VA Disability Claim Appeals

Common Types of Service Connected VA Compensation Claims That are Denied and Appealable

What are the Most Common Types of Service-Connected VA Compensation Clair’s That Are Denied and Appealable?

It is not uncommon for a veteran to have more than one claim at a time and to have different claims at different stages, I think of this as siloed claims and so should you.

Let’s explore the most common types of VA compensation claims that are denied, and which are appealable or claims that can be brought at any time.

1. Direct Service Connection

You might make a claim for direct service connection For one or more medical condition. The VA might accept one and deny another on the basis that you did not establish one or more of the three elements of service connection for that particular medical condition:

• You don’t have a current disability,
• There wasn’t an event that occurred in the service, and
• There isn’t a medical connection, called a nexus, between the in-service event and your current disability.

If you disagree with the rating assigned by the VA to the condition they accepted, you can appeal the rating decision. If you disagree with a denial on the basis that you didn’t establish one or more of the elements of service connection, you can take an appeal on the service connection issue. If you’re successful with that appeal, the VA Regional Office (RO or VARO) will then have to issue a rating decision which you can accept or appeal.

2. Service connection is granted but the VA assigned a rating that was too low or picked the wrong effective date

Once you’ve gotten past the hurdle of establishing service connection, the VA can make significant mistakes in assigning the correct rating or picking an effective date that impacts the amount and period of your benefits.

Both of these issues are appealable as the issue is what’s the correct impairment rating and what’s the correct date of your entitlement to benefits.

3. Secondary Service Connection

If you have a service-connected condition, you may be able to make a claim for another medical condition that results from your service-connected condition. You don’t have to establish an in-service event before the secondary condition, but you do have to prove a medical relationship between the condition that was approved for Service connection and the secondary medical condition you’re claiming. For example, you might have a service-connected herniated cervical disc that is causing migraines. You would want to claim, as a secondary condition, migraines. Or, you might have service-connected back condition, that is causing you to limp resulting in a knee condition. You would want to claim, as a secondary condition, the knee condition.

Increased Ratings for Service-Connected Conditions

Your disability might have gotten worse overtime causing increased symptoms and impacting your functionality. You can file an application at a later date to have a service-connected rating increased. The VA is required to provide you with an examination to determine how severe your medical condition is and what’s the correct rating is currently because of the progression of your service-connected medical condition. For example, you might have a service-connected knee condition which has gotten worse with swelling, popping locking or give way that makes it difficult for you to walk or even go upstairs. You can file an application asking for an increased rating. All you have to do is to document your service-connected condition and your good faith belief that your condition has become more severe or more disabling.

Claims for total disability based on individual unemployability (TDIU)

If you have one or more service-connected disabilities that prevent you from securing gainful employment, you might be able to pursue a claim for TDIU benefits. You must have one condition rated at 60% or a combined rating for multiple conditions at 70% (with at least one of the conditions rated at 40% or more) to qualify for TDIU.

The VA will evaluate whether your service-connected conditions prevent you from working. They are not required to take into consideration non-service-related conditions or factors like your age in determining whether or not you’re entitled to TDIU.

If approved, the VA will pay you compensation at the 100% disability rating level, even if your medical conditions don’t warrant a 100% disability rating under the rating schedule.

Reopened Claims with New and Material Evidence or New and Relevant Evidence

If you were previously denied service connection for a claimed condition and the period to appeal that denial has expired, the decision becomes final. After the Appeals Modernization Act (AMA) was effective on February 19. 2019, the procedure and standard changed. You can pursue the reopening of an earlier claim outside the one-year appeal by filing a Supplemental Claim with new and relevant evidence.

Claims Based on Clear and Unmistakable Error (CUE)

A claim for revision of a previous final VA Regional Office (VARO) or a Board of Veterans Appeal (BVA) decision is known as a claim based on clear and unmistakable error of (CUE),

A CUE claim must be specific and based on patent and obvious errors or omissions. There is no time limit or statute of limitations for bringing a CUE claim, but you do have to file a CUE claim. Don’t forget that if you win a CUE claim, the effective date is the date the claim would have been approved and not denied. In other words, the effective date would be the date of the decision and that can mean a significant period of back benefits.

If you have an issue with

• Direct Service Connection
• Secondary Service Connection
• Rating Issues
• Wrong Onset Date
• Increased Rating Issues
• TDIU
• Reopened claim
• CUE

It is time to call The Veteran’s Disability Law Firm

The Veteran’s Appeal Improvement and Modernization Act of 2017 (AMA)

When you got a letter from the VA, you probably anticipated that you were going to get an increased rating and back benefits. Nothing really prepares you for an unfavorable decision but, after taking a deep breath, read the Rating Decision letter.

Pay close attention as you read through the decision. What did the VA grant? What did the VA deny? Was it service connection, secondary service connection, an individual disability rating? Did they get the VA math wrong? Use the wrong effective date? Cheat you out of back pay?

While it’s easy to get discouraged or confused, it’s helpful to understand the multiple appeal options and determine which one is the right one based on the facts of your case.

There is a lot at stake! An increased rating, back benefits, eligibility for other VA benefits! Let’s first talk about the Appeal Modernization Act (AMA).

The Veterans Appeals Improvement and Modernization Act of 2017 (AMA}

The AMA provides multiple appeal options each of which has advantages and disadvantages. The key is to find the right appeal option for you.

The options are;

• Higher Level Review which is where you request a review of your current claim by a senior VA employee,
• Supplemental Claim where you get to submit new and relevant evidence as part of the supplemental claim,
• Notice of Disagreement where you file a Notice of Disagreement with the Board of Veteran’s Appeal.

Why Having a Veterans Disability Lawyer Can Make All the Difference

A veteran’s lawyer can file a claim or an appeal once they have reviewed your file. The goal is to maximize your benefits and to do so as quickly as possible.

We assemble the evidence to establish :

1. You have a current diagnosis of a disabling condition,
2. The condition is the result of an event, injury or illness during your military service.
3. Any secondary service connection
4. You are entitled to certain legal presumptions that make it easier to win your claim.
5. The correct disability rating based on the severity of your medical condition,
6. The correct combined disability rating using “VA math”,
7. The correct effective date of your benefits, including increases,
8. Eligibility for additional compensation for dependents in your household, including your spouse, children or dependent parent.

Assembling the necessary evidence can include :

1. Obtaining your military records,
2. Medical records, including test results,
3. Personal statements from your doctor,
4. An independent medical examination and report,
5. Statements from buddies, family members, friends and employers, and other relevant and important information.