VA Disability Appeals Process

Hey guys, it’s Laura Page, and today I’m going to talk a little bit about the VA appeals process. The VA appeals process has gotten better–believe it or not–over the last few years and that is due to the Veterans Appeals Modernization Act implemented in February of 2019.

I’m going to talk a little bit about the three options that it allows and which ones I would suggest which I would stay away from. Those three options are now higher level review, the supplemental claim lane, and the old school veteran appealing to the board. I’m not really going to go into detail about the board appeal option because I always use that as a last resort. I want to avoid that if we can so I’m going to talk about the first two options, here we go!

The first option I’m going to talk about is the higher level review and this is known as the “second look.” What this does is submit your case as it was submitted initially, no new evidence is allowed. I’ll say that again, no new evidence is allowed. The best options in this case would be for those claims that were approved and underrated or if they were denied and it’s a blatant mistake. These decisions are based off of a difference of opinion or a clear unmistakable error.

Now many of you have asked me, “Well how do you fight back? How do you get to say your piece of why you think that you’re underrated?” Luckily for you, there is an option for an informal phone call with the VA, so I definitely suggest to take that option. You’ll want to pick two appointment times and I do suggest to keep your phone on ring for the next few months if you submit a higher level review because they can call anytime. You want to make sure you don’t miss that call because they usually will not call back.

This call is where you can take the opportunity to talk about you claim and highlight the issues like “hey look at my evidence on page xyz it explains here my symptoms and I am underrated based on the CFR.” We’ll talk a little bit more about the laws that the VA uses to rate decisions in my other videos.

The second option is a supplemental claim lane and for this one you must submit new evidence. It is kind of the opposite side of the coin from the higher level review. You can submit new evidence.

One example of new evidence would be submitting a personal statement. There’s only so much that the VA can determine from looking at your medical records, so you want your voice to be heard. Tell them the details. Tell them how those disabilities are affecting your life mentally, socially, professionally, and physically. You want to tell your story and write a personal statement for any issues that you have because I always think it’s important to be heard.

Another example of new evidence is a buddy statement, sometimes called a buddy letter. A buddy statement is a written statement from a witness, a spouse, or a friend. Someone who has seen the impacts of you disability on your life. Buddy letters go a long way and they can validate some of these issues if there is an issue with medical evidence.

Nexus statements are one of the best articles of evidence you can provide to support your claim. A Nexus letter is a doctor’s professional medical opinion that your issues were either caused by or made worse by your service. The wordage that they use is more likely than not or at least as likely as not and that testimony coming from a doctor holds a lot of weight. We can get you in contact with the right people to get you evaluated for your issues if that service connection portion is the missing piece of that VA puzzle.

Independent medical opinions are also another great option for new relevant evidence. If you get evaluated by a new doctor or get evaluated for the first time or maybe you didn’t have an official diagnosis and you knew you had an issue but it wasn’t on paper… if it’s not on paper it didn’t happen! Everything needs to be recorded, so make sure that you get an opinion and a diagnosis if that’s the missing piece of the puzzle. Also, sometimes the VA just doesn’t have all the records that you thought they had, so if there was medical evidence that was not previously submitted, you’ll want to get that submitted because that could be the deciding factor in your claim.

If you’ve been denied or underrated with your claim, these are the options you want to take a look at first to fight those decisions. You may not know which route to go. The best advice I can give is to take a look at your decision letters anytime the VA makes the decision on your claim. They will send you a decision letter and they’ll usually explain in there why a claim was denied and/or why it was rated at the level that it was.

So many veterans are afraid to start the appeals process because they’ve heard the horror stories from friends and battle buddies that the appeals process take years. That used to be very true, but these new systems, the higher level review and the supplemental claim lane, take on average three to five months. It’s still not an immediate turnaround, but nothing with the military really is immediate.

Get that process started as soon as you can, especially if you’ve been recently denied or underrated. You have one year from your decision date to fight the decision and still receive back pay to the original intent to file date, so that’s huge. You don’t want to sit on it. You want to move forward and keep fighting. Don’t accept that defeat!