In every denial letter, the VA must explain why they have denied the claim. Though each claim is different, here are 6 common reasons why a VA Disability Compensation claim may be denied.
1. You missed your deadline to appeal or submit evidence
If you have already been denied and would like to appeal your claim, you must do so within certain deadlines. If you fail to appeal your claim within those deadlines, your claim will be denied even if your claim otherwise has merit. Below are the time frames in which a decision must be appealed:
- Rating Decision: 12 months
- Statement of the Case: 60 days
- Supplemental Statement of the Case: 30 days
- Decision from the Board of Veteran’s Appeal: 120 days
If you miss your deadline, you may still be able to reopen your claim and have the VA take a second look. However, you will have to submit new and material evidence. This is not the same as filing an appeal within the deadlines above, and adds an additional burden on the veteran.
Additionally, while your claim is still being processed the VA may ask for you to provide information to them. If you do not provide the information within the timeframe provided, the VA may deny your claim.
2. Your Disability is Not Service Related
In order to receive disability compensation, there must be a link, or nexus, between your disability and your time in service. This is satisfied if your records show that you were injured while in service. Additionally, veterans with conditions that existed before their service can receive benefits if their condition was aggravated by their service. If you cannot show that your condition was caused or aggravated by your service, your claim will be denied.
However, even if you incurred your disability as a result of service, you are ineligible for benefits in the following situations:
- Your disease or disability was caused by your misconduct
- You were dishonorably discharged
- The injury occurred while you were avoiding duty, such as while deserting or absent without leave (AWOL)
- The injury occurred while you were in prison or detained due to court martial or civil court felony
3. You did not attend your Compensation and Pension Exam
When you are schedule for a Compensation and Pension Exam (C&P), you must go. These exams are used to assess your disabilities, and will be an important part of the decision on your claim. Missing this exam could mean that your claim will be denied.
4. VA doesn’t believe your doctor
Many veterans receiving care from private physicians will ask their doctor to write an opinion supporting their claim for benefits. If this opinion was rejected by the VA, it may have been for the following reasons:
- The opinion was not thorough enough
- Your doctor did not review your C file.
- Your doctor did not indicate in his report that he reviewed your C file. An opinion that states the doctor discussed the claim with you and nothing else will be rejected.
- Your doctor did not use VA’s language—that the disability “is likely as not” related to service
- Your doctor did not state why he believes your disability is related to your service.
5. VA says you do not have a disability
To obtain service connected disability benefits your disability must have a diagnosis. Exposure to deadly substances like Agent Orange in Vietnam is not enough if the exposure does not result in a current diagnosis, such as diabetes. Also, if as a result of your service you are a PPD converter, someone who had a negative TB/tuberculosis skin test in the past and now has a positive skin test, you do not have a disability unless and until you are diagnosed with active TB.
Until very recently, pain itself was not a diagnosis. A recent federal court case changed this, however, so if you have been denied in the past on this basis you should consider reopening or appealing your denial.
6. Your Symptoms are Not Severe Enough
The VA does not award the same amount of benefit to every veteran with the same diagnosis. Instead, it compares the severity of your symptoms with the VA Schedule of Ratings to determine the rating to which you are entitled. Thus, if your symptoms are less severe than the Schedule, your claim may be denied, or your rating may be lower than you had hoped.
Sometimes this occurs because your medical records do not reflect the true severity of your disability.