The VA Appeals Process Timeline and What to Expect
As a veteran, you know how important your benefits are. They entitle you to disability payments, educational aid, and many other benefits that your quality of life depends upon.
We know that these benefits are so important it can make the claims process stressful, and it can make things feel hopeless when your claim is denied.
Fortunately, even if your claim is denied, it doesn’t mean you’re out of luck. Through the Veterans Benefits Appeals process, you can challenge your claim’s denial or the rating decision or effective date, and receive the benefits you’re entitled to.
The claims process can be long and stressful. If you just went through it, you may feel worn out. So you might be wondering what the appeals process is like and how long it takes. Here, we’ll break down the process and tell you what you need to know for a successful appeal. Let’s jump right in.
How A Claim Becomes an Appeal
Before we get to the appeals process, let’s quickly review what the claims process looks like. It starts at your local VA office where you file a claim, undergo a Compensation and Pension (C&P) Exam, and potentially additional assessments depending on the claim you’re making, among other things.
In the best-case scenario, a rating specialist will have gathered all the necessary information and evidence they need to make a rating decision within about five months, although this can take longer. Your claim will then be either accepted or rejected.
Now, if you disagree with the claim decision you received, such as a rejected claim, you can appeal it. There are a few main reasons you would appeal:
If your claim was rejected entirely, and you disagree with the outcome. Your Claim may have been rejected because the record does not reflect:
A “stressor” or event in service that caused your medical condition.
A “nexus” letter by a doctor providing a strong enough medical opinion (if any) that your medical condition is related to the service stressor.
A current medical condition compensable under the Veteran Affairs Schedule for Rating Disabilities .
If your claim was allowed, but not all claimed conditions were accepted.
If your claim was allowed, but didn’t provide a sufficiently high disability rating.
If your claim was allowed, but didn’t provide the correct effective date.
There are several different routes you can take to appeal your decision, which we’ll look at now.
The Three Ways to Appeal Your VA Rating Decision
The Veteran Appeals Improvement and Modernization Act (AMA) became law in 2017, and as of Feb. 19, 2019, all new appeals are made through the AMA. Appeals made before Feb. 19, 2019 are referred to as Legacy Appeals, which the Veterans’ Board of Appeals will still be processing for years to come.
If you filed your appeal after Feb. 19, 2019, you have three types of appeal to choose from, depending on which is best for your situation. The three types are:
Supplemental Claims, which are used when you add new evidence that’s relevant to your case and rating. If the new evidence warrants a change in the rating or decision given to you, the change will be made, and a new decision or rating will be returned to you. Complete VA Form 20-0995 if you want to pursue a Supplemental Claim.
Higher-Level Reviews, which allow you to request that your original claim is reviewed again by a senior reviewer. You can’t submit any additional evidence for this type of review, though. You might request a Higher-Level Review if, for example, you believe your C&P exam was poorly administered. To request a Higher-Level review, complete VA Form 20-0996.
Board Appeals, which allow you to appeal to a Veterans Law Judge (VLJ) with the Board of Veterans’ Appeals (BVA) in Washington, DC. A Board Appeal for your claim has three options:
You can request that a VLJ directly reviews the evidence originally submitted with your claim. You can think of this option as being the ‘highest-level review.’ Under the Direct Review option, you can’t submit additional evidence, and you won’t be appearing before a VLJ to argue or make your case.
You can submit more evidence for a VLJ to review with your appeal. This option is similar in ways to a Supplemental Claim, which allows you to submit additional evidence that may not have been considered when your initial decision was made. A skilled attorney can help you prepare arguments and additional evidence for the best chance of seeing your appeal succeed. Evidence needs to be submitted within 90 days of your request for a Board Appeal through your Notice of Disagreement.
You may also request a hearing with a VLJ. In this case, you may choose whether or not you want to add additional evidence, although adding additional evidence can help your case. You'll be allowed to provide additional evidence at the hearing and 90 days thereafter. Again, a skilled attorney can guide you through the process and help you determine whether submitting additional evidence will benefit your case.
To begin an appeal to the Board of Veterans’ Appeals, file a Notice of Disagreement (VA Form 10128) within one year of the decision if you want to preserve the effective date from your application.
Making a Board of Veterans’ Appeals Claim
When you receive your denied claim, the first thing you’ll need to do is file a Notice of Disagreement. Following this, your regional office will create a Statement of Case, which is then reviewed by a Decision Review Officer, who then issues a final decision. You’ll begin the BVA appeal if the Decision Review Officer Decision (DROD) is still unfavorable (which is common).
There are three main steps to filing an appeal to the Board of Veterans’ Appeals (BVA). However, before you start any of them, it’s crucial you consult with an attorney experienced with veterans’ benefits appeals law. They can help you strategize and craft compelling arguments for your appeal to give you the best chances of receiving a favorable outcome.
Once you’ve consulted with an attorney, continue on with the appeals process.
The first step in filing your appeal to the BVA is filling out VA Form VA9 (your appeal to the BVA). This needs to be completed within 60 days of receiving your DROD/Statement of Case (SOC).
Note: You must file your Notice of Disagreement within one year of receiving the VA decision; you must file VA Form VA9 (the type of appeal you want to make) within 60 days of receiving your DROD/SOC.Next, your claim will be escalated to the Board of Veterans’ Appeals. At this stage, your appeal could be denied, granted, or remanded, meaning it is sent back down to the regional level to be further worked on per the BVA’s decision.
If you are denied again by the BVA, you can appeal once more to the United States Court of Appeals for Veterans Claims (CAVC). The CAVC has the exclusive ability to judicially review the final decisions made by the Board of Veterans' Appeals. Appeals to the CAVC must be made within 120 days after the BVA delivers its final decision.
The Veterans Benefits Appeals Timeline
The timeline for veterans benefits appeals is a slow one. The truth of the matter is that there isn’t adequate personnel to process claims and appeals in a timely manner. Claims and appeals come in faster than they can be processed, so there’s always a backlog waiting to be reviewed.
One result of this is that claims processing may be rushed, sometimes at the expense of attention to detail. This, in turn, means more denied claims get turned into appeals, which take longer to process, and bloat the system further.
The VA goal for processing Supplemental Claims and Higher-Level Reviews is about 4-5 months, or 125 days. However, this goal is aspirational, and these reviews may take as long as a year to complete. Board Appeals take longer in almost all cases, but their timeline still depends on a few factors:
If you’re appealing for a Direct Review, you can expect it to take about one year to be completed.
If you’re submitting evidence or seeking a hearing, the appeal process will take longer, often well over a year. However, if your attorney suggests submitting additional evidence or having a hearing, it will be in your best interest, despite creating a longer process. You don’t want a quick decision only to be denied and further stretch out the process.
Although there’s no exact timeline that can be applied to every single case, there are a few things that hold true for all veterans benefits appeals:
Hastily prepared appeals that are poorly presented or missing crucial details are often denied. A skilled attorney can present your appeal and avoid simple mistakes that lead to your appeal being denied.
Consulting with an attorney to help prepare your appeal may take longer, but can increase the likelihood of receiving a better result. This additional time is well worth the expertise and advocacy of an attorney.
How an Attorney Can Help Your Appeal Case
An attorney can help you strategize your appeal, help pin-point and gather relevant evidence, and prepare written and oral arguments for your appeal, among many other things to improve your chances of obtaining the best possible outcome, such as:
Preparing a detailed appeal.
Reviewing Laws and regulations that relate to your case.
Ensuring all necessary forms are meticulously filed and submitted.
Preparing paperwork for the Court of Appeals for Veterans Claims.
Most importantly, an attorney can draw on the experience of hundreds of other appeals processes, and apply the most proven techniques in your appeal case.
Don’t Wait to Contact the Law Office of Michael D.J. Eisenberg
The first thing you should do upon receiving an unsatisfactory rating decision is contact Michael D.J. Eisenberg. As a skilled attorney and counselor at law, he can help you determine which type of appeal you should make, and how to best present your case.
After serving our country, you deserve your benefits. Don’t leave them up to chance. Instead, turn to Michael D.J. Eisenberg: an attorney who will work with you each step of the way, help you make informed decisions, and keep you updated on the status of your case.
Ready to start the journey toward the benefits you’ve earned? Don’t wait; contact the Law Office of Michael D.J. Eisenberg todayto set up a free-initial telephone consultation for your Veterans’ Benefits Appeal!
Note: Consultations for Veterans’ Benefits Appeals Matters are free; however, consultations for Military Records Issues and Medical/Physical Evaluation Boards are paid.