable.
Psychiatric ailments, like PTSD, can warrant disability benefits. However, it can be hard to gauge your mental health and share this information with the VA without a diagnosis to explain your symptomatology. Therefore, your doctor needs to correctly explain the diagnosis results on the medical record you plan to provide as evidence.
Your ailment isn’t related to your service
If you’ve received the dreaded “VA claim denied not service connected” message on your account, it means that the rater doesn’t consider your disability to be aggravated during military service.
The VA only reimburses benefits to war veterans with aggravated injuries or disabilities incurred on deployment. This means that you need to display a correlation between your symptoms and service for you to obtain disability benefits.
Still, the VA rater may not accept the submitted evidence as proof of an aggravated disability or injury during your years of service. To improve your chances of success, presenting medical evidence—such as doctor diagnostic reports detailing how your condition was incurred from your previous service—can help sway the VA in your favor.
VA rejected your medical evidence
If your medical evidence doesn’t adhere to VA criteria proving your disability, then you are likely to receive a claim denial. Therefore, when providing the VA with a doctor’s statement supporting your disability, you should make sure that it fits within the following requirements:
- The statement should explain the disability, symptoms, cause and reason it’s a disability.
- Your doctor should review your C-file and compose a medical statement based on your claim.
- The statement needs to be filled out without any missing sections.
- The doctor’s statement must explain how the disability correlates to your service.
- You should provide proof of your medical practitioner’s credentials.
- Be sure to use VA-appropriate language in the statement.
You submitted the wrong forms
Submitting the wrong form can quickly result in a disability claim denial. Veterans need to ensure that they send the correct forms by either hiring a VA disability lawyer or seeking the assistance of the VSO (Veterans Service Organization) representative.
You may have to fill out additional documents, depending on your condition or line of service. For example, veterans with PTSD must compose a statement on a 21-0781 VA form, while service units besides the military need to send additional service forms and records.
Missed deadlines
Despite the VA not having disability claim submission deadlines, they may refuse your claim if you fail to send additional forms or don’t schedule a doctor’s visit within a specific period as instructed by the VA. Other missed deadlines include failing to show up for VA scheduled appointments or not completing a compensation and pension exam.
You had a pre-existing condition
Veterans with non-aggravated, pre-existing conditions may receive a denial. The VA only approves pre-existing claims if the condition worsened during military service. You would also need to show proof of your pre-existing injury in order to achieve better odds of obtaining an accepted VA claim.
Military service is widely respected in American life, which is why it can be disconcerting to receive a VA claim denial letter. At WPMH Legal, our disability attorneys will fight night and day during your application and appeals process to ensure that you receive the disability benefits and peace of mind that you rightfully deserve. You bravely served our country, so let us serve you.
