VA Form 20-0995
Decision Review Request: Supplemental Claim
Who fills it
veteran
Journey phase
Appeals
Estimated time
30-60 minutes plus time to gather the new evidence.
When to file
Within 1 year of the decision date for full effective-date protection. After 1 year, still allowed but effective date may be the supplemental-claim filing date.
You were denied or under-rated and now have NEW evidence (medical records, buddy statements, doctor opinion, DBQ) that wasn't in the file when VA decided.
Gather before you start
—The decision letter you are challenging (date, claim number, issue(s))
—NEW evidence not previously considered (the entire basis for this lane)
—For each issue: brief explanation of why the new evidence is relevant
—List of new evidence sources VA should obtain (private providers, federal records, etc.)
Attach with the form
—Copy of the decision letter being challenged
—New evidence (medical records, doctor opinions, DBQs, buddy statements, photos, journals)
—Updated VA Form 21-4142 + 21-4142a if you are pointing VA to new private providers
Section I - Veteran/Claimant Identification
Blocks 1-7Name, SSN, VA File Number, address, phone, emailPII
Match exactly to your VA records as they appear on every prior letter or DD-214 - any mismatch causes intake delays.
Example
(use legal name from DD-214)
Common mistakes
- Mismatched name/SSN - supplemental claim rejected at intake.
Section II - Decision Being Reviewed
Block 8Date of decision being reviewed
The date on the decision letter you received. This date starts the 1-year clock for effective-date protection.
Example
MM/DD/YYYY
Common mistakes
- Using the date you received the letter instead of the date on the letter - VA goes by the letter date.
- Filing past 1 year and not realizing effective date may shift forward - file before the anniversary if at all possible.
Authority
38 CFR 3.400 - Effective date rules including ITF protection of effective date.
38 USC 5110 - General effective-date rules and ITF protection.
Section III - Issues for Review
Block 9Specific issues you want reviewedRepeatable
List each issue separately with the condition name + decision (Denied / Under-rated at X%). For each, you'll attach NEW evidence in Section IV. Issues not listed here are NOT reviewed.
Example
e.g., 1. Lumbar DDD - DENIED 03/15/2025 - submitting new MRI showing nerve impingement 2. PTSD - rated 30%, requesting increase to 70% - submitting new private psych evaluation
Common mistakes
- Vague issue descriptions ("my back claim") - name the condition AND the decision (denied vs under-rated at X%).
- Forgetting to list an issue you want reviewed - VA only reviews what you list.
- Listing issues without new evidence - supplemental claim REQUIRES new evidence per 3.2501; without it the lane fails.
Authority
38 CFR 3.2501 - The AMA Supplemental Claim standard: VA readjudicates a decided claim when new and relevant evidence is submitted. Filing within 1 year of the decision preserves the effective date. "Relevant" = tends to prove or disprove a matter at issue - a lower bar than the legacy "new and material" standard at 3.156(a).
Section IV - New and Relevant Evidence
Block 10Description of new and relevant evidenceRepeatable
For each issue, identify the specific new evidence and explain why it's relevant. The "new and relevant" standard under 38 CFR 3.2501 is LOWER than the legacy "new and material" standard - evidence is "relevant" if it tends to prove or disprove a matter at issue. You don't need to prove the new evidence is decisive, just that it relates.
Example
e.g., 1. Lumbar DDD: New MRI 02/20/2026 showing L4-L5 disc herniation and S1 nerve root impingement (not in file at time of 03/15/2025 decision). Relevant because it documents progression of the in-service injury per Dr. Smith's 02/22/2026 nexus letter (also attached).
Common mistakes
- Submitting evidence already in file - not "new" so the supplemental claim lane fails. Use HLR (20-0996) instead.
- Failing to explain WHY new evidence is relevant - examiners need the connection spelled out.
- Submitting too much evidence not specifically tied to the issues - dilutes your strong evidence.
Authority
38 CFR 3.2501 - The AMA Supplemental Claim standard: VA readjudicates a decided claim when new and relevant evidence is submitted. Filing within 1 year of the decision preserves the effective date. "Relevant" = tends to prove or disprove a matter at issue - a lower bar than the legacy "new and material" standard at 3.156(a).
M21-1 VIII.iv.1 - Supplemental, HLR, and Board appeal lane mechanics.
Related ClaimRecon tools
Evidence Strength - Score your new evidence package before submitting.
Doctor Packet - Build a doctor packet that becomes new nexus evidence.
Section V - Evidence VA Should Obtain
Block 11Federal or non-federal records VA should obtainRepeatable
List records VA should request on your behalf (under the duty to assist). For non-federal (private) records, attach a new VA Form 21-4142 + 21-4142a authorization for each provider.
Example
e.g., Records from Dr. Jane Smith, MD - Smith Orthopedic, 123 Main St, Phoenix AZ - 02/01/2025 to present (21-4142 + 21-4142a attached)
Common mistakes
- Asking VA to obtain records but not attaching the 21-4142 release - HIPAA blocks the request without your signed authorization.
- Listing federal records VA already has (DD-214, prior C&P) - waste of time; VA already obtained.
Authority
38 CFR 3.159 - Duty to notify, duty to assist, evidence development.
38 USC 5103A - VA duty to obtain federal records, develop nexus exams.
Related ClaimRecon tools
VA Form 21-4142 - File 21-4142 + 21-4142a for each non-VA provider VA should request records from.
Section VI - Representative
Block 12Representative information (if any)
If you have a VSO, attorney, or agent, list them. If not yet appointed but you want one, file 21-22 (VSO) or 21-22a (attorney/agent) before this supplemental claim if possible.
Example
e.g., Disabled American Veterans (DAV) - 21-22 filed 01/15/2026
Common mistakes
- No representative on a complex supplemental claim - free VSO help is widely available.
Related ClaimRecon tools
VA Form 21-22 - Free VSO representation.
VA Form 21-22A - Attorney/agent representation (fees may apply for past-due benefits).
Section VII - Signature
Blocks 13-14Veteran signature and datePII
Sign and date. By signing you certify the statements are true to the best of your knowledge under penalty of perjury.
Example
(signature/date when filing)
Common mistakes
- Forgetting to sign - VA returns.
- Missing the 1-year anniversary - file before it expires for effective-date protection.
Statutory & regulatory authority
38 CFR 3.2501 - The AMA Supplemental Claim standard: VA readjudicates a decided claim when new and relevant evidence is submitted. Filing within 1 year of the decision preserves the effective date. "Relevant" = tends to prove or disprove a matter at issue - a lower bar than the legacy "new and material" standard at 3.156(a).
38 CFR 3.159 - Duty to notify, duty to assist, evidence development.
38 CFR 3.400 - Effective date rules including ITF protection of effective date.
38 USC 5103A - VA duty to obtain federal records, develop nexus exams.
38 USC 5104C - Supplemental claim statutory authority - new and relevant evidence.
38 USC 5110 - General effective-date rules and ITF protection.
M21-1 VIII.iv.1 - Supplemental, HLR, and Board appeal lane mechanics.
Horn v. Shinseki, 25 Vet. App. 231 - 38 CFR 3.156(c) - service department records require de novo review of claim.