Aug

28

2020

Once the U.S. Department of Veterans Affairs (VA) denies your claim for benefits, you will receive a denial letter in the mail. The type of decision that you receive determines how long you have to file an appeal. 

For most VA Decisions you have one year from the date on the Decision letter to appeal or file a Decision Review Request.

If you have received one of the following decision types, you typically have one year to file an appeal or Decision Review Request:

  • Initial Claim Decision
  • Supplemental Claim Decision
  • Higher Level Review Decision

However, if the decision that you have received is a Statement of the Case, your time limit to file an appeal is limited to 60 days unless, you are still within one year of the Notification Letter for the Rating Decision that you appealed to get to this Statement of the Case. If you are still within one year of the Notification Letter for the Rating Decision that you appealed, then you have one year from the date of that Notification Letter to file a response to the Statement of the Case.   If it has been more than one year since the Notification Letter for the Rating Decision that you appealed, the time limit to respond to the Statement of the Case is only 60 days.

How to File an AMA VA Disability Appeal

Under the Appeals Improvement and Modernization Act (AMA), there are three different appeal lanes to consider for your AMA appeal:

  • Supplemental Claim Lane (requiring a VA Form 20-0995)
  • Higher Level Review Lane (requiring a VA Form 20-0996)
  • Board of Veterans’ Appeals (BVA) Notice of Disagreement Lane (requiring a VA Form 10182)

In order to decide which of the above appeal types to file in response to an AMA decision you need to first determine what type of decision you have received.

Did you receive an Initial Claim Level Decision, a Supplemental Claim Decision, or a Higher Level Review Decision?

  • If you have received an AMA Initial Claim Level Rating Decision you can file a Decision Review Request into any of the three appeal lanes: Supplemental Claim Lane, Higher Level Review Lane or BVA Lane.
  • If you have received an AMA Supplemental Claim Rating Decision you can file a Decision Review Request into any of the three appeal lanes: Supplemental Claim Lane, Higher Level Review Lane or BVA Lane.
  • If you have received an AMA Higher Level Review Rating Decision your only two options for an appeal include the Supplemental Claim Lane and the BVA Lane. You cannot appeal an AMA Higher Level Review Decision into Higher Level Review.

Keep in mind that under AMA, the VA is also allowing anyone that receives a Legacy Statement of the Case (SOC) or a Supplemental Statement of the Case (SSOC) to opt their case into the AMA system.  To do this you can file a Decision Review Request into any of the three appeal lanes: Supplemental Claim Lane, Higher Level Review Lane or BVA Lane, BUT, you must file the appropriate forms to opt your case in to AMA within the appeal window for the Statement of the Case as outlined above or if you have received an SSOC, within 30 days of the Notification Letter that accompanied the SSOC.

Note: It is important to note that even though you have a limited amount of time to file an appeal, getting a decision on your appeal can take months or years.

How Is Each AMA Appeal Lane Different?

Each of the three AMA Appeal Lanes have different attributes.

  • Supplemental Claim Lane: In this lane, VA will readjudicate your case if new and relevant evidence is presented or identified when the Supplemental Claim request is submitted. VA will undertake to assist the Veteran is gathering new and relevant evidence as part of VA’s Duty to Assist.  Importantly, new evidence can be submitted in this lane for VA to consider in rendering a new decision on your case.
  • Higher Level Review Lane: In this lane, the VA will NOT consider any new evidence although there is an option for a one-time telephonic conference with the Higher Level Reviewer.  The Higher Level Reviewer will conduct a de novo review of the evidence and has the authority to come to a different decision than the prior adjudicator. If the Higher Level Reviewer determines that there was a Duty to Assist error in the prior decision, the case will be sent back (returned to the lower level) for the VA’s Duty to Assist to be corrected and a new decision to be issued.
  • BVA Lane: In this lane the claimant has three choices for which docket they want to choose:
  • BVA Evidence Only Docket: With this option the Veteran can submit additional evidence at the time of the filing of the BVA Notice of Disagreement (NOD) or within 90 days of the NOD having been submitted.
  • BVA Direct Docket: With this option the Veteran cannot submit any new evidence and the BVA will issue a decision based on the evidence that was of record at the time of the decision being appealing. The advantage to filing a BVA NOD on the Direct Docket is a faster decision from the Board.
  • BVA Hearing Docket: With this option, the Veteran will have an opportunity to testify at a hearing before the BVA and also an opportunity to submit evidence at the time the hearing and/or within 90 days following the hearing.

Types of Disability Compensation to Which You May Be Entitled

Benefits you may be entitled to receive from VA include:

  • Disability
  • Special monthly compensation
  • Veteran / survivor pension benefits
  • Dependency and Indemnity Compensation (DIC)
  • Burial and funeral expenses

Deadlines may differ depending on the type of compensation for which you are applying.

Contact a VA Disability Lawyer Today: 1-800-777-7070

If you are suffering from a condition that is linked to your military service, you have a right to seek VA benefits. Unfortunately, VA does not make the appeals process easy. Initial claims are often denied, or are approved with improperly low ratings, resulting in insufficient compensation.

In addition to appealing a denial, you can also appeal based on the disability rating(s) you received and your effective date. If the VA grants you service connection, but you disagree with the effective date and/or your assigned rating, you can submit a Decision Review Request. In either case, working with a veterans’ disability lawyer can help you obtain the benefits and peace of mind you deserve.

Do not navigate this process alone. You fought for your country, so let a fight for you. You should be focused on healing, not dealing with appeals and tracking down medical records. Get a free and confidential consultation with a member of a veterans’ disability law firm today: 1-800-777-7070.

Reference:

https://www.va.gov/claim-or-appeal-status/

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