A higher-level review is one option for veterans to appeal a decision on a VA disability claim. The review process does not allow new evidence and is reviewed by a senior-level adjudicator at a VA regional office.
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In this article about the VA higher-level review:
Three ways to appeal a VA disability claim
The VA’s appeal process is officially named AMA after the Appeals Modernization Act of 2017. It replaced the previous appeal system known as the legacy system. Many VA decisions made before Feb. 19, 2019, are still in the legacy system.
Veterans appealing decisions since 2019 have three options: request a higher-level review (HLR), file a supplemental claim, or appeal to the Board of Veterans’ Appeals. The HLR and supplemental claim lanes were created with the intention of reducing the wait time for a veteran to receive a decision on an appeal. This article will describe the HLR process.
Reasons for choosing higher-level review
When a veteran requests a higher-level review, a senior claim adjudicator at a VA regional office reviews the same evidence presented in the initial claim and issues its own decision.
“The best uses of higher-level reviews are to clean up mistakes at the VA regional office,” said VA-certified disability benefits lawyer Zack Evans. “Some of these mistakes are easily identifiable. These are the ones that you want to send back to the VA regional office and say ‘I need you to take another look at this.’”
Common examples of why a veteran would seek a higher-level review include:
Wrong effective date
The effective date of a VA disability claim is the date a veteran becomes eligible for benefits, which affects the total compensation a veteran receives. Evans said one example of an effective date error is when the VA confuses the date a veteran files an intent to file a claim and when the claim itself is received. The effective date should go back to when the intent to file was sent, so long as the completed claim was sent within one year.
Failure to consider evidence
The VA also can fail to consider all the evidence veterans submit with their application. Maybe the VA didn’t fully review a doctor’s report and because of that it gave a lower rating than the veteran deserved.
Veteran has no new evidence
If veterans want a review of their claim but have no new evidence to support the claim, they can file an HLR. They may also file an NOD with the BVA and choose the direct review docket if there is no new evidence. If veterans have new evidence to present, they can either file a supplemental claim, which will be considered by the regional office, or an NOD and choose the evidence or the hearing docket at the BVA.
A request for a higher-level review must be submitted within one year of the date on the veteran’s decision letter.
Typically, these reviews cover whether the original VA claims agent misinterpreted the facts or misapplied the law in making the initial decision. Veterans cannot seek a higher-level review twice in a row on the same claim.
Veterans should use VA higher level review form 20-0996 and submit it to their VA regional office. Here is why recommend sending all of your forms to the EIC instead of your RO.
How long does a higher-level review take?
The AMA appeal system created options for review with the goal of relieving the workload on the Board of Veterans’ Appeals (BVA.) Under the old appeals process, all veterans’ cases were heard by Veterans Law Judges, similar to an administrative law judge. It is unclear if the workload at the BVA has changed much since AMA was launched. The VA higher level review timeline and backlog of cases only got worse since the Covid-19 pandemic.
The VA’s goal for completion time for a higher-level review is four to five months (or 125 days to be exact.)
Through the process, veterans can choose to conduct an informal conference with the senior reviewer to discuss potential errors made by the initial reviewer. If a conference is requested, it can push back the processing time of the second decision. Veterans can only have one informal conference for each HLR review and are asked to set aside ample time for the call. A more timely alternative to an informal conference is to submit a written statement with the HLR form.
“They brought me from being stuck at 30%. Denial after denial. Finally rated at 70%. Appealed for total and unable to work disability since 2014. Without Woods and Woods I would still be stuck at 30%.“
Who to call when you are denied a VA claim
If you would like to challenge a VA decision, you can appeal within one year of the decision date. Hiring an experienced VA-certified disability lawyer to guide you through the process and help you avoid delays from improperly completed paperwork.
Woods and Woods never charges veterans when filing an initial application. Our team of attorneys, case managers, and legal analysts works hard to stay on top of disability benefit changes and to develop innovative case strategies. Contact us today for a free consultation.
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Veterans are entitled to a VA review of their disability benefits decision and often pursue that course if their claim is initially denied or rated too low. This review, called a VA higher-level review, essentially functions like an appeal. A senior claim adjudicator at a VA regional office reviews the same material presented in the initial case and issues an independent decision about the veteran’s claim.
Because BVA dockets are growing by the day, the higher-level review process is often a much faster alternative. The VA currently estimates completion time for a higher-level review as four to five months (or 125 days to be exact.)
The success of any case is going to depend on the veteran’s situation, medical diagnosis, the availability of evidence, and the final decision of the judge. That is why your call to us to assess your case is free and we don’t charge a fee unless you win. Give us a call to review your case with our experienced team.