Supplement Claim vs. Higher-Level Review: Which Appeal is Right for Your Denied Claim?
You may not know that an estimated 30% – 36% of initial disability claims filed with the U.S. Department of Veterans Affairs (VA) are denied, and can be denied for a variety of reasons. This can be incredibly frustrating for veterans who are battling service-connected injuries, illnesses, and medical conditions that impact their overall health and day-to-day lives — but it is not a hurdle that can’t be overcome.
Veterans have three methods of appeal when a claim is denied — file a Supplemental Claim, submit your claim for a Higher-Level Review, or present your claim to a Board of Veterans’ Appeals in Washington D.C. The next question that many veterans ask is, which appeal is right for my denied claim? This comparison of Supplemental Claims vs. Higher-Level Reviews will outline key differences and help you gain a better understanding of how VA Benefits Attorneys can help.
Key Differences Between a Supplemental Claim and a Higher-Level Review
When veterans are battling a service-connected disability, it is not always easy to understand which method of appeal is the right one for you and your claim. Many veterans that attempt to appeal a denied claim on their own under the Appeals Modernization Act (AMA) can choose the wrong method of appeal and can be stuck in an administrative loop. Veterans who have a clear understanding of each method of appeal and when it is the right choice can make the differences between a denied or successful disability claim — and VA Benefits Attorneys is here to help.
- Supplemental Claim: A supplemental claim is a method of appeal that involves providing new and relevant medical documentation and evidence for an initial claim that is denied as additional proof of a service connection.
- Higher-Level Review: A higher-level review is a method of appeal where an initial claim is denied and then sent to a senior VA adjudicator to ensure a claim is not denied due to clerical or administrative error.
Supplemental Claim vs. Higher-Level Review: Best Use Cases
When a VA disability claim is denied, veterans will receive a notification letter that details any missing information, any favorable findings, a specific reason for your denial, a summary of the evidence that was reviewed, and any laws or regulations used to evaluate your claim. The information within this notification letter may influence your course of action, and both supplemental claims and higher-level reviews are intended to be used in specific situations.
Reasons to File a Supplemental Claim
- The denied claim cited missing medical records or the lack of a medical nexus.
- You have a new Disability Benefits Questionnaire (DBQ), Nexus Letter, Independent Medical Opinion (IMO), or treatment records to submit.
- A change in veteran law may be relevant to your medical condition.
Reasons to File a Higher-Level Review
- The notification letter highlights evidence and documentation that was overlooked by VA representatives.
- Veteran disability law or rating schedule criteria was misapplied to your claim.
- There was a clear error with your C&P Exam or results were misinterpreted.
Supplemental Claim vs. Higher-Level Review: Application Forms and Deadlines
When you make the decision to appeal a denied claim, it involves using the correct forms. A supplemental claim involves VA Form 20-0995. Higher-level reviews require VA Form 20-0996 for submission. In addition to the need for specific forms, these methods of appeal have deadlines for application. A supplemental review provides 1 year to preserve the original effective date and can be filed at any time — but the date for back pay may be changed. Veterans that wish to file a higher-level review have a strict 1 year timeframe that starts when you receive a notification letter.
Supplemental Claim vs. Higher-Level Review: Timelines and Statistics
Veterans who have experienced a denied disability claim may have questions about how long an appeal will take to achieve a result — and key statistics can help answer your questions. The estimated completion time for a supplemental claim or higher-level review provided by the VA is 125 days, but the actual processing time can vary. Supplemental claims take an estimated 60 – 95 days on average to achieve results. A higher-level review takes an estimated 120 – 150 days to achieve results. When veterans are faced with a denied claim and choose to appeal, a supplemental claim is the more popular option and is chosen by 70% – 75% of veterans. Higher-level reviews are used as a method of appeal by an estimated 15% – 20% of veterans after an initial denial.
READ MORE: How Do I Increase My VA Disability Rating?
Has your initial disability claim been denied? Are you planning on appealing your denied claim? With multiple methods of appeal, it is not always easy to know what the right choice might be — but this quick comparison of supplemental claims vs. higher-level reviews can help answer key questions like which method of appeal is right for your claim.
Contact VA Benefits Attorneys today for help with your denied disability claim!
