After filing an initial application for VA disability benefits, some applicants receive a rating decision from the U.S. Department of Veterans Affairs that does not match the true extent of their disability.
Veterans Guide published an article on July 19, 2024 addressing this topic: VA Disability Appeals by Matthew Coveney, VA-accredited attorney and co-founder of NVDA.
Click the link above or check out the article quoted below.
Key Takeaways
The VA offers three types of decision reviews: Supplemental Claim, Higher-Level Reviews, and Board Appeals
Appeals that go to the VA Board of Appeals are approved nearly 1/3 of the time according to 2022 data
If your appeal is approved you are owed back pay, going back to your effective date, which can oftentimes be a significant sum
Receiving a denial for VA disability benefits is frustrating, especially if you believe you qualify or received a rating that is too low. Fortunately, the Department of Veterans Affairs offers a straightforward VA disability appeals process you can take advantage of. Denied claims often result from a mistake or review error. An appeal can help you increase your rating or overturn a rejection. Veterans Guide assists applicants with claim denials and can help you get the benefits you deserve.
Types of VA Decision Reviews
The The VA offers three paths for veterans to appeal a benefits claim. You can choose the one you feel is most appropriate, given the circumstances of your case.
Supplemental Claim
Veterans with additional evidence to support their original benefits claim may file a Supplemental Claim appeal. The evidence submitted must be new and relevant under the VA’s standards.
New evidence includes documentation the VA hasn’t seen before, such as medical tests or a witness statement. Relevant evidence must also directly relate to your claim and prove or disprove a relevant element. Supplemental Claims are also appropriate if there’s been a change in the law impacting your VA benefits eligibility, such as the PACT Act.
To initiate a Supplemental Claim, gather your supporting evidence. If your claim is based on a law change, you may need to submit medical evidence documenting your condition and its severity.
You can submit a Supplemental Claim online through the VA’s portal. Other options include filing VA Form 20-0995 through the mail or in person at a VA regional office if your claim isn’t related to health care benefits.
Unlike other VA disability appeals, there is no time limit for requesting a decision review via a Supplemental Claim. However, the VA recommends you file within one year of your initial decision letter date.
Higher-Level Reviews
If you disagree with the VA’s decision but don’t have any new evidence to provide, a Higher-Level Review may be appropriate. In a Higher-Level Review, your case goes to another claims reviewer with greater seniority or experience. This type of review is best for veterans who believe the original reviewer made an error during their assessment.
A Higher-Level Review offers the option for an informal conference, which allows you to schedule a call directly with the reviewer to explain the error made and why you think your case warrants a different decision.
If your claim pertains exclusively to VA disability compensation, you can request a Higher-Level Review from the VA’s portal. If it concerns other benefits, you must fill out VA Form 20-0996 and submit it via the mail or in person at a VA regional office.
The deadline for requesting a Higher-Level Review is one year following the date on your decision letter, so it’s important to act quickly.
Board Appeals
A Board Appeal is the most formal of the review options. It sends your case to the Board of Veterans’ Appeals, where a designated Veterans Law Judge will review your claim. Board Appeals allow claimants to choose between submitting new evidence or requesting the judge to review existing case documents. You may also request a hearing with the judge to discuss your claim, with or without new evidence.
Since Board Appeals can take much longer to resolve than other appeal types, claimants usually try other options first. However, there is no formal requirement for claimants to undergo a supplemental or higher-level review before requesting a Board Appeal. Anyone can request a Board Appeal based on an initial claim, supplemental claim, or higher-level review decision.
You can request a Board Appeal online or by submitting VA Form VA10182 through the mail, at a regional VA office, or via fax. You must file the request within one year of the date on your decision letter.
A Board Appeal has the following three possible outcomes:
Your benefits claim is approved.
Your appeal is denied.
Your claim is remanded to the Regional Office.
In a remand, your claim is sent back to the Regional Office to gather additional information needed for the judge to make a decision.
VA Disability Appeal Success Rate
Is it worth appealing your case? In many cases, it is. The VA discloses a yearly analysis of decisions made through the Board Appeals process. Here’s a look at the results from 2022 for Board Appeals initiated through the Veterans Appeals Improvement and Modernization Act:
Direct Reviews: Of the 16,512 claims reviewed, 31.6 percent were approved, while 48.2 percent were remanded.
Evidence Submission: Of the 10,909 claims reviewed, 33.6 percent were approved, while 28.1 percent were remanded.
Hearing: Of the 24,891 claims reviewed, 29.3 percent were approved, while 21.9 percent were remanded.
Nearly 1/3 of decisions resulted in approval in each type of Board Appeal. A significant portion resulted in a remand. Less than 30 percent of all Board Appeals resulted in an outright denial.
Back Pay From VA Disability Appeal
The VA understands the appeals process can be lengthy. Thus, once you receive a favorable decision, you may get back pay that extends a year or longer. Back pay includes all the disability benefits you would have received between the claim’s effective date and the VA’s final decision, including any appeals you undergo.
In some cases, VA back pay can be significant — reaching into the hundreds or thousands of dollars. That’s one of the reasons why it’s essential to stick with the appeals process and monitor any deadlines or information requests. You don’t want to miss out on back pay simply because you didn’t file or submit evidence promptly.
Hire a VA Disability Appeal Lawyer
If your VA disability claim was denied or you received a lower disability rating than you believe you deserve, you may appeal their decision. While you can handle the appeals process independently, hiring a VA disability appeal lawyer may streamline the process.
An attorney specializing in VA disability appeals understands what the VA wants when it reviews your claim. We can help you avoid errors that cost you time and money. Veterans Guide can connect you with qualified VA disability appeal lawyers for your case. Reach out today to learn more.
Want to increase your VA rating? Get help by clicking here!
How Long Does a Disability Appeal Take?
The time it takes for the VA to issue a decision depends on the type of VA disability appeal you file, among other factors. Here’s what to expect:
Supplemental Claims: The VA aims to resolve Supplemental Claims within 125 days, though it may take longer in some cases.
Higher-Level Reviews: The target decision date for a Higher-Leval Review is 125 days, but you can extend it if you request an informal conference.
Board Appeals: A Board Appeal takes the longest to resolve. The VA aims to decide on direct review claims within one year, new evidence within one and a half years, and hearings within two years. However, some people wait five to seven years for a final decision.
While the appeals process can be lengthy, a favorable decision may qualify you for back pay during the entire appeals process. It’s critical to abide by the VA’s claims deadlines and requests for information to ensure you don’t miss out on back pay benefits.
VA Letter to File an Appeal
The VA used to require that veterans submit a “Notice of Disagreement” letter to initiate an appeal. In the “Notice of Disagreement,” the veteran indicated the claims they wished to appeal and provided any available evidence to help the Board of Veterans’ Appeals make a favorable decision. The VA would respond by approving the claim or providing a Statement of Case indicating their reason for the decision and instructions to begin the appeals process.
However, the Veterans Appeals Improvement and Modernization Act removed the letter requirement. VA Form 20-0998 outlines the appeal initiation process for each type of appeal. Depending on the path you choose, you must complete one of the following forms to kick off the process:
Supplemental Claim: VA Form 20-0995
Higher-Level Review: VA Form 20-0996
Board Appeal: VA Form VA10182
Remember that in most cases, you must submit an appeal within one year of the VA’s decision letter. An exception is available for Supplemental Claims or if the VA made an unmistakable error in its initial decision.
A big thank you to Veterans Guide for allow us to share this on our site. All credit to the Veterans Guide and Matthew Coveney, VA-Accredited Attorney and Co-Founder for NVDA, for the composition of the article and resources.
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