Three Frequently Appealed Issues of VA Disability Rating Decisions
When a veteran receives their rating decision from the Department of Veterans Affairs (VA) for VA disability benefits, the veteran has the opportunity to appeal if the decision is unsatisfactory. There are three frequently appealed issues that veterans appeal on: service connection, evaluation, and effective dates. The following sections discuss each of these topics.
Service Connection
There are three essential elements to service connection: 1) a current disability and 2) an event during military service 3) with an established nexus between the veteran’s disability and the military-service. Service connection is the preliminary requirement for a veteran to receive disability benefits for their disability. If the VA grants service-connection, the rating decision will provide an evaluation and effective date for the disability. If the VA denies service-connection for the disability, then the rating decision will not provide an evaluation or effective date for the disability.
If the VA does not grant service connection for the veteran’s claimed disability, the veteran may appeal the decision. The veteran can appeal through one of three ways. One, the veteran may appeal through a Higher-Level Review where the case will be reviewed without the submission of new evidence. Two, the veteran may appeal through a Supplemental Claim where the veteran can submit new evidence with their appeal. Three, the veteran may appeal directly to the Board of Veterans Appeals (BVA). For an appeal to the BVA, the veteran may request a direct review without the submission of new evidence, submit new evidence, or request a hearing where submitting new evidence is optional.
If the veteran files an appeal through a Supplemental Claim or appeals to the BVA with eligibility to submit new evidence, the veteran can submit additional evidence if it is new and relevant. This means the evidence must be other than what has been submitted in the past and must address the issues on appeal. New and relevant evidence to establish service connection may appear in the form of additional VAMC medical records or private medical records that show that the veteran’s disability is a result of their military service.
For example, let’s consider the hypothetical veteran named Vernon. Vernon filed a formal claim for disability benefits for his PTSD. In the rating decision, the VA denied service connection for Vernon’s PTSD. Vernon appealed the rating decision directly to the BVA with additional evidence. Vernon submitted the following additional evidence: proof of his Combat Action Badge, a lay statement of his experience in combat, and buddy statements from two veterans he served with. Upon review of the case and additional evidence, the BVA found Vernon’s PTSD is sufficiently related to his experience in combat during military service. The BVA awarded service connection for Vernon’s PTSD!
Evaluation
When a veteran’s disability is service-connected, the VA will offer the veteran a rating evaluation for the disability. An evaluation will be assigned to the disability in the form of a percentage according to the VA’s rating schedule. The rating schedule considers the severity of the symptoms of the disability to assign a percentage. The percentage thus represents, “the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations.” Based on the rating percentage, the veteran may be offered a monthly payment “to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability.”
If the veteran is dissatisfied with the evaluation offered for their service-connected disability, the veteran may appeal the decision. The veteran can appeal through one of three ways. One, the veteran may appeal through a Higher-Level Review where the case will be reviewed without the submission of new evidence. Two, the veteran may appeal through a Supplemental Claim where the veteran can submit new evidence with their appeal. Three, the veteran may appeal directly to the Board of Veterans Appeals (BVA). For an appeal to the BVA, the veteran may request a direct review without the submission of new evidence, submit new evidence, or request a hearing where submitting new evidence is optional.
If the veteran files an appeal through a Supplemental Claim or appeals to the BVA with eligibility to submit new evidence, the veteran can submit additional evidence if it is new and relevant. This means the evidence must be other than what has been submitted in the past and must address the issues on appeal. New and relevant evidence for an appeal for higher evaluation may appear in the form of additional VAMC medical records or private medical records that show that the veteran’s disability is more severe than the VA rating decision interpreted and is thus entitled to a higher evaluation.
For example, let’s consider Veteran Vernon once more, but now assume the VA granted service connection for Vernon’s PTSD and provided an evaluation of 70%. Vernon thinks he is qualified for 100% evaluation for PTSD so he appeals directly to the BVA with new evidence. Vernon submitted the following additional evidence: mental health treatment records that shows Vernon’s difficulties with getting out of bed and taking care of his hygiene like brushing his teeth and showering, and hospital records from a previous suicide attempt. Upon review of the case and additional evidence, the BVA found Vernon’s PTSD symptoms most appropriately relate to the 100% rating description. The BVA awarded Vernon 100% for his PTSD!
Effective Date
When a veteran’s disability is service-connected, the VA will offer the veteran an effective date for the disability. The effective date is assigned as the date in which the veteran will make retroactive monthly payments to. The effective date is normally the date in which the VA receives the veteran’s completed formal claim for disability benefits for the particular service-connected disability. An alternative potential effective date is the date in which the VA received the veteran’s completed Intent to File form. But, an Intent to File can only serve as the effective date for a service-connected disability if the veteran filed a completed formal claim for the disability within one year of the Intent to File and no other formal claims were filed between the Intent to File and the formal claim.
If the veteran is dissatisfied with the effective date offered for their service-connected disability, the veteran may appeal the decision. The veteran can appeal through one of three ways. One, the veteran may appeal through a Higher-Level Review where the case will be reviewed without the submission of new evidence. Two, the veteran may appeal through a Supplemental Claim where the veteran can submit new evidence with their appeal. Three, the veteran may appeal directly to the Board of Veterans Appeals (BVA). For an appeal to the BVA, the veteran may request a direct review without the submission of new evidence, submit new evidence, or request a hearing where submitting new evidence is optional.
Normally, an appeal for an earlier effective date will arise when an argument can be made that the effective date should have been dated back to an Intent to File which the VA failed to consider. So, the submission of additional evidence may be unnecessary. Instead, the appeal is a means to bring the overlooked Intent to File to the attention of the VA.
For example, let’s consider Veteran Vernon once more, but now assume the VA granted Vernon’s PTSD at 100% with an effective date of August 1, 2023. Vernon thinks he is entitled to an earlier effective date so he appeals the rating decision directly to the BVA. Vernon filed his completed formal claim for PTSD on August 1, 2023, but filed an Intent to File on June 1, 2023. Upon direct review by the BVA, the Board recognizes the error made at the VA level in failing to consider the Intent to File. The BVA awarded Vernon an effective date of June 1, 2023 for his PTSD!
