DENIAL OF VA CLAIMS

What you need to know

Denials commonly result from these areas:

Not enough medical evidence to support your disability

Agreeing that you have a disability, but not finding enough evidence to show that it is connected to your military service

They may agree that you have a disability that is service-connected, but they might assign a rating that is too low for your actual symptoms

They may agree you have a disability, but find that is was pre-existing to your military service and not aggravated by your service

When VA disability claims are initially denied, the first thing veterans should know is that the VA has a very high error rate. After you receive your decision packet with details of your decision or award, you can appeal all or part of the decision. The appeal process can take a long time, but knowing that there is a high error rate and that a lot of denials are later overturned can help guide your decision whether to appeal.

Denial Error Rate is Very High

The Department of Veterans Affairs (DVA) admits that it makes a lot of errors when evaluating VA disability claims. However, it doesn’t officially agree with the magnitude of the problem. The DVA has stated that it has an error rate of 14%. The Center for Investigative Reporting analyzed a group of claims and found an error rate of closer to 38%.

The Inspector General for the DVA issued a report last spring showing that its Oakland office made mistakes in the way it processed 39% of its claims. The Inspector General reported that the San Diego office had a 53% error rate and the Los Angeles office made mistakes on a whopping 71% percent of its claims.

In response to much media and Congressional attention to the problem with errors, the DVA issued a statement saying that the agency is “retooling procedures and deploying paperless data systems.” Its goal is to lower the error rate to 2% by 2015.

Common reasons for initial denial

Just because your claim was denied does not mean you are not eligible for disability benefits. As noted above, the VA commonly makes errors in its determinations. The denial can be a combination of not analyzing the facts of your case correctly, and it can also stem from not having proper evidence available.

Many of these types of denials have a strong chance on appeal if you can secure documentation to refute them. It’s best to plan ahead and cover all your bases in your initial application. Track down all of your own military records and medical records; don’t rely on the VA to do that for you. In addition, seek your own medical opinion showing the connection between your disability and your military service. Seek advice to spot any weaknesses in your claim before you file it.