Supplemental Claim Appeal

Supplemental Claim Appeal

What is a VA Form 21-0995 and a Supplemental Claim Appeal?

Information on filing a Supplemental Claim Appeal. Excessively long wait times for appeal hearings, among other issues, prompted lawmakers to pass the Appeals Modernization Act (AMA) in 2017. The AMA split the appeals process into three avenues. It also standardized some VA notice procedures and language in claims decisions.

The three avenues are:

  1. Supplemental Claims (discussed in this article) – submitting new evidence to the same
    Regional Office
  2. Higher Level Review – seeking review by a more experienced Claims Examiner, but no
    new evidence
  3. Directly Appeal to the Board – where you can submit new evidence, have review based
    on the record with no new evidence, or have a traditional Board Appeal, which includes
    new evidence and a hearing.

Veterans who want to make supplemental claims must file Form 21-0995. If it is done within one
year of the decision being appealed, it functions more like an appeal; otherwise, it is a way to re-
open a previously denied claim that was not appealed. This avenue allows Veterans to present
new evidence in support of their claims, as long as the evidence is relevant and could alter the
decision’s outcome. Additionally, electing the supplemental claim avenue triggers the VA’s duty
to assist Veteran claimants. However, the VA’s duties are not triggered unless the Claims Examiner finds that the evidence submitted is both “new” and “relevant.”

There is no better ally in these situations than a VA disability attorney. An experienced attorney
knows what evidence to present, and how to present it. Furthermore, an attorney fully advocates
for you. There is no divided loyalty.

Claimant’s Personal Identifying Information (PII)

Generally, anytime anyone asks for PII, you should refuse to provide it. But this situation is
different. No entity has an ironclad PII security system, and the VA certainly does not have one.
But the security is well above average. Besides, if you refuse to fill out this section, you might be
ineligible for supplemental claims review.

Supplemental Claim Issues

As mentioned, supplemental claims review allows Veterans to introduce new and relevant
evidence to support their claims. Form 21-0995 requests a specification of issues, which for VA purposes means the claim condition. It also requires the Veteran to either submit or identify the new and relevant evidence that should be reviewed in consideration of the supplemental claim.

Lay testimony in traumatic brain injury (TBI) claims is a good example. The Claims Examiner
usually rates TBI disability according to the Veteran’s symptoms. Since the brain often conceals
its own injuries, many Veterans do not effectively communicate their symptoms to the Claims
Examiner or C&P doctor. Essentially, many TBI Veterans do not “feel” injured.

In addition, testimony from friends or family members often sheds additional light on this area. These
individuals can provide lay statements about the way the TBI affects a Veteran’s daily
activities. Such evidence often drives up the disability rating.

However, Veterans might not be allowed to present such evidence unless they accurately fill out
this part of Form 21-0995.

Veterans should also pay special attention to the Statement of the Case (SOC) or Supplemental
Statement of the Case (SSOC) election. If they check this box, Veterans waive their rights under
the legacy appeals system and agree to fully participate in the AMA system. Depending on the facts of a Veteran’s case, it may be a good idea to opt into the AMA system by filing a supplemental claim instead of proceeding with their appeal under the legacy process. The help of an experienced Veterans disability lawyer can assist in this decision.

New and Relevant Evidence

In this section, Veterans must include the new evidence to be considered. Simply referring to it is
probably insufficient. This evidence could be lay testimony, as outlined above, or an independent
medical examination. The relevancy of this new evidence will also need to be specified.

This section also gives Veterans a chance to invoke the VA’s assistance duty. Veterans may
request records in the VA’s possession, such as medical center treatment records. The form must
include specific information about such records, so the VA knows where to find them.

Certification and Signature

Remember to sign the form, and remember what that signature means. Veterans are certifying
that all the information is true and correct. Making a false statement on Form 21-0995, even if it
was an honest mistake, is not quite perjury, but it is very close.

Count on Savvy Attorneys

The supplemental review process often gives your claim the boost it needs. 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. Whereas, we are here to represent Veterans
nationwide.

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