Supplemental versus Higher Level Review.webp_431

Can You Do A Supplemental Review Claim After A Higher Level Review Claim?

More often than not, the claims process for filing a VA disability claim is not a clear path to success resulting in a first time go. Unfortunately, the biggest issue for most veterans when they’re filing a claim is not understanding the process which includes required paperwork and terminology. So how can disabled veterans ensure that their claim is not rejected? Even more importantly, what should a disabled veteran do when their claim is rejected by intake? To answer either of those questions, you must first understand the difference between a supplemental claim and higher level review claim.

What is a supplemental claim review?

According to data provided by the Inspector General for the Department of Veterans Affairs, at least 12,000 claims were rejected in 2021. For disabled veterans, this means that there is a high likelihood that their claim could get denied after only their first submission. Fortunately, the VA allows veterans to request another review of their original claim. Usually, veterans begin by filing a supplemental claim review.

A supplemental claim review is a request where the veteran provides new and relevant evidence to support their original VA disability claim. The veteran either provides this evidence themselves or identifies existing relevant records that they would like the VA to obtain for further review. In order for the evidence to be considered, it must be ‘new or relevant’ to the original claim, which could mean furnishing even more medical documents, statements or prior service records that could tie the injury to the veteran’s service.

A supplemental claim review is submitted on the 20-0995 form. It outlines the requirements in detail for submission on the form. It is important to note that this form can only be submitted for one decision benefit type (e.g. life insurance, education, disability compensation, etc). Therefore, if a veteran is trying to submit a supplemental review claim for multiple types of benefits, then they will need to submit one form for each benefit type.

What is a higher level review claim?

If the VA issues a decision on a claim that a veteran disagrees with, that veteran can submit their claim for a higher level review. A higher level review claim is when the VA reevaluates a claim using the same evidence given in the original submission to determine if an error or mistake was made when determining that VA disability rating/decision. A veteran can submit a higher level review claim for a decision on an initial claim and/or for a supplemental claim. A higher level review claim is submitted on the 20-0996 form.

What is the difference between higher level review and supplemental claim?

A higher level review claim is different from a supplemental review claim because you cannot submit new evidence to support your claim after your notification date. Another major difference is that there is a time limit in which a higher level review request can be made. A veteran has 1 year to request a higher level review of their original claim. A supplemental claim should be filed within 1 year to continuously pursue the claim.

An important thing to note when choosing whether to submit a supplemental claim or a higher level review claim is that a higher level review can be requested for a supplemental claim, but a higher level review cannot be requested on top of a higher level review. Therefore, a veteran would likely submit a supplemental claim first so that they can add ‘new and relevant evidence’ to their case; and if they disagree with that decision, then they could choose to proceed with a higher level review of that supplemental claim. However, oftentimes filing another supplemental claim produces shorter wait times on VA decisions.

The timelines for submissions along with processing can be long and frustrating; therefore it is important to determine the best strategy for your situation before taking the leap and filing a supplemental claim or higher level review. Blue Cord Patriots has been working to help educate and empower veterans in fighting for their justified VA benefits since 2019.

How do I submit a higher level review claim or a supplemental claim?

When the COVID-19 pandemic happened, the VA shut down most in-person appointments and moved a lot of their services online to make it more convenient for veterans to submit VA disability claims. The QuickSubmit tool on va.gov allows veterans to submit documentation respective to their claim whether it is a higher level review, supplemental claim, or board review.

As previously mentioned, a higher level review claim is submitted on a 20-0996 form and a supplemental claim is submitted on a 20-0995 form.

 One of the va.gov’s “File for a Disability” tool’s negative intricacies is that it does NOT allow you to include an argument for the HLR, which is allowed per M21-5 (Higher Level Review Procedures Manual). Specifically M21-5, Chapter 5, 5.4.d. This has been a consistent issue, as the VA considers an argument (statement of facts of case) as “additional evidence” on occasion. This has created confusion for many veterans trying to submit their claims. However, the QuickSubmit tool on va.gov does allow veterans to submit an argument with their claim files because you are just uploading files and the tool does not differentiate the documents being uploaded.

How do you win a higher level review?

Blue Cord Patriots recommends adding a cover letter with the verbiage of this Procedure Manual when veterans upload to QuickSubmit. When it is done on va.gov, it does NOT allow an argument to be attached, hence why we recommend QuickSubmit to be used for any Supplemental/Higher Level Review/Board Review claim.

Are higher level reviews successful?

Higher level reviews can be successful if there was evidence that was missed in a previous evaluation, like medical records or service records. Most veterans end up having to go back and forth with claims submissions varying between supplemental claims, higher level reviews, appeals, etc.

Human errors are prevalent when raters review VA disability claims, which is why it is important to keep your claim alive and not give up when the VA sends you a negative notification letter on your claim. It can be a daunting process if you are unsure of what you actually need to successfully win your VA disability claim. Blue Cord Patriots is committed to helping veterans receive the entitlements that they deserve based on their service to our country. Follow the link to set up a free appointment with one of our Blue Cord Patriots representatives to help you strategize your VA disability claim so that you have the foundation for success.

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