How to File an Appeal
The Veterans Appeals Improvement and Modernization Act ("AMA") changed the way Veterans are to file their appeals. Claims filed after February 19, 2019 fall within the AMA system.
The AMA system provides three appeal options: file a Supplemental Claim, request a Higher Level Review or file your appeal directly to the Board of Veterans Appeals. The deadline to file your appeal is the same for all three. You have one year from the date of your Rating Decision to file an appeal. So how do you know which appeal lane to pick?
The table below will help you navigate which appeal lane best suits your needs.
|I want to file a new claim that has never been submitted to the VA before||Use VA Form 21-526 EZ|
|I want an increase on my claim for which I am already service-connected||Use VA Form 21-526 EZ|
|I don't think the VA assigned me the correct disability rating and I have evidence to prove it||Use VA Form 20-0995 Supplemental Claim Application|
|I don't think the VA assigned me the correct disability rating and/or effective date, but I don't have any more evidence to submit||Use VA Form 20-0996 Higher Level Review|
|I don't think the VA made the right decision and I want a Veteran Law Judge to review my case||Use VA Form 10182 Higher Level Review|
If you wish to change lanes you can do so without jeopardizing your effective date if you change within one year of the Rating Decision.
If you have a pending appeal that is still in the old appeal system, known as the Legacy system, you can still opt into the new system after receiving an initial decision, a Statement of the Case or a Supplemental Statement of the Case.
How to prepare in filing an appeal
If you have decided to file an appeal to your Rating Decision, there are a few things you can do to ensure you are fully prepared.
First, request your C-file from the VA. You can obtain a copy of your C-file by completing VA Form 3288 (insert hyperlink form here) and taking it your local VA Regional Office. Your C-file contains pertinent information that is necessary to prepare your argument as to why your Rating Decision was incorrect. Information contained within your C-file includes, benefits application, denial letters, C&P examinations, Rating Decisions and Code Sheets, your Service Treatment Records (STR), and post medical records.
Once you are able to review all of the information in your C-file, you will have a better idea as to why you were denied and what additional information the VA may need in order to provide you with a favorable outcome.
Second, you may need to obtain additional evidence to help support your claims. The evidence required could be additional medical records and/or statements from yourself, family and friends which describe symptoms observed while you were in service, continuation of symptoms and your current medical conditions.
Lastly, contact a Veterans Law attorney. VA attorneys know the process and what the VA requires. Your attorney can obtain an electronic copy of your C-file, review your entire C-file, identify what is missing and what is preventing you from receiving a favorable outcome, help gather additional evidence and present your argument in a manner the VA will understand.
If you require legal assistance for your veterans disability case, please contact our office today for a free consultation.
Common Reasons to File an Appeal
- The VA Failed to Obtain a Medical Exam
- If the VA has enough evidence that suggests your current medical condition may be related to your active-duty service, they are required to provide you with a medical exam. A medical exam is often the determining factor for service connection because it addresses the relationship between your current disability and the in-service injury or disease. If you do not receive a medical examination, your claim may be denied. Thus, the failure of the VA to obtain a medical examination or medical opinion is grounds for an appeal.
- The VA Failed to Notify You of What Evidence is Required
- The VA is required to let you know what evidence is required for your claim to be approved. The VA is also required to notify you of what information you are required to obtain and what information they will obtain. If the VA fails to notify you of what is required, an appeal is warranted.
- The VA Failed to Obtain Your Government Records
- The VA is required to obtain certain records for your claim to be decided. Namely, the VA is required to obtain your Service Treatment Records, and all other relevant records held or maintained by a government entity. The VA is also required to obtain medical treatment records from any VA facilities wherein you sought medical treatment. The failure of the VA to obtain these records is grounds for an appeal.
- The VA Failed to Obtain Your Private Medical Records
- If you notify the VA that you had medical treatment through a private medical provider the VA is required to make reasonable efforts to obtain your records, at their cost. If the VA is unable to obtain the private records notice is to be provided to the Claimant so the Claimant may obtain the records. If the VA fails to take reasonable steps to obtain your private treatment records, an appeal is warranted.