What Can I Do If My VRS Disability Benefits Claim Is Denied?

If your Virginia Retirement System disability retirement application is denied, you can appeal the decision. Generally, an appeal will involve the following steps:

1. You can request another review of your application and submit any requested or additional medical information.

2. If your application is denied again, your case will be referred to an independent fact finder. An independent fact finder is an attorney in private practice with experience in reviewing disability cases. This individual does not represent you or VRS. You can hire your own attorney and would be wise to do so.

3. The independent fact finder will arrange an informal proceeding at a date agreeable to you at a location in your area. The purpose of the proceeding is to consider all current and any additional medical evidence you wish to provide. A court reporter will be present to record the proceeding. Your employer is allowed to attend; if you have an attorney, he or she will be invited. You also can invite family members, co-workers, your doctor or other witnesses. Once the proceeding ends, you cannot provide any additional medical evidence.

4. Any medical evidence you provide at the proceeding will be sent to the Medical Board. The Medical Board will review the additional information and recommend to VRS that your application be approved or denied; the independent fact finder also will send his or her recommendation to VRS. The Medical Board may request additional medical evidence or require you to undergo a functional capacity evaluation or an exam by an independent medical examiner before submitting its recommendation to VRS.

5. Based on the recommendation of the independent fact finder and the Medical Board, VRS will make a final case decision to approve or deny your application. If it is denied, you can appeal the final case decision to the appropriate circuit court.

If your Virginia Retirement System disability retirement application is denied, you should absolutely consult with a lawyer experienced in Virginia Retirement System disability benefits claims. Too often we are contacted by people who have filed claims and exhausted their administrative appeal rights. If you must later file an appeal to Circuit Court, a court is only going to review the agency record to determine whether there was substantial evidence in the agency record to support the agency decision. EVERY case we have reviewed in which the client has applied for benefits and done the informal fact-finding proceeding himself/herself lacks important information and documents that could have been provided with the original claim.

Do you think that the Virginia Retirement System is going to fill the record with information favorable to you? We have never seen that happen!

Your attorney should be experienced in VRS disability claims, should understand the applicable legal standards, and should know how to gather the evidence necessary to support a claim for Virginia Retirement System disability benefits. Ask the right questions. Attorneys cannot simply “dabble” in Virginia Retirement System (VRS) disability benefits claims!

If you have been denied VRS disability benefits, we will review that denial letter at no charge and suggest an appropriate course of action. We have a variety of fee programs available.

Call us at 1 (855) 873-2604.  We want to hear your story and see how we can help.