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When To Hire A VA Appeals Lawyer

Last updated: April 12, 2023

The VA disability compensation system is supposed to make the claims process as simple as possible for veterans, but it's possible for everyone to become confused by the laws and regulations governing it. Furthermore, the large bureaucracy of the VA can be confusing, and the VA claims process isn’t as straightforward as it should be. 

If you want to know more about hiring an attorney in seeking disability compensation from the VA, continue reading below. 

Types Of VA Disability Compensation Claims

There are generally three ways to apply for disability benefits, each with a unique time frame for receiving payments.

Decision Ready Claims Programs

The VA's Decision Ready Claims (DRC) program is the quickest way to apply for disability compensation. This program requires your cooperation with an accredited Veterans Service Organization (VSO), yet it often handles claims in 30 days or less.

As of now, the only types of claims the DRC program processes are:

  • Conditions that began during, or caused by, service (Direct Service Connection Claim)
  • Conditions that are believed to be caused by military service with no direct evidence (Presumptive Service Connection Claim)
  • Conditions caused or made worse by a service-connected disability (Secondary Service Connection Claim)
  • A current disability claim that is medically proven to have gotten worse (Increased Disability Claim)
  • Claims for eligible surviving spouses (Dependency and Indemnity Compensation Claim)
  • Claims for service members with less than 90 days before separating from the military (Pre-Discharge Claim)

The DRC program has additional limitations on filing. To ascertain whether the DRC program is appropriate for you, it’s best to consult with your VSO.

Fully Developed Disability Claims

The Fully Developed Disability Claims (FDDC) program is the following quicker choice. 

The main distinction between the FDDC claim and submitting a regular claim is that the Veteran must provide all evidence upfront and affirm there’s no further proof needed to make a claim decision.

At the very least, the Veteran should provide:

  • All military personnel records on the condition;
  • All service treatment records on the condition;
  • All private (non-VA) medical records on the condition; and
  • All VA health records or supplementary information about related VA health records that the VA can request on your behalf

If the VA requires additional information or evidence, the claim typically gets removed from the FDDC program and is processed as a standard claim instead. 

Standard VA Disability Claims

The VA compiles all supporting documentation and gathers evidence for standard VA disability claims.

The VA may need your assistance if they are unable to obtain a certain document. Records and documents that aren't kept by a federal agency usually require assistance, such as confidential medical records, employer information, and government records.

As with all claim programs, be ready to present your DD214 (or other separation documents), service treatment records, VA medical records, and private medical records about your claim. Anyone in need of assistance with their VA disability claim has the option to work with a certified lawyer, claims agent, or Veterans Service Officer (VSO). 

How To Apply For VA Disability Benefits

The Department of Veterans Affairs advises qualified Veterans to use the VA's online eBenefits system to apply for disability compensation benefits. However, Veterans may also submit an application by mail using VA Form 21-526EZ, in person at their regional benefits office, or with the assistance of a qualified expert. 

In any case, you will require access to your DD214 (or equivalent discharge or separation documents), the medical evidence of your handicap, and any dependency records (marriage license and birth certificates for your children), if applicable.

After filing your application for disability benefits from the United States, you may have to wait for quite some time. As of June 2021, it takes the VA an average of 134.4 days to make a decision about VA benefits. If your application is denied and you want to appeal the decision, you may have to wait a longer period of time since it takes approximately 125 days for a Supplemental Claim or Higher-Level Review and more than one year for a Board Hearing. 

Common Reasons Why VA Disability Claims Are Denied

In order for military veterans to receive their disability benefits for any disease, injury, or disability incurred during service, their application must first be approved by the Department of Veterans Affairs. However, guaranteeing monthly compensation and disability benefits is not easy. If you submit your claim without following the correct procedures, they can outright reject your request.

Veterans whose claims are denied will get claim denial codes detailing the specific grounds for their rejection. They are allowed to appeal, but the process of actually doing so can be drawn out and difficult. 

In some instances, the Veterans Benefits Administration takes 12 to 18 months to review appeals and decide whether to accept all or only a part of them. Furthermore, it may take 5 to 7 years for a Veterans Law Judge to respond to your request for a review at the Board of Veterans' Appeals. 

Misinformation Or Incomplete Form

Just like with any other benefits application, the success of your claim might be seriously hampered by the failure to provide proper information on the forms. Veterans must complete certain information on VA disability forms regarding:

  1. Their personal information, including contact information and family details
  2. Their previous military service
  3. Their medical history
  4. Any evidence proving disability, such as medical records and visual documentation

The VA's ability to approve your claim will be hampered if you omit vital information or skip over a specific document section.

Your condition doesn’t qualify as a disability

You must first demonstrate that your disability is diagnosable in order to be eligible for disability benefits. Back pain, exposure to Agent Orange, and TCE exposure are not sufficient for a diagnosis. However, your condition can be identified if exposure to the said chemical compound results in a medical issue.

Psychiatric conditions like PTSD may qualify a person for disability benefits. However, without a diagnosis to explain your symptomatology, it can be challenging to assess your mental health and communicate this information to the VA. 

Therefore, your doctor must provide an accurate explanation of the results of your diagnosis in the medical record you intend to use as proof. A lack of explanation of your condition and symptomatology could lead to a weak claim, which means a higher chance of being rejected.

Your Ailment Isn’t Related Ro Your Service

The dreaded "VA claim denied not service connected" statement on your account indicates that the rater does not believe your handicap was made worse while serving in the military.

Only veterans of war with exacerbated wounds or disabilities acquired while deployment are eligible for benefits reimbursement from the VA. This implies that in order to qualify for disability benefits, you must show a connection between your symptoms and your military service.

Even so, the VA rater could not accept the provided documentation as support for an injury or condition that worsened throughout the course of your service. Presenting medical evidence, such as doctor diagnostic reports outlining how your ailment was brought on by your prior service, will help convince the VA. 

Should I Hire An Attorney?

As you can see, the requirements to receive disability benefits from the VA are complex and confusing. Even if you think you have a strong case, the VA might argue otherwise. Once the VA makes a decision, it is tough to appeal and get a reversal. 

Also, if you have been denied VA benefits unfairly, have received incorrect information that can hurt your claim, or wish to file an appeal, then you shouldn’t hesitate to seek legal representation. These are instances where hiring an accredited VA attorney is absolutely the right move. Without sufficient knowledge of the ins and outs of disability law, one’s chances of reversing a denial are greatly diminished.

Which Attorney Should I Hire?

Your lawyer must be capable of handling your case and knowledgeable about veterans' law. You should check an attorney's credentials before hiring them to make sure they are:

  • VA-Accredited: Veterans in disability cases may only be represented by lawyers who have received accreditation from the VA.
  • Experienced: The potential outcomes of your disability claim, how to determine when your condition started, and what is required of you along with the appeal procedures should all be carefully and clearly explained by your lawyer.
  • Dedicated: Your attorney should be prepared to represent you throughout the duration of your case, including the highest levels of appeal.

Are you interested in knowing how you could get a TDIU and receive its benefits? Just visit Disability Help today to learn more.

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Cheri Hermanson
Cheri leads our team of writers in producing the best quality content there is regarding society and disability, most especially those that helps ease the quality of life for our differently-abled loved ones.
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