Understanding the Supplemental Claim
When a veteran's claim for benefits is denied by the Department of Veterans Affairs (VA), they have several options for appealing that decision. One of the most common and effective is the supplemental claim. Unlike a Higher-Level Review (HLR) which is a review of the existing evidence, a supplemental claim is the path to pursue when you have new and relevant evidence that was not part of your original submission. The VA will readjudicate the claim, taking this new information into account to see if it changes the outcome.
What Constitutes "New and Relevant" Evidence?
To be considered for a supplemental claim, the evidence must meet two criteria: it must be new and it must be relevant.
- New evidence: Information you did not previously submit to the VA. This could include a recent doctor's diagnosis, new test results, or military records that were not considered before.
- Relevant evidence: Information that proves or disproves a matter in your claim. It must directly pertain to your condition and military service.
Examples of new and relevant evidence include:
- A medical nexus letter from a qualified healthcare professional connecting your current condition to your military service.
- A "buddy statement" or lay statement from a fellow service member, friend, or family member who witnessed the event causing your injury or can speak to the worsening of your condition.
- New medical records documenting a diagnosis or the progression of your symptoms.
- Results of a new diagnostic test or examination not previously part of your file.
- A new medical opinion from a private doctor.
The Supplemental Claim Process
Filing a supplemental claim involves a few key steps to ensure it is processed efficiently:
- Gather new and relevant evidence. Before you do anything else, make sure you have the necessary documentation to support your claim. This is the most critical step.
- Complete the required form. You will need to fill out and submit VA Form 20-0995, also known as the "Decision Review Request: Supplemental Claim". For some claims, this can be done online.
- Submit your claim. You can submit the form online for disability compensation claims, by mail, or in person at a VA regional office.
- Wait for the VA's review. The VA will review your new evidence and the previously submitted information. They may contact you for further examinations or information.
- Receive a decision. The VA will provide a decision letter once the review is complete. If approved, you will receive benefits. If denied again, you can pursue another review option.
Comparison: Supplemental Claim vs. Other Reviews
Choosing the right path after a claim denial is important. A supplemental claim is not the same as a Higher-Level Review or a Board Appeal. This table helps clarify the differences:
| Feature | Supplemental Claim | Higher-Level Review (HLR) | Board Appeal (Evidence Submission) |
|---|---|---|---|
| Purpose | To submit new and relevant evidence for review. | To have a senior reviewer assess for errors based on existing evidence. | For a Veterans Law Judge to review existing evidence and new evidence. |
| Evidence | Must submit new and relevant evidence. | No new evidence allowed. | Can submit new evidence. |
| Timeline Goal | Approximately 125 days (4-5 months). | Approximately 125 days (4-5 months). | Varies significantly, often 18+ months. |
| Hearing Option | Can request a hearing. | No hearing available. | Can request a hearing. |
| Decision Maker | A VA rater reviews the claim. | A higher-level VA reviewer. | A Veterans Law Judge. |
What Happens After You File?
Once your supplemental claim is filed, the process can feel like a waiting game, but there are specific stages the claim goes through. A rater will be assigned to your case, and they will review all the evidence you have submitted. The VA may also use its duty to assist by gathering evidence you identified, such as federal or private medical records. It is crucial that you attend any Compensation and Pension (C&P) exams the VA schedules, as missing them can lead to a denial. You can track the status of your claim online, and it is wise to periodically check for updates.
Potential Outcomes and Next Steps
- Approval: The new evidence changes the outcome, and your benefits are granted. If filed within a year of the initial decision, the effective date may be retroactively applied, which can result in significant back pay.
- Continued Denial: The new evidence was not found to be sufficient to overturn the previous decision. You will receive a new denial letter, which will outline your options, including a Board Appeal.
For the most current information on the supplemental claims process, including updates to forms or procedures, it is always recommended to consult the official VA website.
Conclusion
Supplemental claims are a vital pathway for veterans seeking to overturn a denied VA benefits decision. By submitting new and relevant evidence, you can compel the VA to reconsider your case based on a more complete record. Understanding the process, knowing what qualifies as new evidence, and adhering to deadlines are all crucial for success. For veterans feeling lost after an initial denial, a supplemental claim offers a clear and structured route to continue fighting for the benefits earned through service.
Important: It is highly recommended to seek assistance from a Veterans Service Organization (VSO) or an accredited attorney to help navigate the complexities of gathering evidence and filing correctly.
