Receiving a denial on a VA disability claim can be disheartening, but it’s important to remember that a denial is not the end of the road. For veterans who believe the VA made a mistake or overlooked evidence in their initial decision, the Higher Level Review (HLR) process is an effective way to request a second look. This guide covers everything veterans need to know about filing an HLR, from eligibility to tips on preparing the best possible appeal.
What is a Higher Level Review?
A Higher Level Review is a unique option within the VA appeals process that allows veterans to request a fresh review of their claim by a more experienced VA claims officer. This process is helpful if the denial resulted from a legal error or a misunderstanding of the evidence submitted.
Unlike other appeals, an HLR does not allow for new evidence. Instead, it relies on the existing records, allowing a senior reviewer to take a fresh look at the claim to ensure accuracy and fairness.
Eligibility for a Higher Level Review
Veterans are eligible to file an HLR if they:
1. Have received a denial or decision from the VA within the last year.
2. Believe there was an error or an oversight in the initial review, such as misinterpreted evidence or application of incorrect law.
Steps to File a Higher Level Review
1. Complete VA Form 20-0996
To start the HLR process, veterans must complete VA Form 20-0996. This form serves as a formal request for review, providing essential information about the claim, reasons for requesting the HLR, and any issues they would like the reviewer to address.
•Tip: Clearly state the reasons you believe the VA’s decision was incorrect. Point out any areas where you feel the evidence may have been misinterpreted or overlooked.
2. Request an Informal Conference (Optional)
The HLR process includes an option for an informal conference, where veterans can speak directly with the reviewer to clarify issues in their claim. This conference allows veterans to discuss the case in greater detail and to highlight key evidence or correct any errors directly.
•How to Request: When filling out VA Form 20-0996, check the box to request an informal conference. The VA will contact you or your representative to schedule a convenient time for the conference.
•Conference Tips: Before the conference, review your claim details, organize your evidence, and prepare a clear explanation of why the decision was incorrect. Be ready to point out specific items in your records that support your argument.
3. Submit the HLR Form to Your VA Regional Office
Once completed, submit VA Form 20-0996 to your VA Regional Office. The form can be sent by mail, fax, or delivered in person to your nearest office. Be sure to keep a copy of the completed form and any additional materials for your records.
4. Wait for the VA’s Decision
The VA aims to complete Higher Level Reviews within 4-5 months. During this time, the reviewer will re-examine all existing evidence and issue a decision. The final outcome will be communicated by mail and will outline the reviewer’s decision.
What to Do If the Higher Level Review is Denied
If the HLR does not result in a favorable decision, veterans have additional appeal options:
1. File a Supplemental Claim: This is beneficial if you have new and relevant evidence that was not part of your original submission.
2. Appeal to the Board of Veterans’ Appeals (BVA): For more complex cases, veterans can escalate their appeal to the BVA for a detailed review and potential hearing.
Tips to Strengthen Your Higher Level Review
•Seek Help from a Veteran Service Organization (VSO): A VSO representative can provide valuable guidance, assist with form completion, and help veterans prepare for an informal conference.
•Review Denial Details Carefully: Understand the reasons for denial before filing the HLR. This allows you to address specific issues effectively.
•Organize Your Evidence: Although you cannot submit new evidence, making sure your existing records are in order will help the reviewer navigate your case more easily.
Conclusion
The Higher Level Review process provides veterans a chance to ensure their claims are reviewed accurately and fairly, without needing to submit new evidence. By following these steps and preparing a comprehensive request, veterans can feel confident in their appeal. Veterans Valor is dedicated to helping veterans navigate the HLR process, ensuring they receive the benefits their service has earned.
