What To Do IF Your Claim Is Denied

If your claim is denied, or you don’t agree with any part of the decision that the VA has given you, you have a channel to appeal.

You will receive a decision in the mail by the VA regarding your claim.  It will either deny, partially deny, partially grant, or grant your claim.  If you disagree with any aspect of the decision, you need to send in a Notice of Disagreement as soon as possible.  There is no form for it, but there are some things that should be standard.  On the top of every page, should be your name and VA file number.  In large bold font across the top of the page, Notice of Disagreement should be written.  You need to specify exactly which aspects of the decision you don’t agree with, why you don’t agree with them, and what you believe the decision should be changed to.  Review the Appeals Process by reading this pamphlet from the VA.

Again, you need to review the rating tables for your injury in Title 38 of the Code of Federal Regulations.  You will also need to read through the decision and look specifically for the following:

1. A clear and unmistakable error.  For instance, your diagnosis comes back as Mild Scoliosis, but in the body of the decision, it states that the examiner found no scoliosis.  This would be an error.

2. Any missing information that you feel is material to your case, or any information that seems like it was subdued or glossed over.

In my opinion, your Notice of Disagreement should state specifically whether you will accept a review from a Decision Review Officer or not.  I recommend requesting A DRO review, because your package may not need to be sent to Washington in order to get the decision you believe you deserve, and likely the wait would be longer if you just went straight to the Board of Veteran’s Appeals.

You should also begin to investigate on your injury for any supporting information.  One great resource is  Hadit.com, which is a message board for veterans, which has a section specifically for Compensation and Benefits claims.  This way you can see what others who have been in similar situations have been awarded, what they did to get to that award, and what resources they used.

You should also review prior decisions by the Board of Veteran’s Appeals.  Though you cannot usually use a prior case as a “precedent” as you could in regular court, you can still gain valuable information on the resources that the veteran used, as well as the rules and regulations used by the Board in their decision.  Go here to Search Decisions.

Google it.  Sometimes it really is that simple.  A real world example of this is a PTSD claim that was denied, though the PTSD seemed like it could have been connected to having to run with asthma (misdiagnosed in service) for 6 months.  The asthma was service connected, and I located a study that was done in 2007 (4 years after the asthma claim was granted) that showed a linkage between asthma and PTSD.

If the appeal is denied, you will receive a VA form to fill out saying that you still dispute the decision and you can now go to the Board of Veteran’s Appeals.

Don’t be affraid to write your congressperson or senator.  Find out who they are here.

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