va benefit denialMany veterans will have their initial claims for benefits denied, leaving them to wonder if they should appeal the decision, or file a new disability claim. Since there are many levels of appeal, it is important to know the difference between new and reopened VA disability claims.

The VA classifies claims in the following ways:

  • Original claim. An original claim is the very first claim that you file for VA benefit compensation. This can be filed by active service members, veterans, or surviving spouses of deceased military members. If this claim is denied, veterans have one year from the date of denial to appeal the decision. To file an original claim, complete the VA’s form 21-526ez.
  • Reopened claim. If your benefit claim was denied and was not appealed before the time limit expired, your case can be reopened if there is new evidence available that could change the VA’s decision. In order to reopen your claim, you would send "new and relevant" evidence (such as medical testing or evaluation) to the VA and ask them to reconsider their decision. To file a reopened claim, complete the VA’s form 20-0995

What does the VA mean by “new and relevant” evidence? The VA says that “new” evidence is simply that—new evidence submitted to the VA for the first time. It cannot be information that is already in VA records. It cannot be evidence a veteran has previously provided to the VA or evidence the VA has legally acquired on behalf of the veteran.

“Relevant” evidence is a fact (or facts) that VA did not have enough evidence to verify at the time of their prior decision—a fact that is necessary to substantiate the claim. The VA says that submitted evidence which was previously reviewed in a claim denial is cumulative or redundant. It is not considered new and relevant.  Evidence previously reviewed in the decision that denied your claim can be found in your notification letter or rating decision. This may help you determine if the evidence you’re considering for submission is cumulative or redundant.

Here’s an example that may help clarify what is considered new and relevant evidence. Let’s say a veteran who is pursuing an Agent Orange claim has a private doctor’s medical report that lists non-Hodgkin's lymphoma as one of his diagnoses. If this veteran has never submitted this report to the VA, and his VA Claims File has no record of this disease, then this private medical report would be both new and relevant evidence.

  • New claim. A new claim is any claim that relies on new evidence. An original claim may be considered a new claim, but there are also new claims that can be made by veterans who are already receiving some form of compensation through the VA. New claims may be filed to re-evaluate the percentage of a person’s disability, to apply for pensions or compensation for special circumstances, or if a service member is applying for individual unemployability.
  • Secondary claim. A secondary claim involves a disability that has been caused (or worsened) in relation to a condition that has been connected to military service. The two conditions must be related in order for the veteran to get compensation.

Because each appeals case has its own unique set of facts and conditions, there is no “one size fits all” here. Choosing the best option—to reopen a claim, file a new claim, or file a secondary claim— depends on a case-by-case analysis.  Therefore it is best to consult with a VA-accredited attorney to talk about your options and get guidance in deciding what makes the most sense for your individual case.

We Can Explain Your Benefits at No Cost to You

At Cuddigan Law, our VA accredited disability attorneys provide veterans with the information they need to get maximum compensation for their disabilities. We can help you appeal your VA claim denial, and also examine whether other benefit sources such as Social Security Disability are available. Fill out the short contact form on this page or give us a call at (402) 933-5405 to find out how we can help, or click here to read through a free copy of our book, The Essential Guide to VA Disability Claims.

 

Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska