Many veterans who apply for VA disability benefits disagree with some aspect of the VA’s decision on their claim, such as the denial of benefits, the disability rating, or the effective date. When you choose to challenge one or more aspects of the VA’s decision on your disability benefits claim, you have several avenues to appeal, including requesting a higher-level review (HLR). After the VA has made an unfavorable decision on your application, knowing what happens during a higher-level review can help you develop and pursue an effective appeal strategy to fight for the disability benefits you deserve.
What Is a Higher-Level Review?
In the VA’s administrative appeals process for disability benefits claims, veterans may request a higher-level review. In a higher-level review, a senior VA claims reviewer examines a veteran’s application anew, based on the same evidence and information considered by the initial claims reviewer. A veteran may not submit new information or documentation as part of a higher-level review. Instead, higher-level review focuses on determining whether the initial claims reviewer made a legal or factual error in their assessment of the application.
What the HLR Reviewer Does
During higher-level review, the senior claims reviewer examines the veteran’s entire claim file “de novo,” meaning without deference to the initial claims reviewer’s findings. The senior reviewer looks for potential errors made by the initial reviewer, such as overlooked medical evidence or service records, erroneous application of diagnostic criteria when rating a veteran’s service condition, or failure to apply various legal doctrines such as the “benefit of the doubt” standard (ruling in favor of a veteran when evidence balances for and against). Although a senior reviewer cannot request additional documentation or information as part of a higher-level review, they may find that the initial reviewer failed to fulfill the VA’s “duty to assist” a veteran in obtaining evidence, which may lead the senior reviewer to restart the claims development process.
The Informal Conference Option
During higher-level review, a veteran can request a phone call with the senior reviewer conducting the higher-level review. In this informal conference, the veteran can highlight factual or legal errors they want the senior reviewer to focus on during the higher-level review. Informal conferences allow veterans and their legal counsel to direct senior reviewers’ attention to the issues that caused a veteran to request higher-level review.
How Long Does HLR Take?
The VA typically completes higher-level review within about four months of a veteran’s request. However, timelines can vary depending on the complexity of a case or the VA regional office’s caseload. At the conclusion of higher-level review, the senior reviewer can either confirm the original decision, approve a denied application, increase a disability rating, or reopen development of an application due to a violation of the duty to assist.
Should You Request HLR?
Veterans might pursue higher-level review if they already have robust evidence supporting their disability benefits claim, and they believe that the original claims reviewer made a factual or legal error in deciding their application. However, a veteran should seek an alternative appeal route, such as a supplemental claim, if they need to add evidence to strengthen their claim.
Contact Our VA Disability Law Firm Today
If the VA denies your application for disability benefits or assigns you a lower disability rating than you think you should have received, you might pursue higher-level review to contest the VA’s decision. Contact Coskrey Law today for a free case evaluation with a VA disability benefits attorney to learn more about your options for challenging an aspect of the VA’s decision on your disability claim and to understand what happens when your case goes to higher-level review.