Your Rights To Seek Further Review Of Our Healthcare Benefits Decision - Veterans Health Administration
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Your Rights To Seek Further Review Of Our Healthcare Benefits Decision

If you received a VHA decision on your claim for healthcare benefits, and are dissatisfied or disagree with the decision, in whole or part, you have ONE YEAR to initiate further review by completing and submitting one of the forms described below.

What are my review options?

VA offers 3 types of review, but not all types of review are available in every case. Below is a description of each type of review and an explanation when each type is available.

This chart describes availability of review options:

Review OptionsI am a Veteran, Beneficiary, or Other Person Who Paid for a Veteran or Beneficiary's treatmentI am a Service Provider (Not Under Contract)I am a Service Provider (Under Contract)
Supplemental Claim Available Not Available Not Available. See Contract Terms.
Higher-Level Review Available Not Available Not Available. See Contract Terms.
Appeal to the Board Available Available Not Available. See Contract Terms.
  • Supplemental Claim. If available, you should file a supplemental claim if VHA does not have all the evidence to accurately decide your claim.

  • Higher-Level Review. If available, you should file a request for higher level review if VHA has all the necessary evidence, but you would like VHA to take another look at the claim and see if a new decision can be supported.

  • Appeal to the Board of Veterans' Appeals. You should appeal to the Board of Veterans’ Appeals if you would like a Veteran’s Law Judge to review your claim.

FAQs

How do I request review by VA of my decision?

To select a review option, you must submit the appropriate form to the appropriate office for review.

For a Supplemental Claim, review your decision notice letter for the required forms and ways to submit the request. Either enclose or identify the NEW and RELEVANT EVIDENCE, not previously considered by VA, that you believe supports your claim. If you want VA to help you gather records, complete and return the appropriate Release of Information Form: 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA) or 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA).

For a Higher-Level Review, complete VA Form 20-0996, Decision Review Request: Higher-Level Review, and consult your decision notice letter for the required ways to submit the request.

To Appeal to the Board, complete VA Form 10182 - Decision Review Request: Board Appeal (Notice of Disagreement) and send the form to:

Board of Veterans' Appeals
P.O. Box 27063
Washington, DC 20038
Fax: 844-678-8979

For more information on the Board of Veterans’ Appeals, see https://www.bva.va.gov/.

All forms are also available at http://www.va.gov/vaforms/.

Can someone help me with my request for review?

You may be able to get assistance with your claim from a VA recognized and accredited attorney, claims agent, or Veterans Service Organization (VSO). VSOs and their representatives are not permitted to charge fees or accept gifts for their services. Only VA-accredited attorneys and claims agents may charge fees for assisting in a claim for VA benefits, and only after VA has issued an initial decision on the claim and the attorney or claims agent has complied with the power-of-attorney and the fee agreement requirements. For more information on the types of representatives available, see http://www.va.gov/ogc/accreditation.asp.

If you have not already selected a representative, or if you want to change your representative, a searchable database of VA-recognized VSOs and VA-accredited attorneys, claims agents, and VSO representatives is available at http://www.va.gov/ogc/apps/accreditation/index.asp. Contact your local VA office for assistance with appointing a representative or visit http://www.ebenefits.va.gov.

What happens if I do not submit my request for review on time?

If you do not request a review option within the required time limit, you may only seek review through the following options:

  • File a request for revision of the decision based on a clear and unmistakable error in the decision;
  • If available, file a Supplemental Claim along with new and relevant evidence to support your issue(s). Where a Supplemental Claim is filed after the time limit to seek review of a decision, the effective date for any resulting award of benefits generally will be tied to the date that VA receives the Supplemental Claim.

For more information on all the available review options visit: https://www.va.gov or contact us at the phone number listed on the decision notice you received.

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