why-are-veteran-disability-claims-delayed-and-denied (2023)

why-are-veteran-disability-claims-delayed-and-denied (1)

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Veterans Day is meant to honor and thank those who served in the United States Armed Forces. Unfortunately, respect for veterans does not always extend to them when they need it most.

Veterans filing a claim for disability benefits experience overwhelming delays and unreasonable denials. The Center for Investigative Reporting found that the average wait time to evaluate a veteran’s disability claim was at least 277 days.

In this episode, we discuss why veteran disability claims are delayed and denied and whether veterans can increase their chances of approval.

Show highlights

A history of delays

Current statistics indicate there are approximately 500,000 outstanding veterans’ disability compensation requests for service-related disabilities. Nearly 40% of those have been waiting for more than four months to receive an initial decision.

However, on average, it takes closer to one year for your application to be reviewed, to receive a rating decision, and be approved for benefits. Furthermore, the Department of Veteran Affairs has admitted there is a high error rate when evaluating disability claims.

Why are claims denied?

The Veteran Affairs website reports that 75 percent of all initial applications for VA benefits are denied. These applications are often denied because they have incomplete information or lack necessary documentation.

Other reasons for denial include:

  • Not enough evidence to support your disability
  • Not enough evidence to support your disability is connected to your military service
  • Your disability was a pre-existing condition and was not aggravated by your military service

Causes for ineligibility of benefits

In certain circumstances, a veteran will not be eligible to receive disability benefits, including:

  • The veteran’s disease or disability was caused by the veteran’s misconduct
  • The veteran was dishonorably discharged
  • The injury occurred while the veteran was avoiding duty, such as while deserting or absent without leave (AWOL)
  • The injury occurred while the veteran/service member was in prison or detained due to court martial or civil court felony

Tips for reducing the chances of a denial

Many of these denied claims have a strong chance on appeal if you can secure documentation to refute them. However, it is best to plan ahead and cover all your bases in your initial application.

Many delays and denials come from the hassle of gathering and sharing medical records. Therefore, it is best to track down your own military records and medical records instead of relying on the VA to do it for you. You should also double check that any records you request are sent to the appropriate destinations promptly.

Understanding the appeals process

If you applied for veterans disability compensation benefits and the VA denied your claim, you have the right to appeal. Check out NOLO’s breakdown of the appeal process for details about the relevant deadlines, paperwork, and steps to follow.

Things to remember

Veterans who were denied disability benefits wait an average four to five years for an appeals hearing. However, VA Secretary Bob McDonald predicts that will grow to a 10-year backlog if existing laws are not changed.

It is essential to be aware of and adhere to all relevant deadlines; if you miss them, your appeal is sure to be rejected.

What happens if your appeal is denied?

If the Board of Veterans’ Appeals decides against you, you can:

  • Try to reopen the claim with the local VA office
  • File a motion asking the Board to review your case because of a clear and unmistakable error in the Board decision
  • File an appeal with the U.S. Court of Appeals for Veterans Claims

Remember, data shows that certain Veteran Affairs Regional Offices (VARO) have denied as many as 71 percent of their claims simply because of errors in processing.

Getting help with your disability claim

If you want help with your initial claim, filing an appeal or going to a hearing, you can hire a representative who works for a veterans’ service organization or an attorney who specializes in veteran disability claims.

why-are-veteran-disability-claims-delayed-and-denied (2)


Why is my VA disability claim taking so long? ›

The time it takes to review your claim depends on these factors: The type of claim you filed. How many injuries or disabilities you claimed and how complex they are.

How often do VA disability claims get denied? ›

You've been waiting months to be able to qualify for VA disability benefits, after completing the long and arduous process of filing a claim. Then suddenly, you get the news: The Department of Veterans Affairs (VA) has denied your claim. Believe it or not, each year, the VA denies around 30% of disability claims.

How long are VA claims taking 2023? ›

How long does it take the VA to make a decision? On average, it takes about 134.4 business days to complete disability-related claims.

Why did the VA defer a claim? ›

A deferred claim typically means your claim lacks sufficient evidence. A claim becomes confirmed and continued only after additional evidence has been provided, but VA decides it is not “new and relevant,” meaning it offers no additional insight into your condition at the time of your claim.

How far behind is the VA with processing claims? ›

For veterans waiting for disability compensation, a huge backlog could mean waiting into 2022 and perhaps beyond. This backlog includes pension claims and disability compensation that requires a VA rating to process and approve.

What is the longest a VA claim can take? ›

As of June 2021, the average time it takes for the VA to issue a decision on VA benefits is 134.4 days. If your application is denied and you want to complete the appeals process, it will take approximately 125 days for a Supplemental Claim or Higher-Level Review and more than one year for a Board Hearing.

What is the current VA disability backlog? ›

The number of backlogged claims, defined as those older than 125 days, at the VA is 144,021 -- more than twice the number at the start of the COVID-19 pandemic but down from a recent high of more than 211,000. The 144,000 claims represent 22% of all the VA's current claims workload of 429,000, according to McDonough.

What are the easiest VA claims to get approved? ›

According to a recent Veterans Administration report to Congress, the ten most commonly awarded medical conditions that are getting approved for benefits are as follows:
  • Tinnitus.
  • Mental Health Conditions.
  • Musculoskeletal Conditions.
  • Scars.
  • Presumptive Conditions.
Jan 30, 2023

How long does the decision phase take on a VA claim? ›

Generally, you can expect to receive a VA rating decision within 30 business days of the Preparation for Decision phase.

How can I speed up my VA claim? ›

Veterans can file a Priority Processing Request using VA Form 20-10207 to ask VA to address their claim in a more expedient manner. In order to be eligible, veterans must submit documentation, if not already on file, indicating that they meet one of the following criteria: Experiencing extreme financial hardship.

Are VA claims being processed faster? ›

“When it comes to benefits vets have earned and deserve, we're processing their claims faster than ever before,” McDonough said during the NPC Headliners Luncheon in Washington, DC, Monday.

How far back will VA disability pay? ›

Generally, you are eligible for back pay from the first day of the month following your “effective date” for benefits. In most cases, your effective date is when the VA received your disability application.

What is the most common reason that VA erroneously denies claims? ›

You Did Not Submit Enough Evidence of Your Disability

If a Veteran does not submit enough proof about their disability in their VA claim , the VA will likely deny their claim.

What does it mean when the VA defers a decision? ›

A deferral is neither an approval, an award, or a denial. By issuing a deferral, VA's placing your claim on hold and requiring further evidence or other development to be completed before it will make a decision. VA will try to obtain the information it needs to issue a decision, either granting or denying benefits.

Who makes the final decision on VA claims? ›

After the Rating Veterans Service Representative has attempted to secure all the records (or evidence) required by law, he/she reviews your file and makes a decision on the claim according to the law and the particular facts in your case.

How long after QTC exam can I hear from VA? ›

After your VA C&P exam, and once your claim is complete, the VA estimates it could take 3-4 months before you hear a decision.

What disabilities can the VA not prove? ›

No, there aren't any VA disability claims that cannot be proven. In fact, all VA claims must be proven on an “at least as likely as not” basis. If you have no evidence (no proof), your VA claim will get denied.

Why is my VA claim still under review? ›

If your claim is “under review,” this means that a VA representative is reviewing it to find out if any more evidence is needed. During this stage, the VA representative will also analyze the results of your VA Compensation and Pension exam.

What is considered a permanent disability by the VA? ›

VA deems a disability “permanent” when it is reasonably certain, based on medical evidence that the level of impairment will continue for the rest of the veteran's life.

What not to say at C&P exam? ›

Don't Lie or Stretch the Truth. This is a big one. Don't ever lie or stretch the truth when it comes to your VA disability claim. At your C&P exam, you should think, look, act, and speak as you would on a normal day.

Can you check the status of your VA disability claim? ›

Once I'm signed in, how do I check my VA claim or appeal status? Go to your "My VA" dashboard. You'll find the link for this dashboard in the top right corner of the page once you're signed in. Scroll down to the "Track Claims" section.

What are the hardest VA claims? ›

There are 1,343,013 disabled veterans service-connected for Hearing Loss. Pro Tip: If you've been out of the military for more than 12 months, Hearing Loss is one of the most difficult claims to get service connected and rated above 0%.

What disqualifies a person from disability? ›

To qualify for disability benefits, a person must not be able to engage in substantial gainful activity (SGA) earning up to a certain amount. If you are able to make more than the SGA, then you will not qualify. For 2022 the threshold is $1,470 per month. For an applicant who is statutorily blind the amount is $2,460.

What is the most approved disability? ›

What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.

How long do deferred VA claims take? ›

How Long Will it Take? That's a great question, but there is no exact timeline for deferred decisions. It may only take a few months for the VA to render a decision, or it could take a year or more. It's one of the reasons why it's so important to seek consistent medical treatment for your conditions.

What are the stages of a VA disability claim? ›

Generally, there are eight steps that disability claims follow:
  • Claim Received. Your claim is moved to this stage once it has been received by VA.
  • Under Review. ...
  • Gathering of Evidence. ...
  • Review of Evidence. ...
  • Preparation for Decision. ...
  • Pending Decision Approval. ...
  • Preparation for Notification. ...
  • Complete.
May 14, 2017

Can I see my VA decision letter online? ›

Sign in to get your VA benefit letters

Sign in with your existing Login.gov, ID.me, DS Logon, or My HealtheVet account. If you don't have any of these accounts, you can create a free Login.gov or ID.me account now.

Does everyone get back pay for disability? ›

Answer. Almost everyone who is approved for disability gets backpay, whether the claim is for SSDI or SSI, or both.

Is disability back pay paid in a lump sum? ›

Back pay is received as a lump sum, while future benefits are paid monthly. Since 2011, the SSA has required that all disability recipients have a bank account to receive payments via direct deposit.

How many veterans have a 100% disability rating? ›

In 2021, 8.3% of veterans with service-connected disabilities had a combined rating of 90%, while 16.9% had a combined rating of 100%.

Does the VA always deny claims? ›

The Veteran Affairs website reports that 75 percent of all initial applications for VA benefits are denied. These applications are often denied because they have incomplete information or lack necessary documentation. Other reasons for denial include: Not enough evidence to support your disability.

Is it hard to claim disability with VA? ›

It's nearly impossible for you to win VA disability benefits unless you hire an experienced veterans disability lawyer. MISTAKE #3: Failing to submit detailed statements from your friends and family members. It is important to document your symptoms and how they have affected your life.

Is it hard to get a VA disability rating? ›

As you might expect, it is difficult to obtain a 100% VA disability rating with just one service-connected disability. Most veterans who receive a 100% rating have two or more disabling conditions. Often, these conditions have a secondary service connection.

What will trigger a VA review of disability claim? ›

The VA will require a reexamination if a veteran's disability is likely to have improved or if evidence indicates a disability rating is wrong. The VA must send a notice of the reevaluation exam either by mail or over the phone and give you 60 days to respond.

What conditions automatically qualify you for VA disability? ›

You may be able to get VA disability benefits for conditions like these:
  • Chronic (long-lasting) back pain resulting in a current diagnosed back disability.
  • Breathing problems resulting from a current lung condition or lung disease.
  • Severe hearing loss.
  • Scar tissue.
  • Loss of range of motion (problems moving your body)
  • Ulcers.
Feb 9, 2023

What disabilities get the highest VA rating? ›

Table of Contents
  • List of the Top 50 VA Disability Claims:
  • What are Some Common VA Disability Claims?
  • #1. Tinnitus.
  • #2. Hearing Loss.
  • #3. Limitation of Flexion, Knee.
  • #4. Post-Traumatic Stress Disorder (PTSD)
  • #5. Lumbosacral or Cervical Strain.
  • #6. Scars, General.
Feb 27, 2022

How hard is it to go from 70 to 100 VA disability? ›

According to this table, if you have a disability rated at 70%, you would need a subsequent disability rating between 85 and 90% to achieve a total rating of 100%. You may consider filing a claim for an additional service-connected condition that could combine to equal a higher rating.

What is the 55 rule for VA disability? ›

Revaluating VA Disability Ratings

Once you turn 55, you are typically "protected" and will no longer have to attend an exam to prove that your condition has not changed unless there is reason to suspect fraud. This is sometimes called the 55-year rule.

Is depression a permanent VA disability? ›

100% Individual Unemployability (TDIU)

In cases where a veteran's depression is so severe they are unable to secure and maintain substantially gainful employment, they can apply for total disability based on individual unemployability (TDIU) benefits.

What would cause me to lose my disability benefits? ›

Recipients of SSI will lose benefits if their income or assets exceed the SSI eligibility thresholds. In 2021, the limit is $794 per month for countable income, while the limit for assets is $2,000.


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