Most VA disability claims are won or lost based on the medical evidence available to the adjudicator. The medical evidence process starts with the VA obtaining a one-time medical examination as part of its duty-to-assist, including a written opinion based upon the examination and reviewing the veteran’s medical records. If the VA physicians agree that you have a service-connected disability, the process becomes very easy, and the VA will start benefits almost immediately.
Historically, this has not been the case. The VA-directed evaluation often (and some say usually) fails to support either existence of or seriousness of your disability. Even if the physician agrees on the severity of the disability, the doctor’s opinion may fail to tie a disability to a service-connected event or environmental factor.
To have any chance of succeeding, you must present medical opinions rebutting the VA’s doctor. One possibility is to request a rebuttal opinion from your treating VA doctor. But a treating VA doctor will almost always refuse such a request.
This leaves you only one alternative — to seek a private physician’s review of your case. Your cost for an examination and a prepared written report can easily be in the thousands depending on what medical tests are required. This is a lot to ask the average claimant, so often, the only medical report included in your initial claim is the VA’s medical opinion. When that medical opinion does not support your claim, the VA denies your claim.
If that is the case, you must appeal that denial. Few claimants have the resources or experience money to obtain the necessary rebuttal medical opinion and coordinate their appeal. At this point, you should reach out to a VA accredited attorney such as myself. While attorneys cannot assist in initial claims, an attorney may help in a claims appeal. The VA maintains a database of accredited attorneys, and many veteran service organizations have their own lists.
An attorney can aid you in identifying the missing pieces in the original claim and provide a plan to address the missing elements. Your attorney can help you find the appropriate specialist to aid in your appeal and even cover the expense of the exam or testimony. If your appeal is successful, you reimburse the attorney for those expenses from the lump sum portion of your claim. If your appeal is unsuccessful, you are not responsible for the expenses