Denied Supplemental Claim

Denied Supplemental Claim

What are My Appeal Options After a VA Form 21-0995 – Denied Supplemental Claim Appeal?

Has your Supplemental Claim Appeal been denied after submission of VA form 21-0995?  You are not out of options.

Before 2017, all VA disability appeals had a single, mandatory long progression to the Board of Veterans Appeals. Because the veteran could continuously add evidence throughout the appeal. Many times the the VA could slow down the appeal for additional exams and VA duties to obtain documents.

Many Veterans waited years for their appeals to be heard. To streamline the appeal process and give veterans more choice as to how to appeal the rating decision.  The Appeals Modernization Act (AMA) created three different appeals (or review)s options for an initial appeal of a rating decision. 

These choices, called “lanes,” include the supplemental claim lane. This option allows Veterans to submit new and relevant evidence to the Regional Office (RO).  With the hope that it will reverse its prior decision. 

In some cases, the new and relevant evidence alone is sufficient to reverse an earlier denial. That denial could have been a complete denial of benefits or partial denial of benefits. These benefits include not only monthly cash payments but also free VA medical care. However, in many cases, new and relevant evidence alone is often not enough.

Fortunately, a supplemental claim denial is not the last word in these situations. In fact, it is not even close to the last word. A VA disability attorney can review your case and take your claim to the next level. At this next level, you have a much better chance of obtaining the benefits you need and deserve.

Supplemental Claims: A Closer Look

The AMA made some key substantive and procedural changes in the area of re-evaluating claims based on new and relevant evidence.

Of note, the supplemental claim lane can be used for either appealing a denial that is within the one-year appeal period.  Or it can be used to re-open older rating decisions that were not appealed within the one-year appeal period.

Before AMA, an appeal of a rating decision within the one-year appeal period did not require any new evidence to be submitted before a higher-level decision officer would review the claim. 

However, under the AMA, a Veteran can choose to submit new and relevant evidence within one year to the RO that issued the decision. Then ask the RO to reconsider its decision. The upshot of this is that it is faster than all claims going to the same level of review as it was before the AMA.

Supplemental Claims Changes

Before AMA, in order to re-open a previously denied claim, the Veteran would have to submit “new and material” evidence before the RO would review the claim.  “New and Material” evidence was evidence that was not before the adjudicator during the last decision and that was related to an issue in dispute. 

Under AMA, the standard is “new and relevant”. Yet the AMA does not intend it to be a higher standard than “new and material” under the old system. There is some conflict between the regulations and the statute as to what is required to meet the definition of “relevant”. An experienced Veterans disability lawyer can ensure that the VA does the right thing when submitting additional evidence for a supplemental claim.

Typically, supplemental claims review is a second-review by the same RO adjudicator who issued the prior denial. However, that adjudicator is supposed to assess the new evidence in context with the entire record.

Under the AMA, a Veteran can seek another supplemental review after a Higher-Level Review (which is a more experienced RO adjudicator).  In any event, Veterans must file the Supplemental Claim Form 21-0995 within one year of the previous denial in order to fully preserve their rights.

The Next Step

Thus far, about three-quarters of Veterans have elected the supplemental claims appeal avenue. The VA typically processes these claims within three to four months.

If the supplemental review is unsuccessful, the Veteran has three choices for review:

  1. (Another) Supplemental Claim
  2. Higher-Level Review
  3. Or (new under the AMA) appeal directly to the Board of Veterans Appeals (BVA)

For any of these options, the Veteran must submit their review choice with one year of the decision being appealed to preserve their claim.

If the Veteran appeals directly to the BVA, they again can choose between three lanes:

  1. Direct Review (no evidence submitted and no hearing)
  2. Evidence Submission (new evidence but no hearing)
  3. Or Hearing Lane (the traditional BVA appeal which includes submitting evidence and a hearing)

Which lane of review to choose is heavily dependent on the facts and history of the Veteran’s claim. An experienced Veterans disability lawyer is your best bet for choosing the best option.

Reach Out to Experienced Attorneys

A supplemental claims appeal might be the best way to obtain the benefits you deserve. For a free consultation with an experienced Veterans disability lawyer, contact the Cameron Firm, P.C. at 800-861-7262 or fill out the contact box to your right. We are here to represent Veterans nationwide.

This article is for educational and marketing purposes only. It does not create an attorney-client relationship.