The process of filing a VA claim can be a long and stressful journey. Getting your VA claim denied can feel like a setback on their path to financial stability and support. If you disagree with a VA decision, you can choose from 3 decision review options to continue your case: Supplemental Claim, a Higher-Level Review, or a Board Appeal. In this blog, we are going to be going over some of the common reasons for VA claim denials and talk about each of the different steps you can take if you disagree with a decision. Understanding these steps is crucial for veterans seeking to secure their benefits and overcome challenges along the way.

Claim denied

Common Reasons For VA Claim Denials 

  1. Lack of Sufficient Evidence: Claims often require thorough medical records that clearly establish a connection between the veteran’s current condition and their military service. Insufficient or incomplete medical documentation can lead to a denial. It’s crucial to provide detailed service records that demonstrate how the veteran’s condition is related to their time in service. Missing or inadequate service records can result in a denial.
  2. Incorrect or Incomplete Application: Simple mistakes or omissions in the application can result in a denial. Ensuring that all forms are completed accurately and thoroughly can prevent unnecessary setbacks.
  3. Failure to Attend VA Examinations (C&P Exams): These exams are critical in evaluating the veteran’s condition. Failing to attend a scheduled C&P exam can result in the denial of a claim, as the VA relies on these examinations to assess the severity of the condition.
  4. Pre-existing condition: The veteran may have had a condition before their service. The VA only approves pre-existing claims if the condition worsened during military service. 

Supplemental Claim

If you have new evidence you think would strengthen or change the outcome of your claim, you will want to file a supplemental claim. A supplemental claim is a request for the Department of Veterans Affairs (VA) to review a previous decision based on new and relevant evidence. An example of when a supplemental claim may be necessary is if a condition worsens. New medical evidence would be needed in order for this claim to be successful. To file a supplemental claim, you will need to fill out the VA Form 20-0995 from the VA website or your local VA office. 

Higher-Level Review

If you think the VA made a mistake when deciding your case, but you do not have any new evidence, you can request a higher-level review. A higher-level reviewer will review the decision. This reviewer will consider the same evidence as before. An example of when you might want to request a higher-level review, is if you think that the VA overlooked critical medical evidence in determining the outcome to your claim. To request a Higher-Level Review, fill out VA Form 20-0996 from the VA website or your local VA office. You can submit this form online through the VA’s eBenefits or portal, mail it to the address provided on the form, or submit it in person at your local VA office.

Board Appeal 

You can request a Board Appeal if you want a Veterans Law Judge at the Board of Veterans’ Appeals to review your case. An example of where you may want to request a Board of Appeal is if you’ve already requested a higher-level review or filed a supplemental claim and are still unsatisfied with the outcome, or your case involves complex legal or medical issues that you believe require a judge’s expertise.

There are three different types of board reviews you can choose from: 

  1. Direct Review: if you don’t want to submit evidence or have a hearing
  2. Evidence Submission:  if you want to submit additional evidence without a hearing
  3. Hearing: if you want to have a hearing with a Veterans Law Judge (with or without new evidence)

To request a board appeal, you will need to fill out the VA Form 10182 from the VA website or your local VA office, specifying the issues you disagree with and selecting the type of Board review you are requesting.

Read More: What Can I Expect When I Appeal a VA Disability Denial?

Reach Out to Your San Francisco Veterans Lawyer Today 

Navigating a denied VA claim can be frustrating, but understanding your options such as: supplemental claims, higher-level reviews, and board appeal, provides a clear path to keep moving forward. Let the team at Unruh Law take the lead in filing your appeal and demonstrating your case. They are ready to fight for you and seek out the payments you need to live your best life.

You can easily get in touch with Unruh Law online or by calling (833) 753-5168.