How Can I Appeal a VA Claim Decision?
Three methods for appealing a VA benefits decision
Like many things to do with the VA, the appeals process can be confusing, overwhelming, and lengthy. It’s very common for VA disability benefits to be denied, so it’s important to know how to combat those denials to get the benefits you deserve. Let’s take a look at the process and the various ways you file a VA claim appeal.
Legacy system vs. new system
Appeals filed before February 19, 2019 will be processed through the legacy system, and those filed on or after that date will be processed through the new one created through the Appeals Modernization Act of 2017.
- If you are submitting a new appeal for a decision dated before February 19, 2019, you need to file a Supplemental Claim.
- The VA reviews all new and existing evidence and sends a Statement of Case document if the evidence is not sufficient to grant the appeal.
- You then have 60 days to submit VA Form 9 to the VA regional office OR opt in to the new processing system. If you choose to opt in to the new system here, the rest of the steps do not apply.
- If there is no new evidence up until this point, the case is sent to the Board of Veterans’ Appeals. The Board reviews cases in the order they are received unless an advance is requested due to serious illness, financial distress, or other sufficient cause.
- The Board then decides whether each aspect of your appeal is granted, remanded (which means they need more evidence to decide), or denied.
The new system provides more avenues for appeal. Veterans still have up to one year from the time they receive a decision to the time they submit an appeal. However, they can choose one of three options; Higher Level Review, Supplemental Claim, or Notice of Disagreement (NOD) directly through the Board of Veterans Appeals.
Under the legacy system, it usually took 12 – 18 months to review and decide on new appeals. The VA has set a goal under the new system to issue decisions in under 125 days. Through the NOD method, decisions can often take five to seven years. Various factors such as illness, family, and life expectancy may impact the method you choose.
The three appeal options
There are three avenues you can choose from when you submit a new appeal: Higher Level Review, Supplemental Claim, and a Board Appeal.
- Higher Level Review
This method requests that a senior VA reviewer exam the existing claim. If you have no new evidence to submit but believe your initial decision was denied or rated incorrectly, this may be your best course of action. The new reviewer may catch something the first one did not or have a difference of opinion that falls in your favor.
You can request an informal conference with the new reviewer so you and your representation can “plead your case” and identify errors made in the first decision.
To request a Higher Level Review, fill out VA Form 20-0996 and submit it via fax, mail, or in-person at a VA regional office. If the VA needs more information, they will contact you. If you don’t agree with the decision from the Higher Level Review, you can then request a Board Appeal.
- Supplemental Claim
A Supplemental Claim is the best course of action if you have new evidence that could change the decision or the rating percent issues for a condition. The evidence has to contain information that the VA did not have before the first decision.
To request a Supplemental Claim, fill out VA Form 20-0995. You must then gather evidence to submit or identify which evidence you want the VA to gather on your behalf. Submit the form and wait. You can track the status of your claim here. If you don’t agree with the decision from the Higher Level Review, you can then request a Board Appeal.
- Board Appeal
This option is for decisions that may require more scrutiny and investigation. It’s important to note that this method can take up to seven years to return a decision. The appeal goes to a Veterans Law Judge at the Board of Veterans’ Appeals in Washington D.C. From here, you have three choices:
- Direct review. A Veterans Law Judge will review your case based on existing evidence. There is no hearing. Decisions usually arrive within a year.
- Evidence submission. You can submit new evidence for the Veterans Law Judge to review. This must be done within 90 days of requesting the Board Appeal option.
- Request a hearing. You can request a hearing with a Veterans Law Judge directly. You can submit new evidence here or within 90 days of the hearing. The hearing is transcribed and added to your file for a final decision.
To request a Board Appeal, fill out VA Form 10182. Choose your appeal type, and submit it via fax, mail, or in-person.
Having support through the appeals process
Most veterans have some type of representation throughout the appeals process. It’s important to have the right support throughout this process, so nothing falls through the cracks.
Each claim type has strict deadlines, limitations, and requirements, which all impact the timing and details of your decision. Whether you are appealing a decision for the first time or are years-deep into a battle with the VA, we are here to help.
Veterans Guardian Claim Specialists can help you file a rating increase and secure the benefits you deserve. Contact us today to schedule a consultation.