How To Handle A VA Claim Denials In Houston, TX

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How To Handle A VA Claim Denials In Houston, TX

You’ve filled out all the paperwork, sent all the requested information, and even did another physical exam (or two or more.) But the VA still denied your claim for benefits. Now, what do you do?

How To Handle A VA Claim Denials In Houston, TX

The first thing you must do is not give up. The second thing you must do is file an appeal.

Why They Said “No”

Start by figuring out why your claim was denied. Did they need more information? There may be any number of reasons, and the letter you receive will detail the denial.

The VA commonly denies veteran benefits claims for:

  • A lack of clear medical diagnosis for the condition or disability being claimed
  • No clear “nexus” or connection between your condition and your military service
  • No evidence (or enough) of disability symptoms

While there may not be enough evidence in your service record to justify a service connection, you will need to show that you currently have a medical diagnosis. This can be either from a VA medical provider or through a private medical provider, such as a primary care physician. Add this information to your appeal.

To be eligible for VA disability benefits, you must demonstrate that the symptoms you have today were caused or aggravated by your military service. Without this “nexus,” there is no reason to believe your condition is service-related, so it’s up to you to show that it clearly is.

Frequently, veterans discover that they have no medical evidence in their military service record to back up claims of a disabling condition. It may be more difficult to show years after your discharge, but it’s not impossible. Any medical evidence you submit must be recent enough to demonstrate your claim of disability.

You must also show that you are currently experiencing symptoms that affect your everyday activities, including your ability to work. The VA awards compensation for disabilities that impact and impair everyday life, including work and social functioning. The degree of disability determines your rating, that is, how severe your symptoms are from the disability.

Provide additional support your claim for symptoms:

  • Draft a VA Lay Statement—a personal statement that describes your current condition and why you believe it is directly service-connected.
  • Request that someone draft a “Buddy Letter” to describe your symptoms and how they impact your life. This would be someone over the age of 18 who has first-hand knowledge of your injuries, such as a family member, spouse, fellow veteran, or anyone who can corroborate your claim. This is also considered “lay evidence.”
  • Obtain a Disability Benefits Questionnaire from your primary care physician or other healthcare providers
  • Add any additional evidence from the VA as well as any private healthcare provider detailing symptoms

Time Limit For Appeal

To appeal a negative decision, you’ll need to use VA Form 21-0958, called the Notice of Disagreement (NOD). You’ll have one year from the date of the letter (not the date you received it.) If you miss this deadline, you may have to file a new claim.

It’s important to note that the NOD is simply to inform the VA that you disagree, and you intend to appeal their decision. In the NOD, you’ll include:

  • A letter with the words “notice of disagreement” at the top of Form 21-4138 or in your letter
  • The date of the denial letter and the decision of your ratings
  • The statement that you disagree with the denial letter and the entire decision of ratings
  • The statement that you intend to appeal the VA’s decision

The NOD is simply to preserve your appeal rights, and the right to appeal to all of them. Avoid detailing the specific reasons for appeal, or you may limit your ability to appeal something later. Save the specifics for the DRO (Decision Review Officer) or BVA (Board Of Veterans Appeals) meetings.

Get Help With Your VA Appeals

Appealing a VA claim denial can be frustrating and time-consuming. Without an understanding of how the VA works, you may be at a disadvantage. VSOs are not attorneys and may not be able to give you the help you need.

We’ve been helping veterans win the appeals process for more than 30 years. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges. You don’t owe a fee until we win your case.

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