Spearman Appeals LLC

Jerome Spearman, LLC is a VA-accredited claims agent

VA Higher Level Review: Veteran’s Guide to Decision Review Timeline

by

VA Higher Level Review: Veteran Guide to Decision Review Timeline

Click Here to Listen To A Deep Dive About The Higher Level Review Process

Understanding the VA Higher Level Review Process

What if there was a faster way to challenge a VA decision without starting over?

A way that doesn’t require new evidence, avoids the years-long wait of a Board appeal, and puts your VA disability claim in the hands of a senior claims adjudicator?

This isn’t hypothetical. It’s the VA higher-level review (HLR) – a critical but often misunderstood option for veterans seeking to overturn unfavorable VA decisions.

The path you choose after a disappointing VA decision matters enormously. It’s not just about disagreeing; it’s about selecting the right avenue for your specific situation.

Let’s make this process as easy to understand as possible.

What is the VA Higher-Level Review?

The VA higher-level review is exactly what it sounds like – a fresh look at your existing claim by someone with more experience.

No new evidence. No lengthy hearings. Just a senior VA claims adjudicator(aka VA Rater) to review what’s already in your file to determine if the initial decision was correct.

Introduced as part of the Appeals Modernization Act in 2019, the higher-level review provides veterans with a streamlined option for challenging decisions without entering the traditional appeals process.

Think of it as a second opinion from a more experienced doctor who reviews your existing test results – not ordering new tests, but bringing greater expertise to interpret what’s already there.

Who is eligible for the Higher Level Review?

You can request for a higher level review if:

  • You received a VA decision on an initial claim or supplemental claim
  • You’re within one year of that decision
  • You believe the decision contains an error or oversight

The key limitation? You cannot request a higher-level review of a previous higher-level review decision or a Board of Veterans’ Appeals decision on the same issue.

That restriction exists for good reason: the system is designed to prevent endless loops of the same evidence being reviewed repeatedly at the same level.

What are the key differences between Higher Level Reviews and traditional appeals?

The traditional VA appeals process was like entering a maze with no clear exit. You could wait years, submit evidence continuously, and still find yourself circling back to where you started.

Higher level reviews offer:

  • A de novo review (completely fresh look) of the existing evidence
  • A senior reviewer not involved in the original decision
  • A 125-day target for completion (compared to years for Board appeals)
  • The option to request an informal conference

What you give up is the ability to submit new evidence or have a decision review officer hearing.

This isn’t just a procedural distinction. It’s a fundamental strategic choice that must align with the specifics of your VA disability claim.

The Timeline of the Higher Level Review Process

How long does the Higher Level Review take?

The Department of Veterans Affairs aims to complete higher level reviews within 125 days.

Not years. Not “eventually.” 125 days.

This target represents a dramatic improvement over the legacy appeals system, where veterans often waited 3-7 years for resolution.

Is this timeline always met? No. Reality often falls short of targets. But even when the process takes longer, higher-level reviews typically conclude much faster than traditional Board appeals.

The VA aims to complete most reviews of the hlr process within 4-6 months, though requesting an informal conference can extend this timeline.

What factors can influence the timeline of a decision review?

Several factors can cause your higher-level review to take longer:

  • Requesting an informal conference – This adds scheduling complexity and can add 2-3 months to the process.
  • Claim complexity – Multiple contentions or complicated medical issues require more time to review.
  • VA workload – Higher submission volumes can create backlogs.
  • Duty to Assist errors – If the reviewer finds errors in how VA developed your initial claim, this triggers additional steps.

That last point deserves special attention. If the adjudicator will review and identify that VA failed to properly assist you (by not getting necessary records or exams), your higher-level review gets converted to a supplemental claim for correction – effectively restarting the clock.

What steps are involved in the decision review timeline?

The HLR process follows a defined sequence:

  1. Filing – You submit VA Form 20-0996, Decision Review Request: Higher-Level Review, within one year of your decision.
  2. Receipt and Assignment – VA confirms receipt and assigns your review to a senior claims adjudicator at a different VA regional office.
  3. Informal Conference (if requested) – A phone call with the reviewer to identify specific errors in the initial decision.
  4. Review – The senior VA claims adjudicator examines the review of the existing evidence that was in your file at the time of the original decision.
  5. Decision – The reviewer either grants, denies, or identifies a duty to assist error requiring correction.
  6. Notification – You receive a decision letter explaining the outcome and your options.

Each step has its own internal timeline, but the entire process is designed to move much faster than traditional appeals.

What to Expect During the Review Process

What happens after you submit a Higher Level Review request?

After filing your higher-level review request, the waiting begins.

Unlike the initial claims process, where VA might contact you for exams or records, the higher-level review is largely hands-off for you. The reviewer works with what’s already in your file – no new evidence is considered.

If you request an informal conference, you’ll receive a call from a person at a VA regional office. These calls are typically brief (15-30 minutes) and focused specifically on identifying errors in the original decision.

The reviewer does not provide a decision based on this call alone. They listen, take notes, and continue their review afterward.

How will you be notified of the review outcome of the hlr process?

VA will notify you through a VA decision letter outlining:

  • Whether your request was granted, denied, or returned for correction of errors
  • The specific rating and compensation you deserve
  • Your options for further review if you’re still dissatisfied

This letter is your roadmap for what comes next. Don’t just focus on the “granted” or “denied” outcome – the reasoning provided offers critical insight for your next steps.

What options do you have if you disagree with the review decision?

If your higher-level review doesn’t result in the outcome you hoped for, you aren’t at the end of the road. Understanding the process helps you navigate what comes next:

  • File a supplemental claim – This allows you to submit new and relevant evidence. This is often the best next step, especially if the higher-level review identified areas where your evidence was lacking.
  • Appeal to the board – You can request Board review, choosing from three different dockets (direct review, evidence submission, or hearing).

Each path has different requirements and timelines. The key is choosing the option that addresses the specific reason for the denial of your VA disability rating.

Preparing for a Successful Higher Level Review

What documents and evidence should you gather before submitting a review?

Before filing a higher-level review, gather:

  • Your VA decision letter
  • A copy of your claims file (c-file)
  • Any evidence that was submitted but not mentioned in the decision
  • Notes about specific parts of the decision you believe contain errors

Remember, you can’t submit new evidence with your higher-level review. The focus must be on identifying errors in how VA interpreted the evidence that was in your file at the time of the initial decision.

This isn’t just a procedural distinction. It’s the foundational strategy that determines whether higher-level review is even the right choice for your situation.

How can you effectively present your case during the review?

Understanding the higher level review success rate depends largely on your ability to clearly articulate specific errors:

  • Be precise – Point to exact regulations or evidence that was misinterpreted or overlooked
  • Be factual – Emotion doesn’t change outcomes; identifying concrete errors does
  • Be prepared – For informal conferences, have a concise outline of the errors you want to discuss

The most successful higher-level reviews focus on objective errors like misapplication of law, overlooked evidence, or incorrect interpretation of medical findings that affected your VA rating.

The adjudicator will review only what’s in your file. Your job is to guide them to the specific errors that impacted your initial decision.

What common mistakes should you avoid during the Higher Level Review process?

The biggest mistakes veterans make with higher-level reviews are:

  • Submitting new evidence – This isn’t allowed and will be ignored
  • Making general disagreements without identifying specific errors
  • Choosing HLR when a supplemental claim would be better – If you need to submit new evidence, higher-level review isn’t the right path
  • Missing the informal conference call – These are scheduled with little flexibility
  • Focusing on emotional arguments rather than factual errors

Each of these mistakes stems from misunderstanding the fundamental purpose of the higher-level review. It’s not a do-over of your claim. It’s a focused error-check of the previous decision regarding your VA benefits.

Resources and Support for Veterans

Where can you find additional information about the Higher Level Review process?

The most authoritative sources for higher-level review information include:

These resources provide the technical details, but navigating the VA often requires more personalized guidance.

What organizations provide support to veterans during the review process?

You don’t have to navigate this alone. Expert help is available from:

  • Veteran Service Organizations (VSOs) like the VFW, American Legion, or DAV
  • VA-accredited claims agents like Jerome Spearman
  • VA claim experts who specialize in veterans disability benefits

The right representative can make all the difference. They understand how to identify errors that might not be obvious to you and can guide you through the process in the language VA reviewers understand.

How can you connect with other veterans for shared experiences and advice?

Beyond formal representation, peer support can provide invaluable perspective:

  • Reddit’s r/VeteransBenefits community
  • Facebook groups focused on VA claims
  • Local VA office events and support groups

While personal experiences vary, hearing how others navigated the same process can provide both practical tips and emotional support.

Just remember – advice from other veterans should complement, not replace, guidance from accredited representatives who understand the legal and regulatory framework of VA disability benefits.

Conclusion

What are the key takeaways from this guide on the VA Higher Level Review?

The higher-level review isn’t just another appeal option. It’s a strategic choice that works best for specific situations:

  • When you believe VA made a clear error based on the evidence already in your file
  • When you want a faster decision than a Board appeal would provide
  • When you don’t have new evidence to submit

Success rates vary, but your chance of a favorable outcome hinges on your ability to clearly identify specific errors in the original decision. General disagreement won’t suffice.

Remember: the 125-day target for completion makes higher-level review significantly faster than Board appeals, but at the cost of being unable to submit new evidence.

How can you stay informed about changes in the VA decision review process?

The VA claims landscape is constantly evolving. Stay informed through:

What works today may change tomorrow. The most successful veterans stay adaptable and informed as they review their initial claims decisions.

The VA claims system wasn’t designed for simplicity, but it can be navigated with the right tools. Download our free guide: The 5 Fatal Flaws that Get Post-9/11 Orthopedic Claims Denied to understand the common pitfalls, explore our articles for deeper insights, or book a consultation to create your personalized claim strategy.

REFERENCES:

  1. Department of Veterans Affairs. (2023). “Higher-Level Reviews.” VA.gov. https://www.va.gov/decision-reviews/higher-level-review/
  2. Cornell Law School. (2023). “38 CFR § 3.2601 – Higher-level review.” Legal Information Institute. https://www.law.cornell.edu/cfr/text/38/3.2601
  3. Department of Veterans Affairs. (2023). “M21-5, Chapter 5 – Higher-Level Review Procedures.” KnowVA. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000141004/M21-5-Chapter-5-Higher-Level-Review-Procedures
  4. VA Office of Inspector General. (2023). “VA Developed Reporting Metrics for Appeals Modernization Act Decision Reviews but Could Be Clearer on Some Veterans’ Wait Time.” VA OIG. https://www.vaoig.gov/sites/default/files/reports/2023-06/VAOIG-22-00488-81.pdf
  5. Department of Veterans Affairs. (2023). “VA’s Duty To Assist.” VA.gov. https://www.va.gov/resources/vas-duty-to-assist/
  6. Department of Veterans Affairs. (2023). “Choosing A Decision Review Option.” VA.gov. https://www.va.gov/resources/choosing-a-decision-review-option/
  7. Department of Veterans Affairs. (2023). “Decision Reviews And Appeals.” VA.gov. https://www.va.gov/decision-reviews/
  8. Department of Veterans Affairs. (2023). “Supplemental Claims.” VA.gov. https://www.va.gov/decision-reviews/supplemental-claim/
  9. VA Claims Insider. (2023). “What is the SUCCESS RATE of VA Disability Appeals?” VA Claims Insider. https://vaclaimsinsider.com/va-disability-appeal-success-rates/
  10. CCK Law. (2023). “What is the VA Disability Appeals Success Rate for Veterans?” CCK Law. https://cck-law.com/blog/what-is-VA-disability-appeals-success-rate/

AUTHOR BOX: Jerome Spearman is a VA accredited claims agent and a legal nurse consultant specializing in orthopedic appeal representation for post 9-11 veterans. He believes that every post 9-11 veteran deserves a strategic advocate who turns VA denial confusion into clarity and earned benefits. Connect with Jerome on LinkedIn or by email at jerome@spearmanappeals.com for regular updates on VA policy changes and claim strategies.