Some veterans may submit VA disability claims with 50-50 evidence, meaning the VA could decide the claim either way. However, the “benefit of the doubt” doctrine can help you avoid a denial of your VA disability benefits claim. The doctrine gives veterans a slight advantage that recognizes the goals of supporting them.
Understanding the Benefit of the Doubt Doctrine
Under federal law, a veteran who submits a claim for disability benefits has the burden to submit evidence sufficient to establish a belief that they have a well-grounded claim. However, the law requires the VA to assist a claimant in developing facts pertinent to their claim. Furthermore, once the VA considers all the evidence in the record and finds an approximate balance of positive and negative evidence regarding a claimant’s entitlement to VA disability benefits, federal law gives the claimant the benefit of the doubt, requiring the VA to approve their claim. This “benefit of the doubt” doctrine reflects the VA’s pro-veteran policy. The doctrine also recognizes the difficulty that veterans may face in proving their entitlement to benefits when their disability manifests years after they have left service.
When Does the Doctrine Apply?
The benefit of the doubt doctrine applies when the evidence in a claimant’s case equally supports approving or denying the claim. In other words, the doctrine tips the balance in favor of a veteran when the evidence establishes a 50-50 claim – the evidence equally supports granting or denying the claim.
Various circumstances could lead to an equally balanced claim that triggers application of the benefit of the doubt doctrine, including:
- Lack of clarity in the service-connected nature of the condition
- Conflicting nexus opinions
- Disputes over whether to assign a zero disability rating
- Disagreements over the effective date
The doctrine cannot overcome a lack of evidence. A veteran must present sufficient evidence that reasonable minds could disagree over whether the veteran qualifies for disability benefits.
Practical Examples of How the Doctrine Influences VA Claims
The benefit of the doubt doctrine may influence a veteran’s disability benefits claim if the record contains two medical opinions of equivalent quality that reach conflicting conclusions about whether a veteran’s condition has a service connection. These conflicting opinions could create a perfectly balanced scale. However, the doctrine tips the scales in favor of the veteran, requiring the VA to approve their disability benefits claim.
The doctrine can also affect disability ratings. For example, medical opinions may differ in their assessment of a veteran’s symptoms or the functional limitations they cause. As a result, the evidence may split evenly between two disability ratings. The benefit-of-the-doubt doctrine can again tip the decision in favor of the veteran, resulting in the assignment of the higher disability rating.
How Veterans Can Strengthen Their Claims to Trigger the Doctrine
Veterans who have cases that raise doubts about their entitlement to disability benefits may strengthen their claim to potentially trigger the application of the benefit of the doubt doctrine by:
- Providing consistent personal testimony and buddy statements
- Submitting private medical opinions from treating providers
- Documenting ongoing symptoms and limitations
- Remaining consistent with treatment and rehabilitation
Merely inundating the record with evidence cannot, by itself, move the needle enough to trigger application of the doctrine. Instead, the goal of submitting additional evidence should be to balance the evidence such that the VA cannot definitely decide either way.
Appealing a Decision When the VA Fails to Apply the Doctrine
Veterans can pursue the administrative appeals process when the VA denies their disability benefits claim, including when a veteran believes that the evidence equally supports a finding either way. Arguing that the record contains approximately balanced evidence may give a veteran grounds to say that the VA should have applied the benefit of the doubt doctrine to approve their claim.
Contact a VA Disability Benefits Attorney Today
Contact Veterans Law Attorneys today for a free, no-obligation consultation with a VA disability benefits lawyer to learn more about the benefit of the doubt doctrine and how it may apply to your case to give you an edge in getting approved for benefits.
