The VA Denied My Disability Claim. How to Appeal a VA Benefits Decision
Filing a VA Benefits claim can be a complicated process that can take months, or even years, to resolve....
Filing a VA Benefits claim can be a complicated process that can take months, or even years, to resolve. And sometimes, the VA’s decision doesn’t go the way you want it to.
Does the following sound familiar?
You filed a claim for disability compensation with your Regional Office (RO) of Veterans Affairs.
You logged on to the eBenefits website relentlessly for months (if not years), tracking the progress of your disability claim. Then you receive the packet in the mail stating, that after all of that frustration and waiting, your claim has been denied. Now what?
You know that you need and deserve disability compensation, otherwise, you wouldn’t have applied for it in the first place. You’re most likely frustrated and wondering how they just dismiss the evidence, your service, and the cost it has taken on your daily life. Know that you’re not alone in your frustration.
So, what do you do? After the VA has denied your claim, it can be frustrating to hear that the only way to fight for your disability compensation is with one bureaucratically pushed paper at a time. It’s true though. If you want to receive the compensation you need and deserve, you’ll need to navigate your way through the VA’s bureaucratic process in order to file an appeal and hopefully get a favorable result.
We’ll show you how.
Appealing Your VA Benefits Decision – First Steps to Take
Before we get started, you need to know the date your decision was made. The VA updated the appeals process for all decisions made on or after February 19, 2019. If your decision was made on or after that date, you will need to read the new review process. If your decision was made prior to that date, you will need to read the legacy appeals process (both are covered in this guide).
Finally, these are the first steps you should take before filing a VA benefits claim appeal:
Don’t let anger cloud your vision
A denial of your claim does not mean that you are not eligible, so don’t believe that you will never be successful in pursuing your disability benefits. Data has shown that certain Veteran Affairs Regional Offices (VARO) have denied as many as 71% of their claims simply because of errors in processing.
Keep duplicate records and copies of everything
When dealing with the appeals process especially, only use certified mail, keep your receipts, and make sure that the paperwork that is sent to your VARO has to be signed upon receipt. This not only allows you know that the paperwork physically made it into someone’s hands, but you will also have proof that you met the filing deadline required for the paperwork in question.
Don’t expect it to go fast
Due to countless studies showing the inefficiencies of the disability claims processes the VA has implemented new response benchmarks. The VA now hopes to have all claims reviewed by a higher-level official within 4 – 5 months. Previously this process could take up to 18 months.
New VA Disability Claim Decision Appeals Process (After Feb 18, 2019)
The VA updated the appeals process to apply to all decisions made on or after February 19, 2019. We will show you how to file an appeal using both methods. You can also visit the VA page devoted to the new appeals process. Or you can read more about these steps below:
Step 1: Choose a decision review option
Instead of following a linear, yet circular process, veterans now can choose from one of the following options.
- Add new and relevant evidence
- Request a higher-level review
- Appeal to a Veterans Law Judge
Add new and relevant evidence (Supplemental Claim)
This option is fairly straightforward in that it requires you to produce new evidence that reviewers did not have at the time they reviewed your initial claim. Relevant evidence is considered something that could prove or disprove part of your claim. To file a Supplemental Claim you will need to fill out VA Form 20-0995 (PDF) and follow the steps outlined on the VA website. You can file new and relevant evidence at any time.
Request a higher-level review
This option applies to individuals who do not have any new evidence to present, but would like a different party to review their initial claim. To begin this process you will need to complete VA Form 20-0996: Higher-Level Review (PDF) within one year of your initial decision.
You will have the opportunity to speak to your reviewer over the phone to advocate for why you believe a change is required. This process takes roughly 5 months. A full description of the process can be found on the VA website. You can only choose this option once and cannot apply for an appeal unless you can present new evidence via a Supplemental Claim.
Appeal to a Veterans Law Judge
For those choosing this option, you will have the ability to present new evidence, while elevating the decision to a judge at the Board of Veterans Appeals (BVA) in Washington, D.C. You will need to fill out VA Form 10182: Board Appeal (PDF) and will have the option to request a hearing in Washington, D.C. or via video conference at your local VA.
This process will take roughly one year or longer depending on your request and the time it takes to review any new evidence you present. You cannot request two Board Appeals in a row, but can request one after a denial of a Supplemental Claim or Higher-Level Review. For this reason, it is recommended to begin with a Supplemental Claim or Higher-Level Review. Details on the BVA process can be found on the VA website.
The BVA judge will either grant your request, deny your claim, or remand your claim, saying that additional time or work is necessary before they are able to make a decision. It is recommended that you seek help from someone with appeals experience. Here is a list of Veterans Service Organizations you can turn to for benefits claims help.
The only option after a final decision at this level is to take your appeal to the federal circuit court or to submit new evidence via a Supplemental Claim.
Historical VA Disability Claim Process (Prior to Feb 19, 2019)
Step 1: File a Notice of Disagreement (NOD)
For those who received a denial prior to February 19, 2019, the only way that you can start an appeal of your claim is by filing a Notice of Disagreement form (NOD) with your Regional Office (RO). Without this NOD form you won’t be able to start the appeals process.
The NOD states that you disagree with the decision you received regarding your claim for disability compensation. The NOD form is the only way to begin your appeal process when you disagree with VA’s decision on your claim for disability compensation.
Step 2: Choose a type of review
The next step in the process is deciding whether or not you want to have a Decision Review Officer (DRO) or a traditional review by marking the appropriate box on your NOD. Read the fine print of your denial letter, and take action immediately.
Current VARO procedures allow veterans 60 days to decide whether they want a Direct Review Officer assigned to their appeal or a traditional review of their appeal. After those 60 days, you lose all choice in the process.
So, which should you choose?
A traditional review of your appeal requires a rating staff member to analyze your claim file for completeness, accuracy, and any errors. They will review all of your evidence and paperwork. They are the ones reviewing your file, but they do not have the authority to change the decision unless the regional office staff made a clear and unmistakable error, or they identify new material evidence.
Step 3: VARO Review of your claim
If you choose a DRO, they will conduct a “de novo review” of your claim, meaning that they will completely review every bit of evidence, arguments, and paperwork in your file. All DROs are senior claims examiners who have the authority to reverse, uphold, or make a different decision on your claim.
If you choose a traditional review, your claim will be reviewed either by a DRO or a rating veterans service representative, who will only be allowed to reverse a decision if there is a clear and unmistakable error. It is their job to prepare a rating decision after they review your appeal.
Step 4: The VA makes a decision
If the appeals staff deny that there are any issues with their original decision and claim that any new evidence submitted has no bearing on their decision, they will then prepare and issue a Statement of the Case (SOC), which essentially tells you why they have rejected the reasons behind your NOD claim for an appeal.
Step 5: VA Form 9
The SOC will also provide you with a VA Form 9 which is an Appeal to the Board of Veterans’ Appeals. If you still disagree with the ruling on your disability benefits, then you have to submit the VA Form 9 for further consideration by the VARO staff. You should use this form to explain why you still disagree and also to offer further support or evidence of your case.
Note: The appeals process has a continuous open record, meaning that you may submit new supporting evidence or additional information for the appeals staff to review for the case at any time. Any new evidence will lengthen the time spent before a decision is made though, since each piece of evidence requires a new Supplement Statement of the Case (SSOC) decision, which sends your appeal back in line in the process. So, try to submit all supporting evidence of your case early and altogether. If your condition worsens, or new evidence presents itself, then always submit new medical records and diagnoses to support your claim.
Step 6: Board of Veterans Appeals
If the appeals staff still do not decide in your favor, then they will certify that your appeal has been sent to the Board of Veterans Appeals (BVA) for their review of your claim.
The BVA will either grant your request, deny your claim, or remand your claim, saying that additional time or work is necessary before they are able to make a decision.
It is recommended that you seek help from someone with appeals experience. Here is a list of Veterans Service Organizations you can turn to for benefits claims help.
Step 7: Formal Hearing with a Board Veterans Law Judge
Approximately 25 percent of Veterans whose appeals reach the Board request a formal hearing before a Law Judge. The Veterans Law judge will discuss their appeal and review any new evidence. The Board Veterans Law Judges will make a final decision on your appeal.
The only option after a final decision is to take your appeal to the federal circuit court within 120 days of the Board’s decision.
This is listed as seven steps just as a way to break apart the process. The VA appeals process for disability claims is a non-linear, continuous open record process that is based in law that has accumulated for more than 80 years. This whole, multi-level review process can take up to four years.
Accept the process or work to change it
If you want to have a better chance at a successful outcome, file your paperwork on time (one-year deadline to appeal), submit all records yourself (don’t expect the VA to find them for you), and keep on top of the process.
The appeals process can be long and complicated, with some appeals taking over a year to be decided after you are initially denied your benefits claim. Enlisting assistance is one of the most important things you can do to make sure your claim is filed properly and on time. You have earned your benefits and you owe it to yourself to file your appeal correctly the first time.
If you are unsure of how to proceed, you may even want to consider hiring an attorney who is well-versed with the VA appeals process. Until and unless they are able to successfully change the laws that bind the VA disability claim appeals process, you have no choice but to follow the bureaucratic paper trail.
If you want to try to make a change, contact your state representative and ask that they work towards an effective change in the process for appealing a decision on a veteran’s disability claim.
How has the process outlined above differed from your experience? Let us know!