Appealing Veterans Disability Benefits claim denials
Find out how long you have to appeal denial of Veterans disability claims. Learn the steps in the appeal process, what to expect from a hearing, and how to get help with your appeal.
If your claim for disability benefits is denied, you have the right to appeal. You must file the appeal within one year of the initial decision. Much media attention has been given to the high error rate in denials, so it makes sense to consider appealing the denial. Appeals represent almost one-third of the 800,000 pending veterans disability claims. A recent report found that the Board of Veterans Appeals found mistakes in 73% of reviewed cases.
What you can appeal
According to the VA, an appeal is “a request for the Board of Veterans’ Appeals to review a local VA office decision on your claim.” You have the right to appeal the decision for any reason. You may have received only a partial denial, while another part of your claim was approved – in that case, you can appeal the partial denial. Or, if the VA granted your disability claim, you can appeal the level of benefits awarded.
According to the VA, the two most common reasons for appeals are:
- The VA denied benefits for a disability the veteran believes began in military service, and
- The veteran believes the disability is more severe than the VA rated it.
Appeals of local decisions are made to the Board of Veterans’ Appeals (also known as “BVA” or “the Board”). The Board is part of the VA and is located in Washington, D.C. The Board members are attorneys with experience in veterans issues.
The appeals process
Filing an appeal is a two-part process. You begin the appeal process by sending a form called a “Notice of Disagreement” to your local VA office. You have to file your notice within one year from the date the VA mailed its initial decision. After the local office receives your Notice of Disagreement, it will prepare and send you a Statement of the Case. The Statement will explain the evidence, laws and regulations relied on to decide your case. Along with the Statement, they will send you a Substantive Appeal Form (VA Form 9).
The second step you take in filing an appeal is to fill out the Substantive Appeal Form. In this form, you state the benefits you are seeking, identify any mistakes in the Statement of the Case, and clarify whether you would like a personal hearing. The Substantive Appeal Form is also supposed to be filled out within one year from the date of the VA’s initial decision. However, if the VA sent you its Statement of the Case near the end of that year, you still have 60 days from the date that they mailed you the Statement of the Case to file your Substantive Appeal Form..
For example, if the VA mailed you its initial decision on November 1, 2012, you file your Notice of Disagreement on February 1, 2013, and the VA mails you its Statement of the Case on October 20, 2013. You would have 60 days from October 20, or until December 19, 2013, to file your Substantive Appeal Form.
You can request a personal hearing, either with someone from your local VA office or with a Board of Appeals member. The quickest way to get a hearing with a Board member is via videoconferencing.
Hearings are informal, and you can attend with your representative. They are mostly an opportunity to clarify the issues at hand. After the hearing, the Board member will send you a decision. If they deny the appeal, you have certain additional avenues to contest the appeal.
Getting help – Most people use representatives
Most veterans use representatives to help make their case on appeal. Anyone helping a veteran with an appeal must be accredited by the VA. You can receive assistance from various Veterans’ Service Organizations, like the American Legion and the Disabled American Veterans, and many have staff inside local VA offices. Or choose to be represented by a VA-approved attorney who is experienced and knowledgeable on VA disability matters.
See the article Can Veterans Disability Lawyers Help? for more information.
The appeals process can take years, unfortunately, so consider any advantage you can take to speed along your claim and to make it thorough. Seeking help from a VA approved disability attorney can help you present your case as clearly and strongly as possible to improve your chances of collecting your disability benefits.
For more information on filing an appeal, see Strengthening your VA disability appeal.