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VA Disability Claim Denied? Processor Errors May Be to Blame, Says OIG

A watchdog report released earlier this year from the Office of the Inspector General (OIG) found that during the fiscal year 2021, the Veterans Administration (VA) mishandled nearly seven out of ten disability claims. This resulted in veterans with legitimate claims being denied the care and treatment to which they were lawfully entitled. The VA is promising reforms and better training while attempting to process a significant backlog of cases without repeating these same mistakes.

VA Claims Processors’ Errors Lead to Wrongfully Denied Claims

When a veteran submits a claim for disability benefits to the VA, the claim travels through several stages before the VA approves the claim. Along the way, the VA can deny a service member’s claim if it appears they are not eligible for benefits. A claim may be denied if, for example, the available evidence does not establish a causal link between the veteran’s disability and military service

Claims processors are a critical part of the Administration’s review process. These individuals review the claim paperwork and supporting documentation, including determining if the VA’s medical reviewers need additional medical opinions or disability examinations to adjudicate the claim. 

veteran discharge upgradeAccording to the OIG’s report, the VA’s claims processors did not correctly complete a request for medical opinions and exams in 68 percent of the claims that the OIG reviewed. In 38 percent of requests, claims processors failed to include critical, relevant information. Nineteen percent of requests excluded details used by examiners in deciding claims.

Other errors that the OIG report uncovered included claims processors’ failure to:

  • Use descriptive or helpful language that made issues clear for examiners
  • Identify and request pertinent medical records and evidence 
  • Request medical opinions consistently and when appropriate
  • Other errors and omissions

These mistakes meant that thousands of veterans’ claims for disability benefits were either unjustifiably delayed or denied.

What To Do If Your VA Claim Was Impacted by Processor Error

If you filed a claim for VA disability benefits between 2020 and 2021, these errors might have impacted the adjudication of your claim. Unfortunately, there may not be an easy way to know for sure. One possible indication is if you have yet to receive any decision on your claim. 

The claim process does take some time: however, if several months have passed and you have yet to hear about your claim from the VA, it may be because of an error-induced delay.

Similarly, if you filed a claim during the same period but received a denial, it may be worth having a veterans law attorney review your case. Deficiencies in how the VA handled your claim may have contributed to an improper denial.

Speak with Valor Firm About Your VA Disability Claim

Valor Firm is proud to fight for veterans who have given so much to this country. If you have had your disability benefits claim denied, let us review your claim. When we get involved in your case, we will work to ensure that your claim is evaluated correctly and that you get the benefits you deserve.

Reach out to us online, or call or text us at (504) 218-2510 to schedule your claim consultation.

“We are committed to helping you rebuild your lives after hardship. We are not just your legal team — we are your allies, your partners, and your tireless advocates.

And for every fight we’re willing to take on, know this — We’re right there in the trenches with you.”

YOUR FIGHT IS OUR FIGHT

Werner, Hoffman & Greig

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