Receiving a VA disability rating that doesn’t accurately reflect the severity of your condition can be frustrating. If you believe your rating is too low or your claim was denied unfairly, you have the right to appeal. While the appeals process can seem daunting, it offers veterans a vital opportunity to correct errors, submit new evidence, and secure the benefits they deserve.
In this blog, we’ll walk through the steps for appealing a VA disability rating decision, provide tips on how to strengthen your appeal, and discuss the types of evidence that can improve your chances of success.
Understanding the VA Appeals Process
When the VA makes a decision on your disability claim, it assigns a disability rating based on the severity of your condition. This rating determines how much compensation you’ll receive. If you disagree with the decision—whether it’s a denial of benefits or a rating that doesn’t fully reflect your disability—you have the right to file an appeal.
Key Points to Remember:
- You have one year to appeal after receiving your rating decision.
- There are several ways to appeal, and choosing the right one for your situation is crucial.
Types of VA Appeals
The VA offers three main options for veterans who want to appeal a rating decision:
- Higher-Level Review: This option involves having a senior VA claims adjudicator review your case without submitting new evidence. It’s ideal if you believe there was a clear error in the original decision.
- Supplemental Claim: If you have new and relevant evidence to support your claim, a supplemental claim allows you to submit this information for reconsideration.
- Board of Veterans’ Appeals (BVA): You can request a hearing before a Veterans Law Judge if you believe your case warrants a formal review. This option allows you to present your case in person or virtually and submit new evidence.
Example:
A veteran who was assigned a 30% rating for PTSD but believes their symptoms are more severe may opt for a Supplemental Claim if they have new medical evidence that wasn’t included in the original claim. If they feel the VA made a clear mistake, they might choose a Higher-Level Review instead.
How to Strengthen Your VA Appeal
Appealing a VA rating decision successfully often depends on the strength of the evidence you present. Whether you’re seeking a higher rating or challenging a denial, here are several key strategies to strengthen your appeal.
1. Submit New and Relevant Medical Evidence
One of the most effective ways to strengthen your appeal is by submitting new medical evidence that wasn’t part of your original claim. This could include updated medical records, new diagnoses, or more detailed reports from your healthcare providers.
- Get Updated Evaluations: If your condition has worsened since your initial claim, provide recent medical evaluations or diagnostic tests that reflect the current severity of your disability.
- Seek Specialty Care Reports: For complex conditions, reports from specialists can carry more weight than general practitioner records. For example, a report from a neurologist on traumatic brain injury (TBI) may provide more detailed evidence than a primary care doctor’s notes.
Example:
A veteran with a 10% rating for diabetic neuropathy who has since experienced increased nerve damage may submit updated reports from a neurologist showing decreased mobility and increased pain, which can support a higher rating.
2. Provide Detailed Lay Statements
Lay statements are written testimonies from individuals who know you well—such as family members, friends, or coworkers—and can describe how your condition impacts your daily life. These statements can provide a personal perspective that complements your medical records.
- Why Lay Statements Are Important: Medical records can sometimes fall short of capturing the full extent of how a disability affects your ability to work, interact socially, or perform everyday tasks. Lay statements help fill in these gaps by offering real-life examples of how your condition affects you.
- What to Include in Lay Statements: The statements should describe specific incidents or ongoing struggles related to your disability. For example, a family member might describe how your back pain limits your ability to play with your children or perform household chores.
Example:
A veteran with severe migraines might submit a lay statement from their spouse describing how the migraines lead to frequent missed family events, inability to leave a dark room, and reduced participation in work and social activities.
3. Request a Nexus Letter from a Doctor
A nexus letter is a detailed statement from a doctor that links your disability to your military service. This can be especially helpful in cases where the connection between your condition and your service wasn’t clearly established in your original claim.
- What Makes a Strong Nexus Letter: The letter should clearly state that it is “at least as likely as not” that your disability is related to your military service. It should include a detailed explanation of why the doctor believes your condition is connected to service, based on medical records and knowledge of your history.
- Specialist Opinions Hold Weight: A nexus letter from a specialist in the field of your condition—such as a cardiologist for heart disease or a psychologist for PTSD—can add credibility to your claim.
Example:
A veteran with hearing loss due to exposure to loud machinery during service could strengthen their appeal by obtaining a nexus letter from an audiologist linking the hearing loss to their military service.
4. Document How Your Disability Affects Employment
If your disability affects your ability to work, submitting evidence of how your condition limits your employment prospects can strengthen your appeal. This is especially important if you’re seeking a higher rating or applying for Total Disability Individual Unemployability (TDIU).
- Submit Employment Records: If you’ve been fired, had to leave jobs, or missed significant work time due to your disability, submit employment records that document these events. These records can show that your condition directly impacts your ability to maintain gainful employment.
- Vocational Expert Reports: A vocational expert can evaluate how your disabilities affect your ability to work, particularly if your condition limits your ability to perform tasks required by your previous job or any other type of employment.
Example:
A veteran who was denied TDIU could submit vocational expert testimony showing that their service-connected back injury prevents them from standing, lifting, or performing tasks required in both their previous and similar employment roles.
5. Attend a Board of Veterans’ Appeals (BVA) Hearing
If your case reaches the Board of Veterans’ Appeals, attending a hearing can be an excellent opportunity to present your case in person and provide a more detailed explanation of how your disability impacts your life. You can request either an in-person hearing or a virtual hearing based on your preference.
- Prepare for the Hearing: Work with an attorney to prepare for the hearing. Make sure to review your case thoroughly and be ready to answer questions about your medical condition, how it affects your daily activities, and why you believe the VA’s decision was incorrect.
- Submit New Evidence: You can also submit additional medical records, lay statements, or nexus letters during your hearing to support your case.
Example:
A veteran with PTSD who was assigned a 50% rating may appeal the decision by attending a BVA hearing. During the hearing, they can provide new medical evidence showing that their PTSD symptoms have worsened, such as increased panic attacks or suicidal thoughts, which supports a higher rating.
Statistics on VA Appeals and Rating Decisions
- High Rate of Initial Denials: According to the VA, approximately 30% of initial claims are denied, making the appeals process crucial for veterans seeking fair compensation.
- Appeal Success Rates: Veterans who provide strong medical evidence and participate in the appeals process are more likely to succeed. Nearly 40% of cases heard by the Board of Veterans’ Appeals result in a favorable decision for the veteran.
Common Mistakes to Avoid in VA Appeals
- Failing to Submit New Evidence: If you choose the Supplemental Claim route, make sure to submit new and relevant evidence. Simply resubmitting the same records without additional information is unlikely to change the outcome.
- Not Providing Detailed Lay Statements: While medical evidence is essential, failing to include lay statements that offer a personal perspective on your disability can weaken your case.
- Missing Deadlines: Veterans have one year to file an appeal after receiving a rating decision. Missing this deadline can result in delays or lost benefits, so be mindful of VA timelines.
Let Us Help You Strengthen Your VA Appeal
Appealing a VA disability rating decision can be complex, but with the right evidence and strategy, you can increase your chances of success. At Disability Law Group, we specialize in helping veterans navigate the VA appeals process and secure the benefits they deserve.
Whether you’re seeking a higher rating or challenging a denial, our experienced attorneys are here to guide you through every step of the process. Contact us today for a free consultation, and let us help you build the strongest possible case for your VA appeal.
