10/16/2024
VA Higher-Level Review: When to Request & What to Expect
In the VA disability claims system, there are three main ways to appeal a denied claim or rating. It can be overwhelming to figure out which appeal options are available and ideal in your case. Keep reading to learn more about the VA higher-level review option.
What is a VA Higher-Level Review?
The VA higher-level review appeal option is usually the fastest way to appeal a VA disability compensation claim. Where supplemental claims can easily take longer than six months, and the Board of Veterans’ Appeals takes several years, a higher-level review decision can come back in just a couple of months.
In a VA higher-level review, a more experienced VA employee:
- Reviews the evidence that’s already in your file
- Determines whether the VA handled everything correctly
Their job is mainly to see if the VA:
- Properly obtained all your service and medical records
- Ordered the right medical examinations
- Whether any medical opinions obtained were adequate
When you submit a request for higher-level review, you can also request an informal conference with the VA reviewer to discuss why you think VA was wrong.
Keep in mind, though, that the VA higher-level review is a closed record, meaning that the reviewer can only consider evidence that was already in your file at the time of the last decision.
So, the conference isn’t a time when you can submit new evidence or offer testimony—instead, you need to focus on what was already in your file.
Because the higher-level review option is a closed record focused on whether the VA fulfilled its legal duties, effective argument at the conference often requires specialized knowledge of VA law. An experienced and accredited representative can improve your chances of success.
When to Choose a VA Higher-Level Review
Of the three appeal options within VA, a higher-level review is often a good place to start because it is:
- Relatively faster than the other options
- Particularly helpful when you’ve already submitted evidence of:
- Your current disability
- Any injuries or relevant events in service
- A connection from service to your current disability
- The severity of your current disability
When Can You Use a VA Higher-Level Review?
You can use a VA higher-level review to appeal any rating decision within the past year that did not result from a higher-level review.
So, if you have a decision from the VA within the past year based on an initial or supplemental claim (or a duty-to-assist error—see below), then a higher-level review is available to you.
To file a VA higher-level review, complete VA Form 21-0996 in hard copy or online.
What Happens After You Request a VA Higher-Level Review?
Once you submit your request for higher-level review:
- A decision review officer will receive the file and begin reviewing all the evidence in your file at the time of the decision you’re appealing.
- If you or your representative requested an informal conference, it will likely be scheduled within three months. After the conference, the review officer will write the decision, usually within just a couple of weeks.
What are the Three Possible Outcomes of a VA Higher-Level Review?
1. Denial
This is the worst-case scenario and means that the VA is continuing to deny the claims. But fear not, because you still have additional appeal options.
2. Grant
This is the best-case scenario where the VA overturns the previous decision to give you the benefits you claim. Congratulations
3. Duty-to-Assist Error (or Sometimes a “Difference of Opinion”).
This is the most common outcome we see and is a middle-of-the-road scenario. Overall, it’s a good thing, but it means the fight isn’t over yet. If the decision review officer finds that the VA did not fulfill its legal duties to properly develop your claim, they will return your claim to the Regional Office to correct the errors.
This further development usually takes several months, and then the VA will issue a new decision either granting or denying benefits. If denied, you can request another VA higher-level review or choose another appeal option.
An experienced and knowledgeable veterans disability attorney accredited by the VA can help you navigate your VA appeal options and make the most persuasive arguments possible to improve your chances of success in a VA higher-level review or other appeal.
At the Deuterman Law Group, our VA-accredited attorneys have helped many disabled veterans with their VA disability claims.
For immediate assistance, call us toll-free at 866-738-5532.
