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Top Reasons VA Denies Claims

Top Reasons VA Denies Claims

In denying a claim for disability benefits, VA may provide just one or multiple reasons for the denial.  Here are the most common reasons VA denies claims for disability benefits.

 

Top Reason VA Denies Claims For Service Connection

VA says you don’t have a diagnosis.

VA will often deny veterans service connection for a condition because they do not have a current diagnosis for the condition they are claiming. One of the requirements for filing a claim for service connection is having a current medically diagnosed disability. Without a diagnosis, VA will not grant service connection.

This reasoning is common for Vietnam-era veterans who file claims for compensation for “Agent Orange exposure.” Veterans cannot receive compensation for an event or exposure in service unless they have a diagnosed disability as a result of that exposure. Vietnam veterans can get compensation for disabilities that are caused from their exposure to Agent Orange, such as certain cancers or Ischemic Heart Disease, but not for the exposure itself.

If you do have a diagnosis for the condition you are claiming and VA denies the claim stating that you do not have a diagnosis, you can appeal this decision. You can submit medical records that show your diagnosis to VA in support of your claim.

 

VA says that there is no in-service evidence of your injury

Another requirement for service connection is an in-service event, injury, or illness that caused or aggravated your current condition. Frequently VA denies claims stating that there is no evidence that your condition began in service, or there is no event noted in your service records.

This can often happen for veterans claiming service connection for post-traumatic stress disorder (PTSD). To get service connection for PTSD, veterans need to provide a stressor to VA. A stressor is an event or occurrence during service that caused the veteran’s PTSD. Many times, VA will say that they were unable to verify the veteran’s claimed stressor. This is essentially VA stating that there is not an in-service event that caused the veteran’s current condition.

If VA denies your claim stating that there is no in-service event or injury to cause your condition, you can submit service personnel records or service medical records that show the event. Additionally, lay testimony can act as evidence of an in-service event or injury, and buddy statements from those who witnessed the in-service event can also help to support your claim.

 

VA states that your disability is not linked to your in-service injury

When VA denies claims for service connection, it may cite the lack of a link between a veteran’s disability and service. This link is called a nexus. VA will often schedule a veteran for a Compensation and Pension examination (C&P exam) and ask the examiner to write an opinion on whether the veteran’s condition can be linked to an in-service event or injury. If the VA examiner does not say there is a link, then VA will often deny the veteran’s claim.

If VA denies claims for service connection using this reasoning, a veteran can submit a positive nexus opinion from a medical professional to rebut VA’s denial. If a veteran’s physician does write a nexus opinion, he or she should review the veteran’s service records and medical records since service in order to provide an adequate opinion.

 

Top Reasons VA Denies Increased Rating Claims

The veteran did not attend a C&P Exam.

When a veteran files a claim for an increased rating for a service-connected condition, VA may schedule the veteran for a C&P exam to assess how the veteran’s condition has changed since the last exam of record. These exams, coupled with VA or private medical records, are used by VA to assess if (and by how much) a veteran’s condition has worsened enough to warrant an increased rating.

If a veteran does not attend the C&P exam, VA can deny the veteran’s claim. Sometimes, veterans do not receive notification that they were scheduled for an exam, and will not attend as a result. If this is the case, veterans can appeal VA’s denial and make it clear that they were not notified of the exam. If a veteran does receive notification of an exam but is not able to attend, they should contact VA and ask to be rescheduled.

Category: Veterans Law

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