Disability
Disability
Posted on Nov 6, 2024
What is the reasoning behind a veteran who was honorable discharged for a medical reason to be denied VA disability?
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I was injured on active duty and discharged for this reason but have been fighting for years to get disability benefits.
Disability
Benefits
Veteran Benefits Advisor
Military Benefit Association
Posted >1 y ago
Responses: 15
What type of discharge did you get and when were you separated (your profile doesn't show it).
The reason for the ask is the regulations about administrative discharges for medical reasons have changed over the years as well as the "disability evaluation and separation" route.
For example, if you were separated through a Medical Evaluation Board after 2009, then the Integrated Disability Evaluation System (IDES) would have been in effect and a joint DoD/VA disability rating would have been assigned (even if medically separated for a disability rated at less than 30%).
Was the injury related to a preexisting medical condition, as part of something that was considered to be "non-Line of Duty"? Both of those situations would impact on your having a determination of "service-connected".
Basically, there are many reasons why the VA would deny a service-connection to a disability from your active duty time, but you would have to provide much more information (DM me if you don't want to share publicly).
The reason for the ask is the regulations about administrative discharges for medical reasons have changed over the years as well as the "disability evaluation and separation" route.
For example, if you were separated through a Medical Evaluation Board after 2009, then the Integrated Disability Evaluation System (IDES) would have been in effect and a joint DoD/VA disability rating would have been assigned (even if medically separated for a disability rated at less than 30%).
Was the injury related to a preexisting medical condition, as part of something that was considered to be "non-Line of Duty"? Both of those situations would impact on your having a determination of "service-connected".
Basically, there are many reasons why the VA would deny a service-connection to a disability from your active duty time, but you would have to provide much more information (DM me if you don't want to share publicly).
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COL Randall Cudworth
PFC Nichola Perez, looking back to the Marine Corps separation and retirement manual that was in effect at the time you separated (1996), the only medical issues that would be directed to an administrative discharge instead of going to the Physical Evaluation Board (PEB) are those that would interfere with your duties, but aren't considered as a physical disability by medical officer (e.g., the difference between being medically separated and discharged for a non-physical medical reason).
Why many of the items have changed over the past ~30 years, a chronic physical injury (injury to right knee from a utility run accident) has always been something that would require a PEB referral if it interfered with your duties.
So, I can only assume that the issue you are running into could be one (or both) of the following:
A) Proving that the knee injury is a chronic issue or that the condition is limiting in some manner
B) Proving a nexus to your military service
If you haven't already, I suggest you contact your state's Department of Veterans Affairs* (it's called by different names in each state) or a VSO representative from an accredited organization* (such as DAV, VFW, etc.). Representatives from either of those choices will be able to go though your claim and the evidence you submitted and give you more defined advice on why you are getting denied by the VA.
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* https://www.marines.mil/Portals/1/Publications/MARINE%20CORPS%20MANUAL%20W%20CH%201-3.pdf
* VA page with link to your state’s Departments of Veterans Affairs Office – https://department.va.gov/about/state-departments-of-veterans-affairs-office-locations/
* VA page – Get help from an accredited representative or VSO – https://www.va.gov/get-help-from-accredited-representative/
Why many of the items have changed over the past ~30 years, a chronic physical injury (injury to right knee from a utility run accident) has always been something that would require a PEB referral if it interfered with your duties.
So, I can only assume that the issue you are running into could be one (or both) of the following:
A) Proving that the knee injury is a chronic issue or that the condition is limiting in some manner
B) Proving a nexus to your military service
If you haven't already, I suggest you contact your state's Department of Veterans Affairs* (it's called by different names in each state) or a VSO representative from an accredited organization* (such as DAV, VFW, etc.). Representatives from either of those choices will be able to go though your claim and the evidence you submitted and give you more defined advice on why you are getting denied by the VA.
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* https://www.marines.mil/Portals/1/Publications/MARINE%20CORPS%20MANUAL%20W%20CH%201-3.pdf
* VA page with link to your state’s Departments of Veterans Affairs Office – https://department.va.gov/about/state-departments-of-veterans-affairs-office-locations/
* VA page – Get help from an accredited representative or VSO – https://www.va.gov/get-help-from-accredited-representative/
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PO3 Michael MacKay
PFC Perez, you may also want to contact American Legion as a sponsor, they were very helpful to me in getting my claim off the ground, as well, DAV. You may be able to share your files with them and have them shed some light on a path forward.
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I read your post and I woulkd like to offer my opinion.
Getting a disability rating is difficult. The main reason is the person making the evaluation. They may have a title or degree, but the majority lack common sense.
Me? When I faced many denials. I would consult an expert in the field to refute the VA examiner. Then the VA would, in turn, send me to another VA examiner who, like the first, was not armed with knowledge or common sense. Again, I would seek another expert to refute the new VA examiner.
One expert I selected was quoted by the VA examiner as a reason for the denial. The expert was aware that those trying to make a point used the expert's name, which was quoted in publications such as the Journal of Medicine. The expert said the VA examiner used selected snippets from her publication.
She offered and sent me the entire publication from which the VA examiner's snippet was taken. With that, in the expert’s subject line read “good luck in your battle against ignorance.”
The problem is that the VA is not budgeted to hire qualified experts. They cost too much, and I was told that, when asked, they can find others who work for less.
Let me offer a suggestion. Use a good VSO to properly file your claim. Then find an expert in the field of your claim. The expert’s exam will be submitted with your claim, not a VA examiner. Then if the VA makes the unwise decision to use a VA examiner to refute the expert, it will look as if it is an effort to deny a veteran of a claim that is justified. It will save you years.
Turn the worm in your favor.
Semper Fi Marine
Getting a disability rating is difficult. The main reason is the person making the evaluation. They may have a title or degree, but the majority lack common sense.
Me? When I faced many denials. I would consult an expert in the field to refute the VA examiner. Then the VA would, in turn, send me to another VA examiner who, like the first, was not armed with knowledge or common sense. Again, I would seek another expert to refute the new VA examiner.
One expert I selected was quoted by the VA examiner as a reason for the denial. The expert was aware that those trying to make a point used the expert's name, which was quoted in publications such as the Journal of Medicine. The expert said the VA examiner used selected snippets from her publication.
She offered and sent me the entire publication from which the VA examiner's snippet was taken. With that, in the expert’s subject line read “good luck in your battle against ignorance.”
The problem is that the VA is not budgeted to hire qualified experts. They cost too much, and I was told that, when asked, they can find others who work for less.
Let me offer a suggestion. Use a good VSO to properly file your claim. Then find an expert in the field of your claim. The expert’s exam will be submitted with your claim, not a VA examiner. Then if the VA makes the unwise decision to use a VA examiner to refute the expert, it will look as if it is an effort to deny a veteran of a claim that is justified. It will save you years.
Turn the worm in your favor.
Semper Fi Marine
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I hope you have a VSO or lawyer helping you obtain your earned benefits. Many times, denials are related to the way the form is filled out. That's why having a VSO (Veterans Service Organization) assist with the paperwork and represent you is important. The DAV, VFW, American Legion, your state's local Department of Veterans Affairs, can all help. Another reason for denial is the way you behave in front of the examiner. If you were discharged for a physical aliment, make sure you stop moving whenever it hurts. Say you injured your back and cannot bend over more than 45 degrees without it hurting. Stop at 30 degrees. If your knees are the issue and you cannot squat, don't. Mental health exams are a bit different. When speaking with the psychologist, just don't lie. If you're angry, be angry. If you want to cry, for Pete's sake, CRY. Let them feel what you feel on a daily basis. Holding back is foolish. It will not help you. I know this because the first time I applied I was denied. The doctor said I had a personality disorder (I do not), and those are not covered. I was holding back because I was extremely angry. If all else fails, contact your state legislators and senators, your governor and your federal senators and representatives. Bottom line: Don't ever stop advocating for yourself and don't give up. Good Luck. Edit: I forgot to add for you to get you Military Medical Records. If you did not copy them before you left the service, you might be able to get a copy through the VA (myHealtheVet). Not all your records will be in there. Handwritten notes by doctors may not be included.
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SPC Debra Hill
wish I had known all this when I discharged. Had a P3 profile d/t falling from a 12 FT tower and landing standing up.Still had my M16 in hand!The process I went thru was so awful. Had proof damage to knees, however they ignored the rest of my joints, which I now have arthritis in. I say good luck and use this wisdom offered by the others.
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