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Veterans Day is meant to honor and thank those who served in the United States Armed Forces. Unfortunately, respect for veterans does not always extend to them when they need it most.
Veterans filing a claim for disability benefits experience overwhelming delays and unreasonable denials. The Center for Investigative Reporting found that the average wait time to evaluate a veteran’s disability claim was at least 277 days.
In this episode, we discuss why veteran disability claims are delayed and denied and whether veterans can increase their chances of approval.
Show highlights
A history of delays
Current statistics indicate there are approximately 500,000 outstanding veterans’ disability compensation requests for service-related disabilities. Nearly 40% of those have been waiting for more than four months to receive an initial decision.
However, on average, it takes closer to one year for your application to be reviewed, to receive a rating decision, and be approved for benefits. Furthermore, the Department of Veteran Affairs has admitted there is a high error rate when evaluating disability claims.
Why are claims denied?
The Veteran Affairs website reports that 75 percent of all initial applications for VA benefits are denied. These applications are often denied because they have incomplete information or lack necessary documentation.
Other reasons for denial include:
- Not enough evidence to support your disability
- Not enough evidence to support your disability is connected to your military service
- Your disability was a pre-existing condition and was not aggravated by your military service
Causes for ineligibility of benefits
In certain circ*mstances, a veteran will not be eligible to receive disability benefits, including:
- The veteran’s disease or disability was caused by the veteran’s misconduct
- The veteran was dishonorably discharged
- The injury occurred while the veteran was avoiding duty, such as while deserting or absent without leave (AWOL)
- The injury occurred while the veteran/service member was in prison or detained due to court martial or civil court felony
Tips for reducing the chances of a denial
Many of these denied claims have a strong chance on appeal if you can secure documentation to refute them. However, it is best to plan ahead and cover all your bases in your initial application.
Many delays and denials come from the hassle of gathering and sharing medical records. Therefore, it is best to track down your own military records and medical records instead of relying on the VA to do it for you. You should also double check that any records you request are sent to the appropriate destinations promptly.
Understanding the appeals process
If you applied for veterans disability compensation benefits and the VA denied your claim, you have the right to appeal. Check out NOLO’s breakdown of the appeal process for details about the relevant deadlines, paperwork, and steps to follow.
Things to remember
Veterans who were denied disability benefits wait an average four to five years for an appeals hearing. However, VA Secretary Bob McDonald predicts that will grow to a 10-year backlog if existing laws are not changed.
It is essential to be aware of and adhere to all relevant deadlines; if you miss them, your appeal is sure to be rejected.
What happens if your appeal is denied?
If the Board of Veterans’ Appeals decides against you, you can:
- Try to reopen the claim with the local VA office
- File a motion asking the Board to review your case because of a clear and unmistakable error in the Board decision
- File an appeal with the U.S. Court of Appeals for Veterans Claims
Remember, data shows that certain Veteran Affairs Regional Offices (VARO) have denied as many as 71 percent of their claims simply because of errors in processing.
Getting help with your disability claim
If you want help with your initial claim, filing an appeal or going to a hearing, you can hire a representative who works for a veterans’ service organization or an attorney who specializes in veteran disability claims.
FAQs
These applications are often denied because they have incomplete information or lack necessary documentation. Other reasons for denial include: Not enough evidence to support your disability. Not enough evidence to support your disability is connected to your military service.
Why are VA disability claims taking so long? ›
This is because there are several steps involved in the VA claims process, from the initial application to gathering of evidence, and review by a Veteran Service Representative (VSR). If additional evidence is needed, the process can be delayed while the VA or the veteran obtains and submits the required documentation.
What is the most common reason that VA erroneously denies claims? ›
Inadequate information provided in your claim—it's very possible that you simply didn't provide enough medical evidence in your disability claim for the VA to make an informed decision regarding your true level of disability.
Why would the VA deny my disability claim? ›
Some of the reasons why the VA may reject a claim for benefits include: Failure to prove that the disabling condition resulted from an injury during active duty. Failure to prove that the disabling condition began during active duty.
Why are VA claims taking so long 2024? ›
Due to record numbers of claims applications, the backlog is still expected to grow in 2024 before decreasing at the end of this year – and VA will continue to hire new claims processors, invest in continuous learning for all claims processors, and make technology improvements to ensure that Veterans, family members, ...
What is the longest a VA claim can take? ›
According to the VA website, in April of 2022, the average number of days to complete a disability-related claim was 152 days which is nearly 5 months. In our experience, it can take anywhere from months to a year or longer for an application to be approved.
What is the current backlog of VA disability claims? ›
Because of this record increase in applications, there has also been an anticipated increase in the number of claims applications that take longer than 125 days to process (otherwise known as the backlog), which is currently at 378,000 claims.
What are 5 reasons a claim may be denied? ›
Six common reasons for denied claims
- Timely filing. Each payer defines its own time frame during which a claim must be submitted to be considered for payment. ...
- Invalid subscriber identification. ...
- Noncovered services. ...
- Bundled services. ...
- Incorrect use of modifiers. ...
- Data discrepancies.
Unfortunately, VA disability claim denials are not uncommon, with roughly a third of veterans getting rejected each year. The Department of Veterans Affairs (VA) operates under strict guidelines to ensure that only veterans with genuine claims get the help they need.
What percentage of VA claims are rejected? ›
The VA denies around 30% of disability claims each year. It can be frustrating to learn that your claim for VA compensation was denied. You may feel like you did everything they asked of you and provided all the evidence necessary to get the disability compensation you deserve.
If you're a veteran with a disability, you may wonder why your benefits claim was denied. The answer is simple: the VA needs evidence to approve your claim. To verify that you are eligible for these benefits, you must submit medical records and other supporting documents.
What disabilities can the VA not prove? ›
No, there aren't any VA disability claims that cannot be proven. In fact, all VA claims must be proven on an “at least as likely as not” basis. If you have no evidence (no proof), your VA claim will be denied. Also, you must first ensure you're even eligible for VA disability benefits under the law.
What is the 70 40 rule for VA disability? ›
Odd jobs (marginal employment) don't count. And one of these must be true: You have at least 1 service-connected disability rated at 60% or more disabling, or. You have 2 or more service-connected disabilities, with at least 1 rated at 40% or more disabling and a combined rating of 70% or more.
What is the current average VA claim processing time? ›
They do not make the rating decision. Only a VA regional office can answer questions regarding your claim. When Will I Get My Rating? While every claim is different, it takes VA an average of three to four months to process a claim from beginning to end.
What is the average time for a VA claim 2024? ›
The average processing time for VA claims, supplemental claims, and Higher Level Reviews (HLRs) is between 120-150 days.
How long are VA disability claims taking in 2024? ›
Understanding the concerns surrounding claim processing times, it's essential to address common questions asked by Veterans filing for benefits. The average processing time for VA claims, supplemental claims, and Higher Level Reviews (HLRs) is between 120-150 days.
How long should a VA disability claim take? ›
How long does it take the VA to make a decision? On average, it takes about 11.5 months (341 days) to finalize disability-related claims. This can be longer or shorter depending on the complexity of your case.
Why is the VA so backed up? ›
But why is there such a significant backlog? The reasons span from historical inefficiencies, like the paper-based system of the early 21st century, to more recent impacts such as the COVID-19 pandemic and challenges with the Veterans Benefits Management System (VBMS).
How long does a VA claim stay in preparation for notification? ›
At this stage, your claim is essentially in limbo until the VA's rating office reviews the file and makes a final decision. Preparation for notification. At this stage, your claim has been decided upon and all that's left is to notify you officially. It often takes between seven and 21 business days.
