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Five Reasons to Appeal
1. You filed a claim for a disability benefit and were denied.
2. You filed a claim for a benefit and the rating is too low.
3. You've been denied a health care benefit, for example...prosthetics or dental services.
4. You have had a temporary rating and VA tells you that they are going to reduce that rating.
5. You've been notified that VA is proposing to appoint a fiduciary.
How to Appeal
1. You filed a claim for a disability benefit and were denied.
File a NOD
Use certified mail and send the form to:
Department of Veterans Affairs
Claims Intake Center
PO Box 5235
Janesville, WI 53547-5235
5. You've been notified that VA is proposing to appoint a fiduciary.
You have the right to appeal any benefits decision made by the Veterans Benefits Administration.
The VA appeals process is set in law and is different from other judicial appeals processes.
Have you already filed an appeal? When the Veterans Benefits Administration Regional Office receives your
Notice of Disagreement, you’ll be able to check the status of your appeal on Vets.gov.
How long does it take VA to make a decision? 12-18 months.
The Veterans Benefits Administration usually takes 12-18 months to review new appeals and decide whether to grant some or all of the appeal.
5-7 years When you request a review from a Veterans Law Judge at the Board of Veterans’ Appeals, it could take 5-7 years for you to get a decision.
3. You've been denied a health care benefit, for example...prosthetics or dental services.
You must appeal in writing to the director of your health care facility.
To appeal a denial of a health care benefit, you'll have to contact the director of your facility, usually at the VA hospital that is the hub for the facility that denied your benefit.
You must send the letter to the director at the VAMC address and you must use certified mail.
In your letter you should be as brief as you can when describing the problem you're having with your health care benefits.
Also send a copy via fax to:
Toll Free Fax: 844-822-5246
Once you've done that, talk with a veterans law attorney.
When you are denied a benefit, you have the right to retain a veterans law attorney at no out of pocket cost to yourself.
We urge you to talk to a lawyer as soon as you're able to.
Prostate Cancer Evaluations
Many veterans who are diagnosed with PC choose a new way to deal with it. Men are more and more often choosing "watchful waiting" or "active surveillance." Men who choose this option receive no treatment and their cancer remains active. Thus, they are entitled to the 100% temporary rating for the duration of their disease process.
Simple enough, right? But VA will still manage to screw this up. If during the follow-up exam (this may be a phone call exam) the examiner doesn't understand that your cancer is active, he may rate you as 0% disabled because you aren't having the typical post-procedure problems like frequent urination or erectile dysfunction. If you are taking any medicine for your benign prostate hypertrophy (BPH) the examiner may note that as prostate cancer treatment and VA will propose to reduce your 100% rating. Common medicines for BPH are tamsulosin (Flomax) or terazosin (Hytrin) dutasteride (Avodart) or finasteride (Proscar).
If you take any of the above medicines for BPH the VA is likely to try and reduce your 100% PC rating to 0%.
If you are a veteran who is service connected for prostate cancer and you have chosen watchful waiting and VA proposes to lower your rating, you must take action right now.
Nobody will help you with this, you must DIY.
VA usually encloses instructions of what to do if you disagree with their decision or proposal.
Carefully read any instructions. Read them again. You must notify VA in writing that you still have cancer.
You must notify VA in writing that they made the wrong decision. You should tell them that due to an inadequate examination, they are making a mistake attempting to lower your 100% rating.
Be brief, be courteous, stick to the facts in your letter. One single page is enough.
Use certified mail to send your letter to:
Department of Veterans Affairs
Claims Intake Center
PO Box 5235
Janesville, WI 53547-5235
Then fax a copy to:
Toll Free Fax: 844-822-5246
We've used prostate cancer as our example here but the above instructions apply to other conditions as well.
4. You have had a temporary rating and VA tells you that they are going to reduce that rating.
Prostate cancer is the most frequent rating VA tries to lower. Many, many VA ratings are assigned as temporary ratings during recuperation or are conditions that VA believes will improve with treatment over time.
The term "future exams are scheduled" is your signal that a benefit rating is temporary. The term "permanent & total" is the signal that the benefit is permanent although "permanent" may not mean what you think it does.
All cancer diagnoses are rated as temporary.
VA assumes you will get treatment and be cured. This is why there is a conflict when prostate cancer (PC) is service connected.
The prostate cancer rated veteran is usually a Vietnam vet who has a presumptive agent orange associated cancer. The usual course of the claim is that the RVN veteran gets a diagnosis of PC and then files a claim.
There is always a perfunctory C & P exam. The VA will respond with a temporary 100% service connected rating. The veterans file
will be flagged to schedule a future exam, usually 6 months or so after the assumed treatment. If the veteran chooses treatment such as surgery, radiation or chemotherapy, the C & P exam will determine the residual effects of treatment and the 100% temporary rating will usually adjust downward to reflect any disabilities caused by treatment of the service connected condition.
2. You filed a claim for a benefit and the rating is too low.
File a NOD
Use certified mail and send the form to:
Department of Veterans Affairs
Claims Intake Center
PO Box 5235
Janesville, WI 53547-5235
Also send a copy via fax to:
Toll Free Fax: 844-822-5246
If you have applied for a disability benefit and the benefit is awarded but the rating is too low, you're probably going to have to manage the appeal yourself. Since you weren't denied the benefit, a veterans law attorney won't be able to help in most cases.
You can manage your own appeal. File the NOD as above. As you fill in the NOD form, tell VA that you believe you should have a higher rating.
Explain why you believe your rating should be higher. Compare ratings at The Schedule For Rating Disabilities.
Use examples from The Schedule to support your appeal for a higher rating.
How To File An Appeal Of A Benefit Denial
Notice of Disagreement NOD
We urge vets to talk with an attorney.
It doesn't cost anything to discover your options.
VAWatchdog does not recommend that any veteran proceed beyond the DRO Process unless he/she is represented by a skilled attorney.
Appeals, indeed all claims, have become much more complex. This has opened a door to the VBA making more mistakes than ever before.
Along with all this is the fact that VBA has become more willing to fight appeals. Veterans need an advocate who is trained in law and skilled at the task.
The Court of Appeals for Veterans Claims (CAVC)
How To Appeal a Board of Veterans' Appeals Decision
You must have a final decision from the Board of Veterans' Appeals before appealing to this Court. (The VA Regional Office is not the Board of Veterans' Appeals.)
If you are not sure of the status of your claim at the VA or BVA, please call the BVA status line at 202-565-5436.
Required Steps for Filing an Appeal:
1. The appellant must file a written Notice of Appeal (NOA) that
includes all of the following information:
A. Current name
B. Current address
C. Current telephone number
D. Current e-mail address
E. VA claims file number
F. Date of Board decision being appealed
2. The Notice of Appeal (NOA) must be received not later than 120 days after the date
on which the Board mailed the notice of the decision to the last known address of the appellant.
Please Note: The date stamped on the front of the BVA's decision is the date it was mailed.
3. A $50 nonrefundable filing fee, paid by check or money order payable to the
"U.S. Court of Appeals for Veterans Claims," or a Declaration of Financial
Hardship must be received by the Court no later than
14 days after you send the Notice of Appeal (NOA).
4. File the Notice of Appeal (NOA) and filing fee or Declaration of Financial
Hardship with the Court by mail, fax, or e-mail to the following address:
Clerk of the Court
United States Court of Appeals for Veterans Claims
625 Indiana Ave. NW, Suite 900
Washington DC, 20004-2950
Fax: (202) 501-5848
E-mail: e-submission@uscourts.cavc.gov
E-mailed pleadings must be in separate PDF files.
5. Once the appeal has been docketed, the Clerk will send a Notice of Docketing
to all parties advising them of the date the Clerk received the Notice of Appeal (NOA).
The Clerk will also note what is next required of both the appellant and the Secretary.
The Board of Veterans Appeals (BVA)
The Board of Veterans' Appeals (also known as "BVA" or "the Board") is a part of the VA, located in Washington, D.C. Members of the Board review benefit claims determinations made by local VA offices and issue decision on appeals.
These Law Judges, attorneys experienced in veterans law and in reviewing benefit claims, are the only ones who can issue Board decisions.
Staff attorneys, also trained in veterans law, review the facts of each appeal and assist the Board members. {38 U.S.C. §§ 7103, 7104}
Anyone who is not satisfied with the results of a claim for veterans benefits (determined by a VA regional office, medical center, or other local VA office) should read the "How do I Appeal" pamphlet. It is intended to explain the steps involved in filing an appeal and to
serve as a reference for the terms and abbreviations used in the appeal process. Considering a BVA Hearing? Select a Video Hearing. Board of Veterans' Appeals Decisions Search To conduct a search of BVA's decisions, enter the word or group of words you are looking for in the fields below. From the resulting list, you can connect directly to individual decision texts or you can return to this page to conduct additional searches. Personally identifying information has been removed, so searching by the Veteran's name, C-File or
Social Security Number will not be effective. Decisions are loaded monthly, usually within 45 days after the end of
each month. VA Pamphlet 01-02-02A, April 2002 " How Do I Appeal " (PDF)
The Steps To An Appeal
* Veteran files a claim the usual way.
* The usual process occurs; This may take 12 to 24 months.
* The veteran receives the letter from VA that denies the benefit.
* The veteran then chooses how to appeal. There is a one year time limit.
* The veteran may then retain a lawyer, tell VA that a DRO Process
appeal is desired or the vet may seek a BVA hearing.
* If DRO Process is the chosen, the appeal is handled at the Regional Office.
* If BVA is desired, the claim will be "perfected" by the RO prior to being sent to BVA.
This may equal DRO Process.
* If BVA claim is denied, the veteran may proceed to the CAVC.
* VAWatchdog does not recommend reconsideration.
* VAWatchdog recommends that almost all appeals be handled by an expert attorney.
We believe that most applications for benefits will be wrongly denied or the rating will be too low.
It doesn't matter if the claim is well grounded or not. It is likely that your claim will require an appeal. VAWatchdog advises that veterans must expect that their benefit application will be denied and that the veteran should be prepared to appeal.
This is a routine and ordinary part of the process. Denial of the initial claim should not cause the veteran undue anxiety. Many, if not most, claims are won on appeal.
In every award (denial of award) letter there is information about why the veteran was denied. Now is the time to carefully read through that. You may want to read it a number of times. The information contained in the letter may be full of errors itself and it won't always be easy to understand.
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