Appealing Denied VA Benefits Successfully Takes Knowledge of How System Works

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March 23, 2016, 08:00:00AM. By Gordon Gibb
Tulare County, CARetired service personnel have experience with giving their all in the line of duty, and sometimes experiencing horrific physical or emotional trauma after the fact. However, rather than easing a veteran’s effort when it comes to filing a claim for VA benefits, the Department of Veteran’s Affairs (the VA) appears to require, once again, the complete attention and commitment of the veteran in order to win the battle against the denial of benefits.

Appealing Denied VA Benefits Successfully Takes Knowledge of How System WorksThis, according to a columnist for the Visalia Times-Delta in California (3/19/16), himself a retired Navy Master Chief Petty Officer and currently the Veterans Services Officer for Tulare County. Ken Cruickshank helps veterans with their claims for VA disability benefits and pens a regular column on the subject.

It appears that applying for veteran benefits can be likened to a full-time job, with the requirement to dot all the ‘i’s and cross all the ‘t’s lest you are left spinning in a veteran affairs purgatory.

Cruickshank writes that most VA disability denials are due to a missing element in the claims application that establishes the veteran’s service connection. He notes in the Visalia Times-Delta that those pillars include medical evidence of a current, chronic (continuous) disability; evidence of having suffered a disease, injury or event while engaged in active service; and evidence that links these two items together.

“When a claim is denied, it is usually because the veteran is missing one of these important pillars that form the basis for any service-connected disability claim,” Cruickshank writes.

Were the claimant to disagree with the denial, based on the applicant’s view that the application is complete, it appears as if the applicant can continue to disagree until the cows come home. Cruickshank writes that unless the VA is satisfied that all the so-called pillars of evidence in an application are complete, the VA will systematically deny the VA disability claim.

Cruickshank notes, however, that there is effective protocol to follow should a VA benefits application come back stamped “benefits denied.” A letter of disagreement must be forwarded to the veteran’s local regional VA office within one year of receiving the denial (based on the date on the letter itself – if the letter took six months to get to the applicant, for example, then the applicant has six months to respond). The letter from the claimant disagreeing with the denial must include the name of the claimant, the date of the decision by the VA that is at issue, and the claimant’s signature. If any of these are missing or done improperly, they could come back and delay the process even further.

Following that, Cruickshank writes, there are two avenues the veteran can take: the traditional appeals process or one that involves a Decision Review Officer (DRO).

Cruickshank recommends the DRO process, which sees DROs based at regional VA offices conducting a review of all the available evidence of record, “as well as any new evidence that may be available, and will render a new decision in your claim for service connection.

“In the event that you disagree with the decision made by the DRO, you can use the traditional appeal process,” Cruickshank writes.

He notes that a veteran having a claim stamped VA disability denied can’t undertake that process in reverse: the DRO process can only be triggered before the traditional appeals process, not the other way around. If the traditional appeals process proves unsuccessful for the veteran, the claimant no longer has the option of appealing with help from a DRO.

Little wonder deserving veterans, having been emotionally or physically injured while serving their country and quickly exhausting their options, either give up entirely or file a VA lawsuit, and let their lawyers handle it. To Cruickshank’s credit, getting such important information out to the public and available in an effort to educate the veteran is welcome help for tired and deserving service personnel in need.

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