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Here are a couple of the top reasons why claims get denied and what you can do to ensure your claim gets approved.
Receiving a claim denial can be a very frustrating time. Waiting for what seems like forever and having your claim denied. This will leave you stressed and wondering what you could have done wrong.
Not providing a buddy letter
Not having a good buddy letter is one of the top reasons that claims are denied. A buddy letter is someone else who is able to vouch for you and explain your symptoms in a different way. Here is the link to how to write a good buddy letter.
This is important because it is an outside source validating your story. We have seen solid claims with all the medical evidence and a great C&P exam get denied because of lack of a buddy letter.
A buddy letter can be from a spouse, a buddy who was with you, or anyone else who has seen how your life has been impacted since this event.
Leaving information out during your DBQ
Another necessary component to help prove your case is the DBQ. By completing a DBQ with your health provider, a Doctor is able to report accurate information on your behalf. During this process, make sure not to leave anything out or reduce any of your symptoms.
A DBQ is the chance for a doctor or service care provider to share your story for the reviewer. With this, you must show up as yourself. What is your day to day like? What struggles do you have? Share all of this with your doctor.
During a DBQ is NOT where you want to act tough.
We frequently hear from our clients about how their normal caretaker will not complete a DBQ for them. If this is true, send us a message. We can advise you on the best route to go for your condition and get you to a doctor who can and will fill one out.
No service connection
How your disability is connected to your service needs to be clearly explained in your letters. The easiest way to do this is by submitting service medical records. If those don’t exist, submit your current medical records as well as a buddy letter vouching for your claim.
In the simplest terms, if there is not a CLEAR link between your disability and your time in service, your claim will be denied.
No medical diagnosis
You must have some sort of diagnosis from a medical professional. If you don’t have a diagnosis or an approved disability, your claim will not be approved. For example, if you were exposed to something during service but it has not affected your life post service, your claim would not be approved.
C&P Exam
First of all, show up to your C&P Exam! This is the easiest way to get your claim denied. If you can’t make it to your scheduled time, call the VA office and ask to reschedule. You need to be able to clearly prove your NEXUS letter in order to back up your claims. If it is not presented during your exam, there is a good chance your claim could be denied. There are a couple of key things you must do to get ready for your C&P Exam. Read those here.
If you received your claim and you don’t understand the codes provided, check out the VA’s explanation of rejected codes.
If you have filed your claim multiple times and still are not able to get a good rating, send us a message on social media at VA Claims Insider. We have a system that is sure to get you an accurate claim rating.
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About the Author
About VA Claims Insider
VA Claims Insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible independent medical opinions and nexus statements (medical nexus letters) for a wide range of disability conditions.
