In this post, we’ll answer the question: “Why was my VA claim deferred?”
It can be frustrating (and scary) to learn that the VA has deferred some or all your claim.
But the good news is that having your VA claim deferred is neither good nor bad—it’s neutral, and in some cases—leads to a more favorable outcome.
The VA Rater (RVSR) should defer a claim (rather than deny it) that is underdeveloped or incomplete when proper disposition of that issue depends on resolution of a development action.
VA claims usually get deferred for one of three reasons:
- #1. Your claim needs additional development (38 CFR 3.159 development error)
- #2. The RVSR needs more rationale (or clarification) from the C&P examiner
- #3. The C&P examiner submitted an incomplete Disability Benefits Questionnaire (DBQ)
In these instances, the RVSR will generally make what’s called a “partial rating decision,” which is defined as:
A partial rating decision is one that provides a decision on some issues of a claim such as service connecting a disability or granting a simple increase, but defers a decision on at least one other issue, pending the outcome of additional claim development.
A partial rating decision will award part of the claim and defer one or more issues pending additional evidence or clarification.
Okay, let’s explore each of the three VA claim deferral reasons in-detail.
- VA Claim Deferred Reason #1. Your Claim Needs Additional Development (38 CFR 3.159 Development Error)
- Deferred VA Claim Reason #2. The RVSR needs more rationale (or clarification) from the C&P examiner
- VA Disability Deferred Reason #3. The C&P examiner submitted an incomplete Disability Benefits Questionnaire (DBQ)
- How often is a VA deferred claim approved?
- What is the meaning of “VA claim deferred pending medical opinion?”
- What does “VA claim deferred for exam clarification” mean?
- What is the VA deferred claim timeline?
- About the Author
VA Claim Deferred Reason #1. Your Claim Needs Additional Development (38 CFR 3.159 Development Error)
Sometimes the VA Rater needs additional evidence or clarification of existing evidence to properly review and rate your claim.
This is the most common reason why a VA claim gets deferred.
For example, maybe your claim is missing Service Treatment Records (STRs), private medical records, or personnel records that could provide the VA Rater with an essential piece of evidence.
Remember that the VA has a statutory “duty to assist” veterans throughout the VA claim process.
This means the VA is supposed to help you by attempting to obtain evidence on your behalf.
Additional development to obtain additional evidence such as a medical examination or other records may be needed if:
- It would provide a more complete picture of a question at issue, or
- If the evidence of record is questionable or conflicting
Pro Tip: VA Raters may not arbitrarily or capriciously refuse to assign weight to a claimant’s evidence or develop with the purpose of obtaining evidence to justify a denial of the claim. Instead, VA Raters must be able to support the determination that further development is needed.
References: Here’s three cases regarding deferred claim situations.
- Ordering further development in cases where uncorroborated lay evidence is presented, see Douglas v. Shinseki, 23 Vet.App. 19 (2009)
- A Veteran’s submission of evidence and refusal to attend a VA examination, see Kowalski v. Nicholson, 19 Vet.App. 171 (2005)
- Developing with the purpose of denying and explaining the need for development, see Mariano v. Principi, 17 Vet.App. 305 (2003)
Deferred VA Claim Reason #2. The RVSR needs more rationale (or clarification) from the C&P examiner
The second most common reason why the VA defers a claim is for a more detailed explanation or clarification of the C&P examiner’s medical opinion.
For example, maybe the C&P examiner didn’t conduct a proper examination or failed to adequately explain their medical opinion for service connection.
In these instances, the VA Rater will ask the Veteran Service Representative (VSR) assigned to your case to either get more information from the C&P examiner or order a new C&P entirely.
Pro Tip: It’s important to note that only the VA Rater (RVSR) may defer a claim. And having your VA claim deferred is not a bad thing. The VA Rater is doing so to help you (e.g., he/she needs additional evidence or clarification of a C&P exam or DBQ) before rating the claim.
VA Disability Deferred Reason #3. The C&P examiner submitted an incomplete Disability Benefits Questionnaire (DBQ)
The third reason why the VA rater defers a claim is because the C&P examiner returned an incomplete DBQ.
For example, sometimes the C&P examiner will forget to check certain blocks on the DBQ or even miss entire sections.
Another reason is if the C&P examiner returns a negative medical opinion without proper justification or maybe resorts to writing something like, “can’t give a medical opinion without resorting to mere speculation.”
In these instances, the VA Rater will defer your claim pending additional information from the C&P examiner.
How often is a VA deferred claim approved?
A VA deferred claim has the same chance of getting approved as any other claim, assuming the VA Rater can obtain additional information that’s helpful to the rating decision.
Veterans can improve their chances of having a deferred VA claim approved by helping the VA Rater with the evidence he/she is looking for.
For instance, if your claim is missing Service Treatment Records (STRs), you should upload electronic copies of your military medical records to VA.gov.
If you have private treatment records, a Nexus Letter, statement in support of a claim, or buddy letter, but didn’t upload them at claim submission, you should upload them as soon as possible if your claim was deferred.
What is the meaning of “VA claim deferred pending medical opinion?”
After you’ve submitted your VA claim, you’ll likely get a Compensation and Pension (C&P) exam from a contracted private medical provider.
At your C&P exam, the examiner will ask you a series of question, conduct a physical exam (if necessary), and complete the electronic version of the DBQ for your claimed condition.
On the DBQ form, the contracted C&P examiner is asked to give their medical opinion for service connection.
If you look inside your VA.gov account and see “VA claim deferred pending medical opinion,” this means that the C&P examiner either failed to give a medical opinion or didn’t properly justify the one he/she gave you.
This will either result in a clarification from the C&P examiner or the VA Rater will order a new C&P exam for a new medical opinion.
What does “VA claim deferred for exam clarification” mean?
“VA claim deferred for exam clarification” means the VA Rater needs additional information or rationale from the C&P examiner regarding your exam.
This can be related to inadequate exam results, an unjustified medical opinion, or an incomplete DBQ.
There’s nothing for you to do if this happens—it’s a behind-the-scenes back-and-forth exchange between the VA Rater and the C&P examiner.
What is the VA deferred claim timeline?
A VA deferred claim is typically decided within 30 to 90 business days, depending on the nature and complexity of the information needed to make a VA rating decision.
For example, a C&P exam clarification might only take two weeks while tracking down Service Treatment Records (STRs) and military personnel records could take 90 days or more (unless you upload them).
About the Author
Founder & CEO
Brian Reese is a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned, and founder of VA Claims Insider – “The Most Trusted Name in Education-Based Resources for Veterans.”
His frustration with the 8-step VA disability claims process led him to create “VA Claims Insider,” which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.
Brian is also the CEO of Military Disability Made Easy, which is the world’s largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013.
His eBook, the “9 Secrets Strategies for Winning Your VA Disability Claim” has been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).