Though Veterans are entitled to service-connected disability benefits, studies have shown that the Department of Veteran Affairs (DVA) rejects up to 70% of claims for various reasons.
If you have had a service-connected disability claim rejected and you disagree with the decision, you need to file an appeal. It will not be a simple process, but we’re here to help.
Keep reading to find required forms, tips, and advice on how to make the appeal process as painless as possible.
Step One in Appealing a Service-Connected Disability Decision
Getting rejected is not fun. Especially when your health is on the line. Before you get frustrated, keep in mind that a lot of Veterans’ disability claims are denied because of simple processing errors. It could be as simple as that.
The first step in the appeal process is to file a notice of disagreement (NOD). When completing this form, it is best not to go into too much detail about why you disagree with your decision.
While it is tempting to take out your frustration on the readers of this form, all you need to include is the date of the denial letter, the rating decision, and a statement saying you disagree with the decision and intend to appeal.
Keep it as general as possible. If necessary, you will have time to go into detail later in the appeal process.
Direct or Traditional Review?
Once the NOD is submitted, you will have to make the decision to request a direct review (DRO) or a traditional review.
Traditional reviews are conducted by staff who analyze the claim and check for completeness, but they can only change the original decision if a clear administrative error in processing is detected.
The benefit of selecting a DRO is that the reviewer will be a senior claims examiner who has the authority to make a decision on your claim, right then and there.
The drawback of a direct review is that if the reviewer denies the claim, you may have to wait longer to proceed to the next step: the Board of Veterans Appeals (BVA).
Appeal to the Board of Veteran’s Appeals
At this point, you have submitted a notice of disagreement (NOD) and the VA is sticking to their decision. You should now submit a VA Form 9 (Appeal to the Board of Veteran’s Appeals).
This is when & where you can/should go into more detail about why you disagree with the decision and present new evidence. Keep in mind, any new evidence submitted may draw out this process further, especially if it is new and material to your case.
Working with a good advocate or attorney will help you at this point if you have not already retained one.
Perhaps the best part of a VA Form 9 is that it means you are going to get your day in court. If the VA continues sticking to their guns, you will get to argue why they are mistaken in front of a judge. The judge at this point has several options.
1) Grant your appeal in full. Yay, you won and should be getting a check soon for back-due benefits.
2) Deny your appeal. You can appeal this denial through a federal lawsuit.
3) Remand all or part of your claim. The judge thinks the VA should take another look based off evidence they have seen in the review of your claim or that you presented at the hearing. They will direct VA staff adjudicators what they want them to review again and why. The result will be a new determination, which if found to still be a denial of benefits, will give you the option to file a new VA Form 9 and go through another hearing (your case is still alive – but it is going to take more time!)
4) Grant part of your appeal. Often appeals include multiple items, the judge may find parts of your claims reasonable, and others not supported by current precedent or law. In this case, yay – you will be getting at least a little compensation.
But there is also the potential to have a mix of items 2 & 3 above. It is getting complicated at this point!
The Best Advice We Can Offer
While the service-connected disability process is long, arduous, and dated, it is in place to make sure the money is going to the right people.
To avoid extreme delays, submit your paperwork correctly in the first place. While this does not eliminate the risk of processing errors, it will save time down the road if you submit all your evidence together and meet the deadlines.
Send paperwork using certified mail and keep copies of proof of delivery. Keep copies of everything and do routine follow-ups.
If you are really fed up with the system, you can write to your local state representative and ask that they review and improve the antiquated appeals process.
In the meantime, reach out to us if you need excellent legal assistance with your claim!