How to Appeal a Decision Regarding Veterans Benefits
If your claim for veterans benefits is denied, you can appeal the decision. You can appeal other decisions regarding your veterans benefits as well. An appeal is a request for the Board of Veterans Appeals (BVA) to review the VA regional office’s decision made on your claim.
The BVA is part of the Department of Veterans Affairs and is located in Washington, D.C. You may appeal any decision that you aren’t satisfied with.
The vast majority of appeals (more than 90 percent) are made by veterans who are dissatisfied with their VA regional office’s decision concerning eligibility for disability compensation, disability ratings, or pension. The two most common reasons for appeal are
The VA denied you benefits for a disability that you believe is service connected.
You believe that your disability is more severe than the VA rated it.
However, you can appeal for any reason.
Well, not quite any reason. Under the law, decisions concerning the need for medical care or the type of medical treatment needed, such as a physician’s decision to prescribe (or not to prescribe) a particular drug or whether to order a specific type of treatment, can’t be appealed through the VA appeals process. You need to address such matters to the director of the VA medical center concerned.
However, decisions concerning eligibility to enroll in the VA healthcare program can be appealed.
Start the veterans benefits appeal process rolling
You start the appeals process by submitting a Notice of Disagreement, often called an NOD, to the VA regional office that denied your claim. There’s no specific form used for an NOD. It’s simply a written statement from you to the VA regional office stating in simple, clear terms why you disagree with the decision.
The NOD must be submitted within one year of the date the VA regional office mailed you its original decision denying your claim.
Regional decisions on your veterans benefits appeal
After the VA regional office receives your NOD, it will take another look at your case. It’s possible that it will agree with your argument in the NOD and approve your claim. If the folks at the regional office disagree, they’ll prepare a Statement of the Case (SOC).
The SOC is the VA regional office’s way of telling you that the board isn’t reversing the original decision and why. The SOC will summarize the evidence and applicable laws and regulations, and include a detailed discussion of the reasons for the decision.
The SOC will also explain that to continue with your appeal, you must submit a VA Form 9, Appeal to Board of Veterans’ Appeals. This form will be included in the mailing from the regional office with the SOC.
Federal decisions on your veterans benefits appeal
Up to this point, all decisions have been made by the VA regional office that serves your area. If you still disagree with them, it’s time to jack it up a notch and take your case to Washington, D.C., or more specifically, the Board of Veterans Appeals (BVA).
At this point in the process, about 90 percent of all veterans decide to seek representation to help them through the appeals process and represent their case. About 85 percent of all veterans select a representative from a veterans service organization (VSO) or state veterans office, probably because they work for free.
If you want someone to represent you on your appeal, you need to submit VA Form 21–22, Appointment of Veterans Service Organization as Claimant’s Representative, to authorize a VSO to represent you, or VA Form 21-22a, Appointment of Individual as Claimant’s Representative, to authorize an attorney to represent you.
You begin your appeal to the BVA by completing VA Form 9, Appeal to Board of Veterans’ Appeals. You should have received a copy of this form with the Statement of the Case.
When you fill out VA Form 9, you should state the benefit you want, any mistakes you find in the SOC, and whether you want a personal hearing. You send the completed Form 9 to the VA regional office that denied your claim.
You must submit VA Form 9 within 60 days of when the VA regional office mailed the SOC or within one year of when the regional office notified you of the original denial of your claim, whichever date is later. If you fail to meet these deadlines, you may lose your right to appeal.
If you submit new information or evidence with your VA Form 9, the VA regional office will again reconsider your case. It’s possible that the new evidence or information will cause it to reverse its decision and grant your claim. If not, it will prepare a Supplemental Statement of the Case, or SSOC.
An SSOC is similar to the Statement of the Case, but it addresses the new information or evidence you submitted. If you aren’t satisfied with the SSOC, you have 60 days from the date when the SSOC is mailed to you to submit, in writing, what you disagree with.
At any time during this process, you (or your representative, if you have one) can request a local office hearing. As its name implies, a local office hearing is a meeting held at the VA regional office between you and a hearing officer from the local office’s staff.
To arrange a local office hearing, contact your local VA regional office or your appeal representative as early in the appeals process as possible.
A face-to-face meeting probably won’t add weight to your claim, nor will it speed up the claims process, but it gives you the opportunity to ask questions. It’s often helpful in determining the strength of your claim and whether you need additional supporting documentation.