The Most Common Reasons DIC Claims are Denied
In the past, survivors of disabled veterans who passed away were presumptively entitled to survivor benefits, called Dependency and Indemnity Compensation, or DIC. Then, the law changed, establishing requirements which must be met before DIC claims can be granted. Now, because of the complexity of DIC claims, the initial denial rate is around 75%. Occasionally, the reasons for denial are straightforward and easy to correct. Sometimes, though, even the reasons for denial are as complex as the requirements themselves.
If a claims examiner denies a DIC petition, the claimant does not have to abandon the claim or settle for pennies on the dollar. Instead, a VA disability attorney can file an appeal, advocate for the claimant, and obtain DIC benefits.
Based on the experiences of our attorneys, DIC claims examiners often deny claims based on one of three critical issues: the relationship between the claimant and veteran does not meet the requirements; the examiner denies the claim on technical grounds; or, the veteran’s cause of death was not service-connected.
Improper Relationship
At first blush, this portion of a DIC claim seems straightforward and almost a rubber stamp. Frequently, however, claims examiners look for a reason to deny expensive DIC claims. If they can deny a claim without addressing its merits, that is even better. Surviving family members of disabled veterans are not automatically entitled to DIC benefits.
Surviving spouses must meet one of two requirements: either the spouse lived with the veteran continuously until the veteran died, or if the spouse divorced the veteran, the surviving former spouse was not at fault for the separation. One of the following must also be true: either the survivor married the veteran within 15 years of discharge of the service period during which the qualifying condition began or worsened; there was a marriage of at least one year between the survivor and veteran, or the survivor had a child with the veteran.
Even spouses who divorce a veteran and remarry to someone other than the veteran can receive DIC if they remarried on or after December 16, 2003, and were 57 years old or older at the time, or remarried on or after January 5, 2021, and were 55 years old or older.
DIC and The Burden of Proof
The claimant has the burden of proof on these points. Usually, documentary evidence, such as a marriage certificate, is best. Additional evidence probably is not necessary.
Surviving children must present proof of age. Surviving parents must present proof of relationship, such as a birth certificate, as well as proof of income which must be below a certain threshold.
Do not leave any of the required boxes unchecked. Doing so will be very difficult to overcome the VA’s predisposition to deny such a claim. For example, if a vet surviving spouse and veteran were still married but lived apart, the veteran’s survivor may not think the living arrangement should matter.. It is always best to consult an experienced attorney in these claims.
Disability Technicality and DIC
Even if the survivor successfully proves his or her relationship to the veteran qualifies for DIC benefits, remember that these claims are still reviewed by human beings. It is not an automatic grant of benefits.
The VA has an electronic records system. Every VA medical record is just a few clicks away, at least theoretically. But no system is perfect. Especially if the veteran had moved recently, or moved a lot, current records may be unavailable or hard to obtain. Unfortunately, there is no way to tell what records the claims examiner is reviewing until after s/he denies the claim. Fortunately, the VA is working on updating its records management system to decrease the number of errors in this category, but the current reality is that claims are improperly denied quiet often.
The good news is that such issues are relatively easy to fix. Under federal law, claims examiners must review all VA medical evidence. A simple higher-level review normally reverses the previous denial if the claims examiner missed a critical piece of evidence.
No Service-Related Connection For DIC
This basis for denial addresses the merits of the claims themselves. The VA awards DIC Benefits to survivors if the disability of the veteran, be it an injury or illness, was service-related. This phrase is very broad. Additionally, the burden of proof is low in these situations. So, a little evidence goes a long way.
Contact Assertive Attorneys
An attorney is a valuable partner in all phases of a disability claim. For a free consultation with an experienced Veterans disability lawyer, contact the Cameron Firm, P.C. at 800-861-7262 or fill out the contact box on our website. We are here to represent Veterans nationwide.
This article is for educational and marketing purposes only. It does not create an attorney-client relationship.
