You’ve received a letter from VA about a recent application you submitted for benefits. The news isn’t what you hoped, and for some reason or another, VA has denied your application for benefits, or has given you a lower benefits level or rating than you had expected. What should you do now?
Fortunately, it’s not the end of the matter and there are several options open to Veterans who disagree with VA decisions on their claims or benefits applications. VA awards benefits and approves claims based on very specific language found in 38 CFR Book C, Schedule for Rating Disabilities. This federal regulation is intended to help compensate Veterans for the amount that their disabilities reduces their earning capacity–that is, if your service-connected disability prevents you from employment, or from earning as much money as you could have earned if you didn’t have the disability (earning capacity), VA will help make up the difference. This compensation usually takes the form of a monthly cash payment based on a calculation of what percentage your disability reduces your earning capacity.
A common misconception is that VA compensates Veterans for the accumulated disabilities on their own, which is not the case. While VA guarantees medical care for each service-connected disability, VA only provides monetary compensation for the amount that those service-connected disabilities have reduced the Veterans’ earning capacity.
So, what happens when VA reaches a decision that you believe is wrong or doesn’t reflect the full set of facts related to your specific case? In a post on VA.gov, VA explains:
If you disagree with a health benefits decision, you can request one of three types of review:
- Higher-Level Review
- Supplemental Claim
- Appeal to the Board of Veterans’ Appeals
Requesting a Higher-Level Review:
If you think VA’s decision was wrong and you don’t have new evidence, a Higher-Level Review might be your best option. A senior reviewer will reevaluate your case using the same evidence as before. Make sure to submit the request within one year of your decision. You can also request an informal conference with a senior reviewer to discuss your case.
To request a Higher-Level Review, fill out VA Form 20-0996 and follow the instructions on your VHA decision notice letter.
Filing a Supplemental Claim:
If you believe VA’s decision was wrong and you have new and relevant evidence that VA hasn’t considered, a Supplemental Claim might be your best choice. VA will help you gather the new evidence, such as medical records, to support your claim. You can generally file a Supplemental Claim at any time after the decision.
To file a Supplemental Claim, fill out VA Form 20-0995 and follow the instructions on your VHA decision notice letter.
Appealing to the Board:
If you want a Veterans Law Judge at the Board of Veterans’ Appeals (Board) to review your case, you may appeal the decision. You must file a Board appeal within one year of your decision, and you don’t need to request a Higher-Level Review or file a Supplemental Claim before appealing to the Board.
There are three types of Board review. When you fill out the form, you’ll need to request which type you want:
- Direct Review: If you don’t want to submit additional evidence or have a hearing.
- Evidence Submission: If you want to submit additional evidence without a hearing.
- Hearing with a Veterans Law Judge: If you want to have a hearing with a Veterans Law Judge with the option to submit new evidence.
To appeal a decision to the Board, fill out VA Form 10182 and send it to the mailing address listed in that form.
Final Thoughts:
In many cases, you can also sign into VA.gov and navigate to your open claim, and then request a higher level review or a supplemental claim there, versus filling out and mailing in the physical forms. If you are still unsure of how to handle a disagreement with a VA decision, or you need more help in pulling together additional support for your case, Veteran Service Organizations (VSOs) such as VFW, American Legion, DAV, and AMVETS (and many more) provide absolutely free legal support and can help submit these appeals on your behalf. If you do not already have a VSO, you can locate a VSO in your area through VA’s VSO Locator tool.
