A Knowledgeable Veterans Disability Lawyer Explains How the Benefit of the Doubt Doctrine Should Work

The U.S. Department of Veterans Affairs (VA) has one of the most lenient standards that you’ll find when you have a burden of proof in the legal process. If you can prove that your eligibility for disability benefits is “at least as likely as not,” your claim should be granted. 

But in reality, the VA can be much tougher when you’ve filed a claim. While the agency is supposed to give your claim the benefit of the doubt, it could wrongfully deny it. Attorney Sean Kendall and his team fight for Veterans and get results. We strongly believe that the nation must keep the promises it makes to those who serve. 

How “At Least as Likely as Not” Standard Applies to VA Disability Claims

In a general personal injury case, you would have the burden of proof to demonstrate your claim by a preponderance of the evidence. This standard means the facts underlying your claim are more likely than not to have happened. The preponderance of the evidence is a lower standard than the “beyond a reasonable doubt” burden required of a prosecutor to prove a crime. The former equates to a 50.1 percent chance that something is true, while the latter standard approaches 100 percent certainty in the mind of any reasonable person. 

When you file a Veterans disability claim, you’re facing a standard that should be even more favorable to you than what’s used in personal injury cases. The VA uses a standard of “at least as likely as not’, which means that if you can show there’s at least a 50 percent chance of your disability, you’re entitled to the benefits for which you have applied. 

While there might not seem to be a great difference between the preponderance of the evidence and the “at least as likely as not” standard, there’s a fine distinction between them that means a lot in your claim. There’s a common metaphor used to explain: some cases are considered a “jump ball” that could go either way based on the evidence—if you were filing a personal injury lawsuit, you wouldn’t get over the line and be entitled to compensation. In that context, 50 percent may as well be 0 percent, and you would lose your case. However, if you filed a VA disability claim, 50 percent should be considered 100 percent.

VA Case Law Says You Should Get the Benefit of the Doubt

The way the standard should be applied is that a Veteran is entitled to the “benefit of the doubt” when there is “an approximate balance of positive and negative evidence.” In other words, there should be a slight finger on the scale when there’s an equal amount of things going for and against your claim. Still, you would need to meet your own burden of proof, and the VA can be very strict when determining your eligibility for benefits. Rubber-stamp-with-word-denied

Qualifying for Veterans’ disability benefits certainly isn’t a sure thing, but the courts at least understand the purpose of the law. They recognize that “this unique standard of proof is in keeping with the high esteem in which our nation holds those who have served in the Armed Services.” Appeals courts can and will reverse decisions that deny you benefits when the VA is being overly strict. This is exactly what happened in the case of Gilbert v. Derwinski. 

In this case, Gilbert was a servicemember who claimed he sustained back injuries during his military service. Specifically, he was serving in Korea in 1956, and he fell while holding a machine gun. Gilbert tried and failed to get numerous disability benefits at numerous points over an 18-year period. For Gilbert, the problem was that there wasn’t a note in his military medical records indicating he suffered the injury from the time of his service. In addition, the Board of Veterans Appeals also found that his condition was temporary and didn’t result in his disability. 

Gilbert contested the ruling with the United States Court of Appeals for Veterans Claims. The appeals court took issue with how the lower court reviewed the claim. The appeals court found that there was both positive and negative evidence, but the lower appeals court didn’t properly apply the “benefit of the doubt” standard. 

In its decision, the court looked at the regulation that Congress intended to codify into law when it passed the “benefit of the doubt” standard. Here, the prior regulation said that:

“When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant.”

The appeals court sent the case back to the lower court to properly give Gilbert the benefit of the doubt. The judges outlined both the positives and negatives involved in Gilbert’s claim, and instructed the appeal to be considered in light of the purpose and intent of the law. 

Still, the court made it clear that the “benefit of the doubt” standard applies to evidence that you have put in front of the VA to consider as part of your claim. The agency must give you the benefit of the doubt when weighing the evidence, instead of waiving some of the requirements you must already meet to qualify for benefits. 

The court’s decision accounts for a situation in which the servicemember has proven their claim to a 50 percent standard (just shy of “more likely than not.”) There’s an equal chance that the facts support them—or the agency that denies their claim. There’s that “jump ball” metaphor again. But remember: in a personal injury case, the plaintiff wouldn’t have enough evidence to position them for compensation.

You Must Still Present a Compelling Claim to the VA and Sean Kendall Can Help

Even when you’re given the benefit of the doubt, you must still submit a strong and persuasive claim to Veterans Affairs. You’re still required to include compelling proof of your disability and show how it was connected with your service. You want to have as much evidence as possible to tip the ball in your favor so the VA has to give you the benefit of the doubt if your claim is even a close call. 

The VA often slants its decision towards the negative information, either completely overlooking the positive or not properly weighting it. If the agency is using an extra stringent requirement that could make it extremely difficult to get benefits, a denial could be overturned

This is when you need the expertise of a skilled Veterans’ disability benefits legal team like ours who can partner with you on the claims appeal process. We’ve helped people just like you obtain fortunate results when courts have made mistakes in applying the “benefit of the doubt” doctrine to a denied claim.

For example, Attorney Sean Kendall successfully argued to the Court of Appeals that the agency wrongfully applied the “benefit of the doubt” standard in denying a claim for a Veteran’s death due to heart disease when they already suffered from PTSD. In this case, the VA denied that someone could develop heart disease as a result of PTSD, even though some doctors acknowledge the connection. The appeals court held that it was wrong to require a medical principle supporting a claim to be generally accepted by all doctors, and specified the denial violated the “benefit of the doubt” rule. 

Our knowledgeable legal counsel will assist you in numerous phases of the claims process. Before it becomes more difficult than you deserve, count on us to vigorously represent you when your initial claim has been denied.