As a VA disability law firm, we understand that navigating the complex world of VA decision reviews and appeals can be overwhelming for veterans seeking to challenge a decision made by the Department of Veterans Affairs (VA).
In the past, veterans had to go through a lengthy and complicated legacy VA appeals process.
However, with the implementation of the new decision review process on February 19, 2019, veterans now have three different options to choose from when seeking to dispute a VA decision.
What is a Decision Review Request (DRR)?
A Decision Review Request (DRR) is a formal process within the United States Department of Veterans Affairs (VA) that allows veterans to request a review of decisions related to their disability compensation, pension, education benefits, or other benefits administered by the VA.
It is typically initiated when a veteran disagrees with a decision made by the VA regional office, such as a denial of benefits, a rating decision, or an effective date determination.
The DRR process provides veterans with options to seek reconsideration (review) of VA decisions. The decision review process provides veterans with flexibility and choice, allowing them to select the option that best suits their needs.
The three decision review options available are:
- Supplemental Claim
- Higher-Level Review
- Board Appeal
Each option has its own unique features and requirements, providing veterans with various avenues to pursue their case.
Read on to learn more about each.
Option #1: Supplemental Claim
How long does it take?
The average time to complete a Supplemental Claim in September 2022 was approximately 121 days, which is roughly equivalent to 4 months. It’s important to note that this is an average timeframe and individual cases may differ.
A supplemental claim allows veterans to submit new and relevant evidence to support their claim for VA benefits.
This can include:
- additional medical records
- expert opinions
- other documentation that was not previously considered during the initial decision-making process
The goal of a supplemental claim is to provide veterans with the opportunity to present new evidence that may strengthen their case and potentially result in a more favorable outcome.
It’s important to note that a supplemental claim must be filed within one year of the original decision by the VA, and it is crucial to ensure that the evidence submitted is compelling and directly relevant to the claim.
Is a supplemental claim the right decision review option for me?
If you’re considering a decision review for your VA claim, a Supplemental Claim may be the right option for you if you meet the following requirements:
- Your claim was previously decided by the VA, and your claim is not a contested claim.
- Contested claims refer to claims that are being disputed or challenged by other parties.
- You meet at least one of the following requirements:
- You have new and relevant evidence to submit.
- You’re requesting a review of your claim based on a change in law, such as the PACT Act.
But what exactly do we mean by “new and relevant” evidence?
- New evidence is information that you didn’t submit to the VA in the past or didn’t identify for them to gather.
- Relevant evidence is information that proves or disproves something in your claim.
It’s important to note that unless your Supplemental Claim is based on a change in law, you’ll need to submit supporting evidence that’s new and relevant for your application to be considered complete.
You can also identify evidence that you’d like the VA to gather for you.
Note: If you have new and relevant evidence, you can also request a Board Appeal.
However, it’s important to be aware that this process will take longer than a Supplemental Claim review.
Should I File a Supplemental Claim if My Condition Got Worse?
No, filing a Supplemental Claim is not the appropriate option if your condition has worsened. In such cases, you would need to file a claim for increased disability compensation instead.
A Supplemental Claim is specifically for submitting new and relevant evidence or requesting a review of your claim based on a change in law, and it may not be applicable for cases where your condition has deteriorated.
It’s crucial to understand the proper process for addressing changes in your condition to ensure you receive the appropriate compensation for your disability.
How to Prepare Before Starting Your Application
If You Have New and Relevant Evidence:
Gather any supporting documents that could potentially change a past decision made by the VA.
The VA can assist you in obtaining documents from VA medical centers, other federal facilities, or private healthcare providers.
You will need to provide the name of the facility and treatment dates.
- Examples of documents that could be included in your claim:
- A new medical report: If you were previously denied for a mental health condition, but now have a medical report stating that your service-connected injury led to your mental health condition, you can submit it as new and relevant evidence.
- A buddy statement (also called a Statement in Support of Claim): If you were previously denied for a condition like back pain, but have a fellow service member who witnessed the incident that caused your condition and can provide a letter describing what happened and how it has affected you, you can submit their statement as new and relevant evidence.
If You Have a Presumptive Condition Now Covered Because of a Change in Law:
- You will need to submit or identify medical evidence that documents the diagnosis and severity of your claimed condition.
- If you have qualifying military service, the VA automatically assumes (or “presumes”) that your service caused your condition. You only need to meet the service requirements for the presumption.
- The PACT Act law has added more than 20 presumptive conditions for burn pits, Agent Orange, and other toxic exposures. The law has also added new presumptive locations for Agent Orange and radiation exposure.
Properly preparing before starting your VA disability application can greatly impact the success of your claim.
Ensuring you have all the necessary evidence, including new and relevant documents or evidence for presumptive conditions, can strengthen your case and increase your chances of a favorable decision.
How to File a Supplemental Claim
Filing a Supplemental Claim for VA disability benefits can be done through various methods, including by mail, in person, or with the assistance of a Veterans Service Organization (VSO) or VA-accredited attorney or agent.
Here are the steps to file a Supplemental Claim:
- Download and Fill Out the Supplemental Claim Form: Fill out the Decision Review Request: Supplemental Claim (VA Form 20-0995), which can be downloaded from the VA website.
- Additional Form for Private Health Care Provider Records: If you need the VA to obtain records from your private health care provider, you will also need to fill out VA Form 21-4142.
- File by Mail: Send your completed forms and any supporting documents to the appropriate address based on the benefit type you are filing for.
For Compensation claims, send to:
Department of Veterans Affairs Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
For Pension/Survivors benefits claims, send to:
Department of Veterans Affairs Claims Intake Center
PO Box 5365
Janesville, WI 53547-5192
For all other benefit types, refer to the decision letter from your initial claim for instructions on how to submit the form.
- File in Person: Bring your completed forms and supporting documents to a VA regional office in person. You can find a VA regional office near you on the VA website.
- File with the Help of a VSO: A VSO or VA-accredited attorney or agent can assist you in filing a Supplemental Claim. They can provide guidance and support throughout the process.
Note: You can request forms from a VA regional office or call the VA at 800-827-1000 (TTY: 711) to request forms. The VA hotline is available Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.
Filing a Supplemental Claim with the appropriate forms and supporting documents is a crucial step in seeking VA disability benefits.
Disagree with VA’s Supplemental Claim Decision? Here’s What to Do
It’s important to know that you have options if you disagree with the decision.
Here are some steps you can take:
- Request a Higher-Level Review: If you believe that the VA made an error in its decision, you can request a Higher-Level Review. This involves having a more senior VA reviewer take a fresh look at your case, considering any new evidence or arguments you may present.
- Request a Board Appeal: If you are still dissatisfied with the decision after a Higher-Level Review, you can request a Board Appeal. This involves having your case reviewed by a Veterans Law Judge at the Board of Veterans’ Appeals.
- File Another Supplemental Claim: If you have obtained new and relevant evidence that was not previously submitted with your Supplemental Claim, you may choose to file another Supplemental Claim. This allows you to provide additional evidence to the VA in support of your claim.
At our veteran disability law firm, we are dedicated to helping veterans navigate the complex VA appeals process and advocating for their rights to receive the disability benefits they deserve.
We understand that disagreeing with a Supplemental Claim decision can be overwhelming, but you don’t have to face it alone.
Our experienced attorneys are here to provide expert legal representation and guide you through the appeals process to seek a favorable outcome.
Contact us today.
Our VA Team is currently available: 888-477-2363
Option #2: Higher-Level Reviews
How long does it take?
The VA’s target for completing Higher-Level Reviews is an average of 125 days, which typically translates to a timeframe of 4 to 5 months.
It’s important to note that if you opt for an informal conference as part of your Higher-Level Review, it may result in additional processing time.
To expedite the process, we recommend considering an alternative approach by submitting a written statement with your application to highlight the errors you’ve identified.
This proactive step can help VA make a decision faster, avoiding potential delays associated with an informal conference.
A Higher-Level Review is a formal process offered by the Department of Veterans Affairs (VA) for veterans who disagree with a decision on their disability compensation claim.
It provides an opportunity for a senior reviewer to take a fresh look at the decision and consider any errors or mistakes that may have occurred in the initial decision-making process.
A Higher-Level Review can be requested after receiving an initial decision on a disability compensation claim, and it allows veterans to challenge the decision based on the evidence already in their claim file.
It does not allow for the submission of new evidence, but rather focuses on identifying errors in the original decision or the failure to consider relevant evidence.
During a Higher-Level Review, the senior reviewer will conduct a thorough review of the claim file and may contact the veteran or their representative for additional information.
The reviewer has the authority to overturn the original decision if errors are found, leading to a new decision with potentially favorable outcomes for the veteran.
What is an informal conference?
An informal conference is an option available during a Higher-Level Review, where you or your representative can have a call with the senior reviewer assigned to your case.
This call is scheduled based on the phone number you provided on the Higher-Level Review form.
During the informal conference, you have the opportunity to discuss why you believe the decision should change and identify any errors that may have occurred.
However, it’s important to note that you cannot submit new evidence during this call.
If the senior reviewer is unable to reach you and no one answers the call, they may leave a voicemail.
If they are unable to leave a message or make contact after two attempts, they will review your case without further discussion.
Subsequently, they will make a decision based on the available information.
How can I ask for an informal conference if I feel I need one?
Requesting an informal conference can be a crucial step in the appeals process. Here’s how you can ask for an informal conference:
- Choose the informal conference option when you request a Higher-Level Review. This can be done online, by mail, or in person.
- If you request a Higher-Level Review online, you can ask for an informal conference in step 3 of the online form. You’ll need to choose a morning or afternoon time frame for your call, and indicate whether you want the call to be made to you or your representative. If you choose to have the call with your representative, make sure to provide their name and phone number.
- If you request a Higher-Level Review by mail or in person, you can ask for an informal conference by marking the circle in item 16A on VA Form 20-0996.
It’s important to note that you can only have one informal conference for each Higher-Level Review.
Therefore, it’s crucial to ensure you have enough time during the call to effectively explain any errors in your case to the senior reviewer.
How Do I Request a Higher-Level Review from the VA?
If you’re looking to request a Higher-Level Review from the VA, here are the steps you can take:
- Online Request: For disability compensation claims, you can request a Higher-Level Review online right now.
- By Mail: For other types of claims, you can request a Higher-Level Review by filling out the Decision Review Request: Higher-Level Review (VA Form 20-0996). You can download the form and send the completed form to the benefit office that matches the benefit type you selected on the form. The mailing address for Compensation claims is:
Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444
- In Person: You can also request a Higher-Level Review in person by filling out the Decision Review Request: Higher-Level Review (VA Form 20-0996). You can download the form and bring the completed form to a VA regional office near you. You can find your nearest VA regional office through the VA’s website.
- Requesting the Form: If you prefer, you can also ask a regional benefit office for a copy of the form to fill out. Alternatively, you can call the VA toll-free hotline at 800-827-1000 to request a form. The hotline is available Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.
What if the reviewer finds an error?
If the reviewer identifies an error, the next steps will depend on the type of error found:
- Error Changes Decision: If the reviewer identifies an error that changes the original decision, we will send you a new decision to inform you of this change. This may result in a favorable outcome for your claim.
- Duty-to-Assist Error: If the reviewer finds that the VA failed to provide you with all the necessary evidence to support your claim, this is known as a “duty-to-assist error.” To address this error, the VA will close your Higher-Level Review and open a new Supplemental Claim. The VA will also send you a letter outlining the steps they will take to rectify the error. This may involve obtaining the missing evidence and making a new decision based on this additional evidence.
Our experienced attorneys are here to provide expert legal representation and guide you through the appeals process to seek a favorable outcome, should you need it.
Contact us today.
Our VA Team is currently available: 888-477-2363
Option #3: Board Appeals
How long does it take?
The duration of a Board Appeal can vary depending on various factors, such as the complexity of the case, the backlog of appeals at the Board of Veterans’ Appeals (BVA), and the availability of resources.
On average, the current processing time for a Board Appeal at the BVA is estimated to be several years.
A Board Appeal, also known as an appeal to the Board of Veterans’ Appeals (BVA), is a formal process available to veterans who disagree with the decision made by the Department of Veterans Affairs (VA) on their disability compensation claim.
It provides an opportunity for a veteran to have their case reviewed by a judge at the BVA, an independent body that conducts hearings and renders decisions on appeals.
To initiate a Board Appeal, a veteran must submit a Notice of Disagreement (NOD) within a specific time frame after receiving an unfavorable decision on their claim.
The NOD is a written statement indicating the veteran’s disagreement with the decision and their intention to appeal to the BVA.
This triggers the appeal process and moves the case from the regional VA office to the BVA for review.
Once the case reaches the BVA, a judge will conduct a de novo review, which means they will review the case anew and consider all the evidence, including any new evidence submitted by the veteran.
The judge may also schedule a hearing for the veteran to present their case in person or via videoconference.
After reviewing the case, the BVA judge will issue a decision that can either uphold the original decision, reverse it, or remand the case back to the regional VA office for further development or reconsideration.
If the veteran disagrees with the BVA decision, they have the option to further appeal to the U.S. Court of Appeals for Veterans Claims (CAVC).
Can I Initiate a Board Appeal?
Yes, you have the option to request a Board Appeal if you are dissatisfied with the decision made on your initial claim, Supplemental Claim, or Higher-Level Review.
However, it’s important to note that you cannot request two consecutive Board Appeals for the same claim.
You have a one-year window (364 days) from the date of your decision letter to initiate a Board Appeal, unless your claim is contested.
It’s crucial to be aware of this timeframe and take prompt action to request a Board Appeal within the allotted time to ensure your appeal is properly processed.
Seeking guidance from a qualified representative, such as a VA disability law firm, can also be beneficial in navigating the Board Appeal process effectively.
What are my board appeal options?
Choosing the right Board Appeal option is crucial.
You have three options to consider, and the VA representatives can help you make an informed decision.
Option 1: Request a Direct Review
With the direct review option, a Veterans Law Judge will review your appeal based on the evidence you have already submitted.
You cannot submit new evidence, and a hearing is not allowed.
Please note that the direct review option typically takes an average of 365 days (1 year) for the Board to complete.
Option 2: Submit New Evidence
If you choose the evidence submission option, you can submit new evidence for a Veterans Law Judge to review. This evidence must be submitted within 90 days of the date your request for a Board Appeal is received.
It’s important to be aware that the evidence submission option typically takes an average of 550 days (1.5 years) for the Board to complete.
Option 3: Request a Hearing
By requesting a hearing with a Veterans Law Judge, you have the opportunity to add new and relevant evidence.
This evidence can be submitted at the hearing or within 90 days after the hearing, though it is optional.
The VA will transcribe your hearing and add it to your appeal file.
You can choose from three different ways to communicate with the Veterans Law Judge: a virtual hearing from your home, a videoconference hearing at a VA location near you, or an in-person hearing at the Board in Washington, D.C. (travel costs would be your responsibility).
Please note that the hearing option typically takes an average of 730 days (at least 2 years) for the Board to complete.
The timelines of all three of these options vary greatly, but the important thing to remember is this is the LONGEST time frame of your DRR options.
How to Request a Board Appeal?
Requesting a Board Appeal is easy and can be done online right now. You can also request a Board Appeal using the following methods:
- Fill out a Decision Review Request: Board Appeal (Notice of Disagreement) (VA Form 10182), which can be downloaded from the VA website.
Alternatively, you can obtain the form from a VA regional office, or request it by calling 800-827-1000 (Monday through Friday, 8:00 a.m. to 9:00 p.m. ET). Once completed, send the form to the following address:
Board of Veterans’ Appeals
PO Box 27063
Washington, D.C. 20038
- Bring your completed form to a VA regional office near you.
- Fax your completed form to 844-678-8979.
Submitting a Board Appeal is a straightforward process that can be done using these convenient methods to ensure your appeal is properly filed.
Looking to file an appeal for a decision review request?
Don’t go it alone. At Hill and Ponton, PA, we specialize in helping veterans navigate the VA disability claims process.
Our experienced team of attorneys is here to advocate for you and fight for the benefits you deserve.
If you’re considering a decision review request, contact us today for a free consultation.
We may be able to help you strengthen your appeal and increase your chances of success.
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