[00:00:00] If they are knowledgeable and can support you to get the benefits that you earn by advocate any veteran to get the help that they need. On today's show, we will discuss what veterans need to know regarding each appeal process. Us stay tuned.
Hello and welcome to Prepare to Compete. We talk all things VA benefits, real estate, entrepreneurship, and more. Kenneth Davis, how you feeling today? My brother? Feeling ready, excited, and ready to educate and talk about all things. Va. Absolutely. On today's show, we're gonna be talking about the appeals process.
Now we know that it could be distinctly different for each veteran, which is why we wanna educate on the three [00:01:00] different ways that you could actually foul an appeal. So, you know, Kenneth, while we're getting into that, you know, what kind of advice would you have for veterans looking? To file an appeal.
You know, oftentimes they get denied and they're just down on whether they should even pursue any process at all. Well, um, you know, there's many reasons on why they're filing an appeal and why it could be helpful. Uh, definitely these, uh, more than likely is gonna be circumstantial. However, what I would say is this, you know, there's always that scuttlebutt talk of, well keep filing, they're gonna approve it.
Just keep filing Well. I hate, I hate to break the news. That's not always true. Okay? It's still a process, it's still an adjudication process that needs to be, uh, uh, proceeded to be followed, and also to be able to connect the dots to really get your service connected. However, following an appeal will always, always, always.
Keep [00:02:00] your case file and issues active, which is a great, which is a great part. So those are the things that we really need to follow so we can make sure that you're really benefiting from filing an appeal. Absolutely. Okay. So obviously we told the veterans that there are three distinct ways to file an appeal, right?
So, uh, can you point out those three different ways that they can go about filing appeal? Yes. So when we are filing an appeal, there's again, those three specific ways. Two, five, number one, that's going to be a supplemental filing, okay? That's gonna be on the form, uh, VA form, uh oh 21 T oh 9 9 5, okay? That form there, that is specifically to be able to provide something called new and relevant evidence.
Okay, new and relevant evidence and one big thing that's going on right now is what [00:03:00] is relevant? What constitutes relevant evidence? Well, we want to first be able to, uh uh, really. Understand what the new part is first because we want to be able to really put something to that. So new. We obviously, that's no information that was previously reviewed prior in regards to the prior decision, which is new evidence, relevant, what we wanted relevant to the issue at hand and the issue at hand would be any diagnosis or any claim condition that we're going after.
It. Okay. So that's really what the supplemental claim is for, is to be able to overturn the issue that was previously denied and satisfy two distinct definitions, new and relevant information. Okay? And new and relevant information. Can, we [00:04:00] really could peel back the official definition with regards to that.
But what I want to tell you veterans is I don't wanna get into the weeds, I'm just gonna let you know. If it is a complaint of that issue, it can constitute as relevant. Okay. It can constitute as relevant. It does not always need to satisfy why it was previously denied. In regards to medical evidence or opinion, we just want it to be again, relevant and this is something that has been chronic and continuously affecting you.
Absolutely no, so great on that one. So now when we're talking about the supplemental claim, uh, do, do they have a certain timeline to actually file a supplemental claim? Well, uh, great. Yeah, great question. So you have a year timeframe to be able to file a supplemental claim, uh, from your [00:05:00] decision letter date.
From your decision letter date, so in top left hand corner of your actual date of decision on your notification letter, there's gonna be a specific date. That date you have a year's timeframe to be able to submit a supplemental claim if you were denied the original or new or increased claim to appeal that decision.
Absolutely. And I always get nervous when I see those letters, right? Because, uh, as veterans who have received those letters, may, uh, realize is that you'll have that letter on that page one top left as you described it. But also when you go down and you scroll down and you start looking at like the review of decisions, you may have a.
Date that is something different. It may be one, two, or three days prior. So if you could explain the differences between those two dates. 'cause when I look at it, it is like, Hey, let me just put this claim in by that earlier date. 'cause I'm not even gonna play [00:06:00] with that date at the top of the page. Yeah.
So there's uh, there's multiple days that can be considered. Right? Uh, we can have a rating decision date. We can have the effective date, the effective date of the condition, we can have the date that you are actually going to be, uh, the dates that are actually, uh, that are, are broken out in the ledger system in regards to what date are, what you're getting paid and how you're getting paid.
Okay? And that's typically, again, your pay dates. Alright. Um, and also you have the date of notification letter, right? The date of notification letter may not always match the date of rating decision. Those could be two different dates. Alright? So that's why it is based upon the notification letter date because, uh, we wanna make sure the VA wants to make sure that the veteran has been notified.
Right. So that's a date. Typically it takes about a few weeks before your notification letter gets to you, or you can actually check it on va.gov as well now. Right. Okay. So that's [00:07:00] why I'm seeing it where it's a couple days apart or you know, maybe one or two days because essentially they may have made the decision on September 13th and then.
It was populated a day or two after to be in the portal. And that's what's on the actual letter. Yeah. So it has to get authorized. So it can be also, you know, that the, uh, decision was made. But now it needs to be authorized. Now, uh, again, typical authorization could take a few days or such, or it could take one day or it could be the same day.
Uh, we don't necessarily know once it's authorized at that point, it's moving on. Um, but it depends on if it needs to be authorized or not. Because again, like I said, I don't wanna get in the weeds of that, but, um, it could be done on a Friday evening. Right. Notification letter doesn't go out until Monday, and then Monday could have been a holiday and it doesn't go out till Tuesday.
Yeah, so there could be many reasons on why the date differs. Uh, but one date that we don't want to differ too much is the effective date, [00:08:00] right? Because that's. That's your compensation, that's your benefits, that's what you want to be always either the same or stage and benefit way that's gonna benefit you.
Okay. So, uh, but again, now that, that, we can definitely uncover that, uh, in one of our previous videos that we have talked about effective date, but also some of our future videos as well. Absolutely. Okay. So that is a common way to appeal. So now diving a little bit into a couple more questions about. The supplemental claim process.
Mm-hmm. I want to know, okay, so a claim was denied. You filed a supplemental claim. Now if it remains denied, can you submit for a supplemental claim again? So, yes, you can. If we have satisfied, uh, the definition of the new evidence to be new and relevant. So at that point you will, it can [00:09:00] and will be re adjudicated by the va.
Okay. So as long as you file a supplemental claim with new and relevant evidence, you can continuously do that, uh, as many times as you need to. Yes sir. Okay. Yes sir. Absolutely. And now, so with that fouling of the supplemental claim, uh, what. Is going to, again, I know we don't wanna get into it too much, but, uh, constitute that new and rev relevant evidence, um, new and relevant evidence.
It, it is, I think this is a very hot take and controversial. Anything can affect, I can, I can send a, Hey, my ankle's still hurting and I put some medical records in. That's new. It's not redundant because it's still chronic and continuous. You have to look. That's the, that's the portion when we talk about a judges making [00:10:00] decisions, that's the gray area portion that Raiders aren't doing and that they don't have the A GS seven Raider ain't gonna do that.
That's not how it works. You know? So that's why I'm like, this is, it's so like crazy that all this stuff is crazy. And does not affect the outcome. How you gonna tell me a new diagnosis is not gonna affect the outcome? Because now that diagnosis could have changed from my previous diagnosis where I could have a different type of pain that's affecting the issue.
And now we know, understand this diagnosed, but who to say is that? Who? To say that me climbing the ladder well isn't going to me climbing the ladder? Well. Over the years that one medical opinion has referenced that, but now I have new pain. So could you figure out what is actually the cause of the new pain?
Is it the, the issue of, uh, the climbing a lateral? Well, we don't know [00:11:00] unless you get a a mm-hmm. Exam. But I'm not gonna order you exam because I don't feel as though you meant the definition quality. You don't fit the definition. So now look how many people are getting denied. Just in that because over somebody's subjective view of what that that is, other than looking at what the, the definition and what the law constitutes, but you gotta be trained to do that.
You know what I'm saying? Like mm-hmm. And like I think about this program now, I'm like, damn, this program is perfect. It was perfect for me in a sense. Like that's what I'll do. Uh, but yeah, that's interesting. So when we talk about the new evidence, uh, when we talk about the official definition, the official definition lies to be, um, and this is in regards to the code of Federal regulations and what we're supposed to be able to really go off of and also go off the Warrens manual.
So, uh, merging the two definitions, uh, it it means, again, evidence that has not been previously part of an [00:12:00] actual record. Okay. Before agency adjudicators have been able to review. So it is not previous evidence that was previously reviewed. Okay. Um, and that's kind of the very distinct definition within the CFR.
And then we have the distinct definition when we're talking about, um, the, the, the warrants manual. It's information that the VA did not previously consider in connection with the claim prior. So, uh, this has to be new evidence. And it could be from a physician, it could be buddy letters, it could be, uh, it can be, uh, pretty much anything that's gonna be related to that diagnosis.
That is gonna be constituted as new, uh, constitute as relevant. Well, what is relevant evidence for a supplemental claim? Well, relevant evidence reads as is information that by itself or when considered with other evidence of record, relates to [00:13:00] the un established fact necessary to substantiate the claim.
What does that even mean? Right? So let's really kind of unpack that. So. Is going to be officially evidence that is not cumulative, that is not redundant, or that does not affect the outcome of the decision, is not considered new or relevant. So it does, if it does not affect the outcome of the decision, it will not be considered new and relevant.
And that was a big change because this was a big change that happened around in around May. Okay. Of 2025. So that actually increase, could possibly increase a lot of denials. Hmm. So this is why it goes back to be so important in regards to moving your case forward. Appealing could really matter because [00:14:00] historical changes in regulation and policy, you guys, it changes so very often, but it could be beneficial to you.
Or can negatively impact you. But if you do not continuously file your appeals, you're never even in the game. So that's why it's very important that you continuously file as an appeal, whether if it's a supplemental and you have new and relevant evidence, new evidence that is evidence that has not ever been considered before.
And relevant evidence. Evidence that could potentially. Disprove the, the outcome of the previous claim. So that's why it's very important to make sure that we continue as continuously appeal your case file. Uh, absolutely. So not great with explaining the supplemental claim. So now when we talk about that new and relevant, right, so [00:15:00] always want to give our veterans here an example of how that would apply in the real world.
So what about a situation where the evidence is new? Because I did not submit that evidence previously. So let's say, Hey, I submitted my claim. I'm doing a claim for a back condition, and I submitted all my VA medical records because I've been receiving care through the va, but I also. Was doing physical therapy with the private that wasn't covered through community care.
So that wouldn't have been in my blue button report. And I'm like, Hey, I didn't submit that last time. Maybe that's why I got denied, and now I wanna submit that. So now would that constitute new and relevant because it was not previously considered. So let's break that down a little bit. Okay. So, uh, veterans now, so now, uh, we have veteran X.
Who [00:16:00] is submitting their claim And they have, uh, resubmitted their service medical records, correct? Yeah, yeah. Service medical records are even just their, uh, what the service? Medical records. Medical summaries. Okay. So that, so those are two. Let's be very, very, right. Yeah. Yeah. So yeah, I was referring to the medical summaries.
So basically they. Have their treatment records and things through their VA medical and the VA had all that stuff, but they never submitted anything from the private medical of them going to physical therapy and seeking treatment outside of their VA care. So with that being said, so we have, uh, the VA's reviews of service medical records.
Uh, they denied it based upon. Um, what was the denial based upon? Because this is important, it's important information that we have, uh, because I wanna make sure that the viewers understand that there's different nuances and strategies. Okay. Yeah. So they denied it. Um. Just based on [00:17:00] saying something along the lines of there was nothing con, there was no incident or anything connecting, uh, what I'm dealing with, uh, to anything in service, but it also, it was, there was no, I guess current diagnosis, they said that as well.
Excellent. So, uh, we have a claim that has one, no current diagnosis and also no issue that transpired within service medical records. Okay, let's say you are an 11 Bravo, right? Uh, we're infantry. We're infantry. So now with that being said, so no, no entries in service, medical records, and no diagnosis. So with that being said, nine times outta 10, what has probably transpired, which is uh, uh, a very common scenario is that, you know, this has happened while in service.
Okay? Um, but you probably. It wasn't seen by medical. Right. 1987, right around that timeframe. Right, exactly. Uh, I don't wanna tell your age [00:18:00] too much, but definitely not me. But, um, nine. Uh, so, uh, yeah, obviously around that timeframe, there's, uh, there's kind of frowned upon going to medical. So, uh, there was no injury in service.
Um, but, uh, also no current diagnosis. So, so now we have no entry and service, no current diagnosis. That seems like it's probably gonna roll over into a negative opinion, um, because they have no information of this being of an issue, let alone to be a chronic issue. So with that, and you actually submitted new evidence for a supplemental claim.
Right, because it was denied based upon no entry in service and also no current diagnosis. Right? Yeah, because they not seeing anything currently in my VA medical history about it. And they're, but it's like, Hey, I've been going, I used medical through my employer. I just never submitted it. So now we have new evidence, right?
So we satisfy, [00:19:00] uh, the verbiage of new. This is evidence that has not been previously reviewed by an adjudicator prior, and now we also have the relevance of evidence. Why is it Rev? Why is it relevant? Well, because prior you said that I didn't have a, a current diagnosis. Well, without a current diagnosis, you probably don't get an exam.
Um, but there can be some leniency to that, but it's gonna be based upon obviously your adjudicator. But now taking consideration of that, now you have a new diagnosis they need to, uh, review. So in taking consider now you need to take consideration your full military experience. So with that said, now with, with that happening at that point, it satisfies new and relevant.
Because it could possibly prove or disprove, [00:20:00] uh, the issue of your claim. No, great Kendall. So thank you for explaining really in depth regarding the supplemental claims, but obviously. It's not always enough with the supplemental claim process. Right. Yeah. And that gets us to the second layer, which is higher level review.
So can you explain to the viewers what exactly is a higher level review? Yes, sir. So, uh, when we're talking about a higher level review, a higher level review is very, very, very, um. Substantial in importance, right? Um, so let's say, uh, that claim that was submitted by Veteran X was denied again after you actually resubmitted, uh, medical evidence.
Well, at this point in time, a high level review is going to be, uh, the claim that you're submitting that has been previously denied, and now you want a senior adjudicator to be able to review these things, uh, [00:21:00] more, uh, in the realm of decision review officers, right? Uh, these, these, uh, these adjudicators have some really major experience to, to be able to get into this, uh, you know, role.
So, uh, with that being said, uh, basically, uh, a team of adjudicators are able to, uh, review your file and they're, these are senior adjudicator. This will be a senior adjudicator. Um, and they're gonna review your file at a whole. Okay. At a, at a kind of a, uh, a bird's eye view with experience and also application of law, uh, again, regulations, uh, CFR, and also the Moores manual.
Okay. Definitely. Alright, so now they're reviewing that information. And, and typically for a higher level review claim, uh, how long does that usually take? The process? Is that gonna be longer than doing? Um. Supplemental claim, what can veterans [00:22:00] expect out of a higher level review? Well, uh, typically a higher level review is gonna be about four months or so, four or five months or so.
So, um, and again, that's just a typical average, right? And that's what the come, the VA says. But we, again, you have, uh, some that get done a lot sooner 'cause they could be shorter longer. It doesn't, it, it, it, it depends, right? Um, you know, like all case files, um, however. Uh, on average we can kind of count on that.
Okay. So I'm submitting a higher level review 'cause I filed a claim. I may have done a supplemental claim prior to. Mm-hmm. I guess the question is, can I file a higher level review before submitting a supplemental claim? So yes, you can. So if it was denied, uh, you have one year's timeframe to be able to submit that higher level review, take it up, uh, to that again, senior adjudicated team to be able to, uh, review your file.
You know? Um, and again, [00:23:00] so when we talk about supplemental, there's different, there's different components that are being, you know, reviewed. But when you go for a high level review, guess what? There's no new evidence that's gonna be, uh, submitted to be reviewed. So they're basically taking a fresh set of eyes, uh, at a bird's eye view with long fact, uh, to be able to adjudicate that claim.
So, uh, specifically when we're talking about that taking consideration, there is nothing that is going to be adjudicated, that is new or considered that is. Okay, so they're not considering anything that's new with that higher level review claim. So now it, are there, I guess, certain other nuances that veterans should, uh, be informed about in regards to submitting that higher level review?
Um, well, I would tell you this. When you are submitting a higher level review, there's always gonna be instances, uh, that something has [00:24:00] probably not been completed. Um, or adjudicated properly when you send it out to a higher level review. And what do I mean by that? 'cause some veterans, you, uh, you may get something called a, they're, they're correcting an error.
You may get a notification that they're correcting an error. And, you know, uh, what that does is puts some people, it puts some people up in arms, right? So, and, and that error sometimes may have nothing to do. With disproving or approving your claim, or it was probably just a process that was missed that was supposed to be completed.
So, you know, uh, but it, it, it really depends, you know? 'cause we, when we talk about these files, it, it, it, it veterans, uh, it could be very, very complex sometimes. So when we're talking about sending it up, it is being reviewed by some of the most senior, uh, adjudicators There. And there could be a lot of overturning of things and [00:25:00] information requests.
Please fulfill these information requests as fast as possible. Uh, the faster you're able to get your. Uh, information over the faster they're able to adjudicate your file. So, um, and not, so not promising that obviously, uh, that's a federal agency. They, they, they, they can, uh, you know, put the gas on it or slow it down.
But what I am, what I am saying is if you want to make sure that this process goes smoothly, try to cooperate as quick as possible and comply. Absolutely. And obviously we're on, uh, the VA news site. Learning more about the higher level review process. Uh, they just had a recent article and we have it on the screen for those who are actually, uh, uh, watching and able to see here regarding informal conferences mm-hmm.
Uh, during that, uh, higher level review process. So I just wanted you to be able to educate. Uh, the veteran in the community here regarding exactly what is an informal conference? [00:26:00] Yes. So an informal conference is basically a conference, uh, that may clear up some misunderstandings, right? Um, it gives opportunity where the veteran can be able to speak with a claims processor.
Um, and that may not be a Raider that may. Uh, be someone who is connected to an adjudicator, right? So, uh, so when we talk about that, we want to be very specific. So when you go in and say, Hey, I need to be granted because X, Y, and Z. Well, sometimes they may not be the people that granted it. Okay? So let's take that in consideration.
Um, but think of it as a phone call, okay? Think of it as a phone call, and you want to be able to provide clarity. Uh, to what may happen in service, uh, what may is aggravating you today, uh, or what could, you could actually potentially help the file and some misnomers that was, that was uncovered, right? So, uh, with that being said, uh, that is gonna be simply, uh, a [00:27:00] conference where you're being able to, uh, say your piece and make sure, uh, that they understand exactly what's happening.
Uh, where it's not anything that is going to be, uh, kind of at a bird's eye view, right? We wanna be very distinct and very concise, uh, throughout this process. And veterans, when I tell you, be concise, make sure, uh, that your information that you provide, um, is in alignment with the information that is within the file, right?
There's so many different portions of the file. We want to be concise as possible. How we be concise as possible is consistently, consistently having your records, how many times, uh, we can say it. Make sure that you have your records to understand everything in the sense of what's going on with your diagnosis, your issue, and what transpired during servicing.
You should be very, you should just do just fine. No, absolutely. So now [00:28:00] when you're describing the informal conference, kind of puts me in the mind of like a compensation and pension exam. So what I wanted to, I guess think about there, and the question that I want to have answered for the community here is that with the higher level review, would they ever schedule a compensation and pension exam?
Yeah, with a high level, yeah, that may happen. That may occur. Uh, you may, uh, had an opportunity where you didn't get a, a, a, a compensation pension exam. There were adjudicators that closed your file, you didn't get an exam. So now, uh, anca an exam was missed, and now since the exam is missed, well guess what?
You qualified or you meet the metrics of that supplemental claim that was denied, and now you met the new. And also relevant portion of that's required before actually scheduling the exam. And now the higher level of review, [00:29:00] adjudicators may go ahead and order that exam for you. Okay. So is that like more common or is it a 50 50 shot, or just depends on the situation, you know?
Uh, circumstantial, it's always circumstantial, so we always wanna make sure that we take consideration of the circumstantial issues. It, it's a, it's circumstantial. But what I will tell you is this, if you have met the metrics that you, uh, you feel strongly of, uh, new and relevant evidence, um, it's more than likely probably gonna lean to your side and really being able to achieve that exam.
So, uh, because there is gonna be slight, um, subjectivity in this, uh, decision. So, um, I would always make sure that if you feel as though that it meets the re new and relevant evidence, um, you should and be able to achieve receiving exam. Okay. Receiving exam. So, so what I guess I wanna understand there is, 'cause I know typically what the high level review, you're not submitting new evidence.[00:30:00]
Yes. You're not. It's so I was getting. Providing an example if it was previously denied for under supplemental claim. Oh, okay. Yeah, yeah. So, uh, you don't, you don't, there's no new evidence that will be submitted. The only new evidence that will be considered, uh, are gonna be kind of the informal conference.
Right. Uh, because again, they may want to clear up some inequities that was in the file that, uh, instead of guessing you have the opportunity to be able to discuss. And that's, uh, and that's something that's offered to you. Uh, but what I will tell you is if, if, if you're expecting, uh, your file to go as quick as possible, that's probably not gonna be the best way to go, right?
Because, uh, you have to get scheduled and so on and so forth. It is a process, uh, but what I will tell you is it's going to be one of the best options in regards for clarity, okay? For the high level review and informal conferences, something that you may wanna pursue. Yeah. Yeah. And again, it, it really depends.
It really depends, uh, typically depends on, like I said, [00:31:00] uh, complexity of files. Okay. And then also for the clarity there. So sometimes with the high level review, uh, if they saw a certain error or omission in the previous decision, they may request that additional exam. They may request an additional exam, they may not.
You know, it just really depends. Okay. And, and why I want to make sure veterans understand that is because, you know, sometimes they're looking forward to certain processes, right? Mm-hmm. And they're looking at the timeline of saying, Hey, well, okay, once this happens, then I know they're closer to the decision or different things.
And you know, everybody's talking to their buddy and getting that advice. And it's like, well, I submitted a high level review and I got. Uh, CNP exam and this other veteran's thinking their higher level review is gonna be denied because they didn't get a CNP exam. Yeah. And you may be very surprised of the person that did not receive a CNP exam of being granted.
Right. Because you met the [00:32:00] requirements that someone could have possibly overlooked. Got it. Okay. So they could have overlooked it there. And, um, so the other thing that I wanted to make sure with the higher level reviews and covering that is just regarding the process and the steps, right? Because I've seen it where sometimes veterans will foul the higher level review.
Then they'll will send you a letter of saying, Hey, whoa, it's all denied. Or. Some things are denied, but we do identify that we did have an error here, so wanted you to kind of talk to 'em a little bit about that nuance process, right? Because you may get a decision letter that doesn't actually have a decision for your higher level review.
It's just saying like, oh yeah, we messed up, but. We are not gonna tell you what our decision is. We just know we messed up. So I don't know how they know they messed up. Yeah, if they didn't review it yet, but they're sending a letter saying they messed up, but they don't have [00:33:00] a decision. Yeah. Yeah. Uh, some, again, there's so many different notification letters that go out.
Uh, some may, uh, be very confusing, some may be very informative. Um, and that's what I always urge veterans to do is read their notification. Letter. Right. Um, again, every piece of mail that comes in the mail isn't a decision. Okay. Um, it is to be able to inform you and also to be able to, uh, really equip you with information that you need to know.
So when we're talking about a notification letter of that fact, when we're talking about higher level review, as you mentioned, and again, in regards to denials and also correcting an error. So there are steps and processes that, um, when you go through a claim, um, that you must meet. Uh, to be a by law to be able to deny or approve a claim.
Okay? Because we could be considered on the other side too. So when we talk about high level reviews, it is not always gonna be benefit you at times, because now that now [00:34:00] opening a claim or a previous decision that was denied could also open it for scrutiny and also reduction. Right, so it's very important that you seek the help and guidance you need.
Um, however, when we're talking about a notification letter of that fact, um, if there is denials and also, uh, there may be an issue that they correct in error. Now that error correction doesn't necessarily happen itself. There's processes that they need to actually, uh, to be able to transmit, to be able to, uh, satisfy the policies and regulations and laws before they're able to either approve you or deny you.
If there was medical records that was missed, that was not reviewed in the file, um, by law and by regulation, you must, uh, be able to provide the veteran the duty to assist, right? The VA has a duty to [00:35:00] assist you in garnishing those records. So now, um, with if they skipped or bypassed that process or bypassed the process on the second nature again.
Well, guess what? They need to correct that error before they deny you. Oh, wow. Wow. Okay. So no, that's, that's very good information. So, in other words, just because they said they have a duty to assist error, that means, hey, we didn't help you secure your records or this, that, and that. So we're gonna go try to help you, and then we're still gonna deny the call.
Possibly, possibly, possibly. But they may also approve it because now they garnished those records. So it, it, it's, it's, you know, um, but that's just one instance. It's so many other instances that could apply to that same scenario. Um, but in that instance, they need to garnish these records [00:36:00] so they can be able to either support.
Or not support your file? Absolutely. Yeah. Well, at least, you know, at that point, if they have identified an error, whatever that error is, your claim still has life, right? Yes. It hasn't been denied, hasn't been closed out. So there's still a fight to be had at that point. Yes, true indeed. And so something else that you hinted on there while you were talking was around a higher level review.
It not just being for denied conditions. Right. So that's something that you talked about. Uh, so just wanted to go more into, uh, why a veteran may file a higher level review claim. Uh, there could be a many instances, right? There could be. Um, effective date issues, right? There can be, uh, percentage assignments.
Um, there could be, uh, obviously the obvious, the overturn of denial. [00:37:00] Okay. Um, and there's, uh, many other issues that actually a higher level review applies when we're talking about. Uh, the VA and its, uh, appealing, uh, processes. Okay. Uh, there's other benefits that are applied that also apply to higher level review as well.
So if you are simply, um, basically, uh, you know, going after a certain benefit, um, and it could be a benefit of caregivers, right? Uh, having the opportunity for your. Spouse, significant other, or you know, a family member to supporting you as a veteran, as a caregiver, you're denied. Well, there's a, an appeal process with that as well.
Okay. There's a supplemental appeal process and there's a higher level review appeal process. So it does not only apply to, uh, VA compensation and pension. Absolutely. Okay, great, great. So that's very good to know there. So now we discuss supplemental claim. That's pretty much just [00:38:00] gonna be if you have a denied condition.
Uh, so for the higher level review, it could be for a denied condition, it could be for. A increase 'cause you got 10% but you thought you deserved 30 or et cetera, et cetera. Our effective data, a multitude of different reasons why you would get into that. So great understanding that information there. Now as we get to the third part, which is the Board of Veteran Appeal.
Now I hear that is some mountain to climb when trying to file that claim. So can you give us some context on what the Board of Veteran Appeals actually is? So filing a Board of Veterans Appeals. So essentially when you're filing Board of Veterans of Appeals, you're requesting a review. From a veteran law judge.
Okay. Um, and again, when we're talking about filing a [00:39:00] review from the veteran law judge, understand it's a process. You guys understand. It's a process. It could be adjudicated and it could take years to be adjudicated, um, and regards to getting to the judge's docket. Okay? So when you are filing a BVA claim, uh, I want you to understand that it's going to take some time.
Okay. Uh, and this may be, uh, some best action plan to be able to file the BVA claim based upon the issues that they're dealing with. Um, when we're talking about BVA claims, a veteran law judge is able to review some of the evidence that you may wanna submit that is new, and also to be able to have a sit down hearing with you.
And this is an official. Formal conference that is gonna be considered as evidence where an informal [00:40:00] conference is not considered as specific evidence. It is more or less to clear up any misunderstandings. So when you file a direct review, you accurate re you actually relinquish. Your right to file the new evidence or have a hearing, which the hearing could be held in Washington DC or at the regional office of your, uh, choosing which, uh, it, it just really depends.
And having that official hearing is going to sit you down and talk about your issue or diagnosis or medical issue that the service your military service has caused. So when we're talking about Board of Veterans of Appeals, distinct differences is that a veteran law judge will be looking at the file, your file in its entirety of all the time since you've [00:41:00] submitted all the way back to your original claim.
Okay? And when I mean, original claim, that is the original claim, supplemental higher level review, and BVA, uh, going to the BVA. Okay, increased timeframe, so there will be an increased timeframe. It allows you, it possibly allows you to be able to submit new evidence. However, one thing I do want to tell you veterans is that a lot of adjudicators don't talk about the VVA because it is very cryptic to them.
Uh, because every adjudicator isn't the same when you are talking about a veteran law judge. Now rules, regulations, and policies that are in insert the CFR and also Warren's manual could be stretched a bit based upon the judge's deferment of more information.[00:42:00]
So, uh, when we're talking about the duty to assist in assisting veterans in getting additional medical records that can be applied, uh, we're talking about getting, uh, additional medical exam, CMP examinations that can apply. Um, and also the judge has the power and right to do so many different things with your claim to include automatically grants in it based upon the evidence of rec.
Now when we're talking about a BVA claim, if a grant is an order, it can go all the way back to the original intent to file could, and that could be potentially years. Yeah, absolutely. And and that's a very good point because you hear so many stories about veterans saying, Hey, I got $500,000 of back pay.
Right? So that's typically how that would happen. And you know, sometimes, obviously I know you know, with Veterans for Veterans, you know, a veteran who may have got [00:43:00] outta service in the nineties or so comes and you help them with their claim and they're thinking that they're going to get back pay all the way from that day to service, right?
And it doesn't work that way. And it's because of they heard different people's stories with the BVA claims and that, so even with the BVA claim, it doesn't necessarily go back to the date of service. It's based on that continuous prosecution and that intent to file and, and that sort of thing There.
Yeah. Yeah. Uh, it can it again, and it can, it can include many decisions, right? Because, um, this, uh, uh, uh, uh, a Board of Veterans of Appeal, an appeal of that magnitude, it can, let's say it goes back to 2000 and and seven, which we hope not, right? Uh, however, uh, but again, your severity of injury could differ in many stages, uh, based upon the evidence that's rendered, which could.
Actually provide you a 10% in [00:44:00] 2010, uh, 20% in 2012, and then back down to another 10%, back to 2025. So it, it could, it could, it could vary, you know, in regards to, uh, the severity of issues as well. So there's so many different things that can actually go, you know, right in the BVA process. But also we want to take into consideration, uh, that the things that could, could rock the boat a bit.
Okay. And, and we're talking about. Things that could potentially go against the veteran. Right. So now at what point does the veteran know when they file that board of veteran appeals claim, whether they're gonna actually pick it up for review? So, uh, with that, uh, it typically, I would say once it's submitted, you want to get an official notification that it has hit the docket, uh, the judge's docket.
And, uh, that could, uh, potentially, again, I would auto, I would. I would say give it about 30 days or so, 30 to 60 days to [00:45:00] officially know. Uh, but on average, uh, once it's submitted, you, uh, the are actually gonna provide you with the confirmation and have you, uh, but you wanna see. It on the docket and, uh, getting to the docket could take some time.
Uh, but I would say about 30 to 60 days to be allowance to see it on your file. nva.gov. Understood. Because I'd imagine they get a lot of different requests for claims. So is it like. Somebody just filed a claim and they're like, we're not even gonna review this, and they just throw it out. Sometimes that happens.
Yeah. Because, uh, every claim it could not be, uh, certified for a BVA review. Right. Um, it again, let's say it's a past year of the decision of the higher level review. Is that gonna be eligible for a BVA review? Well, no. Right. So, uh, there's different metrics and, and understandings that you must kind of, uh, processes that you must go through to be able to get to the Board of Veterans of Appeals.
Okay, understood. So I guess, so what would that, uh, process be and what [00:46:00] questions should veterans be looking at as far as criteria to even be eligible for a Board of Veteran Appeals Review? So in order to be able to follow BVA appeal, you don't necessarily need to. Go straight. Uh, well, you don't necessarily need to file a supplemental or higher level review.
That's not the case. Uh, if you're denied once in the initial review, you can actually go straight to the Board of Veterans of Appeals if you like. Um, and you can be able to have them re-review the file. Uh, but there's also processes before that right supplemental claim that we kind of spoke about and also higher level review.
So to be, in order to be able to go straight to the Board of Veteran Appeals, uh. You know, I would believe there's other processes prior to that, uh, just due to timeliness, uh, additional support where you can be able to get a dis additional support and evidence that's gonna be able to support you and also a better outlook on other [00:47:00] reasonings on why it was denied so you can be able to try to overturn it.
Right. So going, and also I just, I don't necessarily recommend veterans to go straight to the Board of Appeals, but that's just, again, my consideration. It, it could be a reason why you do that. Uh, but, um, again, I would say, uh, typical means you would go for a supplemental claim, high level review, and then Board of Veterans of Appeals Makes sense.
Right? Because you did say it could be a longer process for board of. Veteran appeal. So how much longer on that particular process you've seen, uh, that take, oh, well you're talking about years versus months. Okay. Uh, and when we're talking about a supplemental claim or high level review, that could take months, right?
Uh, a Board of Veterans of Appeals could, uh, BVA could take a few years to be adjudicated, or a year or more. So, um, it really, it, it really, really all depends you guys. So I wanna make sure [00:48:00] that you get the professional help you need to make these decisions. Um, it's just not all a, you know, uh, uh, uh, one size fits all.
Right? Uh, there's a very complexity, nuances to every military, veterans, uh, military member or veterans files. So you wanna get the support you need. Absolutely. No, very good stuff there, Kenneth. We've being able to cover that. So we talked about the three kind of main ways to appeal and obviously as we know, there may be one or two other levels after the Board of Veteran Appeals, but you know, once you're getting there.
There's a lot more nuance, uh, things there. So, but when veterans are filing for their claims, especially appeals, whether it be the supplemental, whether it be. Higher level review. Are Board of Veteran appeals, uh, should they be doing that [00:49:00] themselves or should they be really seeking out a professional to help them?
You know, especially when we're talking about the higher level review and the board of appeals, we're using certain terms and different things to make it seem like they may need to hire a lawyer. To assist them with that. Now, is that actually the case or would should they be looking at to assist them with navigating that nuance process?
Well, when we talk about all of this, you know, VA world, um, it's always gonna be good to be able to get support where you can. And that's what I'll always tell veterans. If they are knowledgeable and can support you to get the benefits that you earn, I advocate any veteran to get the help that they need.
Lawyer, consultant, [00:50:00] educator, P-O-A-V-S-O, get the support you need so. I will always make sure that veterans, it is not a position to, to turn you in a specific direction. The direction is to get the benefits you earn for the service. That you serve. Absolutely. That's a phenomenal point to go out on. Kenneth, uh, really appreciate you for explaining everything to the community today.
Uh, did you wanna have any other kind of closing words or anything else you wanted to add there? Um, listen, veterans, uh, we are in times where there are benefits that are gonna be out here for you. We need to be able to uncover those and [00:51:00] also support one another. So sharing the information to your brother or sister in arms as quick as you receive it is could change someone's life.
So take the opportunity to really be impactful to your brother or sister in their arms. Thanks a lot, Kenneth. Community. Prepare to compete. We out. Peace.
