VA's "Denial Tool box"

[broncovet]

VA has many ways to deny you, and has some tools to help them do just that.  Im gonna list "some" of those "denial tools" WHICH may help you.  

   1.  Filing an appeal late.  This is an easy one for VA.  If you file a VARO appeal "beyond the 1 year time period", its immediately denied as not having been filed timely.  It works every time for them, not so good for you.  Fix:  File your appeal on time next time.  If you have already missed your appeal deadline, its much harder.  Try filing a supplemental claim, especially with new evidence.  

   2.  Failure to attend a c and p exam.  This is a VA favorite tool.  They love denying Vets who fail to go to exams, "at least some of the time" even when you did not get notice of the exam.  If you get an exam letter late, after the exam, be sure and call to reschedule the exam.  Ditto if you could not make the c and p exam due to illness or other important reason.  Fix:  Keep VA informed of your change of address, and show up for scheduled c and p exams, when possible.    (The VA sends the exam notice to "your last known address", and its important you keep it updated when you move). 

  3.  Veterans failure to respond to VA's "request(s)" for information.  As an example, if the Va requests information as to the dates/times/stressor for your PTSD claim, and you dont respond, expect a denial.  Once again, it helps to prevent this when you:

     A.  Read and respond to VA letters sent to you.  (Ask for help if you dont understand what they want, hadit memembers may be able to help). 

     B.  Keep your address/phone/email up to date, and inform VA when they change.  

 4.  "Abandoned claims".  The VA can consider your claim abandoned, for example, if they mail you a claim form, and you dont fill it out and send it in.  Fix:  Comply when VA sends you a claim form by filling it out properly and mailing it in, or send it electronically to VA.  

5.  Losing/shredding Veterans key evidence.  This may be VA's "all time favorite" method of denial.  Do you have a favorable nexus?  Expect VA to lose that, and you will rarely be disappointed.  Its happened to me multiple times.  Fix:  Keep a copy of your records and dont trust VA to keep them for you.  Send documents to VA via registered/certified mail and keep a copy. Do not trust VA's record keeping of your documents, when they have a "vested interest" in losing them.  

 

[Dustoff1970]

Yes to number 5 for sure.  After 30 years and many successful claims and appeals I can say their number one chicken chit reason given for denial is "no evidence" even when you sent them solid positive and favorable medical evidence to support your claim and even after they listed this evidence in the denial decision letter they still lie and say no evidence.

On appeal the BVA granted me at least two of my appeals based on the same evidence denied by VARO lousy raters.

[broncovet]

Agreed, Dustoff.  

    Almost all of these things can be fixed and Vets get a favorable outcome provided the Veteran do these 2 things:

1.  Knowledge is power.  You can get knowledge for free here on hadit, and/or we can point you where to get that knowledge if we dont know the answers.  

     But, the one thing we can not give you:

2.  Persistence.  Just keep trying until you win.  Never give up.  The VA will wear you down.  If you are worn down, like I was, I contacted a law firm and let them fight for me.  It wound up costing me "less than nothing" because all the retro I got, I would not have gotten as VA "exhausted me" after fighting me for more than a decade.  They did not count on me turning it over to an attorney, because the attorney has a "dog in the fight" and fought for me.  Mostly, EAJA paid virtually all of my attorney fees, anyway.  

     The VA has a tool box, but we have tools also!  We have the 38 cfr's, and, we also have at our disposal attorneys who will fight for us.  

Edited August 15, 2023 by broncovet

[El Train]

The one that got me, is no ongoing treatment after service.  Even though this is not a legitimate excuse to deny.  They still use it.  Even with support letters and a Dr's IME stating 'more than likely than not' connected to accident in service as the cause.  What's crazy is I got TBI connected for same accident and had no ongoing treatment for that.

I'm 100% P&T SMC-S or I'd fight the hell out of it and win.

[broncovet]

This is because the VA confuses "symptoms" with treatment, to effect a denial.  

You see, not every condition has a great treatment result, and not every Veteran seeks treatment in the same way, but can still suffer symptoms.  

Some Vets elect "no treatment" but simply suffer the symptoms in silence.  This does not mean the symptoms dont affect you, its just that many elect to "suck it up" , like we were told to do so frequently in the military.  Other Veterans self medicate, sometimes with things like alcohol to kill the pain.  

Veterans are compensated for "symptoms", not for treatement.  We dont get paid to go to the doctor.  

Further, many Vets "dont trust the VA" and seek alternative treatments.  Generally, the VA "earns" their reputation of mistrust of Veterans, by doing things like persistent, unnecessary delays, as well as bogus denials.  

BOGUS DENIALS: definition

    A bogus denial happens when VA cant think of a legit denial and makes one up, instead, which is not

in the required criteria.  

     ONE example of a bogus denial:  VA denied my hearing loss "because it was too long since military service".  Bogus.  "Length of time since military service" is not one of the criteria for rating hearing loss.  

FIX:  If the reasons and bases for denials, is "not" in the criteria, then its bogus and should be appealed or CUE'd.  IF IT SOUNDS BOGUS, IT PROBABLY IS.  

 

 

[Vync]

@Dustoff1970 Same thing happened to me when I filed my initial claims after service. The claim form and a full copy of my service treatment records were sent in the same envelope. Not long after, I got a denial letter saying my STRs were silent for all claimed conditions. My VSO actually decided to lift a finger on this one and found they made the decision based on the contents of my claims folder which was practically empty. The misplaced STRs were never located, so they were resent...

@broncovet Agree regarding symptoms. Don't forget how they also rely on continuity of symptomology against the vet. The vet can say the issue bugs them daily or weekly, but because they didn't go to the doc there is nothing documented, thus it gets denied.

Edited August 16, 2023 by Vync

[Dot09]

What frustrates me the most which isn’t added is how our pcp or psych dr takes notes. Often they poorly reflect the symptoms that we experience. Often I tell my psych dr my problems and it goes in one ear and out the other. He’s more focused on getting you in and out. But back to the issue is when you get an imo that actually listens to you and they don’t equal the same as the Va notes. So the VARO or dro basically state that your Va records don’t reflect the severity as your imo and discredit it. Hopefully the BVA sees through the bs.