What Are Conditions That Do Not Qualify for VA Disability Benefits?

CCK Law: Our Vital Role in Veterans Law

To obtain disability compensation from the Department of Veterans Affairs (VA), veterans have to prove that their disabling condition is somehow related to their military service — a process VA calls establishing service connection. However, there are also conditions for which VA does not offer disability benefits, and there are various reasons as to why.

If you are a veteran who was denied compensation for a disability, it may be because your disability is one that is not eligible for benefits from VA. This article will list and explain the conditions that do not qualify for VA disability benefits, as well as circumstances that may disqualify veterans themselves from earning compensation from VA.

Key points of this article include:

• There are several conditions that do not qualify for VA disability benefits, including congenital conditions, certain personality disorders, and substance abuse disorder. Typically, conditions will not qualify if they are hereditary or if they were caused by the veteran’s own willful misconduct.
• Some exceptions do exist by which veterans can earn compensation for disabilities that would not otherwise qualify. This is often because, while these conditions may not be directly compensable by VA, they can still serve as a secondary condition or intermediate step that leads to a compensable condition.
• Veterans themselves can be disqualified from earning disability compensation from VA. This can occur if the veteran received a dishonorable discharge for their service, or if they were declared AWOL for an extended period of time.

What Does “Not Qualify” Mean in Regard to Certain Conditions?

Conditions that do not qualify for VA disability benefits are those VA does not recognize as eligible for a direct disability rating or compensation. There could be a couple of different reasons for this, including:

• The condition is pre-existing and has not or cannot be aggravated by military service–Many mental and physical disorders are congenital, developmental, genetic, or otherwise arise from unchanging, lifelong behavioral patterns. VA does not recognize military service as being capable of causing these disorders, and so will not grant service connection for them.
• The condition does not meet VA’s definition of “disability”–Some conditions are not perceived by VA to be true disabilities, since they cannot be said to count as a proper “disease or injury.” Others may be considered disabilities, but not ones that can occur due to a service-related event or illness. In either case, VA typically does not offer ratings or compensation for these conditions.
• The condition was caused by the veteran’s own willful misconduct–VA has laws and regulations in place to prevent compensation for conditions caused by a veteran’s own “willful misconduct.” In short, if a veteran’s disability can be linked back to intentional wrongdoing or illegal activity on the veteran’s part, VA is not obligated to provide them with disability compensation.

What Are Conditions That Do Not Qualify for VA Disability Benefits?

There are a number of conditions that do not qualify for VA disability benefits based on the criteria listed above, including:

• Personality disorders–These types of conditions are often marked by lifelong behavioral patterns that do not change. Therefore, VA does not usually recognize military service as being capable of causing a personality disorder.
• Substance abuse disorders–VA does not directly grant service connection for substance abuse disorders, since these disorders are often ruled by VA to be caused by the veteran’s own willful misconduct.
• Impulse control disorders–Similar to other psychiatric conditions, impulse control disorders often arise from genetics or behavioral patterns that VA does not think can be linked back to military service. Therefore, they usually do not recognize such disorders as service connected.
• Cognitive delays and developmental disabilities–These disorders are often present from birth, making it highly unlikely that they can be service connected, in VA’s estimation.
• Obesity–VA does not recognize obesity as a compensable disability. A significant aspect of VA’s disability rating process is pinpointing a specific event, injury, or exposure during a veteran’s military service that leads to their condition developing. Since obesity is usually caused by multiple different factors occurring over long periods of time, it does not meet VA’s standards for service connection.
• High cholesterol–VA does not recognize high cholesterol as a disability in and of itself. Instead, it is perceived more as a lab result that may be indicative of other disabilities. Veterans cannot earn a disability rating for high cholesterol alone.

This is not a comprehensive list. Nonetheless, when in doubt, veterans should still file a claim for any condition that they believe may be caused by their time in military service and allow VA to make a decision on it.

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Are There Exceptions Where These Conditions Might Still Be Compensated?

Yes, there are exceptions in place where certain non-qualifying conditions may be rated and compensated by VA. These include:

Substance abuse disorders – Veterans can be service connected on a secondary basis for disabilities that arise from substance abuse due to an already service-connected condition. For example, a veteran who uses alcohol to cope with symptoms of PTSD and later develops cirrhosis of the liver may be entitled to disability compensation for the liver condition as secondary to PTSD.

Obesity – While not directly compensable by itself, VA does recognize that obesity often serves as an intermediate step in the development of separate disabilities. For instance, if a veteran’s chronic back condition confines them to their home, they may become obese over time. If this obesity then contributes to the veteran developing diabetes, then VA may recognize that diabetes as a secondary condition to back pain by way of obesity.

Psychiatric disorders – Certain impulse control or personality issues have been linked to the occurrence of traumatic brain injury (TBI). If a veteran is service connected for TBI, there is a chance they can earn compensation from VA for changes they are experiencing in mental health or personality.

Pre-existing disorders – If a veteran can prove that their pre-existing disorder was worsened beyond its natural course by their military service, they may be able to earn a disability rating for the condition on the grounds of aggravation.

“There’s a statute and a regulation setting forth a presumption of aggravation,” says Amy Odom, an attorney and partner at CCK Law since 2018. “They say that a pre-existing injury or disease will be considered to have been aggravated by active military, naval, or air service where there is an increase in disability during such service. That is, unless there is a specific finding that the increase in disability is due to the natural progress of the disease.”

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Can a Veteran Become Disqualified From Earning VA Compensation?

Yes, there are multiple circumstances that can lead to a veteran being disqualified from earning VA compensation, even if their condition might otherwise qualify. Examples include:

• Dishonorable discharge–Receiving a dishonorable or other-than-honorable discharge can render a veteran ineligible for VA benefits like compensation and health care.
• Felony imprisonment–Veterans who are imprisoned for more than 60 days due to a felony conviction will have their benefits greatly reduced. If a veteran’s rating percentage was 20 percent or higher, it will be reduced to the 10 percent compensation rate. Those who were already at the 10 percent compensation rate will have their payments reduced by half.
• Absence without leave (AWOL)–If a veteran is absent without leave (AWOL) for 180 days or more, they may be disqualified from receiving disability benefits. However, there are exceptions to this rule depending on whether the veteran’s absence had “compelling circumstances” behind it.
• Presenting fraudulent evidence–If VA discovers that a veteran presented fraudulent evidence to obtain their disability rating and compensation, VA may terminate that veteran’s benefits.

“If there is evidence that a veteran committed fraud to obtain VA benefits, it could result in termination of those benefits,” says Kayla Rogers, an accredited VA claims agent since 2017. “This could include submitting false evidence, providing false statements about the severity of your condition, or manipulating test results.”

Can I Alter the Status of My Military Discharge?

Veterans who received an other-than-honorable, bad conduct, or dishonorable discharge may not qualify for VA disability benefits. However, there is still a pathway to become eligible if they can apply for a discharge upgrade.

All branches of the military consider veterans to have a strong case for a discharge upgrade if they can show their discharge was connected to any of these categories:

• Mental health conditions, including post-traumatic stress disorder (PTSD)
• Traumatic brain injury (TBI)
• Sexual assault or harassment during military service (military sexual trauma, or MST)
• Sexual orientation (including under the Don’t Ask, Don’t Tell policy)

Even without a discharge upgrade, veterans may be able to access some VA benefits through the Character of Discharge review process. When applying for VA benefits, VA will review the veteran’s record to determine if their service was “honorable for VA purposes.”

What Do I Do if My Claim Is Denied?

For veterans whose claims are denied by VA, it is important to note that VA’s decision is not necessarily final. Veterans can appeal disability claims that have been denied by VA, allowing them to potentially overturn VA’s decision and either earn a disability rating or increase their current rating.

Under the Appeals Modernization Act, there are three major “lanes” a veteran can take to appeal a VA decision:

• Higher-Level Review Lane
• Supplemental Claim Lane
• Notice of Disagreement Lane (i.e. appealing to the Board of Veterans’ Appeals)

Notably, before choosing one of the above lanes, veterans should closely review VA’s decision letter to determine why their claim was denied. This will allow them to choose the appeal pathway that most effectively addresses the issues VA had with their claim.

I Am Uncertain if My Condition Qualifies — Should I Still File a Disability Claim?

Yes, even for veterans who are not sure if their condition qualifies, it is typically a good idea to file for disability compensation from VA. The worst that can happen is VA denying the claim, at which point the veteran can potentially appeal and overturn VA’s decision, earning the compensation they deserve.

However, before getting started, veterans should research both their condition and the disability claims process as a whole, so they have a general idea of whether their claim has merit. They should also consider consulting with a Veterans Service Organization (VSO) or accredited attorney to better understand how VA’s claims process operates.

VA Claim Denied? Contact Chisholm Chisholm & Kilpatrick

If VA denied your disability claim, then Chisholm Chisholm & Kilpatrick’s team of VA-accredited representatives — among the nation’s largest and most accomplished* — may be able to help.

Call CCK Law today at (800) 544-9144 or contact us online for a free case evaluation.

*Past results do not guarantee future outcomes.

Frequently Asked Questions

Can VA deny a claim for an otherwise qualifying condition?

Yes, they can. Regardless of whether a condition is compensable by VA, the veteran must still prove service connection to earn a disability rating and compensation. This is because eligibility depends not just on a diagnosis, but also on proof that a condition is linked to a veteran’s military service.

What three pieces of evidence help to earn a disability rating?

There are three key components needed to establish service connection and help a veteran earn a disability rating and compensation. They are:

• A current diagnosis of a disability or illness;
• Evidence of an in-service event, injury, or illness; and
• A medical nexus opinion linking the veteran’s current disability with the in-service event that might have caused it.

Can a veteran earn VA disability compensation while working?

Yes, they generally can, even if they are rated by VA as 100 percent disabled.

However, this may not be the case for veterans receiving Total Disability Based on Individual Unemployability (TDIU). TDIU is offered specifically to veterans whom VA has deemed incapable of gainful employment due to their disabilities. As such, there are some restrictions on how much a veteran can work while still receiving TDIU.