If your VA disability claim has been denied or if you believe the VA made an error in your decision, requesting a Higher-Level Review (HLR) can be a powerful tool to challenge the decision. The HLR process allows veterans to have their case reviewed by a senior VA claims adjudicator without submitting new evidence. In this article, we’ll break down what a Higher-Level Review is, how it works, and when it’s the right option for your appeal.
What Is a Higher-Level Review?
A Higher-Level Review is part of the VA’s modernized appeals system under the Appeals Modernization Act (AMA). It provides veterans with an opportunity to have their case reviewed by a more experienced adjudicator who was not involved in the original decision. The HLR process focuses on identifying errors in the previous decision based on the evidence already submitted with the claim.
Unlike a Supplemental Claim, an HLR does not allow the submission of new evidence. Instead, it relies on the existing record and any additional arguments or explanations you provide to highlight errors.
When Should You Request a Higher-Level Review?
An HLR is an excellent option in the following situations:
•You Believe the VA Made an Error: If you suspect that the VA misinterpreted the law, overlooked evidence, or applied the wrong disability rating criteria, an HLR can help correct these mistakes.
•Your Evidence Was Misunderstood or Ignored: Sometimes, evidence submitted with your claim may have been misinterpreted or not considered properly. An HLR provides a fresh set of eyes on your case.
•You’re Unsatisfied with the Initial Decision: Whether it’s a denial, a low disability rating, or an incorrect effective date, an HLR can help resolve issues in the original decision without starting a completely new claim.
How to Request a Higher-Level Review
Requesting an HLR is a straightforward process. Here are the key steps:
- File VA Form 20-0996: This is the official form used to request an HLR. Be sure to complete it accurately and include details about why you’re requesting the review.
- Choose an Informal Conference (Optional): When filing an HLR, you can request an informal conference with the senior reviewer. This is a phone call where you or your representative can explain your case and point out errors in the original decision.
- Submit the Request Within the Timeframe: You must request an HLR within one year of the date on your VA decision letter. Missing this deadline means you’ll need to explore other appeal options.
- Prepare Your Arguments: While you can’t submit new evidence, you can provide a written statement explaining why the original decision was incorrect. Use clear and specific language to point out errors or omissions.
What Happens During the Higher-Level Review Process?
Once you submit your HLR request, a senior reviewer will evaluate your case. They will examine the evidence already on file and review the arguments you’ve presented. If you’ve requested an informal conference, they will contact you to discuss your case.
The reviewer may:
- Overturn the original decision if errors are found.
- Uphold the decision if no errors are identified.
- Return the claim to the VA Regional Office for additional clarification or corrections.
Advantages of a Higher-Level Review
• Faster Resolution: HLR decisions are typically made more quickly than other appeal options, such as Board of Veterans’ Appeals reviews.
• Focus on Errors: By concentrating solely on correcting errors, an HLR can often result in a favorable decision without requiring new evidence.
• No Need to Start Over: You don’t have to file a new claim or gather additional evidence, saving time and effort.
Limitations of a Higher-Level Review
While HLRs offer many benefits, they also have some limitations:
• No New Evidence: You cannot introduce new evidence during the HLR process, which may limit your ability to strengthen your case.
• Final Decision: If the HLR does not result in a favorable decision, you must pursue other appeal options, such as a Supplemental Claim or Board of Veterans’ Appeals review.
Conclusion
A Higher-Level Review is an essential tool for veterans seeking to correct errors in their VA disability claim decisions. By understanding when and how to request an HLR, you can navigate the appeals process more effectively and improve your chances of securing the benefits you deserve. If you’re unsure about the best course of action, consider seeking assistance from a Veterans Service Organization (VSO) or a pre-filing consulting company like Veterans Valor to guide you through the process.
