What is the Best Way to Appeal a VA Claim?
Navigating the complex process of appealing a VA (Veterans Affairs) claim can be frustrating, but the path to obtaining the benefits you deserve doesn’t have to be difficult with the right guidance and support. If the VA denies your claim for disability and healthcare benefits, you may choose to appeal to obtain the benefits you believe you are entitled to.
The appeals process exists to ensure fairness and proper evaluation of VA claims. Veterans have the opportunity to appeal, enabling them to provide supplementary evidence, rectify mistakes, and pursue a more precise assessment of their entitlements.
Veterans currently receiving VA benefits can appeal a claim for other reasons, including insufficient disability rating, new evidence, worsening condition, loss of income, and other reasons. If they feel their compensation, determined through the current VA rates system, is too low, they may choose to appeal for a higher rating. For example, if you have a condition that worsens and it becomes more debilitating, you may be entitled to increased compensation. Appeals can be pursued to reflect these changes.
Types of VA Claims
The VA offers three main options for appeals, called appeal lanes, including (a) Supplemental Claim, (b) Higher-Level Review, and (c) Notice of Disagreement (NOD) to the Board of Veterans’ Appeals (BVA). Although the types of appeal lanes generally apply to various claim issues, including malignant mesothelioma, the specific circumstances and evidence involved may vary.
VA Higher-Level Review
The Higher-Level Review lane allows veterans to request a more senior VA adjudicator to review their claims. In this process, veterans cannot submit new evidence. Instead, the reviewer will reassess the existing evidence and any previous decisions made. The goal is to identify errors in the initial decision-making process, such as misinterpretation of evidence or a failure to apply relevant laws or regulations to ensure a proper VA Higher-Level Review. Correcting errors in a higher-level review is not that uncommon. When there is an error, the BVA will close the review and open a new claim.
VA Supplemental Claim
The Supplemental Claim lane allows veterans to submit new and relevant evidence to support their claims. It is an opportunity to introduce additional medical records, expert opinions, or other evidence not previously considered. This lane is useful when there is new information, such as a diagnosis of one of the types of mesothelioma, or when the initial decision was based on insufficient evidence.
Ensure the inclusion of evidence directly relates to the appealed issues. Evidence For example, if a veteran was initially denied benefits related to mesothelioma due to inadequate medical documentation, they can gather new medical records, test results, or a medical expert’s opinion to support the appeal. Additional documentation of asbestos exposure at shipyards or other military property could help an appeal.
Notice of Disagreement (NOD) to the Board of Veteran’s Appeals (BVA)
If you disagree with the decision after going through the previous two appeal lanes or if you want a direct review by the BVA, you can file a Notice of Disagreement appeal. This initiates the appeals process at the Board level. Following the NOD, the VA gathers additional evidence relevant to the claim, such as medical or service records.
The appeal is then docketed, entering the BVA’s caseload, and veterans have the option to request a hearing before a Veterans Law Judge, where they can present their case, provide oral arguments, and submit additional evidence. After a thorough review of all the evidence, the judge will make a decision. If dissatisfied with the judge’s decision, veterans can pursue further appeals through the U.S. Court of Appeals for Veterans Claims (CAVC) and potentially the U.S. Court of Appeals for the Federal Circuit.
Step-By-Step Guide to Appealing a VA Claim
When it comes to appealing a VA claim, there are several steps you can take to improve your chances of a successful outcome. With over 100 years of experience, Mesotheliomavets.com has gained valuable insight into successfully and properly following the VA claim process, explained below.
Step 1: Understand the Decision
Start by carefully reviewing the decision letter you received from the VA. Pay close attention to the reasons provides for denial or the aspects of your claim that were not granted. Understanding the specific issues will help you build a stronger appeal.
Step 2: Determine the Appropriate Appeal Lane
Choose the lane for appeal that aligns with your circumstances and desired outcome. Each lane has different requirements and implications, including Supplemental Claim, Higher-Level Review, and Notice of Disagreement (NOD).
Step 3: Gather New Evidence
Collect any new evidence supporting your claim if you believe the decision was incorrect. This can include medical records, reports of mesothelioma treatments you received, buddy statements, expert opinions, or any other relevant documentation. New evidence is crucial for a successful appeal.
Additional evidence that can prove military asbestos exposure occurred and caused your condition can significantly help your case. Exposure to asbestos and other carcinogens while serving in the military has been linked to various diseases that require complex treatment.
Step 4: Seek Professional Assistance
Consider reaching out to a Veterans Service Organization (VSO), such as the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW), or similar organizations. VSOs can provide free assistance and guidance throughout the appeal process. They have experience with VA claims and can help you navigate the complexities.
Step 5: File the Appeal
Prepare and submit the appropriate appeal form to the VA within the required timeframe. This step is where you will submit your evidence of asbestos poisoning or other health conditions. Make sure to follow all instructions carefully and include any supporting documentation. Retain copies of everything you submit for your records.
Step 6: Request a Hearing
If you choose the NOD lane, you can request a hearing before a Veterans Law Judge. A hearing can provide an opportunity to present your case in person, clarify any issues, and address any concerns directly. Requesting a hearing is generally advisable, as it allows for a more comprehensive review.
Step 7: Stay Patient
It helps to be persistent and patient. The appeals process can be lengthy and can take months or even years to reach a decision. Stay informed about the status of your appeal and be prepared for potential delays.
Step 8: Consider Seeking Legal Representation
If your appeal reaches the stage of a BVA hearing, you may want to consider hiring a VA disability attorney who specializes in VA claims. Legal representation for veterans can provide additional expertise and advocacy.
Veterans who were diagnosed with mesothelioma may be eligible for VA compensation. To find out if you qualify, speak with a patient advocate today.
Types of VA Disability and Health Decisions
Decisions can be appealed if a veteran disagrees with the outcome. Decision processing time varies based on factors like case complexity and volume. The average wait time for an initial VA claim decision can take up to 100 days or more, while the wait time for an appeal decision at the Board of Veterans Appeals could range from several months to over a year.
Medical Determination Claim Decision
The medical determination decision involves the VA’s evaluation of a veteran’s medical condition, determining its severity of symptoms, service connection, and impact on disability claims. It establishes eligibility for VA disability benefits.
Health Benefits Claim Decision
The health benefits decision determines a veteran’s eligibility for various healthcare services and benefits provided by the VA. For some mesothelioma patients, this can help veterans receive treatment at some of the top VA treatment centers.
What Are the Chances of Winning a VA Appeal?
Assessing the chances of winning a VA appeal can be challenging as it depends on various factors specific to each case. However, following the steps listed above can influence the outcome and improve your odds of success. Strong evidence obtained through medical records and expert opinions is crucial as it demonstrates the link between your condition and military service. Mesothelioma patients often work with attorneys to help them prove asbestos exposure during military service occurred.
Veterans face elevated risks of developing a disease due to asbestos exposure. Before the government recognized asbestos as a health hazard, the military used it for various applications, such as insulation inside ships. Diseases caused by asbestos are rare and can be costly to treat, demonstrating the importance of obtaining VA benefits.
Each VA claim is unique, and the specifics of your case may require tailored advice. Consulting with a VSO or an attorney experienced in VA claims can provide you with personalized guidance based on your circumstances.