Four Reasons Your PTSD Rating Increase is Getting Denied

 Posted on April 15, 2025 in Uncategorized

Understanding VA Denial of Increased Rating for PTSD and Mental Health Claims Post-Traumatic Stress Disorder (PTSD) and other mental health conditions are significant challenges faced by many veterans. Securing adequate disability compensation is vital for those affected, yet it's not uncommon to encounter denials when seeking an increased rating for these conditions. Understanding the reasons for these denials and how to address them effectively is crucial in strengthening your case before the Department of Veterans Affairs (VA).

1. Misunderstanding the Rating Criteria: The VA rates mental health conditions using specific diagnostic codes, each with defined criteria and symptoms necessary for a particular rating. Without a clear understanding of these criteria, veterans might find it challenging to argue for an increased rating successfully. The focus is often on social and occupational impairment—how well a veteran can interact with others and maintain employment. Familiarizing yourself with the specifics of your condition's diagnostic code and the required evidence can significantly impact the outcome of your claim.
2. Insufficient Evidence: A lack of substantial evidence can lead to a denial. While medical documentation is paramount in establishing the severity of mental health conditions, veterans should also leverage buddy statements—testimonies from individuals who have observed the impact of the condition. These statements should provide concrete examples of social interaction and work-related impairments. Whether or not you seek mental health treatment, these supplemental statements can bolster your argument for an increased rating.
3. Inconsistent Reporting of Symptoms: Variability in symptom reporting between regular treatment sessions and Compensation & Pension (C&P) exams can raise red flags. Consistent reporting across all medical appointments and documentation is essential to avoid the perception of dishonesty or exaggeration, which can contribute to a denial. Ensuring that your symptoms' severity remains consistent will help clarify the true impact of your condition on daily life.
4. C&P Exam Issues: Issues during the C&P exam, whether due to the veteran's reporting or the examiner's conduct, can also result in denials. It's crucial for veterans to accurately and specifically convey how their symptoms affect their social and occupational functioning during these exams. Additionally, if the examiner's evaluation is brief or lacking in depth, reviewing the exam report for factual inaccuracies is critical. Addressing discrepancies through supplemental claims or higher-level reviews can help rectify the situation.

Need help with your claim? Reach out to our VA-accredited team for a free consultation: https://calendly.com/vetlawoffice

Addressing a Denial

If your increased rating claim for PTSD or mental health conditions has been denied, don't be discouraged. Review the denial details, gather additional documentation, and consider reaching out to professionals who specialize in VA claims. They can guide you through submitting a supplemental claim, pursuing a higher-level review, or taking other appropriate actions based on your circumstances. In conclusion, comprehending the VA's rating criteria, ensuring sufficient and consistent evidence, and addressing potential C&P exam issues can enhance the likelihood of a successful increased rating claim.