Your Claim Was Denied...Now What?
So, you know the difference between
SSDI
and
SSI. You have talked to a Veteran Service Representative (VSR) and opened a claim. You filled out the forms and gave the VA your service records within the year. And after waiting months, you received a letter that you don’t agree with! This decision letter says that the Veterans Administration Examiner looked at all of your documents and believe that your injuries are not related to your service. Now what?
If you receive a decision letter with a rejection of your claim from the Veterans Administration, you may think that you have missed your chance to receive benefits. The truth is, your claim is never finished until you give up. The longer you work to get the claim you deserve, the more likely you will receive them. A rejection letter does not mean that you lost completely. It usually means that you only need to give the VA more information.
What does a rejection letter mean?
A rejection letter means that the Veteran Service Representative (VSR) saw something that could be wrong with your claim. Sometimes, it is something that you can fix by sending information that they ask for. Sometimes it is a mistake that they make. Either way, it is something that can be fixed by contacting the VA directly.
3 Common Reasons why Claims are Rejected
- In most cases, you will be rejected if you do not provide enough proof of your medical condition being related to your time in the military. You will be denied if they do not think your injury was caused in service or because of service. Remember, you can file a claim for an injury or a disease that you received during and/or for injuries after your service if an event during your service caused your injury. The key is, you have to show medical records to show the service connection
- It is possible that the VA made a mistake that can easily be fixed. Service members with the same or similar name, misspellings, or incorrect date of birth. Sometimes, the VA even sends a denial letter to the wrong veteran…if you believe the VA has made a typo or a mistake, write it down and contact your VSR right away.
- Has the VA set up a C&P examination for you? If you have one coming up, make sure you go. It’s really important to go to your Compensation and Pension Examination. You could lose your claim if you miss your C&P Exam and if the VA believes that you don’t want to pursue your benefits. If you missed your C&P exam, call them right away to reschedule.
What can I do? You have 3 choices if you receive a letter rejecting your claim.
There are 3 things you can do if your claim has been denied by the VA
Requesting a higher-level review
- If you decide to request a higher-level review, a more experienced reviewer will take a look at the records that you have already given the VA. They will only use the records that are already submitted and no additional information can be added. Make sure the VA has all the information that you have because you are not able to provide additional records with a higher-level review.
- Do you believe the VA made a mistake or a lot of mistakes? If you believe the VA has made mistakes on your claim, write a letter listing the mistakes that you think they made. Your arguments and your request for a higher-level review should be submitted to the VA together.
- Request to meet with a Higher-Level Review officer by submitting VA Form 21-0966 (click here to download a copy of VA Form 20-0996). This gives the VA an opportunity to look at all of the medical records that you provided. The new Higher Level Review Officer is only able to use the records and information that you have given them already.
Providing More Supporting Evidence
You can submit...
Recently received military records
You can send the VA new and/or relevant evidence that you haven’t submitted before. You might not have enough medical proof to support your claim. If you have been denied and you have additional medical information that the VA does not have, now is the chance to give it to them. That means you are able to give them any new records from your service.
Also, “buddy letters” may be able to help. A “buddy letter” is a written letter from someone that you served with. This letter should be able to describe to the VA your service-related injury and anything that could have caused your injury.
You can also submit...
New and current medical records
Do you have updated medical evidence from your current doctor? You can give the VA medical records that you get from your current doctor but only if they support your claim. The VA wants to see your medical records for anything related to your service condition. If you have seen a doctor recently you can request a copy and send them to the VA as Supplemental Evidence. They want to see if your service-related injury has gotten better, worse, or stayed the same.
Also, your doctor may describe your issues differently than the VA’s Medical Examiner. You may want to request an Independent Medical Opinion from your personal physician. These Opinions are also called Nexus Letters or Nexus Opinions. It’s not required to have an Opinion but it is highly recommended to submit one. These letters from your doctor will provide a link from your service injury or incident to your current injury.
If your doctor does not offer
Independent Medical Opinions
or
Nexus Letters,
Chambers Law has a list of medical providers that do. Contact Chambers Law for more details.
Directly Appealing to the Board of Veterans Appeals
Your third option that you may consider is to file an appeal. An appeal is when your claim is presented in front of a judge. If you choose this option, you should consider hiring a qualified attorney to help you get what you deserve. You NEED to make sure that your claim has all the correct documents for the judge’s review. In some situations, you may be able to provide more information and evidence for the judge to review. If you have additional information, you will have 90 days after filing the appeal. If you lose the Appeal, it will take EVEN LONGER for you to receive your claim benefits. It might even mean that you will have to start over and file another claim!
***Please Note: These options only apply to VA decisions that are dated on or after February 19, 2019.***
Click HERE for our frequently asked questions.
Remember, the claim isn’t over until you give up! If you have received a denial letter, you still have choices. You may feel like giving up, but you still have options to save your claim.
In some cases, the claim process can take over 1,500 days!
Contact Chambers Law at 352-515-9464 to set up a free consultation today! Chris & Stephanie Chambers are qualified attorneys that have 25 years of combined experience!
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Coronavirus Response for our Veterans Law Office
We can accommodate video conferencing upon request. Both VA and SS are holding hearings either by phone or virtually through online teleconference. Chambers Law remains committed to serving you during these challenging circumstances.