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Appealing Your PTSD Claim Denial

Help With Appealing Your PTSD Claim Denial

VA accredited attorneys help vets access disability benefits

Post-traumatic stress disorder is often a disabling condition that can qualify a veteran for benefits, especially in the category of Total Disability Based on Individual Unemployability. Unfortunately, the VA’s process for evaluating claims continues to suffer from systemic problems. Recently, it was revealed that about 440,000 veterans’ claims may have been improperly denied or stalled because evaluators switched codes on the applications. Thus, veterans were inadvertently asked to submit information they’d already provided instead of new information the evaluators needed. The code snafu is merely the latest of the systemic problems that have plagued the VA for decades.  In the meantime, veterans with PTSD have been denied the benefits they need. At Marcari, Russotto, Spencer & Balaban, we find this unacceptable. If you’ve been unfairly denied, our VA accredited attorneys are ready to fight for the benefits you deserve.

How do I file an appeal for my denied PTSD claim?

The error rate for processing VA claims is notoriously high. The VA admits officially to a 14 percent error rate, but critics place the rate closer to 38 percent. The Inspector General for the VA found rampant errors in California regional offices: 39 percent for Oakland, 53 percent for San Diego, and 71 percent for Los Angeles. Not all errors lead to denials of claims, but these numbers certainly do not inspire confidence in the system. Fortunately, if your claim for disability benefits is denied, you have the right to appeal within one year of the initial decision.

Common reasons for an initial denial of disability claims

Our attorneys are very familiar with the claims process and thoroughly understand why you might be denied even though you have a valid claim. Common reasons why VA disability claims get denied include:

  • Insufficient medical evidence in your file to support a finding of disability
  • Insufficient evidence that your disability is connected to your military service
  • Disability rating that is mistakenly too low to qualify for benefits

Our attorneys can help you cure deficiencies in your file, so your claim has a much better chance of acceptance on appeal.

Capable guidance throughout the VA appeals process

There are five basic steps in the VA appeals process, and our attorneys stand with you from start to finish:

  • File a Notice of Disagreement (NOD) — You have one year from the date of your decision letter to file VA Form 21-0958. Your decision letter from the VA will tell you where to file your NOD.
  • Receive VA Statement of Case (SOC) — Your local VA office responds to your NOD with an explanation why your claim was denied.
  • File a Substantive Appeal — Within 60 days from the date of the cover letter accompanying your SOC, you must file your Substantive Appeal on VA Form 9. If you file a Substantive Appeal, the Board of Veterans’ Appeals sends its decision by mail.
  • Hearing — You may request an optional personal hearing before a coadjutor at your local VA office or before a Veterans Law Judge at the Board of Veterans’ Appeals, either in person or via video teleconference. Hearings are informal, but you do testify under oath. You may take this opportunity to present more evidence.
  • Decision — After your hearing, the Veterans Law Judge considers all evidence and renders a decision. There are three possible outcomes: grant, which means you get what you requested; remand, which means the judge has ordered the local VA office to revisit your claim in light of new evidence and/or with particular instructions; and denied, which means the judge has upheld the previous decision to deny your claim.

Even if you receive a denial, you still have options. You can file a new claim with the VA office and start the process over. You can file a motion with the Board of Veterans’ Appeals to reconsider your appeal or to review your appeal because of a clear and obvious error. Finally, you can file a Notice of Appeal with the U.S. Court of Appeals for Veterans Claims. You have only 120 days for this last option.

The appeals process can be long, confusing, and frustrating, but you can rely on our attorneys to fight tirelessly for a positive outcome.

Contact our VA accredited attorneys to appeal your PTSD disability denial

Don’t take on the VA alone. Marcari, Russotto, Spencer & Balaban fights for veterans all the way through the appeals process. Call us from anywhere in the country at 866-866-VETS, and someone will be ready to talk to you, or you can contact us online. Our firm never charges upfront fees, and there are no attorney fees unless we win your claim for benefits.

  • Thank to Mr. Spencer I was able to get my VA disability claim re-reviewed and given another chance to receive disability. By far he is one of the most professional lawyers I have ever dealt with. So Veterans if you are looking for help with your VA disability claim I would suggest that you hire Macari, Russotto, Spencer, & Balaban. Thanks again for everything.

    — Alfred Daye

  • As a disabled veteran trying to navigate the complexities of the Veterans Administrations regulations, I turned to the law firm of Marcari, Russotto, Spencer and Balaban. They helped me understand what I needed to do and prepared and presented to the VA an excellent presentation of my case. I recommend them for your legal needs.

    — Harry Johnson

  • I was very satisfied with the excellent and professional manner the law firm handled my claim. I highly recommend any veteran who needs help with his or her claim to use Marcari, Russotto, Spencer & Balaban P.C. Special thanks to Mr Spencer for being very professional and courteous during the appeal process. Again Thanks to the entire firm for a job well done!

    — Luther Henderson

  • My husband & I highly recommend this law form to any veteran trying to navigate the endless red tape of the VA. We turned to Marcari, Russotto, Spencer & Balaban to handle my husband's appeal and could not have been happier. We enjoyed open and consistent communication regarding our case. Any questions we had were answered immediately.

    — Michele DeZayas

  • Amanda Medina-Morales was our point of contact and she kept us up to date on the progress of our case. It was a pleasure and relief knowing that someone truly competent and professional was handling this and fighting for us.

    — Michele DeZayas

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