The VA disability claim system is nearly constantly overburdened with claims from veterans. As a result, it is common for veterans to receive unfavorable results to their claims. At times, the result is reasonable and legal. At other times, however, the veteran is denied assistance he or she should lawfully have received. If you feel your claim was denied or underpaid wrongfully, you may file to have the claim contested in court.
VA Disability Claim Process
The first step in the claims process is submitting your claim to the VA. You will notify the VA by submitting an Application for Compensation, and the VA will respond immediately with a letter confirming receipt of the application once it arrives. The VA will include a request for a list of forms from you. These can include medical records, service records and other materials.
Verifying Your VA Disability Claim
Once you submit your claim with the requested materials, your claim will go to a Rating Veterans Service Representative. This individual is responsible for evaluating all the information present to determine how much of your claim will be paid, if any. The service representative should go through the process slowly, and this individual may even request an independent medical examination. This will occur free of charge to you. You may be surprised to see how long it takes to receive a response from this representative. Remember: there is a lot of paperwork involved in this process, and you must be patient. While the claim is being processed, your doctor cannot enforce payment against you.
Resubmitting a VA Disability Claim
If your claim is denied or underpaid, you should immediately request an explanation of why. Typically, the service representative will provide you with a list of reasons. You always have a right to ask for an explanation of the denial. Based on this explanation, you may see further documentation is required. For example, disability benefits may not start paying toward an illness until the illness has persisted for 3 months. Therefore, you must wait to see if this occurs to claim your benefits. At times, the information was submitted incorrectly or with the wrong coding. In any case, you may attempt to resubmit your claim with new information. The claim will again go through the evaluation process.
Contesting a VA Disability Claim
Your claim may again be denied or underpaid. It is important to ask again for an explanation. This time, if you would like to contest the results, you must file a lawsuit in order to do so. The case will be discussed before an impartial judge. All of the documents you provided the VA will be presented, including an explanation of why your claim was denied. For its part, the VA will provide a reason the claim was denied based on your benefit plan. The judge will have to determine if the VA acted lawfully and reasonably in denying your claim; if so, you cannot recover. If the judge determines you are owed money as part of your claim, the VA will be ordered to pay.