We have noticed the VA may be changing what information they include in Rating Decisions. In the past, when the VA denied a claim, they included the VA examiner’s medical opinion in the rating decision letter. Recently, we have seen the VA leaving this information out. This change makes it harder for veterans to appeal denials and obtain benefits. In this article, we will explain what we have observed and what actions veterans should take.
How Rating Decisions Used to Work
Until recently, VA rating decisions included the examiner’s medical opinion when a claim was denied. The letter would quote the VA examiner’s negative opinion.
Here is one example:
This allowed veterans to quickly seek a private medical opinion, also known as a nexus letter, to refute the VA’s findings. Both the veteran and the private medical expert could read the exact reasons for denial and respond to them.
What We Are Seeing Now
At Valor 4 Vet, we track patterns across VA Regional Offices. Regional Offices often make changes at the same time, which reveals system-wide shifts in how the VA handles claims. By watching for these patterns, we can help veterans stay ahead of new denial tactics.
We have found that the VA is often failing to include their medical expert’s opinions in rating decision letters.
Here is a more recent rating decision:
As you can see, the VA only states that the examiner found no link. It does not include the VA examiner’s medical reasoning or explain why they reached that conclusion. Without this information, the veteran cannot effectively respond to the denial.
Why This Matters
This change creates a problem for the veteran. A private medical expert cannot refute the VA examiner’s opinion without knowing what that opinion says. Therefore, veterans must now request a copy of the VA examination from their claims file before they can move forward with a private opinion or an appeal.
File requests from the VA are not fast. Getting copies of documents from your claims file can take weeks or even months. During this time, the veteran cannot obtain a private opinion for a supplemental claim. The delay pushes benefits further out of reach.
Recommended Action
If your claim is denied and the rating decision does not include the VA examiner’s medical opinion, take these steps:
Contact your representative. Sometimes a representative such as a Veterans Service Organization, claims agent, or attorney can obtain copies of the VA examination faster than you can on your own.
Or, request a copy of the VA examination from the VA as soon as possible. You can make a claims file request here.
Once you have the VA examiner’s opinion, you can work with a private medical expert, like Valor 4 Vet, to write a medical opinion to refute the VA examiner’s negative opinion.
We recommend that all veterans check their rating decision denials carefully. If the VA examiner’s opinion is missing, get a copy of the VA examiner’s reports.
