Applying for VA disability benefits can be a challenging process. When veterans seek disability compensation for injuries or conditions related to their military service, they often expect the process to be straightforward. However, not all claims get approved on the first attempt. If your claim for disability benefits has been denied or you received a lower rating than expected, you have the right to request a reconsideration. In North Carolina, understanding the process for appealing or reconsidering your VA disability claim can make a big difference. At, Phillips & McCrea, PLLC, we are here to guide you through the legal process and help you navigate the complexities of your case.
Understanding the VA Disability Claim Denial
When the Department of Veterans Affairs (VA) denies a disability claim, they issue a decision letter explaining why the claim was not approved. Sometimes, the VA may deny a claim due to missing information, insufficient medical evidence, or a lack of clarity about how the condition is connected to service. In other cases, the VA may assign a lower disability rating than what you feel is appropriate for your condition. If your claim was denied or rated too low, you are not alone, and you have options to get a second look.
A denial or a lower rating can feel frustrating, especially after gathering medical records and evidence to support your claim. Veterans in North Carolina should know that they have a right to request a reconsideration or appeal the decision. Reconsidering your claim does not mean starting over from scratch. Instead, it involves providing additional evidence or clarifying details to strengthen your case and show that your condition deserves benefits. Understanding why claims get denied or given lower ratings is the first step toward successfully appealing or requesting a reconsideration.
Options for Appealing a VA Disability Claim Decision
When the VA issues a decision that you disagree with, you have several choices for responding. The three main options for appealing or requesting a reconsideration are the Supplemental Claim, the Higher-Level Review, and the Board Appeal. Each of these options provides a different approach to reconsidering your claim.
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The Supplemental Claim involves adding new and relevant evidence to your existing file. If you have new information that was not available during your initial claim, this option might be right for you. The Higher-Level Review allows a senior VA official to review your case without any new evidence. This option may be helpful if you believe the VA made a mistake or misinterpreted the information you provided. The Board Appeal involves taking your case to the Board of Veterans’ Appeals, where a judge will review your claim. Each of these methods has its own requirements and timelines, and choosing the right option can impact your chances of success.
How to Submit a Supplemental Claim
The Supplemental Claim option is one of the most common ways veterans request a reconsideration. If you have new and relevant evidence that was not available or included in your initial claim, submitting a Supplemental Claim can be a way to strengthen your case. This evidence could include medical records, doctor’s opinions, or any documentation that supports your claim.
To begin the Supplemental Claim process, you will need to fill out VA Form 20-0995, known as the “Decision Review Request: Supplemental Claim.” This form requires you to provide information about your claim and the new evidence you are adding. It is important to clearly explain how the new evidence supports your case. Veterans in North Carolina should make sure that their additional information is directly related to the denied claim or the condition for which they seek a higher rating. When filling out this form, ensure that all sections are complete and that you submit any supporting documents with your request.
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After completing the form and gathering your new evidence, submit everything to the VA. The VA will review the Supplemental Claim and consider the new information you provided. If the VA finds that the new evidence supports your claim, they may adjust your disability rating or approve the benefits you initially requested. The Supplemental Claim process is beneficial for veterans who have gathered additional information that strengthens their case.
Requesting a Higher-Level Review
Another option for reconsidering your VA disability claim is the Higher-Level Review. This option is suitable if you believe the VA made an error in its initial decision, such as overlooking critical information or misinterpreting the evidence. The Higher-Level Review does not allow new evidence, so this option is best when you feel that the original evidence was strong enough to support your claim.
To request a Higher-Level Review, veterans should submit VA Form 20-0996, the “Decision Review Request: Higher-Level Review.” This form is similar to the Supplemental Claim form, but it emphasizes that you want a fresh look at the same information by a more senior VA reviewer. In some cases, veterans can request an informal conference to discuss their case over the phone. This can provide an opportunity to point out specific issues or concerns with the initial decision.
It is important to keep in mind that the Higher-Level Review is a one-time option for each claim. If the reviewer agrees with your appeal, they may overturn the denial or adjust your rating. However, if the decision remains the same, you can still pursue a Board Appeal as a final step. Veterans in North Carolina often choose this option when they believe their evidence was strong but was not properly evaluated in the initial review.
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Pursuing a Board Appeal for Your VA Disability Claim
The Board Appeal option provides a final level of reconsideration for your VA disability claim. In this option, your case is reviewed by the Board of Veterans’ Appeals, where a judge evaluates your claim based on existing evidence or with additional evidence if you choose. Veterans have three different options when submitting a Board Appeal: the Direct Review, Evidence Submission, and Hearing with a Veterans Law Judge.
The Direct Review option is available if you do not have any new evidence and do not wish to have a hearing. The judge will review the original evidence and make a decision based on the existing record. The Evidence Submission option allows you to submit additional evidence within a 90-day period after filing the appeal. Finally, the Hearing with a Veterans Law Judge gives you the opportunity to present your case in a formal setting, either in person or via video conference. This can be a valuable chance to explain your situation directly to the judge, especially if you feel that the documents alone may not provide a full understanding of your condition.
The Board Appeal process can take longer than the Supplemental Claim or Higher-Level Review, but it may be necessary for complex cases. Veterans who choose this path should be prepared for a potentially lengthy process. However, the opportunity to have a judge review your case may provide the outcome you seek.
How Long Does the VA Reconsideration Process Take?
One of the common concerns among veterans in North Carolina is how long the reconsideration process might take. Each type of appeal has its own timeline, and understanding these can help manage your expectations. The Supplemental Claim process typically takes around four to five months, depending on the complexity of your case and the evidence provided. The Higher-Level Review may take several months, especially if you request an informal conference.
The Board Appeal process usually takes the longest, with cases sometimes lasting a year or more before a decision is made. While these timelines can seem lengthy, the VA has made efforts to speed up appeals in recent years. During this time, it is essential to stay patient and continue gathering any necessary evidence. Remember that each step of the process is designed to give your claim the best possible chance of approval.
Importance of Seeking Legal Guidance in the VA Reconsideration Process
Requesting a reconsideration of your VA disability claim can be complex, especially if you are not familiar with the specific requirements and deadlines involved. Veterans in North Carolina should consider seeking assistance from knowledgeable professionals who can guide them through the appeal process. Having someone who understands VA law and procedures can help you avoid mistakes and ensure that all necessary documents are submitted accurately.
A representative or advocate can also help you decide which appeal option best suits your case. They can review your evidence, help fill out forms, and make sure that your claim is as strong as possible before submission. When dealing with VA disability claims, even small errors can lead to further delays, so taking the time to seek help can be beneficial in the long run.
If you or a loved one in North Carolina needs assistance with a VA disability claim reconsideration, don’t hesitate to reach out for help. The process may seem overwhelming, but you don’t have to face it alone. Phillips & McCrea, PLLC is dedicated to supporting veterans through every step of the appeal process. Our team understands the challenges you may be facing and is here to provide the guidance you need. Contact us today to learn more about how we can assist you in securing the benefits you deserve.