Defining A Condition As Service
Applications for VA disability benefits require a veteran to demonstrate that they suffer from a service-related injury. This usually involves pointing to a specific incident which occurred during active-duty service that resulted in a disabling condition. For example, former servicemembers may have been exposed to toxic chemicals, loud noises, or environmental hazards during their time in uniform.
An inability to make this connection is a common reason for the VA to deny a claim for benefits. This can lead a veteran to file an appeal, but the appellate process can often take many months or even years to reach a resolution. Fortunately, a veteran who qualifies with a presumptive service-connected condition can quickly satisfy this essential requirement.
Top 3 Reasons Why Va Claim Denied Not Service Connected
VA Claim Denied
- Reason #1: No medical diagnosis of a disability
- Reason #2: No clear nexus to prove service connection
- Reason #3: No evidence of current disability symptoms
Okay, lets explore each of these reasons in detail, andchart a path for you to get your VA disabilities service connected under thelaw.
Establishing The Service Connection
To qualify for VA disability compensation, the VA must determine that your medical condition was caused or aggravated by your military service. Service connection for a disability or death can be established through many ways. The four most common are:
The disability or condition was incurred in military service. These determinations are usually cut and dry because the evidence should be in your military medical records. An example would be if you were shot or were wounded by an explosion during combat.
The aggravation of a before-service disability during service. This can be harder to determine because it precludes prior-service conditions that get worse due to the natural progression of the disease or condition.
When making a determination, the VA considers the places, types, and circumstances of your military service as documented in your service records. The VA gives particular weight to combat duty and other hardships of service.
Because of a service-connected disability, a secondary condition has occurred. It has been scientifically proven that some medical conditions can cause other medical conditions. For example, it is medically known that individuals who have had an amputation of the leg at or above the ankle are prone to develop heart disease. In such cases, the condition caused by the service-connected disability can be rated as a service-connected disability by the VA.
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Am I Eligible For Va Service
In order to qualify for benefits due to a service-connected disability, the following factors must be present:
- You have served on active duty and have proven the disability was caused while on active duty
You may also:
- Have been injured while serving in the military and can link the injury to your disability
- Have had an illness or injury, and serving worsened your condition
- Have a disability related to active duty that did not appear until your service ended
Veterans and qualified dependents are eligible for service-connected disability benefits pending approval. If you are unsure if you qualify for veterans service-connected disability, contact the experienced attorneys at Tuley Law today for a case evaluation.
Can Knee Pain Cause Depression And Anxiety
Service connected Knee Pain can absolutely lead to day-to-day work and life challenges such as immobility and weight gain.
Thus, Knee Pain can impact a veterans work, life, and social functioning, which can cause or aggravate Depression and Anxiety.
Accordingly, a veteran can be service connected for Depression and Anxiety secondary to Knee Pain.
Depression and Anxiety VA ratings depend on the severity of a veterans mental health symptoms, meaning, the more severe your symptoms, the higher the VA rating for Depression and Anxiety.
The average VA Rating for Depression and Anxiety is currently at 70%, but veterans can be rated from 0% to 100% with breaks at 10%, 30%, 50%, 70%.
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Resolution At The Cavc
The parties agreed that the BVA erred when it failed to prove service connection for arthritis. The BVA decision by Veterans Law Judge Michelle L. Kane was vacated and remanded for the BVA to fix its errors.
This appeal is an example of a very common BVA mistake in an appeal seeking service connection for arthritis. The BVA notes some testimony that a veteran experienced symptoms of arthritis during service or after service. The BVA then discounts that lay testimony by finding that a veteran is not competent to testify about the etiology of his medical condition and denies service connection for arthritis.
A veteran is always competent to testify about the symptoms he experienced or is experiencing, prior diagnoses of a particular condition, or other matters that he can personally perceive or experience.
A veteran is not competent to testify about the medical cause of a condition. However, in a claim for service connection of arthritis, the VA does not require a veteran prove that active military service caused his or her arthritis. He need only prove that it is more likely than not that the arthritis is related to military service. He can do that with an expert medical opinion or with competent and credible lay testimony of continuous symptoms of pain or arthritis in the joint from service to diagnosis.
Service Connection For Chronic Sinusitis
Chronic sinusitis can be caused by any number of things that veterans may experience while serving on active duty. For example, a veteran may suffer facial injuries that result in a deviated septum, which then leads them to develop chronic sinusitis. In other instances, veterans may be exposed to air pollutants and toxins emitted from burn pits. Inhaling toxic substances such as asbestos and contaminants can lead to complications with sinus functioning in the future. Service connection for chronic this condition can be established in several different ways:
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Establishing Evidence For A Current Disabling Illness Or Condition
Medical evidence is required for proving existence of a current disabling illness or condition. The Regional Office will want to see the VA healthcare medical file or the current private medical file of the claimant pertaining to the disabling illness or condition that is being claimed. You should be aware that the Regional Office does not want to see medical records that are not pertinent. They are useless and end up bogging down the decision process. It is important that the condition be persistent or long-lasting and not temporary in nature. VA will want to see evidence of the continuity of the disability or condition from discharge or reasons why that is not the case.
Service Connection Due To Aggravation
This is, technically, a form of secondary service connection.
This type of claim requires a veteran prove that the service connected disability aggravates, or worsens beyond natural progression, a non-service connected disease or disability. For example, if you have service connected sleep apnea, and non-service connected PTSD, you can often argue that the sleep apnea aggravated your PTSD or made it worse.
You will invariably need both lay evidence and medical evidence to establish service connection using an aggravation theory.
CAUTION: do not confuse proving service connection by aggravation with the presumption of aggravation.
The presumption of aggravation applies when a veteran has a pre-existed condition noted on a military service entrance examination. That condition is presumed aggravated by military service unless the VA can provide clear and convincing evidence that the condition got worse not because of military service, but because of the natural progression of the disease or disability.
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Military Burn Pit Exposure And Sinusitis
Military burn pits are large areas of land that were used by the United States military to incinerate waste in places such as Iraq and Afghanistan in the post-9/11 era. Though the practice was effective in reducing large quantities of waste, the burn pits emitted large plumes of toxic smoke which was later found to cause many adverse health effects.
Waste materials commonly disposed of in these burn pits include:
- Human waste
At this time, there is little conclusive research on the long-term health impacts of burn pits. However, the main dioxin released by burn pits is
Establishing A Link Between The Current Disability Or Disease And The Illness Injury Or Aggravation That Occurred In Service
Establishing Presumptive Service Connection
It is important to note that some VA-listed presumptive conditions may not actually be the result of service, but many years after discharge may be the result of other non-service health developments. In order to be service-connected, many presumptive conditions must have manifest within a certain period of time after leaving the service usually to a degree of 10% disability within the first year.
For those presumptive conditions where there is no time limit, and the condition has been recently diagnosed and the time between discharge and the claim is significant, the Regional Office will question whether the condition is service-connected. In this case, a continuity of symptoms must be produced to show that the condition would have been or was manifest meeting the proper time frame even though it was not diagnosed. Diagnosis is not required, only evidence of manifesting.
For some presumptive conditions such as Agent Orange or ionizing radiation or exposure to hazards causing Gulf War Syndrome there does not have to be a continuity of symptoms, nor do they have to show up within 1 year of discharge. Symptoms from these conditions could show up many years after discharge.
Establishing Direct Service Connection
Please go to the table of contents in the right column on this page to learn more about presumptive service connection and direct service connection. Here are the links:
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Va Claim Denied Not Service Connected Due To No Evidence Of Current Disability Symptoms
No evidence of current disability symptoms
This is another very common reason why a veteran sees VA claim denied not service connected or they receive a low-ball rating.
In order to be eligible for VA disability compensation underthe law, you must have current symptoms of the disability into the present day.
Generally, the more severe your disability symptoms, the higher the VA rating and compensation youll receive.
At VA Claims Insider, we refer to this as severity of symptoms.
Ultimately, the VA compensates veterans for disabilities thatcause impairment in their work, life, and/or social functioning.
The degree of disability, aka, your VA disability ratingpercentage, depends upon how severe your symptoms are of the current disability.
For example, if you have a medical diagnosis of PTSD, its related to a combat situation in Iraq, but you dont have any current symptoms that cause occupational and social impairment, youll likely receive a 0% or 10% rating according to the PTSD Rating Scale.
However, on the other end of the spectrum, if youve got very severe PTSD symptoms that cause major impairment in your work, life, and social functioning, you could receive a 100% VA rating for PTSD, which is the highest rating under the law.
Again, your disability percentage depends upon the severity ofyour symptoms over time and your current level of impairment.
There are some things you can do to help show severity of symptoms:
How To Prove Your Disability Is Service Connected
Some veterans do not have any problems proving that they have a disability that stems from their service in the US military. After all, some disabilities like amputations are so obvious, it makes them easy to prove.Again, most veterans have no difficulty explaining and proving the events that led to their disability. However, problems can start when veterans attempt to connect their current disability to the time they served in the US military.The VA will never let you in on the laws and guidelines on how to prove if your disability is service-connected. Their website provides almost nothing in regards to that. That is why in this article, we have shared a few different ways you can prove to the VA that your disability is connected to your time in service and that you are eligible for VA disability compensation.
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How Va Rates Aggravation Claims
Again, VA will try to determine what the rating would have been prior to any aggravation due to a service-connected condition or due to service. After the condition has been service connected, VA will assign a rating based on what the current severity is. From there, VA will take the difference between those two and determine the severity that is due either to another service-connected condition, or due to service.
Importantly, veterans should try to provide medical evidence or an expert opinion to establish both the baseline level and current level of severity of their condition.
Disabled During Va Medical Treatment
The fifth and final method of proving that a current disability is related to military service doesnt really have anything to do with military service.
If you are disabled or die while receiving VA medical care, the resulting disease or disability will be treated as if it is service connected.
Service connection by reason of medical malpractice a so-called Section 1151 claim is incredibly complicated, incredibly individualized, and often requires knowledge of state law in the state where the injury occurred or the veteran lives.
For that reason, I dont go into depth on Section 1115 claims, because you are better off talking to an experienced VA medical malpractice advocate. One of my favorite advocates for these types of claims is Erin Steffin. Tell her Chris Attig sent ya.
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How To Prove Secondary Service Connection
In accordance with 38 CFR § 3.310 disabilities that are proximately due to, or aggravated by, service-connected disease or injury, a current disability condition, which is proximately due to or the result of a service-connected disease or injury shall be service connected.
Service connection on a secondary basis requires a showing of causation.
A showing of causation requires that the secondary disability claim be shown to be proximately due to or aggravated by another service-connected disability.
There are three evidentiary elements that must be satisfied for VA secondary conditions to Knee Pain to prove service connection under the law:
The first part can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records.
The second part can be satisfied with a veterans existing service-connected disability rated at 0 percent or higher, which in this case, is Knee Pain.
The third part, and often the missing link needed to establish secondary service connection, can be satisfied with a credible Medical Nexus Letter from a qualified medical provider.
Heres the brutal truth fellow veterans
Ibs Secondary To Knee Pain
IBS can be rated secondary to Knee Pain , and normally causes stomach pain along with changes in bowel habits, either diarrhea, constipation, or both.
IBS is rated under diagnostic code 7319, Irritable Colon Syndrome and can be rated at 0%, 10%, or 30% depending upon the frequency, severity, and duration of symptoms.
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Issue On Appeal To The Cavc:
The BVA denied service connection for arthritis, holding arthritis was not diagnosed and did not manifest within one year of separation from service. The veteran, who served until October 2006, reported continuous symptoms of knee pain from 2006 to the present. The BVA mentioned that the veteran testified about continuous symptoms of knee pain from August 2006 to present.
Did the BVA err when it failed to consider continuity of symptomatology as a means of proving service connection for arthritis?
Aggravation Of A Before
Did you enter active duty with a preexisting condition? If so, that condition should have been noted in your entrance exam. The VA will use this information if you submit a claim for VA benefits under the assumption of an aggravated service connection. This service connection relates to any conditions that may have been exacerbated by your time in service.
When you claim this connection, the VA has the responsibility of determining whether your condition has progressed naturally or has progressed faster because of your time in the service. This can be a challenging determination to make, so its a good idea to arm your application with plenty of medical evidence and statements from your medical team that can help you prove that your condition worsened because of your service.
The tricky part of this service connection is especially apparent in genetic conditions that often progress naturally as one ages. During the determination process, the VA will consider all evidence you and your medical team provide to decide whether your condition worsened because of your service or if it would have met its current state regardless. The VA will also only allow this connection when your condition has been deemed to be a permanent disability.
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Does Back Pain Qualify For Va Disability
Medical Diagnosis Back pain is a broad term, and not all forms of it qualify for VA disability. In other words, back pain, even if it is constant and severe, does not mean you can receive benefits based on that alone. You need to have a medical diagnosis, and the VA requires that your diagnosis meets certain criteria.
Was Your Va Claim Denied For Not Being Service Connected
If this is the case, then you may have the option of appealing the decision. An experienced attorney can help you throughout the entire appeals process. He or she will know the laws and procedures that apply to your specific case. He or she will also know how to prove a service connected disability and present your appeal in a clear and effective manner.
At Tucker Law Group, we have decades of combined experience helping disabled veterans appeal VA disability claim denials. For more information, contact us today at , or message us online. We provide counsel in all fifty states. Our attorneys are licensed in Florida and many federal courts across the nation. Receive answers to your legal questions during a free initial consultation.
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