As a Veteran, you deserve the best health care possible. But you may not always agree with decisions we make about your medical care or whether you are eligible for some types of care.
If you disagree with a decision we made, you can appeal it. Here’s how.
First, a word about where benefits come from within VA. The Veterans Benefits Administration (VBA) handles non-health benefits, including service-connected compensation, education, dependency and indemnity compensation, VA home loans and life insurance. The Veterans Health Administration (VHA) also has its own set of health benefits involving your health care and eligibility for certain health services.
To learn more about VBA benefits, please visit its website.
Two kinds of health care decisions, two kinds of appeals
In VA health care, you can appeal two kinds of decisions: medical determinations and health benefits decisions.
A medical determination is a decision made by your care team about your health care, like whether to prescribe a certain medication, treatment or physical therapy. It can also mean a decision to refer you to a community provider for care.
A health benefits decision is about whether or not you are eligible for VA health benefits, such as VA health care, VA nursing home and domiciliary care, reimbursement for non-VA emergency care and certain medical devices.
How to appeal a medical determination
You can appeal a medical determination by filing a Clinical Appeal, which allows other medical professionals to review your medical needs and decide whether the determination was correct.
To file a Clinical Appeal, contact the patient advocate at your VA medical facility and ask to initiate a Clinical Appeal.
Find your local patient advocate here.
How to appeal a health benefits decision
If you disagree with a health benefits decision, you can request one of three types of review:
- Higher-Level Review
- Supplemental Claim
- Appeal to the Board of Veterans’ Appeals
You can select the type of review you think is best for your case.
When and how to request a Higher-Level Review
If you believe our decision was wrong and you don’t have new evidence, a Higher-Level Review may be your best option. You can’t submit any new evidence, but instead a senior reviewer will look at your case again. This reviewer will evaluate the same evidence that was previously considered. You must file a request for Higher-Level Review within one year of the date of your decision.
You can also request an optional, one-time informal conference with a senior reviewer to discuss your case.
To request a Higher-Level Review, fill out VA Form 20-0996 and follow the submission instructions on your VHA decision notice letter.
When and how to file a Supplemental Claim
If you believe our decision was wrong and you have new and relevant evidence that VA hasn’t already considered, a Supplemental Claim may be your best choice. We can help you gather any new evidence you identify, such as medical records, to support your claim. A reviewer will decide if this new evidence changes the decision. You can generally file a Supplemental Claim at any time after the decision.
To file a Supplemental Claim, fill out VA Form 20-0995 and follow the submission instructions on your VHA decision notice letter.
When and how to appeal to the Board
If you want a Veterans Law Judge at the Board of Veterans’ Appeals (Board) to review your case, you may appeal the decision to the Board. You must file a Board appeal within one year of the date of your decision and you do not need to request Higher-Level Review or file a Supplemental Claim before appealing to the Board.
There are three types of Board review. When you fill out the form, you’ll need to request which type you want:
- Direct Review: If you don’t want to submit additional evidence or have a hearing
- Evidence Submission: If you want to submit additional evidence without a hearing
- Hearing with a Veterans Law Judge: If you want to have a hearing with a Veterans Law Judge with the option to submit new evidence
To appeal a decision to the Board, fill out VA Form 10182 and send it to the Board. The mailing address is in the form.
How to appeal a Caregiver Support Program decision
If you disagree with a decision about care or services under the VA Caregiver Support Program (CSP), you have four options. You can file a Clinical Appeal, or you can choose any of the three benefits decision appeals options. For more information, review your CSP decision letter or visit the CSP website.
How to find help with an appeal
If you need help filing a claim or appeal, you may want to work with an accredited attorney, a claims agent or a Veterans Service Officer (VSO). We trust these professionals because they’re trained and certified in the VA claims and appeals processes. They can help you with VA-related needs.
VSOs work on behalf of Veterans and service members, as well as their dependents and survivors. Find out more about professionals who can help you.
For more information
Visit the VHA appeals website for more information.
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Do not appeal.
Take a different approach. Failure to meet their fiduciary mandate is no trivial matter. Point out to the trier of facts that they have breached thier fiduciary duties.
Greetings. One of my neighbors is a veteran and he’s been battling cancer since last year. I like the idea that filing a supplemental claim may help veterans gain access to health benefits. Perhaps a management company can be employed to provide him with much-needed assistance.
Ive been trying to get help navigating thru the system, not savvy with this technology or educated enough to complete what i need to do .
I was told to apply for compensation by my local outpatient clinic. Had a hearing that resulted in my agent orange flag being turned on. Found this outside the VA compensation by a billing clerk, not by any compensation
people. Compensation department is America at its worst, corrupt, and the
people at the VA are heartless bastards. Deny, deny, and hope you die. That is their motto. Our government can give the Taliban 300 billion dollars worth of equipment, spend billions on 6 million illegal migrants, billions on Ukraine, etc. but can not give a highly decorated drafted vet any compensation without any reason, is a disgrace in my opinion.
Why don’t we Veterans have more support through our Law Firms & credited Attorneys? Loved, “Deney until we die”. I’ve been telling my Attorney that for 11 years. The system is for the VA health program. It’s not for the Veteran. They have people in these regional offices that have no idea what they are doing or have the knowledge of what they are doing. WHY don’t SOME OF YOU LARGE FIRMS GET TOGETHER & Annie up to fight this terrible, ridiculous, greedy, selfish, VA system & help us with our claims. I’d be willing to give some proceeds to help. I’m sure there is many Veterans that would do the same. We have to be concerned each day what is going to happen with our claims. I & many others have to wait years for claim settlements & appeals. I bet the boy’s on the HILL have NO LONG WAITING PERIODS for their health issues. I’d be ashamed. We’ve served our COUNTRY, told what to do & when to do it & we get a dysfunctional Health system from the VA for claims & appeals for the TIME WE SERVED TO PROTECT OUR COUNTRY. Many times I wanted to call the SUICIDE LINE. But they would probably tell me, Oh, Don’t worry Sir your claims will be settled after you pass.
I am a diable 70% vet. I use the VA hospital a lot. Do I have to let the VA hospital system have my other insurance information?
No entiendo como la Administración de Veteranos tiene una empleada tan irresponsable en la clinica de Cody, Wyoming. No me quiso atender ni diciéndole que era un paciente de cáncer y tenia un acceso en un testículo provocado por la medicación del cáncer del hospital de Orlando, FL . La perra me dijo que yo tenía que ir a Orlando que no podía hacer nada por mi.
I did everything except to remind the VHA/VA about what my Medicare doctors said. Oh wait, when I told the VHA/VA what my ENT said then the VHA/VA discontinued the Meclizine and changed the diagnosis but not to what my Medicare diagnosed.
This article is all well and good but NOT how the system really works. I followed this “system directed procedure” over a 10 month period on a simple rejection of Glucose test strips for daily testing as a VA Agent Orange Type II diabetic. I found the VA in every single case, every appeal whether in writing or by phone, the appeal and my justification was redirected back to the VERY same office, the VERY same person who had made the initial decision against me. I received phone calls from the VERY same office that were recorded and when I called the national office to check on my appeal number that recorded phone call was quoted back to me with another rejection. In the VA an appeal to a higher authority does not exist. Sorry, your information sounds great but it is not how the system really works. Vet are always left out. VA uses all congress allocated funds to support their own staff and operational cost and leave very little to actually reach the veteran who needs help. I know the facts and the facts are not there for the veteran. The odd thing, even an appeal to my Alabama Senator was referred by the national VA congressional contact back to the VERY SAME office in Birmingham that initially and always rejected by needs. The VA just supports its own organization. The Vet is a tool. I have to purchase my once daily test strips from a non-VA source or do without.
My husband was in the Air Force for over nine years. We were married for 50 years. I was told that because of that I am qualified for benefits. I need to know what I’m qualify for and how to get it started. Please please please contact me. Thank you and God bless every veteran.
Most States have Veteran Service Offices (they are not VA the are State to County Offices) The can assist veterans in emergency situations, possible help with utilities, groceries other possibilities, based upon income) they will in some areas provide to veterans free transportation to VA Facilities, They have in some offices multiple employees trained to file disability claims for vets and YOU as a surviving spouse. Brought to you by A NAM vet doing something the VA should be doing. I find it repulsive that a VA doctor can say your dieing of cancer but will bot say you should file a disabilty claim.
I am a 100% Service-Connected Viet-Nam Naval Combat Veteran. I have been going to Muskogee V. A. Hospital since the 1980s. Since Covid, and now Okmulgee, Oklahoma Hospital loss of medical personnel. When I go up for appointments Primary care, surgery, or ex-rays, or Emergency Room. they are all new, or no Medical Personal at all; this is the worst I have ever seen 40 years. You can guess that I am Over 70 years old. I live 100 miles from Muskogee, Ok. (I Must Drive My Self) due to the fact I Have No Family. It is the closest V.A Hospital for me. I cannot just drop-in at any time. It is Very Hard to Get a Reasonable time for medical appointment.
I was born with a Congenital Heart Defect (BICUSPID AORTIC VALVE -BAV). In 1979, I injured my left arm and emergency surgery at Fort Carson Army Hospital. This was after several weeks of PAIN MEDS and ANTIBIOTICS. The end result was that my left arm became paralyzed.
I was later discharged. I applied for and was originally disability but was declined. I resubmitted via my Congressman and later awarded PTD of 10% without a follow-up C&P examination or interview.
In 2015, the PFC Lindstrom Clinic was opened in Colorado Springs. It was at this time that I was diagnosed with my condition. On August 9, 2022 I underwent a routine annual echocardiogram and was advised that my condition had changed. Approximately, 24 hours later I was contacted by Cardiology Department in Aurora and advised I needed EMERGENCY SURGERY to replace my heart valve.
Given that my 10% disability rating did not include my heart I questioned why the VA wanted to perform the surgery. I was advised by the head cardiology team nurse that…”It’s already been approved. I just need you to say yes.”
On August 15 I went through the CATH LAB and on August 18, 2022 I had my surgery. I departed the hospital on August 23, 2022. My understanding is that a veteran may request a TEMPORARY RATING ADJUSTMENT to 100% for up to six months for heart valve replacements and bypass surgery.
This is to reimburse and provide compensation during the recovery period. I was prohibited from driving and working for one month, and underwent cardiac rehab for three (3) months. I applied for consideration.
At one time, my primary care doctor advised me that MY HEART was in my medical files and related to issues I was having with my arm. According to the physician at my C&P Exam on February 5, 2023 he indicated that I would not need to file any supplemental records as he could see my heart related issues from my file and that the VA WAS NOT DISPUTING MY CLAIM.
However, I received my REJECTION LETTER in April. The VA AUTHORIZED MY SURGERY, and has provided my medical care and ADMITS MY CONDITION. Yet, denies me ever the reimbursement or compensation for my recovery. They say I FAILED TO CONNECT how my heart and arm were related.
Seriously? Here are a few questions:
1) If my heart and arm aren’t related? Why did they authorize my surgery in the first place?
2) The VA ADMITS they were aware of my AORTIC VALVE CONDITION. How? No ECHO CARDIAGRAMS were ever administered to me from 1976 to 1979.
3) Over 70% of the people born with my condition live NORMAL LIVES WITHOUT MEDICAL INTERVENTION. Just months before my injury I received a Silver Medal for a 20k race during Iron Horse Week.
4) After my surgery, I began complaining of shortness of breath, heart palpitations, etc. Was I administered a FLUOROQURNALINE (like CIPRO) to combat my infection? If so, why wasn’t I a) tested before they administered the antibiotics, and b) advised of the side effects?
Recently, I learned that there are NUMEROUS ANTIBIOTICS that ARE NEVER TO BE ADMINISTERED to individuals with an BAV. For example, CIPRO is so TOXIC it causes heart palpitations after 30 days, and deformities to the AORTIC VALVE after 60 days. In a study, a total of 247% of the BAV PATIENTS who were administered CIPRO suffered ADVERSE SIDE EFFECTS…INCLUDING DEATH.
A review of 12 major Veteran Appeals Cases share the SAME RESULTS and DETERMINATIONS. ALL SERVICE MEMBERS were AWARDED COMPENSATION by the Court.
As my THORACIC SURGEON said to me, “We only see a patient with your condition once every 10-12 years. You did ALL THE RIGHT THINGS. You were an athlete, you use tobacco products or marijuana, and you don’t consume alcohol. That is what has kept you alive.”
That said, WHY DON’T I FEEL SPECIAL? If I maintained my healthy lifestyle and was NEVER INJURED, would I have been one of the 70%. I think so. Just because the ARMY discharged me without advising me of my situation in NO WAY ABSOLVES THEM OF THEIR RESPONSIBILITIES.
To that, I have requested copies of ALL RECORDS relative to my case to include all tests, medications, and notes. Houston, we have a problem.
I waited 5 months for a decision upon a Disability Claim. Ur was denied by the VA Six months of my life which now has a time limit upon it. Facts Va spend me to a contractor Veterans Evaluation Services that has a BBB rating of only 1 in the State of Texas! The NP that did my evaluation has for Medical Years of Experience: 0 that is a BIG FAT ZERO! They eliminate my Nexus that was my attending physician that saved my life last year at this time and also, they paid. MD. PHD neurologist, immunology, scientific researcher, assistant professor of Neurology of the Neurology Department Ohio State University! They not only trashed my Nexus letter but attacked it with a somewhat mysterious, partial reason that my military record showed no entries or treatments. How many Viet Nam Vets died of Agent Orange decades after separation? Was this intentional or just incompetence? We filed for review, they found a ERROR! What was the error? Now it appears as they want to start all over again ! Why not correct it and continue? My bill collectors don’t give a dang about the VA screw up it is the money they want ! Another 6 months for what the VA Slogan DENY UNTILL THEY DIE? VA is like asking your executioner for a cough drop while looking at the guillotine. Please send me death benefits at this rate! Oh they paid no attention to the fact they had denied another vet for the same AGENT ORANGE DISEASE that the veteran won in appeal in which they were given the case information of. In other words we don’t give a hoot
I read a different article that said that VA compensation is tax payer money which is not correct. The way the it works is the money is taken from me the retired veteran and given back to me tax free. If the truth is that then why is it stated differently on this website? Until you become unable to work and in a situation that you need the help from the government then they will not pay you anything. The hard part is the come up with a numbers that is crazy. They will take $80 more dollars from me and give it to me for being married? Who wrote this that if lose your wife that you have to pay $200 more in taxes every year? Seems the government should pay you more after lossing your wife to PTSD you suffered.
If I need to appeal a decision by prosthetics how do I handle this one? I’m have a 100% service connected rating and I’m a paraplegic so I rely upon prosthetics a great deal.
I’m a Widow of a Vietnam Veteran who Served in the Navy (1968 to 1972) & was Killed in August 1980 . Are there any Benefits for me because I’m His Widow ?
Something that needs to be addressed is how to get more help with getting copies of medical records for older veterans. I’m 74 and have requested my medical records for the years of 1975 thru 1978 with no results except entry medical exam and a hard to read DD214. I don’t know where to go for help. I’m sure I am not the only Vet to have this problem. Any advice will be appreciated ?
I started my claim approximately 10 years ago was denied because they said they couldn’t find the records to back up my claims. I then resubmitted, and I’ve been going through the process again for over three years. This time I’ve seen all the doctors have gone to all the test. I’ve had my CMP exam and they again said well we can’t make a decision because we can’t find your records was denied and then told well I had to go to one of the boards. After calling everybody and I mean everybody on a daily basis finally about a month ago received a letter through my congressman from homeland security as to why they can’t find the records. The Coast Guard has a strange way of keeping their records. They only keep them for three years, and then they physically destroy them! Needless to say, I was a little upset and frustrated by this news went back to calling everybody again and was told well I’ll just have to wait. It’ll proximately two years before I can have my hearing, which means it will have taken me all toll 15 years. But just yesterday I found out that there’s a provision that the VA has it in their bylaws or whatever you wanna call them that if military records are destroyed by the military I get to write a letter explaining what I did and what happened and what caused and what triggers, my PTSD . How come nobody knew about this or did anything about it or helped me for the past 15 years?! I did my time I did my time honorably not asking for anything that I haven’t earned and I don’t deserve I’m 66 years old, high blood pressure, diabetes, and I’ve had three strokes in the last couple years , there’s a better than 50-50 chance. I won’t last the two years that it takes. I keep writing letters to everybody just like here and nothing repeat again nothing gets done. They blame it on something else they pass the buck they tell me it’s my responsibility to come up with these records. It is not my responsibility. It never was my responsibility. And it’s absolutely insane. To think that I should have had control over these records that have been physically destroyed decades ago. How about somebody actually doing something instead of saying thanks for your service.
Very hard to prove my hearing was damaged because my job involved being very close to fighter aircraft!
Good evening, My name is Gaylia Clark Washington. My Father is Kevin J.Clark a 65yrs. old Army veteran. In August of 2021 he had a traumatic fall while doing Physical therapy at the VA clinic on Jefferson Street in Jacksonville,Florida. From the fall he sustained a massive rotator cuff tear in his right shoulder and a massive quad tear in his left knee. From the fall he also received a traumatic brain injury. He was diagnosed with a moderate to serve brain injury. He have had a procedure done on his right side neck. He also injured his right side hip which makes it difficult for him to walk. He is also very much depressed and a great deal of anxiety and anger. Along with that he is on several medications that the VA doctors have prescribed for him. He not sleeping and again very depressed. After the traumatic fall he didn’t receive any medical treatment until the next day. The physical therapist simply picked him up off of the floor and sent him home. I pray my dad won’t try to harm him self. I live in the state of South Carolina, but I call him everyday to make sure he is taking his medication and check on his well-being because sometimes he forgets to take his medication. I am worried sick about my Father. I have taken over all of his important matters. He has put in several claims but denied. The VA clinic should be held accountable for the accident. They yet to take responsibility. Will someone please help my Father. He now in a day treatment program Rehabilitation Center for traumatic brain injury( Brooks Rehabilitation Center). Thanks in advance.
If the VA is giving you the run around like they normally do to everyone reach out to your state senator and see if there’s any help or support they can give you.
Excellent Information