VA denial letter sample — what a real rating decision looks like

The sample letter

Below is a composed example — not a real veteran's decision letter, but every block is accurate to the template VA Regional Offices use. Names, dates, and conditions are fabricated. The structure and prose style match what you will actually see in your own mail.

Block-by-block walkthrough

1. The Decision block

Five numbered issues. Read each outcome carefully:

• Lumbar strain — GRANTED at 10%. Win, but a small one. The 10% rating suggests there is room to push to 20% (see the Reasons for Decision below).
• PTSD — DENIED. This is the core denial. The Reasons paragraph tells you why.
• Bilateral hearing loss — DENIED. The audiogram did not meet 38 CFR 3.385 thresholds.
• Tinnitus — GRANTED at 10%. Win. Tinnitus is capped at 10% under DC 6260 — no higher rating is possible.
• TDIU — DENIED. Schedular threshold not met (makes sense — combined rating from this decision is only about 20%).

2. The Evidence Considered list

The rater lists seven items they looked at. What is interesting is what is NOT here:

• No buddy statements (21-10210). If the veteran has fellow service members who witnessed the combat exposure or the stressor, those are missing. That is one pathway to a Supplemental Claim.
• No personal statement (21-4138).The rater had the veteran's narrative from the application but no separate stressor statement for the PTSD claim. A 21-4138 describing the stressor in detail could be new evidence.
• No nexus letter from a private provider.The only medical opinion on record is the VA examiner's — who opined against the veteran. A private nexus letter from the veteran's treating provider using “at least as likely as not” language would reopen the PTSD claim cleanly.

3. The Reasons for Decision section — where to focus

This is the only section that tells you why. Read each issue's paragraph carefully.

The lumbar paragraph tells us something important

The paragraph cites forward flexion to 70 degrees and applies DC 5237. The thresholds under DC 5237 are:

• 10% rating — flexion greater than 60° but not greater than 85° (or combined ROM 120-235°).
• 20% rating — flexion greater than 30° but not greater than 60°.
• 40% rating — flexion to 30° or less.

Our sample veteran had flexion to 70° on the VA exam. That is a clean 10% fit. But DeLuca/Mitchell functional-loss analysis allows rating based on flare-up ROM, not just baseline. If this veteran has flare-ups 2-3 times per week where flexion drops below 60°, that is a Supplemental Claim case — the new evidence being a flare-up journal and, ideally, a private examination during a flare.

The PTSD denial is the high-leverage issue

The Reasons paragraph hinges on two findings:

• The VA examiner opined “less likely than not” on nexus — this fails 38 CFR 3.102's 50% benefit-of-the-doubt threshold.
• The stressor “could not be verified against the service record.”

Both are beatable. A private psychologist's opinion using “at least as likely as not” language neutralizes the first one. For the stressor, 38 CFR 3.304(f)(3) allows fear-of- hostile-military-activity stressors to be verified by the veteran's own testimony plus consistency with the service location — no direct STR documentation needed. For MST claims, 38 CFR 3.304(f)(5) allows markers (performance drops, transfer requests, disciplinary changes) to substitute for STR documentation.

Both pathways require new evidence. That makes this a Supplemental Claim (20-0995), not an HLR.

The hearing loss denial

Under 38 CFR 3.385, VA defines hearing loss as: puretone thresholds of 40+ dB at 500/1000/2000/3000/4000 Hz, OR three or more of those frequencies at 26+ dB, OR speech discrimination less than 94%. If the VA audiogram did not meet any of those thresholds, service connection fails as a matter of law — no amount of lay evidence changes it.

But audiograms can change. If the veteran gets a private audiogram a year later showing worsening that does meet 3.385, that is a new Supplemental Claim with a clear nexus back to in-service noise exposure.

Putting it together — the appeal strategy for this letter

From this one sample letter, a competent appeal strategy would be:

1. PTSD: Supplemental Claim with a private nexus opinion and a 21-4138 stressor statement citing 3.304(f)(3) fear-of-hostile-activity verification.
2. Lumbar strain — increase to 20%: Supplemental Claim with flare-up journal + private DBQ showing flexion below 60° on flare. Optionally an HLR if the veteran feels the VA examiner already captured the flare-up (he did not here, based on the clean 70° measurement).
3. Hearing loss: Delay 6-12 months, get a follow-up audiogram, file a Supplemental if the numbers have moved into the 3.385 zone.
4. TDIU: Re-file once PTSD and lumbar are at their appropriate ratings. TDIU is contingent on the schedular threshold, which changes when the underlying ratings change.

Use the decoder on your actual letter

The denial decoder reads your real letter — paste the text or upload a scanned PDF — and walks the same block-by-block analysis automatically. It tells you which paragraph is the denial paragraph, which CFR section the rater applied, which appeal lane fits each issue, and which forms to file. Two minutes, no account, letter contents never leave your browser.