What Is a Higher Level Review in VA Disability Claims?
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- čas přidán 9. 07. 2024
- 0:55 Three Appeals Lanes in AMA
1:23 Why Choose A Higher Level Review?
3:04 The Best Uses of HLRs
3:34 Errors in Effective Dates
6:43 Failure to Consider Evidence
7:41 Inadequate Reasons for the Decision
8:56 The Rating Doesn't Match the Evidence
10:41 What to Consider Before Filing an HLR
12:39 Why Veterans Seek Out Lawyers
Read more here: www.woodslawyers.com/what-is-...
Under the Veterans Appeals Improvement and Modernization Act (AMA), Congress created an intermediate level of review between the VA’s claims adjudicators and the Board of Veterans Appeals. These options were created to cut the time to receive an initial review to about four months. Higher Level Review is one of those options.
A Higher Level Review is a review by a senior claim adjudicator using the same record that the initial decision was based on. An HLR is used when the initial denial was mistaken, and no further relevant evidence is needed to correct the mistake.
Some examples of when to use an HLR:
*Effective date errors
*Not all the evidence was considered
*Insufficient reasons provided for decision
*Evidence doesn't match the rating criteria for the decision
Consider where your other claims stand before you file an HLR. We recommend seeking the advice of a VA disability attorney.
If you are unable to work due to your service-connected disabilities, you may qualify for total disability based on individual unemployability (TDIU) benefits. Contact us to see if you are eligible. Give us a call and receive a free legal consultation.
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I went through exactly the scenario you described. Got rate at 30% for mental health, submitted an HLR for increase in rating, which led to 70%, which triggered a Duty to Assist Error leading to TDIU. The rating increase only took two months to decide, the TDIU another six months. Worked with a great VSO.
We're so glad the HLR process worked for you! VSOs do great work for our vets.
Did you open a supplemental claim to save your effective date like he said you the clip? Or did you not ?
Unfortunately, my original MH claim was denied and more than a year passed from the denial before my supplemental. I filed my supplemental claim to re-open my MH claim. My 30% rating was from the supplemental.
This is my favorite episode of Hot Ones.
You aren't the first person to draw that comparison! Luckily, like the host of Hot Ones, Zack has a great sense of humor about it. 😉
The reason now for more BVA appeals are due to bad decisions by RVSR at the RO.
I watched your videos and the HLR for my migraines was the best route and i won it back in April 2023 now I am just waiting for them to change my migraines from 0% back to 50% and I filed the HLR in January 2023
Great information
Excellent explanation, Zack. Thank you. I am not quite at the forks in the "AMA" road, yet. C&P this Monday, then waiting, then responding to VA.
Best of luck!
Knee claim denied, with medical evidence, but stated I waited too long to apply. Went back to orthopedic doctor, completed a letter stating that "as likely as not to be associated with Army injury". Filed supplemental claim, denied again. Filed HLR and now I wait.
Best of luck! Feel free to reach out, if there's anything we can do to help.
Thanks for the Great information, i have to do a hlr soon, they low balled me with 30% for ptsd. They ignored my nexus letters, so im waiting on the decision letter to arrive. I also been trying since 1997 to get all my medical/personnel records but without any success.
That's so frustrating! I hope you get the decision you're seeking with the HLR. If not, there are other ways to appeal, either with a notice of disagreement or a supplemental claim.
This "stone walling" by VA (Viperous Aggravators) is so frustrating. My original Claim File was circa 2002-2004. They won't even acknowledge by FOIA request other than sending me a robo-letter this week saying their contractor delayed sending responses for the last many months.
@@donalddodson7365 Hello what stage are in right now? Are service connected now and how much?
@@sargentking2436 Amended PTSD Claim filed in April 2022 to fix the Denial of 2004. C&P with contract Ph.D. next week. Expecting another Denial or a Service Connection 0%. Then start through however it takes to get the right decision.
Very good overall presentation but would be better if acronyms are clearly stated & defined [ another Vet under comments also pointed this out ] .
Thank you for the suggestion! We will keep this is mind for future videos.
Zack, great information. I'm waiting on my individual unemployability higher level review decision at this moment, since Sep 2023. I was wondering, by chance, do the HLR raters look at recent claims to help them make a decision?
Great question! When a veteran requests a higher-level review, a senior claim adjudicator at a VA regional office reviews the same evidence presented in the initial claim and issues its own decision. Common examples of why a veteran would seek a higher-level review include: the wrong effective date, failure to consider evidence, or the veteran has no new evidence.
My Dad was denied for two PACT act presumptive conditions. They agreed he had them, agreed he was in VN but said the conditions weren’t service connected. We weren’t sure whether to go with an HLR or Supplemental Claim. We did have new Drs notes. The VSO offered almost no advice (which was weird) and left the decision up to me. We went with adding the supplemental info. Hope we made the right choice. It all seems like such a waste of time and money for the VA having to review all of this. How could they get something so simple wrong?
It's hard to answer this question without knowing the specifics of your claim. We'd be happy to discuss it with you and your father to see if we can help. We're at 800-544-2108, or you can request a free consultation at: www.woodslawyers.com/contact/?.com&EvansHLR
When we finally got mine to the judge she reviewed everything and she basically scolded the Raiders I am a combat Infantry squad leader with a Valor award I have every problem there is with jungle rats my reading is 70%
Dad finally got 100%. It took two appeals each with supplementary info. About 9 months total. The last C&P examiner was shocked that things went this far and said don’t worry you’ll get 100%.
Been waiting 7 months for a decision on my higher level review and still no response. The attorney said my document review didn't go well. I provided a clear and unmistakable Nexus and I'm worried I might not get anything for developing Schizoaffective disorder. It's pretty disgusting.
I'm trying to appeal a decision due to effective dates discrepancies. Would HLR send me to another C&P and risk my recently granted 100%? I mean, based on the records, RO already made that decision to rate me a 100. Can they even changed that prior grant on appeal?
It's hard to answer your question without knowing more about your claim. We would be happy to discuss this with you to see if we can help. You can reach us at 800-544-2108, or you can request a free consultation here: www.woodslawyers.com/contact?.com&CommentShare
I have an HLR coming up this week. I was denied 100% for symptoms that they said I didnt have listed in my C&P exam, but my nexus letter has these symptoms listed and was submitted evidence. Since its obvious they glossed over my nexus letter without reading it, during our informal confrence call would it be enough for me to just reference my nexus letter?
If the VA ignored evidence you submitted with your original claim, this is a situation in which requesting an HLR could be helpful. There is a section of the HLR form (VA Form 20-0996) that asks you to specify the issue and decision date you would like reviewed. As long as the issue your nexus letter addresses was included on your HLR form, the VA should review that evidence as a matter of course. You can certainly discuss evidence in your informal conference.
@@woodslawyers How about this? They completed my HLR. The VA wont email me the results and that I have to wait 10 days for my decision letter to arrive. However, Im under the impression they AGAIN ignored my nexus letter, including AFTER I referenced the appropriate CFR citing to reference all documented evidence and in favor to recipient in lieu of reasonable doubt. What comes next? Do I absolutely have to get a hold of my congressman?
We filed a unemployability case but denied. He has rating 70 percent ptsd 10 each knee 10 for ears so total 80 percent payout. We requested higher level review are they likely to see it our way.
Each veteran's case is different, so it is hard to determine the outcome of a higher level review. However, there are advantages to requesting a higher level review: faster review time, faster appeals, and some positive outcomes. There are no disadvantages to filing for a higher level review because the adjudicator will either reverse the original decision or let the original decision stand. If the higher level review does not result in a reversal, you can seek its correction through a supplemental claim with new evidence or an appeal to the Board of Veterans Appeals.
I put mine in January, my claim says VA is correcting an error "2 compensation issues" any advice on what happens next?
According to the VA, their goal is to complete a Higher Level Review claim within 125 days. If you request an informal conference as part of your HLR claim, it may take the VA longer to complete.
This means, they are going to correct their 2 erras. They may take it back to a supplemental claim, or leave it at hlr. Either way, nothing to worry about. That's on them, not you.
I developed schizoaffective disorder during training and I lied to my doctor about receiving adequate care when I was actually suicidal. I received a general discharge for missing a morning formation due to insomnia. I went 14 years in extreme poverty and nearly starved to death, lost 50 jobs and can't take care of myself. But because an examiner lied and wrongfully said I had schizoaffective disorder before I entered service, I've been fighting with the VA for 17 months. My HLR has been stagnant for 4 months since they failed to develop for federal files that I already provided with my initial claim. It's getting really tough to think about this every day and wonder what they're going to say next. My rating is still 0% and people are claiming to get decisions in 2-4 months for migraines and PTSD. I honest to god, don't know how this hospital prioritizes treatment but I'm probably going postal before I get helped. To think they could ignore nexus letters, advocates and psychologists makes me think there's no limit to the unfairness they're capable of.
I'm so sorry to hear that. If you would like to discuss your claim with us to see if we can help, you can call us at 800-544-2108, or you can request a free consultation at this link: www.woodslawyers.com/contact/?.com&CommentShare
@@woodslawyers I already have one of your representatives appointed as POA. They're just taking forever.
Thought this was a hot ones episode.
We get this comment more often than not!😂
Thanks..the back log will get longer....the covid19 excuse is used for not having the manpower to do the job..
Yes I love the VA blaming covid on the backlog. There was a backlog BEFORE covid too!
@TomMarineVet, in addition to the Covid 19 excuse they probably will start claiming the shortage of red ink for their DENIED rubber stamps is because of the Russian invasion of Ukraine and the shipping container crisis (where all the red ink is stuck of the Ports of Los Angeles and Long Beach, CA) ... ha, ha.
@@donalddodson7365 the bullshit never stops
Exactly!!!
There is no backlog HLR informal conference schedule the day I called 4 hours later all done. Shipmate git er done
Best do on your own in my opinion HLR informal conference big time raters DRO these katz want to talk direct vet no blokes taggin along actin afool. These guys will fix ur claim tell them the skinny in plain language once they hear it from ur mouth what the skinney is the sky s the limit the VA will take kare of u shipmate
Way to many acronyms. Most of us aren’t familiar with the letters. Don’t say HLR, say High level review. Same with all the others letters.
Thank you for the feedback. We will keep your suggestion in mind for future videos.