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When the VA issues a rating decision you disagree with, the Appeals Modernization Act (AMA) gives you three distinct options for challenging that decision. One of those options is the Higher-Level Review, commonly referred to as HLR. Unlike a Supplemental Claim, which allows you to submit new and relevant evidence, or a Board of Veterans Appeals filing, which moves your case to a Veterans Law Judge, the HLR keeps your claim at the regional office level but assigns it to a more experienced reviewer. Understanding when HLR is the right tool, and when it is not, can make a significant difference in the outcome of your claim.
A Higher-Level Review is filed using VA Form 20-0996. You can submit this form online through VA.gov, by mail, or by fax. The form itself is relatively straightforward compared to an initial claim. You identify the decision you are contesting, list the specific issues you want reviewed, and indicate whether you would like an informal conference. There is no fee to file an HLR, and you do not need a representative to file one, though having an accredited representative can be helpful.
The most important rule to understand about HLR is the "no new evidence" restriction. When you file an HLR, the senior reviewer will only look at the evidence that was already in your file at the time of the original decision. You cannot submit new medical records, new nexus letters, new buddy statements, or any other documentation that was not part of the original record. This is the single most critical factor in deciding whether HLR is the right path for your situation. If your claim was denied because the evidence was insufficient, HLR is probably not your best option. If your claim was denied because the rater misinterpreted existing evidence or made a procedural error, HLR may be exactly what you need.
One exception to the "no new evidence" rule involves duty to assist errors. The VA has a legal obligation to assist veterans in developing their claims, which includes obtaining relevant federal records, scheduling necessary medical examinations, and providing adequate reasons for its decisions. If the original decision was made without the VA fulfilling these obligations, the HLR reviewer can identify the error and return the claim for correction. For example, if the VA failed to obtain your service treatment records, did not schedule a required C&P exam, or used an inadequate medical opinion, those are duty to assist errors that an HLR reviewer can flag.
The informal conference is one of the most valuable aspects of the HLR process. When you request an informal conference on VA Form 20-0996, a senior reviewer will call you (or your representative) to discuss the claim before making a decision. This is not a formal hearing with testimony under oath. It is a phone conversation, typically lasting 15 to 30 minutes, where you can highlight specific errors in the original decision and direct the reviewer to particular pieces of evidence in your file. Many veterans and representatives credit the informal conference with turning unfavorable decisions around, because it allows you to point out exactly where the original rater went wrong.
Timing is an important consideration with HLR. You have one year from the date of the decision you are contesting to file an HLR. If you miss that one-year window, you may still be able to file a Supplemental Claim with new evidence, but the HLR option will no longer be available for that specific decision. Once filed, the average processing time for an HLR is approximately 125 days, though this can vary significantly depending on the complexity of the case and the workload at the reviewing office. Some HLRs are completed in under 90 days, while others take longer than six months.
There are several common scenarios where HLR tends to be most effective. The first is when a rater applied the wrong diagnostic code to your condition, resulting in a lower rating than your symptoms warrant. The second is when a rater ignored or failed to address favorable evidence in your file, such as a positive nexus opinion or documented in-service treatment. The third is when the decision contains clear factual errors, like an incorrect date of service or a misstatement about your medical history. The fourth is when the rater did not properly consider the benefit of the doubt doctrine under 38 USC 5107(b), which requires the VA to resolve reasonable doubt in the veteran's favor.
It is worth understanding how HLR compares to your other options under the AMA. A Supplemental Claim (VA Form 20-0995) is best when you have new and relevant evidence to submit, such as a new medical opinion, updated treatment records, or a buddy statement that was not previously in the file. A Board appeal (VA Form 10182) is best when you want a Veterans Law Judge to review your case, particularly if you want to present testimony at a hearing or submit evidence directly to the Board. HLR occupies a specific middle ground: same evidence, different (more senior) reviewer, faster timeline than the Board.
When you file an HLR, three outcomes are possible. First, the senior reviewer can overturn the original decision and grant your claim or assign a higher rating. Second, the reviewer can identify an error (such as a duty to assist failure) and return the claim for a new decision, which may involve a new C&P exam or additional development. Third, the reviewer can confirm the original decision, leaving it unchanged. If the HLR results in a confirmation of the original denial, you still have options. You can file a Supplemental Claim with new evidence or appeal to the Board of Veterans Appeals.
A common mistake veterans make is filing an HLR when they actually need to submit new evidence. If your claim was denied because you lacked a nexus opinion connecting your condition to service, filing an HLR will not help because the senior reviewer will look at the same evidence and likely reach the same conclusion. In that scenario, obtaining a nexus letter and filing a Supplemental Claim would be the stronger strategy. Conversely, if you have a strong nexus opinion that the rater appeared to ignore, HLR allows the senior reviewer to address that oversight.
Another consideration is the "lane switching" flexibility built into the AMA system. If your HLR results in an unfavorable outcome, you are not locked out of other options. You can file a Supplemental Claim with new evidence after an HLR denial, or you can appeal to the Board. Similarly, if you file a Supplemental Claim and receive an unfavorable decision on that, you can then file an HLR on the Supplemental Claim decision. This flexibility means that choosing HLR does not close any doors; it simply represents one step in a potentially multi-step process.
Disclaimer: This article is for educational and informational purposes only. It does not constitute legal, medical, or VA claims advice. VA regulations, fee structures, and enforcement actions are subject to change. Always verify current requirements at VA.gov or consult with an accredited VSO, attorney, or claims agent before making decisions about your benefits.
Written by ClaimRecon Editorial