Filing an Appeal
If you do NOT agree with your claim's decision, you may file an appeal. Just like Filing a claim you may use the assistance of a VSO, lawyer, or an accredited claims agent.
There are three different methods to appeal:
Higher-Level Review;
Supplemental Claim; or
Board of Veteran Appeals (BVA).
If your appeal is denied again you CAN try another eligible option (see applicable notes).
IMPORTANT NOTES:
If you want to keep your Effective date (your back pay) you MUST file an appeal within one year of your claim's decision date! Veterans who fail to do that can only get their original effective date and back pay if there is a Clear and Unmistakable Error (CUE).
Lawyers and claims agents CANNOT charge more than 33.3%* (excluding expenses**) of the Veteran's back pay. Further, they can only get paid if/when the Veteran wins their appeal. Again, VSOs are a resource that is free to the Veteran.
*The VA will only pay up to 20% automatically from the back pay. If the agreement is over 20% then, the Veteran will need to pay the difference to the lawyer themselves.
**Expenses can be things like postage, travel costs, or printing supplies.
BEFORE You File an Appeal
BEFORE you appeal your claim do so in an informed manner! Don't run back onto the battlefield without a plan!
Read your Decision Letter!
Was all the evidence you submitted listed under evidence considered?
What were the favorable findings?
What does it say your claim was missing?
Did it say you missed an exam?
Your decision letter should outline what you need to do in order to make a successful appeal!
Getting a Copy of Your Decision Letter
You can get a copy of your decision online HERE*.
Alternatively, after 10 days have past since the claim closed, you can call the VA at 1-800-827-1000 and request them email your decision letter to you.
*This CAN be used to get old decision letters as well.
Getting a Copy of Your C-file/Examiner's Report
Click HERE to learn how to get your C-file/Examiner's reports.
Denied Service-Connection
If you were not granted Service-connection, what was missing from your claim?
Was it a current diagnosis;
An in service event; and/or
Did the examiner say that there was a less likely than not chance that your disability was the result of your service or service-connected disability?
If you feel that the rater did not properly evaluate the evidence that was a part of your claim, an HLR may be appropriate.
Otherwise if you need to submit additional supporting information, a supplemental claim may be appropriate. Veterans who need help with the determination of service-connection may want to look into submitting an Independent medical opinion (IMO)/Nexus letter, Personal statement, or Buddy statement(s), as appropriate.
If you were told you missed an exam then file a supplemental claim and state, "I am willing an able to attend exams at this time" on the appeal form.
Low Evaluation
If you were granted service-connection (at least 0% evaluation) but were given an evaluation that was lower than what you expected, you can appeal this. Your decision letter should detail what the criteria is for the next highest evaluation. It should also note if the rating you were awarded was the maximum. If it says you are the maximum... you should really leave it be...
If you feel that you meet the Requirements for a higher rating then you should verify the information in the Examiner's Disability Benefits Questionnaire (DBQ). If the DBQ indicates you should have gotten a higher rating, an HLR may be appropriate. If the DBQ indicates otherwise then a supplemental claim (with medical evidence dated BEFORE the rater made their decision, would be more appropriate.
Higher-Level Review (HLR 20-0996)
An entirely new review of your claim by an experienced (more senior) rater.
Importantly, you CANNOT submit new evidence with a Higher-Level Review!
NOTES:
The Veteran CANNOT file a HLR, back-to-back. HOWEVER, you CAN file a HLR into a supplemental, into another HLR, into a supplemental, etc.
The Veteran CANNOT request an HLR after having a BVA denial.
The Veteran can MUST submit their HLR within a year of their claim's decision. Veterans are NOT allowed to request an HLR after this time frame.
Supplemental Claim (20-0995)
An opportunity to submit NEW AND RELEVANT evidence.
New: The VA did not previously have/consider it.
Relevant: Directly addresses the rationale for the denial.
For example: If you were denied for having no diagnosis, you need to supply evidence of a diagnosis.
New and relevant evidence can take the form of:
Being seen by your doctor for the claimed issue(s);
New theory of service connection (claiming your condition was caused by another service connected disability);
This does include Presumptive conditions be they old or recently passed presumptives;
Exam willingness - if you were previously denied because you missed an exam, simply state that you are willing and able to attend new examinations;
DBQ;
IMPORTANT NOTES:
Remember you have one year from the claim's decision to file an appeal (if you want to potentially keep your back pay). Which means one year to develop additional evidence for your claim. We recommend waiting until you have enough evidence to be successful before filing - your VSO or lawyer can advise you on this. Do not file appeals with insufficient evidence, this just gums up the system for you and other Veterans!
Do know you CAN extend this window for by filing an Intent to file! The intent to file will give you a year (from the intent to file) to gather evidence. While allowing you to keep back pay.
If the VA grants an increased rating based upon a supplemental claim, the Effective date does NOT automatically go back to the original claim!
Do NOT file a supplemental claim for an evaluation after a year! Even if you have new evidence showing a higher evaluation was previously warranted! If you do, at best the effective date will be the date the supplemental was initiated or at WORST the date of the Examination conducted AFTER your filed the supplemental! So in these cases, just file a increase claim!
NOTES:
Veterans CAN file a supplemental claim ANYTIME after their denial. However, to potentially get back pay from the start, they must file within a year of the last decision.
Veterans CAN submit a supplemental claim over and over again. So long as, there is new and relevant evidence being submitted every time.
If you need the VA to get non-federal medical records or Vet Center records for you, then you will need to also submit a VA Form 21-4142/21-4142a.
Board Veterans' Appeals (BVA) AKA, Notice of Disagreement (NOD), AKA 10182
Review by a Veterans Law Judge at the Board of Veterans’ Appeals.
IMPORTANT NOTE:
Due to the time this takes to complete a BVA appeal (years) it is commonly only chosen once the other appeal options (Supplemental Claim and/or Higher Level Review) have been exhausted.
NOTES:
The Veteran can MUST submit their appeal to the BVA within a year of their claim's decision. Veterans are NOT allowed to request a BVA after this time frame.
Veterans are NOT allowed to request a BVA appeal after receiving a BVA decision for the same claimed item.
Choosing an appeal docket:
There are three lanes in which the Veteran can choose when going through the BVA:
Direct Review
Evidence Submission
Hearing
Direct Review
In essence an HLR. However, instead of a senior rater a judge reviews your claim. Due to there be far fewer judges than senior raters, this WILL take much longer than an HLR.
NOTE:
You CANNOT submit new evidence.
Evidence Submission
In essence a supplemental claim. However instead of a rater a judge reviews your claim. Due to there be far fewer judges than raters, this WILL take much longer than an supplemental claim.
NOTE:
You CAN submit new evidence. If you do not submit all the evidence with your claim you have 90 days from the day VA receives your NOD.
Hearing
Your chance to plead your case before a judge by videoconference (or in-person in DC). After your hearing you will have 90 days to submit new evidence. The Judge will make a decision considering the hearing and the evidence you provide.
Researching Previous Cases
The BVA decision Search engine is your best friend to see how other cases similar to yours have been decided. Plug in keywords for your claim/appeal and search away!
IMPORTANT NOTE:
BVA does NOT establish case law! But the decisions can help you.
Frequently Asked Questions
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