Claim Denied? Here's What's Usually Missing (And How to Fix It)

A recent discussion on r/VAClaims highlighted a question many veterans face: "Claim denied—what's missing?" This is one of the most frustrating moments in the VA claims process. You've submitted your claim, waited months for a decision, and received a denial letter that doesn't clearly explain what went wrong.

Here's what veterans need to know about common denial reasons and how to strengthen their claims.

The Three Pillars of a Successful VA Claim

Every VA disability claim requires three essential elements:

1. Current Diagnosis – A medical professional has diagnosed you with a condition
2. Service Connection – Evidence that the condition is related to your military service
3. Nexus – A medical link connecting your current condition to an in-service event, injury, or illness

If any of these are missing or weak, your claim will likely be denied.

Common Reasons for Denial (And What's Actually Missing)

1. Missing or Weak Medical Nexus

The Problem: The VA can't connect your current condition to your military service.

What's Missing:

• A nexus letter from a medical provider explicitly stating your condition is "at least as likely as not" related to service
• Medical evidence showing the progression from in-service event to current condition
• Clear documentation of when symptoms began

How to Fix It:

• Get a nexus letter from a private doctor or use a service like Valor AI to connect with providers who specialize in VA claims
• Document the timeline: when did symptoms start? When did you first seek treatment?
• Gather service medical records showing any treatment or complaints during service

2. Insufficient Medical Evidence

The Problem: You have a diagnosis, but not enough documentation of ongoing treatment or severity.

What's Missing:

• Ongoing treatment records (not just one visit)
• Detailed medical records showing symptoms and their impact
• Disability Benefits Questionnaire (DBQ) completed by your doctor
• Test results, imaging, or lab work supporting your diagnosis

How to Fix It:

• Continue seeking treatment—ongoing care strengthens your claim
• Request your doctor complete a DBQ for your condition
• Keep detailed records of all medical appointments
• Document how your condition affects daily life (work, relationships, activities)

3. No In-Service Event Documentation

The Problem: You can't prove the condition started or was aggravated during service.

What's Missing:

• Service medical records showing treatment or complaints
• Incident reports or accident reports
• Unit records documenting events (deployments, training accidents, etc.)
• Buddy statements from service members who witnessed events

How to Fix It:

• Request your complete service medical records from the National Archives
• Get buddy statements from fellow service members who can attest to events
• Document any incidents that occurred during service, even if you didn't seek treatment immediately
• Check your DD-214 for any awards or decorations that might indicate exposure to events

4. Lack of Lay Evidence

The Problem: Your personal statement is too brief or doesn't clearly explain the connection.

What's Missing:

• Detailed personal statement (at least 500 words) explaining:
  • When and how the condition started
  • How it affects your daily life
  • The connection to your military service
• Statements from family members about changes they've observed
• Statements from employers about work limitations

How to Fix It:

• Write a comprehensive personal statement (21-4138 form) that tells your story in detail
• Ask family members to write statements about how your condition has changed you
• Document specific examples of how symptoms impact your life
• Use Valor AI's narrative generator to help structure your statement

5. Missing C&P Exam or Poor Exam Performance

The Problem: You missed the exam, or the examiner didn't get a complete picture of your condition.

What's Missing:

• Attendance at the scheduled C&P exam
• Preparation materials (list of symptoms, medications, treatment history)
• Honest description of your worst days, not your best days

How to Fix It:

• Never miss a C&P exam—reschedule if necessary, but don't skip it
• Prepare thoroughly: bring a list of symptoms, medications, and treatment history
• Describe your worst days, not days when you're feeling better
• Bring a support person if allowed (they can help you remember important details)

6. Incomplete Application

The Problem: Forms weren't filled out completely or correctly.

What's Missing:

• All required sections completed
• Accurate information matching your records
• All claimed conditions listed
• Proper signatures and dates

How to Fix It:

• Use Valor AI's guided form filling to ensure completeness
• Double-check all information matches your DD-214 and medical records
• List every condition you're claiming—don't leave anything out
• Review your forms before submitting

The Most Critical Missing Piece: The Nexus Letter

Based on discussions in veteran communities, the single most common reason for denial is a missing or weak nexus letter. This is a medical opinion from a qualified provider that explicitly states your condition is "at least as likely as not" related to your military service.

What Makes a Strong Nexus Letter:

• Written by a qualified medical professional (MD, DO, NP, PA)
• Reviews your service records and current medical records
• Uses VA language: "at least as likely as not" or "more likely than not"
• Explains the medical reasoning connecting service to current condition
• References specific medical literature or research when applicable

What to Do After a Denial

If your claim was denied, you have three options:

1. Supplemental Claim (VA Form 20-0995)

Best for: When you have new evidence that wasn't in your original claim.

Submit new and relevant evidence that addresses the specific reason for denial. This could be:

• A nexus letter
• Additional medical records
• New test results
• Buddy statements

2. Higher-Level Review (VA Form 20-0996)

Best for: When you believe the VA made an error reviewing existing evidence.

A senior reviewer examines your existing evidence without new evidence. This is faster (usually 4-5 months) but you can't add new evidence.

3. Board Appeal (VA Form 10182)

Best for: Complex cases or when you want a hearing.

Appeal to the Board of Veterans' Appeals. This takes longer (often 1-2 years) but allows for a hearing and legal representation.

How Valor AI Can Help

Valor AI is designed to help veterans avoid these common pitfalls:

• Evidence Gap Detection: Our AI analyzes your claim and identifies exactly what evidence is missing
• Narrative Generation: Helps you write comprehensive personal statements that clearly explain your case
• Form Guidance: Ensures your forms are complete and accurate before submission
• Appeal Strategy: If denied, we help you determine the best next step and what evidence to gather

Key Takeaways

1. The nexus letter is critical – Most denials happen because the VA can't connect your condition to service
2. More evidence is better – Submit everything upfront rather than waiting for the VA to request it
3. Document everything – Keep detailed records of symptoms, treatment, and how your condition affects your life
4. Don't give up – Denials are common, but many claims are approved on appeal with the right evidence
5. Get help – Use a VSO, attorney, or tools like Valor AI to strengthen your claim

Resources

• r/VAClaims – Community support and shared experiences
• VA.gov – File claims and check status
• Find a VSO – Free accredited representatives
• Valor AI – AI-powered claim assistance and evidence gap detection

Remember: A denial doesn't mean your claim is invalid. It often means you need stronger evidence or a clearer connection to service. With the right approach and evidence, many denied claims are eventually approved.

---

This post was inspired by discussions in the veteran community, particularly on r/VAClaims, where veterans share their experiences and help each other navigate the VA claims process.