Common Reasons VA Disability Claims Are Denied & How to Appeal

Veterans who develop physical, cognitive, or mental health issues due to their military service may qualify for disability payments from the Department of Veterans Affairs. However, the VA maintains strict eligibility requirements for benefits, leading to the denial of many disability claims. Veterans seeking benefits should understand the common reasons for claim denials and what options they may have if the VA denies their application. 

Common Reasons for VA Disability Claim Denials

Some of the most frequent reasons for denials of VA disability benefits applications include:

Insufficient medical evidence

The VA can deny disability benefits when veterans submit insufficient medical evidence to prove they have a disability. Failing to include medical records, test results, medication records, or doctor’s notes can lead to denial of a disability claim, as the VA may conclude that a veteran does not have an impairment. 

Lack of a service connection

Veterans may have their disability benefit claims denied if they cannot demonstrate a connection between their claimed disability and military service. VA regulations presume a service connection for certain disabilities, which relieves qualifying veterans (including POWs, Vietnam/Gulf War/War on Terror veterans, and veterans exposed to ionizing radiation) from needing to prove that their military service caused their disability. Alternatively, veterans must prove they have a primary service-connected disability (disability caused by military service) or a secondary service-connected disability (disability caused or aggravated by another service-connected disability).

Failure to attend exams

Sometimes, the VA may ask veterans to attend a physical exam to evaluate their disability. Failing to attend a scheduled exam without providing good cause or rescheduling the exam may lead the VA to deny a benefits claim for lack of medical evidence. 

Disqualifying discharge status

Veterans discharged on grounds other than an honorable discharge may become disqualified from seeking VA disability benefits. 

How to Challenge the Denial of Your VA Disability Claim

Veterans can appeal the VA’s denial of their disability claims. The administrative appeals process for VA disability claims involves several steps, including:

• Reviewing the denial letter: First, you and your attorney should carefully review the denial letter to understand the reason(s) why the VA denied your disability benefits claims. Reviewing the basis for denial can help you gather additional evidence and develop compelling arguments you will need to challenge the decision. 
• Filing a supplemental claim: A veteran can file a supplemental claim after the denial of their disability benefits application when they have new and relevant evidence that the VA did not consider during the initial review. Veterans can also file supplemental claims to take advantage of changes in applicable laws that may lead to the approval of their disability benefits claim. 
• Requesting higher-level review: Veterans can request higher-level review of a denial of an initial or supplemental claim within one year of the denial. During higher-level review, a different VA claims adjudicator will review the veteran’s initial or supplemental claim. Veterans cannot submit new or supplemental evidence during higher-level review. 
• Pursuing an appeal with the Board of Veterans’ Appeals: After exhausting supplemental claims and higher-level review, a veteran can further appeal the denial of their disability benefits claim by requesting an appeal before a Veterans Law Judge with the Board of Veterans’ Appeals. Veterans can request a direct review – in which the judge reviews the claim without further evidence submitted by a veteran; evidence submission – which allows a veteran to submit new evidence; or a hearing – which permits veterans to submit new evidence and present oral argument to the judge. 

Contact a VA Disability Attorney Today

When you receive a denial notice after filing a VA disability claim, an experienced attorney can help you explore your legal options for appealing that decision. Contact Veteran Benefits Law Group today for an initial consultation with a VA disability lawyer to discuss the reasons for the denial of your benefits application and the steps you can take to challenge the denial of your benefits application.