If the US Department of Veterans Affairs has denied your Supplemental Claim request, you may still have options to receive benefits. Veterans who believe that they are entitled to disability compensation for service-related injuries can file VA Form 20-0996, Decision Review Request: Higher Level-Review, to have their file assessed by a more senior administrator.
Filing a Request for a Higher-Level Review
A Higher-Level Review is usually employed to correct an apparent misinterpretation of fact or law. Veterans may file Form 20-0996 if their claims adjudicator assigned a low rating to a Supplemental Claim request that should have been clearly approvable.
However, Higher-Level Reviews are subject to some restrictions. You may not be able to file Form 20-0996 if:
- You wish to submit new evidence. The Department of Veterans Affairs will only review the evidence submitted with the original claim. While the agency will not stop you from including additional paperwork, the senior-level adjudicator will not consider it relevant to the application.
- Your Higher-Level Review Request has already been denied. If you have already submitted a Higher-Level Review Request and lost, you may not re-file for the same case. Instead, you must either submit another supplemental claim with additional evidence or initiate an appeal through the Bureau of Veterans Affairs.
If you meet the criteria to file a Higher-Level Review Request, you may file VA Form 20-0996 within one year of receiving your supplemental claim request denial.
While a Higher-Level Review affords Veterans the chance to have their application reviewed by a more experienced adjudicator, it can take months for officials to make their decision. In the past, the Department of Veterans Affairs took years to adjudicate higher-level reviews. Waiting times have since decreased, but the agency still takes—on average—about four months to process claims.
If Form 20-0996 contains any significant mistakes or discrepancies, the petitioner may be asked to either re-submit the form or offer clarification.
Tips for Filling Out VA Form 20-0996
VA Form 20-0996, Decision Review Request: Higher-Level Review, is comprised of the following sections:
Section I – Veteran’s Identification Information
The first section of VA Form 20-0996 contains eight fields intended to identify the Veteran. You must provide, at a minimum, the following information:
- Your name
- Your Social Security number
- Your VA file number, if any exists
- Your date of birth
- Your VA insurance policy number, if applicable
- Your current mailing address, which is where you receive mail
- Your telephone number
- Your email address, if desired
The Department of Veterans Affairs can, under most circumstances, still process an application that is missing a telephone number or email address. However, other fields—including those for your Social Security number and date of birth—are mandatory and should never be left empty.
Section II – Claimant Identification Information (If Other Than Veteran)
The first and second sections of VA Form 20-0996 are almost identical. However, since Section II is intended for claimants other than the Veteran, applicants need not provide a VA file number or insurance policy details.
Section III – Benefit Type
A Decision Review Request: Higher-Level Review may only be submitted for a single benefit type. You may select any of the following issues for review:
- Pension, DIC, Survivors Benefits
- Veteran Readiness and Employment benefits
- Loan guaranty
- Life insurance
- Veterans Health Administration
- National Cemetery Administration
If you need to file higher-level review requests for more than one benefits-related issue, you must file a separate Higher-Level Review Request for each additional issue.
Section IV – Optional Informal Conference
The completion of Section IV is optional. If you indicate that you would like an informal conference with a senior-level reviewer, then you will have the opportunity to discuss the errors of fact or law that resulted in your Supplemental Claims request being denied.
Since a Higher-Level Review only considers the same information provided in your original request, you may not introduce new evidence or ask the adjudicator to consider extenuating circumstances.
An optional informal conference could provide a critical chance to explain why you believe that your claims denial was issued in error. However, requesting an informal conference could delay your review and subsequent decision. Instead of attending an informal conference, you can ask your attorney or appointed representative to submit a written statement explaining the alleged errors of fact or law. This written statement must accompany your VA Form 20-0996.
Section V – Issues for Higher-Level Review
In Section V, you may identify each issue adjudicated by the Department of Veterans Affairs which you would like reconsidered during your Higher-Level Review. While completing Item 18A, you should cite a specific area of disagreement. Your specific area of disagreement could include the following:
- Entitlement to service connection
- Higher evaluation
- Earlier effective date
You should review your earlier decision letter for a list of issue and adjudication dates. When filling out each entry on Item 18A, enter the dates provided by the department for each decision. Since the senior-level adjudicator will only consider the issues detailed on Form 20-0996, you must list every issue that you would like reassessed.
Section VI – Certification and Signature
You must sign and date Form 20-0996. Your signature should be in ink. The Department of Veterans Affairs will not adjudicate a Higher-Level Review Request if it is not properly signed and dated by the claimant, unless you have either completed Section VII or submitted a separate Alternate Signer Certification.
Section VII – Authorized Representative Signature
A Department of Veterans Affairs authorized representative may sign and submit the application on the claimant’s behalf, provided that VA Form 21-22 or VA Form 21-22a has either been submitted or is attached to the application.
Contact an Experienced Veteran Affairs Attorney Today
VA Form 20-0996 is—at least in theory—a simple document. However, its subsections contain language and questions that can be confusing. Since the Department of Veterans Affairs processes large amounts of claims, any mistake could be grounds for rejection.
Sean Kendall, Attorney at Law, has spent decades advocating for Veterans’ rights. Our attorneys understand that making sense of the department’s bureaucracy and requirements is anything but easy. Fortunately, you do not have to risk your benefits. Please send us a message online or call us at 877-629-1712 today to schedule your initial consultation.