How to Appeal a VA Disability Claim Denial: What Veterans Should Know

Receiving a denial from the VA for a disability claim can be frustrating and disheartening, but it’s important to remember that a denial doesn’t mean the end of your pursuit for benefits. Veterans have the right to appeal the VA’s decision, and with the right approach, you can successfully challenge the denial and secure the compensation you deserve.

In this guide, we’ll walk you through the steps of appealing a VA disability claim denial, common reasons for denials, and practical tips to strengthen your appeal.

Understanding VA Disability Claim Denials

Before filing an appeal, it’s crucial to understand the reasons why the VA may deny a claim. Some of the most common reasons for denials include:

• Lack of medical evidence: The VA may deny your claim if they determine there isn’t enough medical evidence to prove that your condition is service-connected or severe enough to warrant compensation.
• Failure to establish a service connection: If you don’t provide sufficient evidence linking your condition to your military service, your claim may be denied.
• Missed deadlines: If you miss the deadline to submit necessary forms or documentation, the VA may deny your claim based on lack of timely evidence.

Understanding why your claim was denied is the first step in building a strong appeal. Once you’ve reviewed the VA’s decision, let’s move on to the types of appeals you can file and the steps involved.

Types of VA Appeals and the Appeals Process

Veterans have several options for appealing a VA disability claim denial, depending on the circumstances of their case. Here are the three main appeal options under the AMA (Appeals Modernization Act):

1. Supplemental Claim The Supplemental Claim option allows veterans to submit new and relevant evidence that wasn’t previously included in the original claim. This could be updated medical records, nexus letters, or new treatment reports that help prove your condition’s severity or service connection. The Supplemental Claim process typically takes around 125 days, and the VA will review the new evidence to determine if the denial should be overturned.
   • When to choose this option: If you have new medical evidence that wasn’t considered in the initial claim, a Supplemental Claim may be the best way to strengthen your case.
2. Higher-Level Review The Higher-Level Review option involves having a more experienced VA reviewer re-examine your claim, without considering any new evidence. Instead, the reviewer will look for any errors in the initial decision-making process and determine if the denial was made in error. This process typically takes about 90 to 120 days.
   • When to choose this option: If you believe the VA made a mistake in its initial decision, such as overlooking key evidence or misinterpreting your medical records, a Higher-Level Review may be the right option.
3. Board of Veterans’ Appeals (BVA) Appeal Veterans also have the option to appeal directly to the Board of Veterans’ Appeals (BVA). This option allows you to present your case to a Veterans Law Judge, who will review your claim, consider new evidence, and possibly schedule a hearing. This process takes longer, often between 12 to 18 months or more, but it provides a more in-depth review of your claim.
   • When to choose this option: If your claim involves complex legal or medical issues, or if previous appeals have been unsuccessful, appealing to the BVA may offer the best chance of success.

Each of these appeal options has specific advantages, depending on the nature of your denial. Let’s now discuss the steps you’ll need to take to file a strong appeal.

Steps to Appeal a VA Disability Claim Denial

Appealing a VA disability claim denial can be a complex process, but following these steps can help you build a strong case:

1. Review the VA’s Denial Decision The first step is to carefully review the VA’s denial letter (known as the Rating Decision). This letter outlines the reasons your claim was denied, as well as the evidence the VA considered when making the decision. Understanding the specific reasons for the denial is key to preparing your appeal.
   • Tip: Look for any gaps in the evidence the VA considered, such as missing medical records or a lack of information linking your condition to your service.
2. Gather Additional Evidence If you choose to file a Supplemental Claim or appeal to the BVA, gathering new evidence is crucial. This could include:
   • Medical records that document the worsening of your condition.
   • Nexus letters from your healthcare provider explaining the connection between your condition and your military service.
   • Lay statements from family, friends, or coworkers who have witnessed the impact of your condition on your daily life.
   • Tip: Be sure to gather new and relevant evidence that wasn’t included in your original claim to strengthen your appeal.
3. Submit the Correct Appeal Forms Depending on the type of appeal you choose, you’ll need to submit the appropriate forms to the VA:
   • For a Supplemental Claim, submit VA Form 20-0995.
   • For a Higher-Level Review, submit VA Form 20-0996.
   • For a BVA Appeal, submit VA Form 10182 to request a formal hearing or submit new evidence.

Ensure that all forms are completed accurately and submitted before the appeal deadline.

4. Track Your Appeal Status After submitting your appeal, monitor the status of your case through VA.gov or the VA’s toll-free number. Keeping track of your appeal can help you stay informed about any additional requests for evidence or updates on your case.
   • Tip: If the VA requests additional evidence or information during the appeals process, respond promptly to avoid delays.
5. Prepare for a Board Hearing (if applicable) If you’ve appealed to the Board of Veterans’ Appeals (BVA) and requested a hearing, it’s important to prepare thoroughly. During the hearing, a Veterans Law Judge will ask questions about your condition, your service, and the evidence you’ve submitted. Be ready to discuss how your condition affects your daily life and your ability to work.
   • Tip: Consider working with an experienced VA-accredited attorney who can represent you during the hearing and help present your case effectively.

Now that we’ve covered the steps for filing an appeal, let’s look at common mistakes veterans make during the appeals process and how to avoid them.

Common Mistakes Veterans Make When Filing an Appeal

Many veterans make errors during the appeals process that can lead to delays or denials. Here are some common mistakes to avoid:

• Not submitting new evidence: If you file a Supplemental Claim without including new and relevant evidence, the VA is unlikely to change its original decision. Be sure to gather updated medical records or other supporting documents.
• Missing deadlines: Appeals must be submitted within a specific time frame—usually one year from the date of the VA’s denial decision. Missing this deadline could result in the loss of your right to appeal.
• Not preparing for a BVA hearing: Veterans sometimes attend BVA hearings without fully preparing their case. Be ready to explain your condition’s impact on your life and submit any relevant evidence to support your claim.

Avoiding these mistakes will help you build a stronger appeal. Now, let’s go over some practical tips to set your VA appeal up for success.

Setting Your VA Appeal Up for Success: Real Tips and Practical Advice

To improve your chances of a successful appeal, follow these practical tips:

1. Get a Nexus Letter: If your claim was denied due to lack of evidence connecting your condition to your service, a nexus letter from your healthcare provider can strengthen your appeal by explaining how your condition is linked to your military service.
2. Submit New and Relevant Evidence: If you choose the Supplemental Claim route, ensure that you include new and relevant evidence that wasn’t considered in your original claim. This could be updated medical records or additional treatment reports.
3. Work with an Accredited Representative: Navigating the appeals process can be overwhelming. Consider working with an experienced VA-accredited representative or attorney who can help gather evidence, submit forms, and represent you during hearings.
4. Be Thorough in Your Documentation: Ensure that all forms are filled out accurately, and that your medical records and supporting documents clearly demonstrate the severity of your condition and its connection to your service.
5. Respond to VA Requests Promptly: If the VA requests additional evidence or information during your appeal, respond as quickly as possible to avoid unnecessary delays.

By following these tips, you can improve your chances of success and build a strong appeal. Now, let’s explore how Disability Law Group can assist you with your VA appeal.

Why Disability Law Group Is Your Best Resource for VA Appeals

Appealing a VA disability claim denial can be challenging, especially when it comes to gathering new evidence and navigating the appeals process. At Disability Law Group, we specialize in helping veterans successfully appeal denied claims and secure the benefits they deserve. Our experienced VA-accredited attorneys will work with you to gather the necessary evidence, submit the correct forms, and represent you during any hearings.

Let Disability Law Group guide you through the VA appeals process, ensuring that your case is handled with care, attention to detail, and expertise.