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April 17, 2019

When will VA Disability Claims get Denied? +7 REASONS WHY

Last updated on March 22, 2021

Do you know that there are a few reasons why VA disability claims get denied? Knowing what these key factors are will help you in understanding what NOT to do for your claim!!

The 7 reasons why a VA Claim will get denied are:

  1. Dishonorable discharge
    • The veteran must apply for a discharge upgrade before they are eligible for VA benefits
  2. Veterans own “willful misconduct” is the cause of condition/disability
    • Veterans illegal activity or disobeying a direct order
  3. Abuse of drugs or alcohol is the cause of condition/disability
    • Cirrhosis of liver from long term alcohol abuse
  4. Use of tobacco products is the cause of condition/disability
    • Lung cancer from smoking
  5. No clear NEXUS to prove service-connection
  6. Not enough medical evidence to substantiate a medical condition or Dx even exists
  7. No symptoms of the condition/disability into the present day

Dishonorable discharge

If your discharge from service is labeled as dishonorable, you will not qualify for VA Disability compensation. To file for an upgrade, read our post here!

Marijuana use to cope with a mental health condition

Even though more veterans are utilizing marijuana for PTSD and more states are legalizing it, it is still an illegal drug under federal law. The VA is a Federal program

If there is any mention of illegal drug use in veterans medical records or DBQ. Do your best to explain “why” the veteran was using illegal drugs to cope if it’s in their medical records already

For example, the veteran was part of an illegal drug ring overseas. He gets jumped, beat up, and develops PTSD. The VA would deny the claim and say that the PTSD was a result of the veterans own “willful misconduct” aka the veteran was engaged in illegal activity at the time of injury

The VA rating official determined it was the veterans own “willful misconduct” as to why they developed a mental health condition.

It must be VERY clear that alcohol or drug use was a coping mechanism to deal with chronic pain or another mental health consition, NOT the other way around.

If the VA Rater determines that the veteran was abusing drugs or alcohol and developed a disease or condition, the VA will deny the claim.

Lack of medical evidence!

This is the number one reason why VA Disability claims get denied. We realize that many people do not have their military medical records, but if you can get them, these will be extremely important to have!

Some examples of documents you can gather to paint the picture of what the incident was are buddy letters from those in service with you, spousal buddy letter, a statement in support of a claim, and DBQ’s.

One of the benefits of working with VA Claims Insider is that we have a medical team contracted out from our company. You can book same day evaluations with our team for DBQ’s. Using these systems we have gotten Veterans to the disability compensation they deserve.

NEXUS

A NEXUS essentially means the link between the disability you are trying to claim and your time in service. To have a successful claim, you must have this NEXUS, or service connection, for your claim to be approved. If this is not clear, then your disability claim will be denied. For more information about your NEXUS, check out our post here.

No symptoms present

You will not receive compensation if there are not daily effects from the incident. To receive compensation for a claim you must be able to show the VA that your disability was caused or made worse by your time in service. Without this connection or nexus, the VA will not award you compensation for a claim.

Failure to show up for a C&P exam

Do not skip your C&P exam! This is one of the most important dates and your claim will get denied if you fail to show up! If you did not receive notice that you were scheduled for a C&P exam, you may follow up with the VA and file for a reschedule.

These are some of the prevalent reasons in which we have seen the VA has denied claims and have in return, made ourselves experts in. If you have gone through the pain of having denied claims and still need help, fill out of intake form and one of our Veteran Claim Coaches will contact you within 24 hours!

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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 & Nexus Statements (Medical Nexus Letters) for a wide range of disability conditions.

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