How to Re-Open a Claim That Has Been Denied

New York, NY – The New York Times recently published an article about VA employees at the Columbia, SC Regional Office protesting their working conditions. The employees were protesting their inability to efficiently assist veterans due to the backlog of cases and complicated procedures. The article touched on some of the difficulties veterans face. However, as an experienced veterans’ attorney, I can confirm that the Times did not adequately portray just how bad the situation is for veterans and their attorneys who are fighting the system. This prompted me to write a letter to the editor of the Times.

I mentioned how the process of filing a claim, appealing, and getting denied can consume an entire lifetime. I suspect that some at the Times thought I was exaggerating. But the truth is I probably did not state my point sufficiently.

Case in point: A veteran client of mine enlisted at age 17 in 1952. He suffered an injury in the service during boot camp. He struggled with the effects of this injury all throughout his Naval career. Upon discharge in the mid 1950s, he filed a claim. The VA promptly denied him. He did not immediately appeal so the claim became final. In the mid 1960s he again re-filed the claim. The VA again denied him. And he repeated this process of filing and re-filing claims for several decades. We finally won his claim after about 55 years of trying. But because his claims had been denied before, he had to re-file to reopen the claim. His situation is common and so an understanding of what you need to do to re-open a claim is critical.

First and foremost, you must know exactly why VA denied you before. In prior articles I have explained the basic elements of service connection. The VA will usually deny you for the lack of one or more elements. So you will need to read the prior VA decisions carefully to understand what VA found to be the missing link in your case. The most common reason is the lack of a medical connection between your current disability and your military service.

If VA denied you because of the lack of a medical connection, you cannot simply submit new medical records concerning your treatment. Unless those medical records give the opinion that your disability is caused by service, the VA will not re-open your claim.

To get a claim re-opened you must present evidence that is new and material. If the evidence did not exist before then it is “new”. But the evidence must also be “material”. And unless the new evidence addresses the reason why the Board denied you before, then it is unlikely VA will re-open your claim. So, in our example, if VA denied you before because there was an absence of a medical connection to service, then to reopen the claim you would need to obtain and submit a doctor’s letter stating that your current disability is linked to service. If you simply submit more treatment records do not be surprised if VA refuses to reopen the claim.

To be successful in reopening claims we strongly recommend that veterans contact a private physician to review their file and write a report. If the file contains a negative VA medical opinion, your new evidence should include your doctor’s analysis as to why the VA doctor was wrong.

Finally, keep in mind that our advice is designed to provide information that would assist in getting a claim reopened. There is case law that mandates cases be reopened without providing a medical opinion. However, to avoid unnecessary appeals, we recommend that you make every effort to obtain such evidence upon your first attempt to reopen your claim.