Posted byBerry LawonSeptember 15, 2023inAppeals
Making a claim through the Department of Veteran’s Affairs can be a long and challenging process. From taking the time to gather evidence and writing up the claim, the process can take months. Even longer can be the decision made by the VA.
It is a sad reality, but many times, the decision made by the VA is a denial of a Veterans claims. It can be extremely disheartening to receive a denial after all the hard work.
The truth is, there’s no way to know if VA will approve your claim because VA decisions often don’t consider the evidence in a Veteran’s file.
The good news is that this is not the end for the Veteran. A Veteran can appeal any claim that the VA makes.
To do so, they will have to do things a little bit differently than the initial claims process.
Key Takeaways:
- You’ll learn what is necessary to have in a claim
- You’ll know how long a Veteran has to appeal a VA decision
- You’ll understand the signs that show your appeal will be approved
- You’ll learn how long it takes for the appeals process to complete
What Is Necessary for a VA Disability Claim?
It is important to know what is necessary for a VA disability claim before we begin detailing the appeals process. All claims and appeals have to prove the necessary components at the end of the day.
If any parts are missing, the VA will always deny or give the Veteran a low rating for their disability.
Many Veterans could avoid the appeals process if they knew ahead of time what the VA expects to find in a Veteran’s claim.
In order for the VA to approve a Veteran’s claim, there are three necessary components:
- A current disability
- Evidence that proves an in-service event, injury, or disease
- A medical nexus that connects the current diagnosis with the in-service event, injury, or disease
If any one of these things is missing in a Veteran’s claim, it will be denied.
Usually, the main factors are missed because the Veteran did not give sufficient evidence to prove any of the items. The evidence could be medical records, service records, or even buddy statements. Any piece of information that goes to help prove the three points above should be used in the claims process.
The VA will only give benefits to Veterans whose disability or illness was caused by something during their time in the service. If they cannot find the Veteran’s evidence and claim convincing, they will not give benefits or compensation for it.
It is crucial that when a Veteran begins the disability claims process, they seek to prove these three things before anything else. Even the smallest piece of evidence can go a long way to prove any one of these items.
Even with all the evidence necessary, sometimes VA will still deny a claim because of lack to attention to detail or other bureaucratic obstacles. Working with an experienced VA attorney is a Veteran’s best chance that nothing is missed when they compile evidence for their disability claim.
What Decisions Can a Veteran Appeal?
A Veteran can appeal any decision that the VA makes. However, it usually falls within two categories.
The first is appealing a denial of a disability claim. This is where the VA denies the claim in total. They do not award the Veteran with any rating or benefits. If the Veteran wants to appeal this claim, they must prove all the necessary elements that make up a disability claim.
The second category is appealing a low disability rating. This occurs when the VA gives the Veteran a lower rating than what the Veteran feels they should get.
To appeal this sort of decision, the Veteran will have to show evidence that proves they need more benefits than what they are receiving currently.
More details will follow on how a Veteran can appeal a VA decision. If a Veteran decides to appeal any decision that the VA makes, they will have to make an appeal within one year of the most recent VA rating decision.
Failure to do so will result in the Veteran having to make a whole new claim. They will have to file a claim to reopen using a supplemental claim for and submitting new and relevant evidence. This usually also means a later effective date if the claims are eventually granted.
Different Options for the Appeal Process
Once a Veteran decides to appeal a VA decision, they will have to decide which route they will take to appeal the VA’s decision.
Hopefully, if the Veteran is working with an attorney, they will consult their attorney on what route is best.
There are three main routes that Veterans can choose from.
Supplemental Claim Appeal
The first option is for a supplemental claim appeal. In this form of appeal, the Veteran will provide new and relevant evidence to the already existing claim that the VA either denied or gave a low rating.
As for all appeal processes, it is important to know why the VA denied or gave a low rating for the claim in the first place.
However, it is essential for this one since the Veteran will be giving new evidence that has to be relevant to the claim.
If the evidence is not new or relevant, they will have nothing to appeal with, which will most likely not result in the VA making a different decision.
The Veteran must find out exactly why the VA denied or gave a low rating and go from there when they compile the evidence.
Higher-Level Review
The second option is for a higher-level review. Often in the VA, newer workers can make mistakes when reviewing a Veteran’s claim.
So much detail is involved that even experienced workers make mistakes and overlook key details. When this happens, it leads to decisions that do not benefit the Veteran.
Having a higher-level worker within the VA review a Veteran’s claim can clear up any mistake that the VA made and change their overall decision regarding the Veteran’s claim.
Go to the Board of Veterans Appeals
Finally, the Veteran can appeal to the Board of Veterans Appeals. This option is best for Veterans who feel they have no other option and that a supplemental claim or a higher-level review will not produce the desired results.
The evidence that a Veteran will provide for this sort of option depends on what channel the Veteran decides for the BVA. They can either choose a direct review, evidence submission, or a hearing.
Different Statuses for the VA
When a Veteran appeals a VA decision, it will take some time until they reach the final verdict.
Throughout the process, the VA will regularly update the appeal claim with different statuses to signify where the VA is at in the process.
Different appeal options, such as a supplemental claim, higher-level review, or an appeal to the BVA, will have different statuses that correspond to a specific route.
However, Veterans should be aware that the status on VA.gov is often incorrect and unreliable. The best way to stay abreast of an appeal status is to ask your attorney to check VA’s internal system, Veterans Benefits Management System (VBMS), to see the latest progress.
Supplemental Claim:
If a Veteran receives a status that reads “We made a decision,” that does not necessarily mean that the appeal was approved, but rather an overall decision was made. However, it could mean that the supplemental claim was successful in acquiring the Veteran’s desired outcome.
Higher-Level Review:
One status that may signify approval of an appeal is “We are correcting an error.” This is a good sign for a Veteran because it means that mistakes were made on the VA’s part and not on the Veteran’s part.
Claims are often denied because of a lack of evidence or simple mistakes on the Veteran’s part, but if it is because of the VA, then the Veteran can have some relief knowing that it was not completely because of them.
Appeal to the BVA:
Appealing to the BVA also has a status of “We corrected an error.” Like the higher-level review status, this can be comforting for a Veteran to know that it was not their fault that the VA denied their claim.
Conclusion
Appealing a VA decision can be a long and difficult process.
After spending so much time working on a claim, it can be extremely disheartening for Veterans to receive a denial.
In moments such as this, it is best for a Veteran to reach out to an experienced attorney so that they can give the best guidance on what to do next. From there, the Veteran will have a better chance of getting the benefits they deserve.
For more information on Veteran law and benefits, visit our website.
Sources:
The VA Denied My Disability Claim. How to Appeal a VA Benefits Decision | The Military Wallet
9 Reasons Why Your VA Disability Claim Was Denied | Benefits
What Your Decision Review Or Appeal Status Means | Veterans Affairs
