Getting a claim through the Veterans Affairs (VA) disability claim system can be difficult. There are a lot of requirements, complex paperwork and sometimes conflicting information as you deal with a constantly changing system that may be a bit too over-tuned towards catching fraud. If you're suffering from legitimate conditions that need specific medical and financial support, keep a few VA claim system concepts in mind as you make your claim more compelling and seek legal assistance
Medical Proof Isn't Always Readily Available
The first thing to understand about the VA disability compensation system is that it exists to help veterans suffering from service-connected conditions only. There are other services available for veterans in need for other reasons, but the disability compensation is a limited service.
A service-connected condition is any condition that could have been caused by military service. Service-connection also covers preexisting conditions that were made worse because of military service; a distinction that may be more difficult to prove than new conditions, but not possible.
You'll also need proof that the condition is currently a problem or could become a problem in the future. Many veterans leave this step to the VA compensation and pension (C&P) exam, which performs cursory exams and even techniques such as CT scans for certain physical conditions. Unfortunately, while the C&P exam can find a not of issues, it is not truly comprehensive.
Not every VA hospital has unlimited access to the best equipment and examination techniques. Although you can look forward to quality referrals and better medical care opportunities after winning a claim, there are a lot of veterans making their way through a large backlog of medical claims, which may mean a less-than-ideal medical experience with results that aren't as in-depth as a dedicated medical exam.
Understanding VA Denial Reasons
If you've been denied VA benefits, look at the denial reason. There are some VA denial reasons that are common amongst veterans, but many VA facilities are moving towards offering a more detailed, personalized set of decision statements.
- Beneficiary not eligible on date of service claimed. This code is the reason for the service-connection explanation. It means that the VA thinks your injury was caused either before or after your military service. For pre-existing conditions, it means that your condition wasn't considered severe enough to be qualified for benefits.
- Too close to End of Active Obligated Service (EAOS). This reason is often infuriating because it insinuates that your problem may not be a legitimate injury. The VA may suspect that your injury is suspiciously close to getting out of the military in order to receive benefits. To fight this reason, make sure to have as many details about the incident to prove the legitimacy.
- Appeal not timely filed. If you have an issue with a claim decision, you need to file an appeal within 120 days of receiving a decision. Any claims beyond 365 days will need to be started over, which means a longer wait time as you move to the end of the claim queue. You don't need to file a completed appeal full of evidence; an intent to appeal document can be sent as you work on the claim to keep your spot in the queue. Appeal rights are listed in this explanation document, which should be attached to every response from the VA that you receive in the mail. A personal injury lawyer can represent you in the appeal process.
For help with developing evidence to fight against these codes and more, as well as assistance in finding a medical team that can examine your issues closely for detailed claim evidence, contact a personal injury attorney.