Finality of VA Disability Claims

The Finality of VA Disability Claims

Understanding The Finality of VA Disability Claims

 

This article covers fundamental regulations and the finality of VA Disability Claims. Most VA disability claims take months to successfully resolve. Many take much longer than that. Particularly since VA disability attorneys are not on board during the initial phases of these claims, they often lapse because time deadlines come and go. Lapsed claims are difficult, but not impossible, to resuscitate. Making matters even more complicated, a claim can be “pending” for many years, even though it is inactive.

 

2007’s Ingram v. Nicholson laid out some basic rules in this area. This case also outlined the pleading (request for VA benefits) requirements in VA disability matters. Since attorneys are not in the picture initially, some Veterans submit rather unclear pleadings. Ingram further articulated the “sympathetic reading” rule which assists Veterans in these situations.

 

Facts

 

Ingram returned from Vietnam in 1968 with breathing problems. In 1985, he underwent a pneumonectomy and a right bronchoscopy at a VA medical center. The next year, a Regional Office denied his disability claim due to his breathing problems.

 

In 1992, Ingram filed a new disability claim, this time alleging that surgical complications and VA negligence left him disabled. An RO denied this claim but the Board of Veterans Appeals granted it, setting a disability date of 1992.

 

The Secretary appealed, asserting that a denial of one part of a claim is a complete denial of all parts of the claim. So, Ingram’s subsequent application was legally invalid. Ingram maintained that, since there were no allegations of VA negligence in his original claim, his subsequent claim was valid.

 

Decision

 

In a previous case, Deshotel v. Nicholson (2006), the Court of Appeals for Veterans Claims held that “Where the veteran files more than one claim with the RO at the same time, and the RO’s decision acts (favorable or unfavorable) on one of the claims but fails to specifically address the other claim, the second claim is deemed denied and the appeal period begins to run.” That holding would invalidate Ingram’s subsequent claim.

 

But the CAVC noted some factual differences between these two cases. In Deshotel, the Veteran filed a claim for brain injury-related headaches and a later claim for brain injury-related psychiatric symptoms. Those two claims are quite similar. But there is a big difference between breathing problems and medical negligence, even if they have some common elements.

 

Furthermore, the CAVC concluded that a broad reading of Deshotel was contrary to federal law and due process principles. Indeed, such an interpretation “would shift the burden onto a claimant to prove the high standard of CUE that not only did the RO err in not providing reasons for the ‘deemed denial’ but that the claimant was entitled to a grant of the benefits.”

 

In terms of sympathetic pleading rules, the CAVC noted that Veterans know the facts and what symptoms they are experiencing, and the Secretary knows the law and how it applies to those facts. So, when a court reads a Veteran’s pleadings, the court must be mindful that the Veteran is not a lawyer and therefore the pleading might be rather vague. 

 

Reach Out to Confident Attorneys

 

If the VA denies part of your claim, you might still have legal options. 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 to your right. We are here to represent Veterans nationwide.

 

This article is for educational and marketing purposes only. It does not create an attorney-client relationship.