Denied? Your Appeal Options Explained

Understanding Your Denial

When the VA denies a claim, the decision letter tells you exactly why. Read it carefully — the denial reason determines your best appeal strategy.

Common denial reasons:

• No current diagnosis: Get diagnosed and file a supplemental claim
• No nexus/service connection: Get a nexus letter and file a supplemental claim
• Insufficient evidence of in-service event: Gather buddy statements and records, then supplement
• C&P exam unfavorable: Get an independent medical opinion contradicting the exam

Your Three Options

Option 1: Supplemental Claim (VA Form 20-0995)

Best when: You have NEW evidence the VA hasn't seen

• Submit new and relevant evidence that addresses the reason for denial
• No deadline (but file quickly to preserve earlier effective dates)
• You can submit multiple supplemental claims
• Average processing: 4-5 months

New evidence can include:

• A nexus letter (if you didn't have one before)
• Additional medical records
• A private medical opinion countering the C&P examiner
• Buddy statements
• Service records you recently obtained
• A new diagnosis

Option 2: Higher-Level Review (VA Form 20-0996)

Best when: The VA made an error with existing evidence

• A senior reviewer re-examines your claim using ONLY the evidence already on file
• You CANNOT submit new evidence
• You CAN request an informal conference (10-20 minute phone call) — always do this
• Must file within 1 year of the decision
• Average processing: 4-5 months

Use HLR when:

• The rater misapplied the rating criteria
• The rater ignored favorable evidence in your file
• The C&P exam was inadequate (too short, wrong tests, wrong examiner specialty)
• The decision contradicts the evidence on record
• There's a clear and unmistakable error (CUE)

HLR Informal Conference Tips:

• Request the informal conference — most veterans skip this and it's a mistake
• Write out talking points before the call
• Reference specific page numbers in your C&P exam or evidence
• Point out specific errors: "The examiner said X, but my STR on page Y shows Z"
• Be respectful but firm — this reviewer has authority to overturn the decision

Option 3: Board Appeal (VA Form 10182)

Best when: Your case is complex or requires a judge's interpretation

Three sub-options:

• Direct Review: Judge reviews existing evidence only. Fastest board option.
• Evidence Submission: Submit new evidence without a hearing.
• Hearing: Testify before a Veterans Law Judge (in person or video). Most thorough option.

• Must file within 1 year of the decision
• Longest processing time (1-2+ years)
• Strongest option for complex legal arguments

Strategic Decision Tree

1. Denied for lack of evidence? → Supplemental Claim with new evidence
2. Evidence was there but ignored? → Higher-Level Review with informal conference
3. Rating criteria misapplied? → Higher-Level Review
4. C&P exam was inadequate? → Supplemental Claim with private IMO, OR HLR arguing exam inadequacy
5. Complex legal issue? → Board Appeal with hearing
6. Denied multiple times? → Board Appeal with attorney representation

Important: You Can Lane-Switch

If your HLR is denied, you can then file a Supplemental Claim with new evidence. If your Supplemental Claim is denied, you can request an HLR. This gives you multiple chances — a denial at one level doesn't prevent you from trying another.