VA Higher Level Reviews: Success Rates and Essential Tips for Veterans

HLR is distinct from the traditional appeals process in several critical ways:

• No New Evidence Required: HLR focuses exclusively on the evidence already presented in your initial claim. This limitation speeds up the review process as no additional documentation needs to be gathered or submitted.
• File an Argument: via VA Form 646 outlining why they feel the decision was incorrect.
• Informal Conference: Veteran or their representative can meet with the claims adjudicator to review.
• Faster Resolution: The streamlined nature of the HLR means decisions are typically made quicker than traditional appeals, shooting for resolution within 125 days.

Eligibility for an HLR is straightforward:

1. Review Your Initial Claim Decision: Understand the basis of the VA’s decision on your initial claim. This understanding is crucial as it guides your HLR application.
2. Complete VA Form 20-0996: This form initiates the HLR process. It’s available online or at your local VA office.
3. Submit Your Request: You can submit the form via mail, fax, or in person. Alternatively, online submission through the VA’s eBenefits portal is available for those who prefer digital communication.

Choosing an HLR offers several advantages:

• Faster Processing Time: As mentioned, the goal is to resolve HLRs within about 125 days, significantly quicker than the years it often takes for traditional appeals.
• Opportunity for Error Correction Without New Evidence: If your initial claim suffered from errors or misinterpretations, the HLR provides a fresh set of eyes to correct these without complicating the matter with new evidence.
• Senior Adjudicator Review: Your claim will be reviewed by a senior VA claims adjudicator, which could increase the likelihood of a favorable outcome due to their greater experience and authority.

Here’s what the process typically involves:

• Senior Reviewer Assessment: The adjudicator reviews all the evidence presented in your initial claim. This review is done de novo, which means the adjudicator does not consider the conclusions of the original decision-maker but looks at the evidence with fresh eyes.
• No New Evidence: Remember, in an HLR, the review is restricted to the evidence already on file. If you have new evidence, a Supplemental Claim might be a better route.
• Informal Conference (Optional): You have the option to request a phone conference during the HLR process. This can be beneficial to clarify points and directly address any potential misunderstandings or errors with the reviewer.
• Decision Notification: Once the review is complete, the VA will notify you of the decision. This notification will detail the adjudicator’s findings and, if favorable, will update your disability rating and benefits accordingly.

To ensure the best possible Higher Level Review success rate, consider the following tips:

• Prepare Thoroughly: Before filing for an HLR, review your initial decision letter carefully. Understand where the VA’s conclusions may have been flawed or where additional clarification might change the outcome.
• Organize Your Evidence: Even though new evidence isn’t considered in an HLR, having your existing evidence well-organized and clearly linked to your arguments can help the senior adjudicator understand your case better.
• Opt for an Informal Conference: If offered, use the informal conference to directly communicate with the adjudicator. This is your chance to point out specific errors or provide explanations that could influence the decision.
• Follow Up: Keep track of your HLR status and maintain communication with the VA office handling your review. Prompt responses to any additional queries they might have can prevent delays.

If you find yourself still dissatisfied with the decision, you have further options:

• File a Supplemental Claim: If you have new and relevant evidence that was not included in your original claim or the HLR, you can file a Supplemental Claim. This allows another review where the new evidence will be considered.
• Appeal to the Board of Veterans’ Appeals: For a more formal appeal process, you can take your case to the BVA, where different options, including hearings, are available.
• Consider Legal Assistance: Navigating the complexities of VA claims and appeals might require professional guidance. Consulting with a VA-accredited attorney can provide strategic advice tailored to your specific situation.