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VA Guidance: Top Reasons a Claim for VA Disability Compensation is Denied

VA states that disability compensation is "a monthly tax-free payment to Veterans who got sick or injured while serving in the military and to Veterans whose service made an existing condition worse." 

After leaving service, an injury or disability can limit or reduce a Veteran's ability to earn a living. Additional expenditures on care, equipment, and supplies might be necessary. Disability compensation is the benefit that addresses this situation.
At a high level, the process to obtain disability compensation is as follows:
• The Veteran provides information and VA forms (referred to as a claim), documenting their injury that occurred during military service and continues to affect them.
•    VA staff review information, comparing it with the relevant rules and regulations, to determine if the Veteran qualifies.
•    VA decides to grant, and at what level, or deny benefits and informs the Veteran.
Here are the top reasons a claim is denied, with a brief explanation. Avoiding these increases the likelihood of a favorable decision.
• The stated condition was not present - Disability compensation is based on an injury that occurred during service and continues to affect the Veteran at the time a claim is filed. There is no basis for this benefit if the injury isn't present when filing. 
•    Didn't demonstrate injury occurred during service - To qualify for this benefit, the injury must occur during one's military service. It must happen during active duty or inactivity duty under certain circumstances, or else this benefit isn't relevant. 
•    Didn't demonstrate the connection between current condition and what happened in military service – Disability compensation addresses a current condition that exists because of an event that occurred during military service. Critically, it depends on demonstrating the link (or Nexus) between what the Veteran is currently experiencing and what happened during military service.
• The condition was preexisting and not due to military service-conditions that existed prior to military service should be documented. If the condition remained unchanged during military service, disability compensation would not apply. However, if the condition worsened because of military service, disability compensation would be granted.
•    Veteran didn't attend required medical examination -A may request a Veteran who has applied for disability compensation to attend a medical exam, formally called a Compensation and Pension Examination. (This is generally referred to as a C&P exam.) VA does this when more information is needed to make a decision. The rules are straightforward: Failure to attend the exam will result in the claim being denied.
•    Veteran provided incomplete information or used wrong forms – Attention to detail when applying for disability compensation is critical. All needed information must be supplied. This can be complicated as medical information can be in multiple formats and contain terms that most are unfamiliar with. In addition, the proper VA Forms must be used. Again, this can be complex because of their titles and numerical designation.  

Need help?
You can get no-cost assistance from a Veteran Service Officer, who can help you complete the forms and file your claim. Service Officers have been trained in VA processes. Look for one who is "Accredited" by the U.S. Department of Veterans Affairs, indicating they keep up to date with training and have passed a background screen.
Service Officers are available from:
•    The American Legion
•    Disabled American Veterans (DAV)
•    Paralyzed Veterans of American (PVA)
•    Veterans of Foreign Wars (VFW)
•    Wounded Warrior Project
You can also access a Service Officer from your state Department of Veteran Affairs/Services. Some counties also provide Service Officers. A quick internet search should allow you to find one or both of these near you.

Paul R. Lawrence, Ph.D., served as Under Secretary of Benefits at the U.S. Department of Veterans Affairs from May 2018 to January 2021. He is the author of "Veterans Benefits for You: Get What You Deserve," available from Amazon.