Tacoma Disability

In This Article

Denied Disability Claims: Options for VA Service Connection

If you’ve been denied a VA Service-Connected Disability claim, you have several options open to you!

Depending on who you talk to you may not be aware or understand all the options you have.  On the other hand, it’s very possible someone hasn’t told you all your options on purpose.  There is a significant difference between VA Accredited and just someone helping out.    

This is going to be brief on your options.  We will lay it out for you, with candor, the benefits, and drawbacks of each option.  As we cover the options, it’s important for you to realize that your claim is yours.  

At the end of the day, you’re going to be the person most benefited by good representation or most harmed by bad. 

Generally speaking, you have five options when facing a denial of your service-connected disability claim 

First: Go it Alone

The process of representing yourself through the VA Service-Connected Disability appeals process is possible.  There is a wealth of knowledge available online to help you in understanding the fundamentals.  If you’re quick on the uptake, even the more advanced issues of process & hearings are something you can work through.  However, be cautious about jumping straight in on this.  The big risk you face by going it alone is inadvertently harming your own appeal.  You could do this through your lack of knowledge and experience in the appeals process, and you can do it through dozens of other means.

We should note that of your options, this is probably the least advisable in the general context.  But if you are familiar with claims processes, Veterans issues, the VA itself, you could certainly do well at a Board of Veterans Appeals (BVA) hearing.

And to add in another cautionary note about this method; depending on your claim, by being able to represent yourself well, you might hamstring your appeal.  If, for example, you are appealing that you should be 100% PTSD / TDIU and you are able to represent yourself well in a number of stressful situations.  A judge may view this as inconsistent with your claimed symptoms, and because of this… deny your appeal.

Second: Get help from a Friend

VA regulations allow for anyone to assist another Veteran,  at least once, in developing a claim for appeal.  So you might still be in luck if you know someone who isn’t VA accredited but for some reason, they REALLY know the system well.  Having a friend represent you or help you closely in representing yourself is a viable option.  If your friend knows what they are doing.

Third: Retain a Veterans Service Officer (VSO)

You can engage a Veterans Service Officer (VSO).  VSO’s are trained by their organization which is accredited by the VA.  By being part of the accredited organization they are seen as VA Accredited themselves.  However, the quality of VSO’s varies wildly from superb to extraordinarily sub-par.  The reasons for this come down to initial training, supervision, funding, ongoing training, and personal factors.

If you choose to pursue this course, you need to remember that you can change representatives at any time you choose.  Interview several VSO’s and work with someone who YOU get along with.  You will be wanting to have a good relationship with your VSO when hiccups arise in your appeal (they likely will).  More importantly, you want your VSO to be able to speak with knowledge about your specific claim.   If the appeal requires a hearing in front of a Board of Veterans Appeals (BVA) judge, a VSO with deep knowledge of your history and claim is priceless.

However, keep in mind that many VSO’s fall into the under-resourced category.  There are thousands of VSO’s, but only a few of them do it as a full-time, paid, gig.  Most are volunteers.  A majority of them, even though volunteers, spend a great deal of time educating themselves on the processes and changing laws associated with VA disability.  By and large, the good outnumber the bad.  VSO’s are truly those committed to supporting Veterans in our communities.

The true Achilles heel for many volunteer VSO’s is the lack of an accountable paper-trail.  This falls back on resources.  It takes a deliberate effort and dedicated staff to maintain hundreds of different forms, doctor statements, historical records, service records, contact records, and everything else that is or even could become material to a claim.  VSO’s are excellent for getting a claim filed and introducing you to various other benefits within your community.  But unless you’re working with a paid VSO, it is “more likely than not,” that a complex claim or appeal is going to be a challenge for the VSO

The cost of this option is, free…  In some cases you’re going to be getting a great value, in others, you’ll be getting what you paid for.  Shop around until you find a VSO you like or consider another option.

Fourth: Retain a VA Accredited Claims Agent.

VA Accredited Claims Agents are non-attorney, non-VSO representatives.  They are accredited through the VA Office of the General Counsel after having passed a background check and a test on VA Law and processes.  Claims Agents, like attorneys, are authorized to collect a fee for their representation (20%).  The fee is collected only when an appeal is decided on the Veterans behalf.  And the fee is deducted directly from the Veteran’s award.  It is paid directly to the Agent by the VA so the Veteran never cuts a check from their own pocket.  Instead, the fee is subtracted from the award and the Veteran receives a diminished back-pay award.

One big downside to VA Claims Agents is that there are few of them.  Moreover, they are often accredited so that they can provide financial advice for Veterans in elder law & pension planning situations.  Many of them don’t represent Veterans in disability claims and appeals.

VA Accredited Claims agents have to pass an in-depth knowledge and procedures based test to initially receive their accreditation.  In addition to this, they must have personal references and work through a process just as mysterious, cumbersome, and at times opaque as any disability claim.

Anecdotally, it’s been noted by one particular claims agent that they had to call 10 different people before he could get ahold of the Assistant General Counsel in charge of pushing their Accreditation request through.  It was only after using highly advanced phone tree skills and dogmatic persistence that the agent was able to schedule his accreditation test and move forward to become accredited.  To become a claims agent can require much of the same skills that will be required to successfully pursue your case. Either way, many/most claims agents have spent years working within the systems of the VA and are intimately familiar with its failures.

Claims Agents come in three basic varieties..

1) Claims Agents that work for a law firm that represents Veterans in disability or some other form of law.  In this case they fill-in as a paralegal-like specialist.  And in some firms, they do the advocating and argue claims in front of the Board of Veterans Appeals judges.  

2) Claims Agents that work for themselves.  These agents represent Veterans on their own.  Independent of any law firm or Veterans Service Organization.  

3) Claims Agents that work for financial planners.  There are some benefits that only allow for accredited agents or attorneys to give advice.  Some financial planners rely upon Claims Agents to advise and coordinate wealth planning with certain Veterans disability benefits, such as Aid and Attendance.  

Because of a Claims Agent’s advanced VA knowledge, they are often great to seek for support on simple or medium complexity claims, and for advice on situations that bleed over into other areas of Veterans benefits.  However, most agents will not provide you support on initial claims as there is no way for them to get paid to do so.  The VA only allows for compensation/fee collection in appeals claims that are successfully appealed (this is true for attorneys as well).

Many Claims Agents have a more difficult time working on medium to more complex VA disability claims unless they are paired with a law firm.  It comes down to procedural support.  There are only so many forms, so many briefs, so much research, so many classes, and so many phone calls one person can handle.  Add in running the business and going several years on a typical claim before a payoff, and you can see why there are so few independent Agents.

Fifth: Retain a VA Accredited Attorney

Lastly, you can bring in an attorney to help you with your appeal claim.  Like Claims Agents, Attorneys are also accredited through the VA Office of the General Counsel.  

But this is where things are slightly different. Here’s a dirty little secret in VA law..  To obtain VA Accreditation as an attorney is very easy.  All you need to do is file a form.  Unfortunately, there are MANY attorneys that are accredited on paper, but only a few that actually do represent Veterans.  Of those few, fewer still have the breadth of knowledge to provide a value-added vs Claims Agents or VSO’s.   Heck, VSO’s are free!

So why would a Veteran want to use an attorney vs a FREE VSO?

First, consider attorneys for VA disability appeals only.  It does a Veteran no good to seek an attorney to help them for initial claims.  In fact, one could easily point out there can be a conflict of interest for attorneys filing initial claims for Veterans.  If the Veterans claim is denied, and they use the attorney to appeal, the attorney can then collect a fee.  Where if the attorney developed the initial claim to the point of success in the first place, they would not be able to collect a fee at all.  The incentive is 100% at the appeals level for attorneys.  Attorneys that are eager to lock up your power of attorney at the initial claims level should raise your eyebrows and suspicions.

The real strength of working with a law firm at the appeals level comes from process control.  Disability law, in general, is very competitive, these competitive forces have made it to where only the most efficient succeed in this industry.  Firms that succeed have a rock-solid process, don’t lose paperwork, communicate well with clients, and differentiate themselves through excellence.  If you have an appeal, especially something where you have >30% in one or more areas being appealed, this is when a good law firm starts to make sense.  They are set up from the ground up to handle evidence gathering and claim development.  VSO’s and independent claims agents just don’t have the same process control for more complex, longer-term claims.

We alluded to this in the last paragraph; if you’re going to work with an attorney for a VA Service Connected Disability claim appeal, you would be well served to seek one that has experience in disability law.  Especially one that knows Social Security Disability.

Again!  Choose your representative wisely.   You want to work with an attorney that has a caseload of Veterans already.  They should be able to quickly and casually speak to various issues involved in pursuing a VA claims appeals.  You don’t just want any attorney, you want an attorney that knows how to advocate in disability law, AND in VA Law.

There are several key benefits in working with a VA Accredited Attorney 

Attorneys that practice a lot of VA & Social Security Law often have a rock-solid internal process setup.  Claims don’t “get lost” when a good firm is working on them.    

Law firms have a financial motivation to win an appeal.  This can cut both ways, it does mean that they may not take every case, but it also means that if they take your case they believe they have a strong chance of succeeding in the appeal and will make every effort to do so.  

If your case is determined against you, you’ve already built a relationship with an attorney that can represent or refer you for a further appeal before the Court of Appeals for Veterans Claims (CAVC).

If you do Opt to Hire a VA Attorney, You Should Hire one that Also Does Social Security

Both the Veterans Administration and Social Security Administration have disability benefits. In Social Security there are two programs Supplemental Security Income (SSI) & Social Security Disability Insurance (SSDI). SSI is designed to provide for the basic needs of the aged, blind, and disabled. While SSDI is basically an insurance advance for workers who become disabled before retirement age. These are similar to programs in the VA, the non service connected disability (VA pension), and service connected disability (compensation).

SSI & VA Pension

SSI is very similar to VA non service connected disability, also known as a VA pension. In fact, the basic qualification for a non-service connected disability pension is that a Veteran would otherwise be qualified to receive SSI.

The easiest way to determine whether or if you would be qualified to receive SSI is to apply for SSI.  (And/or talk to a Social Security Lawyer.  You can imagine, this is not always a black and white case though. Only about 1 in 3 of those that apply for Social Security are awarded initially. At the VA, your odds aren’t really that different.

Applying for both is your workaround on this, but it comes at a risk…Overpayments.

There are overpayment risks if you are eventually awarded both SSI & VA pension. You need to have someone who is ready to jump in and advise you through both processes as you go through them.

As much of a risk as overpayment are, if you work with a good lawyer, you can minimize them. And you can do this while literally doubling your chances of success upfront. Once you get one success, in VA or SSA, your lawyer will then use it as a fulcrum to start seeking the best possible mix of SSI / VA pension benefits.

SSDI & VA Service Connection

SSI & VA Pension are much closer to each other than SSDI and VA service connection. In fact, SSDI and VA service connection aren’t altogether similar at all. But they do have one very strong thing in common. Unlike SSI & VA pension, You can collect BOTH SSDI and service-connected benefits at the same time.

This is a significant point. The average SSDI award is about $1,300 per month, and VA disability rates can be more than $3,000 per month in some cases.

It’s not uncommon that the reason you are now disabled from working is from injuries you sustained while serving in the military. And in the reverse, it’s not uncommon that injuries sustained while in the military have worsened over time. Essentially making you unable to work, despite your heroic attempts to compensate for your injuries or illnesses.

Brining it Together and Making it Simple

The real test of skill and commitment of a VA & SSA disability lawyer is being able to tease out the connections between your experiences. Both your experiences in the military and wherever your journey has taken you since your service are material to the success of your claims. When knowing this background information, a skilled disability lawyer will be able to craft a plan that pursues both Social Security and VA benefits. Which will result in you increasing your chances of success and maximizing your benefits awards.

In Summary

Here’s a little cheat sheet to help you in figuring out who to work with for VA disability.

VSO – Best for Initial Claims and connections to benefits in general

Claims Agent – Best for Simple to Medium complexity Appeals.  If part of a law firm can handle complex cases.

Attorney – Best for all levels of appeals especially those >30% and/or of multiple disability claims.  Also best for cases that span multiple areas of law.

Recent Posts

Is This Article Helpful? Share & Care!