Veterans benefits can only be awarded for a condition that is connected to your military service. You can’t be awarded benefits for an impairment that existed before your service or is from an unrelated event. However, Veterans are often unfairly denied benefits when a disability is wrongly classified as a preexisting condition.

Denials that unfairly categorize a disability as a preexisting condition are common for complaints of sleep apnea, heart problems, or orthopedic conditions, but any condition may be unfairly denied if it is wrongly classified by the VA. If you receive a denial that you believe is incorrect, understanding the VA appeals process is crucial.

How the Presumption of Soundness Can Be Grounds for an Appeal

Application for VA disability benefits must use what’s referred to as the presumption of soundness. The law states, “Every Veteran shall be taken to have been in sound condition Preexisting Condition Button on a Keyboardwhen examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment.”

This may sound like confusing legalese, but what it essentially means is that you are presumed to be healthy at the time you entered the military. If a condition is not listed on your entrance exam, the VA can’t legally claim it is preexisting. There is an expectation that any health issue you suffered from at the time you entered the military would have been identified and documented by the doctor who conducted your exam.

The presumption of soundness favors Veterans, but it doesn’t automatically mean you have a right to disability benefits. You must still be able to prove your condition is related to your service. For example, claims for sleep apnea are rarely approved as a primary disability because most Veterans do not receive the sleep study necessary for a diagnosis while on duty. However, sleep apnea can more easily receive a secondary service connection for Veterans who have also been diagnosed with PTSD or traumatic brain injury.

The presumption of soundness can only be rebutted by the VA in very limited circumstances. For example, the VA would need to provide proof that the initial exam missed the diagnosis of a congenital or developmental defect.

Disability Benefits for Aggravation of a Preexisting Condition

If your condition is noted on your entrance exam, this does not mean you are automatically not entitled to disability benefits. If you can provide evidence that your condition worsened during your military service, you can receive benefits for aggravation of a preexisting condition.

There are two key points to remember when seeking benefits for aggravation of a preexisting condition:

  • The worsening can’t be due to the natural progression of your disease.
  • A temporary flare-up of symptoms does not entitle you to benefits.

Worsening of a preexisting condition includes physical impairments as well as mental health issues. The key is to show that your condition was being managed effectively at the time you entered service. For example, if you were diagnosed with depression before entering the military, you might provide evidence showing that you were taking medication and able to work full-time, maintain an active social life, and volunteer in your community.

Get Started With Your Appeal Today

If you believe your application for VA disability benefits has been unfairly denied, you should start the appeals process as soon as possible. The best way to increase your chances of a successful appeal is to hire an attorney who understands the intricacies of VA disability law and how it should be applied to your particular impairment. According to VA statistics, 46.31% of appeals were approved with an attorney in 2019, while only 26.18% were approved with no representative.

The office of Sean Kendall, Attorney-at-Law, has over 20 years of experience helping Veterans access the VA disability benefits they need to provide for themselves and their families. Call our office or fill out the contact form on this page to schedule a free, no-obligation initial consultation.

 

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