Understanding VA Form 20-0996 and Higher-Level Review Requests

VA Form 20-0996, the Decision Review Request: Higher-Level Review, is an important document for veterans who disagree with a decision made by the Department of Veterans Affairs (VA) regarding their VA claim. This form allows veterans to request a fresh look at their case by a more experienced VA reviewer without having to submit new evidence.

The form is part of the VA’s modernized review system, which aims to provide veterans with faster and more efficient ways to appeal decisions. It’s important to note that VA Form 20-0996 is specifically for requesting a Higher-Level Review, which is just one of several options available to veterans who want to challenge a VA decision.

When you file VA Form 20-0996, you’re essentially asking the VA to take another look at the evidence that was already in your file when the original decision was made. This can be a good option if you believe the VA made a mistake in how they interpreted the law or the facts of your case.

The Purpose of a Higher-Level Review

The main purpose of a Higher-Level Review is to give veterans a chance to have their case looked at again by a more senior VA employee. This review is based on the same evidence that was available when the original decision was made. It’s a way to catch and correct errors without going through a more lengthy appeals process.

During a Higher-Level Review, the reviewer will check for any mistakes that might have been made in applying VA laws and regulations to your case. They’ll also look for any clear errors in how the facts of your case were understood or interpreted.

This process can be particularly useful if you think the VA overlooked something important in your file, or if you believe they misunderstood a key piece of information. It’s a way to potentially get a decision changed without having to gather new evidence or go through a more complex appeal.

However, it’s important to understand that because no new evidence is considered in a Higher-Level Review, this option might not be the best choice for everyone. If you have new information that you think could change the decision, you might want to consider other options, like filing a Supplemental Claim instead.

Eligibility Criteria for Filing VA Form 20-0996

To be eligible to file VA Form 20-0996 for a Higher-Level Review, there are several criteria you need to meet:

1. You must have received a decision from the VA on a claim for benefits within the past year. The one-year time limit is crucial – if it’s been more than a year since your decision, you’ll need to look at other options.
2. You can’t have a pending appeal on the same issue. If you’ve already started an appeal through the Board of Veterans’ Appeals, you can’t also request a Higher-Level Review on the same matter.
3. You must be requesting a review of an initial claim or a Supplemental Claim decision. You can’t request a Higher-Level Review of a previous Higher-Level Review decision.

It’s also important to note that you can’t submit new evidence with your Higher-Level Review request. The review will be based solely on the evidence that was in your file when the original decision was made. If you have new evidence that you think could change the decision, file a Supplemental Claim instead.

Remember, you can only choose one review option at a time for each issue. So if you decide to file for a Higher-Level Review, you can’t simultaneously appeal to the Board of Veterans’ Appeals or file a Supplemental Claim for the same issue.

Step-by-Step Guide to Completing VA Form 20-0996

Filling out VA Form 20-0996 correctly is crucial for ensuring your Higher-Level Review request is processed smoothly. Here’s a step-by-step guide to help you through the process:

1. Start by downloading the form from the VA’s official website. You can fill it out online or print it and fill it out by hand.
2. In Section I, fill in your personal information. This includes your name, Social Security number, VA file number, date of birth, and contact information. Make sure all this information is accurate and matches what the VA has on file for you.
3. Section II is for claimant information if someone other than the Veteran is requesting a review of a VA decision. If you’re filling this out for yourself, you can skip this section.
4. In Section III, select the benefit type you’re requesting a review for. Remember, you can only select one benefit type per form.
5. Section IV is where you can request an informal conference. This is optional, but it can be helpful if you want to talk to the reviewer about specific issues in your case.
6. In Section V, list the specific issues you want reviewed. Be as clear and specific as possible about what you disagree with in the original decision.
7. Finally, sign and date the form in Section VI. If you have a representative helping you, they should sign in Section VII.

Remember to double-check all your information before submitting the form. The VA must be able to identify the veteran and errors or missing information can delay the processing of your request.

Common Mistakes to Avoid When Filing

When filling out VA Form 20-0996, there are several common mistakes that veterans should be careful to avoid:

1. Missing the deadline: You have one year from the date of your decision to file for a Higher-Level Review. Don’t miss this crucial deadline.
2. Trying to submit new evidence: Remember, a Higher-Level Review is based only on evidence already in your file. Don’t try to submit new evidence with this form.
3. Not being specific enough: When listing the issues you want reviewed, be as specific as possible. Vague statements can lead to confusion and potentially unfavorable outcomes.
4. Forgetting to sign and date the form: This might seem obvious, but it’s a common oversight that can delay your review.
5. Requesting a review of a previous Higher-Level Review decision: You can’t use this form to review a previous Higher-Level Review decision. Make sure you’re requesting a review of an initial claim or Supplemental Claim decision.

Avoid these to ensure that your Higher-Level Review request is processed as quickly and smoothly as possible. Remember, if you’re unsure about any part of the form, you can reach out to a Veterans Service Organization or a VA-accredited representative.

Understanding the Higher-Level Review Process

Once you’ve submitted VA Form 20-0996, it’s helpful to understand what happens next in the Higher-Level Review process. This can help you set realistic expectations and prepare for potential outcomes.

After the VA receives your form, they’ll assign your case to a senior reviewer. This person will be someone who didn’t make the original decision on your claim. They’ll do a fresh review of all the evidence that was in your file at the time of the original decision.

The reviewer will look for any errors that might have been made in applying VA laws and regulations to your case. They’ll also check to make sure all the evidence was properly considered. If you requested an informal conference, the reviewer will contact you to schedule this.

It’s important to note that the Higher-Level Review is a de novo review, which means the reviewer looks at your case as if it’s new, without giving any weight to the previous decision. They’ll make a new decision based on their review of the evidence.

The outcome of a Higher-Level Review can go a few different ways. The reviewer might agree with the original decision and keep it the same. They might find an error and change the decision in your favor. Or, they might find that more information is needed and send your case back for further development.

How Long Does a Higher-Level Review Take?

One of the most common questions veterans have about the Higher-Level Review process is how long it takes. The VA’s goal is to complete Higher-Level Reviews within an average of 125 days. However, the actual time can vary depending on a number of factors.

Some reviews might be completed more quickly, especially if the issues are straightforward. Others might take longer, particularly if they involve complex medical or legal questions. If you requested an informal conference, this could also add some time to the process.

It’s important to remember that while you’re waiting for your Higher-Level Review to be completed, the VA will not be able to consider any new evidence related to your claim. If you realize you have important new evidence while your Higher-Level Review is pending, you might want to consider withdrawing your request and filing a Supplemental Claim instead.

The VA does provide a way for you to check the status of your Higher-Level Review. You can do this online through the VA.gov website, or by calling the VA’s toll-free number. Checking the status can give you an idea of where your review is in the process and how much longer it might take.

While waiting can be frustrating, try to be patient. The reviewer needs time to thoroughly examine your case to ensure they’re making the right decision.

The Role of Informal Conferences in the Review Process

When you fill out VA Form 20-0996, you have the option to request an informal conference as part of your Higher-Level Review. This is an important decision that can potentially impact the outcome of your review.

An informal conference is a phone call between you (or your representative) and the senior reviewer assigned to your case. During this call, you have the opportunity to talk about specific issues in your case and point out any errors you believe were made in the original decision.

The main advantage of an informal conference is that it allows you to directly communicate with the person reviewing your case. You can explain why you think the original decision was wrong and point out any evidence you believe was overlooked or misinterpreted.

However, it’s crucial to remember that you can’t introduce new evidence during an informal conference. The discussion must be limited to the evidence that was already in your file when the original decision was made.

While an informal conference can be helpful, it’s not always necessary. If you feel that the issues in your case are clear and well-documented in your file, you might choose to skip the informal conference. This could potentially speed up the review process.

If you do decide to request an informal conference, be prepared. Have your case file in front of you during the call, and be ready to clearly and concisely explain why you believe the original decision was incorrect.

What Happens After You Submit VA Form 20-0996?

After you submit VA Form 20-0996, the VA will begin processing your Higher-Level Review request. Here’s what you can expect:

1. Acknowledgment: The VA will send you a letter acknowledging that they’ve received your request. This usually happens within a few weeks of submission.
2. Review Assignment: Your case will be assigned to a senior reviewer who wasn’t involved in the original decision.
3. Evidence Review: The reviewer will examine all the evidence that was in your file at the time of the original decision. They won’t consider any new evidence.
4. Informal Conference: If you requested one, the VA will contact you to schedule the informal conference.
5. Decision Making: Based on their review, the senior reviewer will make a new decision on your case.
6. Decision Notification: Once a decision is made, the VA will send you a letter explaining the outcome of your Higher-Level Review.

During this process, you don’t need to do anything unless the VA contacts you for more information. However, it’s a good idea to keep an eye on your mail and be prepared to respond quickly if the VA does reach out.

Remember, you can check the status of your review online or by phone. If you have any questions or concerns during the process, don’t hesitate to contact the VA or your veterans service organization for help.

What to Do If Your Review is Denied

If your Higher-Level Review results in a denial, it’s important not to lose hope. You still have options available to you:

1. File a Supplemental Claim: If you have new and relevant evidence that wasn’t part of your original claim, you can file a Supplemental Claim. This allows you to submit new evidence for consideration.
2. Appeal to the Board of Veterans’ Appeals: You can request a Board Appeal, which will be reviewed by a Veterans Law Judge. There are three options for Board Appeals: direct review, evidence submission, or a hearing with a Veterans Law Judge.
3. Seek Legal Help: Consider consulting with a Veterans Service Organization or a VA-accredited attorney. They can review your case and advise you on the best course of action.
4. Review the Decision Letter: Carefully read the explanation for the denial. Understanding why your review was denied can help you decide on your next steps.
5. Consider Another Higher-Level Review: If your denial was for a Supplemental Claim, you could request another Higher-Level Review. However, you can’t request a Higher-Level Review of a previous Higher-Level Review decision.

Remember, each of these options has its own deadlines and requirements. It’s crucial to act quickly and understand the process for whichever option you choose.

Don’t be discouraged if your Higher-Level Review is denied. Many veterans have to go through multiple steps in the VA claims process before receiving the benefits they deserve. Stay persistent and don’t hesitate to seek help when you need it.

Resources and Support for Veterans Filing for Higher-Level Reviews

Navigating the VA benefits system can be challenging, but there are numerous resources available to help veterans through the process of filing for a Higher-Level Review:

1. Veterans Service Organizations (VSOs): Organizations like the American Legion, Veterans of Foreign Wars (VFW), and Disabled American Veterans (DAV) offer free assistance to veterans filing claims and appeals.
2. VA Regional Offices: Local VA offices can provide information and assistance with filing VA Form 20-0996.
3. VA.gov Website: The official VA website offers detailed information about the Higher-Level Review process, including how to file online.
4. VA Decision Reviews and Appeals Online Tool: This tool on VA.gov allows you to check the status of your review request.
5. Veterans Affairs Call Center: You can call 1-800-827-1000 for general information about VA benefits and the review process.
6. VA-Accredited Attorneys and Claims Agents: These professionals can provide legal assistance with your claim, though they may charge fees for their services.
7. Vet Centers: These community-based centers offer counseling and guidance on VA benefits.

Remember, while these resources can provide valuable assistance, the ultimate responsibility for filing your Higher-Level Review request accurately and on time rests with you. Don’t hesitate to reach out for help if you need it, but also make sure you understand the process and what’s required of you.

Frequently Asked Questions About VA Form 20-0996

Here are answers to some common questions veterans have about VA Form 20-0996 and the Higher-Level Review process:

Q: Can I submit new evidence with my Higher-Level Review request?

A: No, a Higher-Level Review is based only on evidence already in your file when the original decision was made.

Q: How long do I have to file for a Higher-Level Review?

A: You have one year from the date of your decision to file VA Form 20-0996.

Q: Can I request a Higher-Level Review for any type of VA decision?

A: Higher-Level Reviews are available for most types of claims, but not for decisions on certain VA debts or housing grants.

Q: What if I miss the one-year deadline?

A: If you miss the deadline, you may need to file a Supplemental Claim with new and relevant evidence.

Q: Can I withdraw my Higher-Level Review request?

A: Yes, you can withdraw your request at any time before the VA issues a decision.

Q: What happens if the reviewer finds an error?

A: If an error is found, the reviewer will either correct it or send your case back for correction and adjudication.

Q: Can I appeal the decision from a Higher-Level Review?

A: If you disagree with the Higher-Level Review decision, you can file a Supplemental Claim or appeal to the Board of Veterans’ Appeals.

Remember, don’t hesitate to seek help if you’re unsure about any part of the process. With the right approach and resources, you can maximize your chances of getting the VA disability benefits you’ve earned through your service. Learn more and start today by taking our free medical evidence screening at AllVeteran.com.