VA disability benefits provide a financial lifeline for veterans with service-connected conditions, but the process of being approved for benefits isn’t easy. Taking the time to understand the top reasons why claims are denied can help you prepare a stronger application or formulate a more effective appeal.
5 Reasons Why VA Disability Claims Are Denied
While every case is unique, there are some common errors veterans make that frequently result in a denial of benefits. These include:
1. You Don’t Have a Credible Diagnosis
To be eligible for disability benefits, you need a diagnosis of a specific disabling injury or illness. There are three main scenarios where the lack of a diagnosis comes into play:
Veterans with mental health conditions.
Mental health issues such as anxiety and depression need to be fully documented. Often, doctors will treat specific symptoms without providing a proper diagnosis.
Veterans with chronic pain.
Pain on its own is not an acceptable diagnosis, regardless of how it affects your quality of life. The pain needs to be tied to arthritis, spinal stenosis, or some other specific cause.
Veterans who are attempting to claim exposure as a disability.
Simply being exposed to a dangerous substance such as Agent Orange does not make you eligible for disability benefits. You need to show proof that exposure resulted in a specific illness.
2. There Was No Proof of a Service Connection
Once you have a diagnosis, you need to show proof that your illness or injury is related to your time in the military. Sometimes, the VA has records of the incident—such as if you were shot or wounded in an explosion. In other cases, however, you may need to submit buddy statements from people you served with who can verify the event occurred and/or corroborate when your symptoms first appeared.
Note that proof of service connection doesn’t apply to veterans who qualify for a presumptive service connection due to the unique circumstances of their military service. Prisoners of war, Vietnam veterans, Atomic veterans, and Gulf War veterans can each qualify for a presumptive service connection for certain types of disabling conditions.
3. Your Application Lacked Necessary Evidence
Relying on the VA to help prepare your application for benefits is likely to result in a denial due to a lack of evidence. The VA has a duty to assist a veteran in preparing their claim, but this duty has limits. For example, there is no guarantee the VA can successfully obtain private medical records on your behalf—and the VA won’t pay any fee that is needed to gain the records.
A lack of evidence is a common reason for a denial of Total Disability Individual Unemployability (TDIU) benefits. TDIU claims require you to submit proof that your condition limits your ability to maintain substantially gainful employment, which means you’ll need to provide your work history, past job descriptions, statements from supervisors or coworkers, and potential testimony from a vocational expert.
4. The VA Doesn’t Believe Your Doctor
When you are applying for disability benefits, it’s best to see a doctor who has experience treating veterans and understands what information must be provided. If your doctor doesn’t review your C-File or fails to adequately explain why they believe your disability is service-connected, your application will be denied.
Your doctor’s area of expertise is also important to consider. As a rule of thumb, your medical nexus letter should be written by a healthcare professional who is practicing in a specialty relevant to your specific condition. For example, you would need a psychiatrist to write a medical nexus letter for a PTSD claim and a nephrologist to discuss your kidney failure.
5. You Didn't Show up for Your C&P Exam
When you apply for disability benefits, you’ll be scheduled for a Compensation and Pension (C&P) exam. This exam will be conducted by a VA healthcare provider or a VA contracted provider. The examiner will review your file and ask questions to determine the severity of your condition and whether or not it qualifies for a service connection. Exams last from 10 minutes to one hour, and you are entitled to request a copy of the results for your own records.
The C&P exam is not optional. If you miss your C&P exam, your claim for benefits will automatically be denied. If you are unable to attend the exam at the scheduled time, you must contact the VA to reschedule the appointment.
How A Veterans Benefits Attorney Can Help
Don’t assume that a denial of your claim means you aren’t entitled to benefits. Cases can often be won on appeal by providing the necessary evidence or by identifying errors made by the VA employees who reviewed your application. VA statistics show that access to legal representation increases your chances of a successful appeal by about 15%.
Do You Need to Speak With a Veterans Benefits Lawyer?
If you need to speak with an experienced veterans benefits lawyer, please contact us online, or call our Virginia Beach office to schedule your free consultation. We have offices throughout Virginia, including Chesapeake, Newport News, Norfolk, and Suffolk.