Appealing a decision from VA


When you receive your rating decision from the VA, look over it carefully. Make sure all of the evidence you sent them is listed in the ‘evidence” section of the rating decision. In the “Decision” section will be what VA decided. In the “Reasons and Bases” section will be VA’s rational for their decision. If you disagree with VA’s rating decision, there are now three different choices you have.

Higher Level Review (HLR):

The first choice you have is to request a "Higher Level Review" (HLR) of your claim based on the same evidence as before. If you choose this route, your claim will be reviewed by a senior rating official, and he or she has the authority to change the decision under the de novo. Please keep in mind that with choosing this route you cannot submit any new evidence. The Reviewer will make another decision either granting the benefit sought by the claimant, or upholding the previous decision by issuing another rating decision. The claimant can either then file a supplemental claim (with "New and relevant" evidence") or file an appeal -a "Notice of Disagreement"- to the BVA (see the third option below). To choose this route you have one year from the date of the notification letter notifying you of VA's decision to submit VAF 20-0996.

  • Note: VA started a pilot program called the "Claims Accuracy Request (CAR)" on 4/19/2021 in which the accredited representative of a claimant can request an expeditious review and decision based on an obvious error in fact or law.

Now, as of 10/01/2022, this pilot program (phase III) as been extended to foreign claims as well! To initiate a "Claims Accuracy Request" your accredited representative must submit VAF 20-0996 to VA within 30 days of the rating decision in question. Also your accredited representative must note the phrase "Claims Accuracy Request" or "CAR" somewhere "prominently" on the VAF 20-0996, and explain in enough detail the error of fact or law at hand.

VAF 20-0996
VBA-20-0996-ARE.pdf
PDF-Dokument [2.4 MB]
Claims Accuracy Request overview
Claim Accuracy Request Job Aid for Repre[...]
PDF-Dokument [280.0 KB]

Supplemental Claim:

The second option you have is to request VA re-adjudicate the claim based on "New and Relevant" evidence. This is the same proceedure as previously mentioned under "Supplemental claim (having VA re-adjudicate a previously denied claim)" However, the only difference here is that you would be submitting the VAF 20-0995 within the one year appeals period, and the effective date of any grant in benefits may go back to the date of the orginal claim (depending on what the "new and relevant" evidence dictate). The reviewer will review the "new and relevant" evidence and make another decision based on that by issuing a rating decision. The claimant then can either file another Supplmental claim (with "new and relevant" evidence), request a HLR, or appeal directly to the BVA within one year from the date of the letter notifying the claimant of VA's decision.

VAF 20-0995
VBA-20-0995-ARE.pdf
PDF-Dokument [2.6 MB]

Notice of Disagreement:

The third option you have is to appeal your denied decison directly to the Board of Veterans Appeal (BVA). To do so, you'll want to submit VAF 10182 "Notice of Disagreement," within one year from the date of the letter notifying you of VA's decision. By choosing this route you will skip the additional review options.

 

When choosing this route you do have the oppurtunity to submit additional evidence, which must be done within either 90 days of submitting the VAF 10182, or within 90 days of a hearing (if you elect to have one). If you do not agree with BVA's decision, then a claimant can either appeal to the Court, or file a supplemental claim (with "new and relevant" evidence).

VAF 10182
VA10182.pdf
PDF-Dokument [102.4 KB]

Legacy Appeals:

If you filed an appeal prior to February 19, 2019, using the old VAF 21-0958 (now called a "Legacy Appeal" in VA speak) and did not opt into the modernized appeal process before this date via RAMP, you can still opt into the Modernized Appeals system once you receive a Statement of the Case (SOC), or Supplemental Statement of the Case (SSOC), or you can file the below VAF 9 within the applaicable time frame to have your appeal decided by BVA under the "legacy appeal" system. However, keep in mind that once you opt in to the modernized appeals process, you cannot switch back to the Legacy appeal process.

 

Here is an excerpt from the M21-5.7.D.5.b.

"The law allows claimants with legacy appeals to opt-in to the two AMA review lanes for issues that are part of those appeals.  A legacy appeal stems from any decision (involving original, new, or reopened claims, and SOCs or SSOCs) VA made before February 19, 2019.  An election to participate in the new AMA review programs received within 60 days of the date of the SOC/SSOC, or within one year after the notice of the original contested decision, whichever is later, results in withdrawing the legacy appeal for those issues.  However, claimants may still appeal to the Board those same issues after VA issues a decision on the HLR or supplemental claim."

VAF 9
VA9.pdf
PDF-Dokument [122.4 KB]
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U.S. Department of Veterans Affairs claims assistance for veterans worldwide. Accredited VA claims Agent pursuant 38 C.F.R. §14.629. © 2011-2024 Copyright - Kevin Janey. All rights reserved.

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