Can You Do A Supplemental Review Claim After A Higher Level Review Claim?
Yes, you can do a supplemental review claim after a higher level review (HLR). 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 HLR 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 the process for submitting a VA supplemental claim?
If a disabled veteran’s VA disability claim is rejected, the veteran can request another review of their original claim. One option is to file a supplemental claim, which is a request where the veteran provides new and relevant evidence to support their original VA disability claim. The veteran must provide the evidence themselves or identify 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.
The 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.
The VA allows veterans to continuously pursue their claim with a supplemental claim as long as it is filed within 1 year of the previous decision. The timelines for submissions and processing can be long and frustrating. Veterans may choose to use the QuickSubmit tool on va.gov to submit their documentation online to make it more convenient to file for VA disability claims, including a supplemental claim.
What is a HLR claim?
If the VA issues a decision on a claim that a veteran disagrees with, that veteran can submit their claim for a HLR. A HLR 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 HLR claim for a decision on an initial claim and/or for a supplemental claim. A HLR claim is submitted on the 20-0996 form.
Is There A Specific Timeline For A Higher-Level Review?
Following the submission of a VA Higher-level review form, the review process is designed to meet an average timeline of 125 days. However, this higher-level review timeline can vary based on multiple factors, such as the complexity of the claim, the availability of records, or the amount of evidence to be reviewed. Although it may be frustrating, it’s important to remember that each claim is unique and the VA is working to ensure a thorough review of all information submitted.
What is the difference between the VA Higher Level Review process and a 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 HLR request can be made. A veteran has 1 year to request a HLR 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 HLR claim is that a HLR can be requested for a supplemental claim. A HLR cannot be requested based on a HLR decision.
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 HLR 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 HLR. Blue Cord Patriots has been working to help educate and empower veterans in fighting for their justified VA benefits since 2019.
How Does The Appeals Modernization Act Impact Veterans?
The Appeals Modernization Act, implemented in 2019, aimed to streamline the appeals process for veterans’ disability claims. This Act created three paths for appeal: the higher-level review, supplemental claim, and appeals to the Board of Veterans’ Appeals. It provides veterans with more options and flexibility in pursuing their claims.
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 HLR, supplemental claim, or board review.
As previously mentioned, a VA higher level review form is the 20-0996. A supplemental claim form is completed 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.
Who Is The Decision Review Officer In The VA?
The Decision Review Officer (DRO) is a senior-level employee at the VA who has the authority to review appeals or requests for higher-level reviews. They conduct a ‘de novo’ review, meaning they reexamine all aspects of the claim from the beginning without considering the previous decision.
What Is A De Novo Review?
A de novo review is a fresh, comprehensive review of a claim. The reviewer, typically a Decision Review Officer, examines all aspects of the claim as if it is the first time it is being reviewed. This includes looking at all the evidence provided in the initial claim and any additional evidence provided in the appeal or higher-level review.
How long does a Higher Level Review take?
Once you submit your VA Higher-level review form, the process averages and attempts to meet a 125 day average. Several variables can affect this outcome, but generally you can assume a decision will happen within 4 to 5 months. .
What Is The Higher-Level Review Success Rate?
While the VA does not publicly disclose specific success rates, anecdotal evidence suggests that many veterans do find success with the higher-level review process, particularly when an error or oversight has been identified in the original claim evaluation. As with any review or appeals process, the success rate is greatly improved by the thoroughness and accuracy of the claim and supporting evidence.
How do you win a HLR?
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/HLR/Board Review claim.
How Successful Is A VA Supplemental Claim?
The success rate of VA supplemental claims can vary significantly based on many factors such as the nature of the disability, the evidence provided, and the accuracy of the claim form. However, the VA does not release specific statistics on the success rate of supplemental claims. Anecdotal evidence suggests that the success rate is improved with a well-prepared claim, complete with all necessary supporting evidence.
Are higher level reviews successful?
The VA Higher-level review process 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, HLRs, 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. To see some of our VA HLR success stories, please see our testimonials page.
Navigating the claims and appeals process with the VA can be a challenging journey. Veterans often find themselves moving back and forth between supplemental claims, HLRs, and appeals. However, it’s important to remain persistent and continue to gather and provide as much relevant evidence as possible. With the right support and resources, such as those provided by Blue Cord Patriots, veterans have the best chances of successfully attaining the VA benefits they deserve.
Frequently Asked Questions
Yes, following the submission of a VA Higher-level review form, the review process is designed to meet an average timeline of 125 days. However, this timeline can vary based on several factors.
The success rate of VA supplemental claims can vary significantly. Anecdotal evidence suggests that the success rate improves with a well-prepared claim.
When a VA supplemental claim is closed with a compensation issue, it means that the VA has reviewed the evidence and made a decision on the veteran’s eligibility for compensation.
While the VA does not publicly disclose specific success rates, anecdotal evidence suggests that many veterans find success with the higher-level review process.
The Appeals Modernization Act streamlined the appeals process for veterans’ disability claims, providing more options and flexibility in pursuing claims.
The Decision Review Officer is a senior-level employee at the VA who has the authority to review appeals or requests for higher-level reviews.
A de novo review is a fresh, comprehensive review of a claim. The reviewer, typically a Decision Review Officer, examines all aspects of the claim as if it is being reviewed for the first time.