It’s frustrating to have your VA claim denied, and I’ve personally experienced this disappointment multiple times.
So, what should you do now?
First things first, don’t panic—the VA claim process is never over unless you quit!
Wait for your VA decision letter to arrive by mail so you can understand exactly why your claim was denied.
Once you know the “why,” you can figure out the “how” and “what” to overturn a wrongful claim denial.
This article will help guide your decision-making process and lead you to VA claim victory.
Let’s begin!
Table of Contents
Summary of Key Points
- Understanding the VA Claim Denial: After receiving a denial for a VA disability claim, it’s important to wait for the VA decision letter to understand the specific reasons for the denial. This information is crucial for determining the next steps.
- Common Reasons for Denial: The most common reasons for VA claim denials include a lack of medical evidence, no diagnosis, no “Nexus” for service connection, or no documented symptoms. To qualify for benefits, the Caluza Triangle must be proven: a medical diagnosis, evidence of an in-service event, and a nexus linking the two.
- Options After a Denied VA Claim: If you believe your claim was denied due to an error, you can file a Higher-Level Review (HLR) where you may opt for an informal conference to explain your situation. It’s essential to refer to your submitted medical evidence and stick to the facts.
- Further Appeal Options: If the HLR is denied, you can file a Supplemental Claim with new and relevant evidence to address any gaps or provide additional support. If the Supplemental Claim is also denied, you can pursue a Board Appeal, with a “records-only” option for a potentially faster decision.
Why Does the VA Deny Claims?
The most common reason for VA disability claim denials is a lack of medical evidence—specifically, no diagnosis, no “Nexus” for service connection, and/or no documented symptoms.
Remember, to be eligible for VA disability benefits, you need to prove The Caluza Triangle, which includes:
- Part #1: Medical Diagnosis of a Disability Condition (no medical diagnosis; no service connection).
- Part #2: Evidence of an In-Service Event, Injury, Disease, or Aggravation.
- Part #3: Nexus (link between #1 and #2) via Competent Medical Evidence (no nexus; no service connection).
What Should I Do After a Denied VA Claim?
First, review your VA decision letter to understand why your claim was denied.
If you believe your claim was denied due to an administrative error, consider filing a VA Higher Level Review (HLR).
VA HLR Tips:
- You’ll have the option (not required) for an informal phone conference with a more senior-level claims adjudicator, where you can explain your situation and advocate for yourself.
- Be sure to refer to your submitted medical evidence and stick to the facts.
- Many claims are overturned during the HLR appeals process!
What If My VA Higher-Level Review Gets Denied?
If your HLR is denied, the next step is to file a Supplemental Claim.
The key difference between an HLR and a Supplemental Claim is that you can submit new and relevant evidence with a Supplemental Claim.
This can help address gaps in your service treatment records or provide new medical evidence to support your claim.
Supplemental Claim Tips:
- If denied due to lack of evidence of a disability, submit new medical records with a current diagnosis.
- If denied for lack of service connection, obtain a new Nexus Letter and include it with your Supplemental Claim.
- If your rating is lower than expected, submit new medical evidence that clearly documents the severity of your symptoms. A Disability Benefits Questionnaire (DBQ) from a private provider can be helpful in demonstrating the severity of your symptoms.
What If My Supplemental Claim Gets Denied?
If your Supplemental Claim is denied, you can request an HLR on the denied Supplemental Claim.
A more senior adjudicator will review the Supplemental Claim denial for any errors.
If this is also denied, you have the option to pursue a Board Appeal.
For faster results, consider a “records-only” Board Appeal, which is assigned to a judge and generally results in a quicker decision.
YOU SERVED. YOU DESERVE. We Got Your Six!
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
