Overview of Claims Process and Appeal Process Claim s Process - Overview of receipt of a claim up to the completion of a Rating Decision and Notification of the VA s decision. Appeal Process - Overview of the appellate process from the receipt of a Notice of Disagreement up to the point the appeal is transferred from the local VA Regional Office to the Board of Veterans Appeals in Washington, DC. 1
Claim s Process Overview of receipt of a claim up to the completion of a Rating Decision and Notification of the VA s decision. Receipt of Veteran s claim which initiates Duty to Assist/ Development. Effective March 24, 2015, all claims have to be filed on a official VA Form, such as VA Form 21-526EZ. Veteran can file an intent to file VA Form 21-0966 putting the VA on notice that he/she is going to be filing a claim and they have one year to file a formal claim on a VA Form 21-526EZ. www.ebenefits.va.gov 2
Claims for reconsideration after issuance of a Rating Decision A Veteran can file a claim for reconsideration after completion of a Rating Decision and within the one year notification period. A Veteran files a claim for reconsideration after completion of a Rating Decision and within the one year notification period: If the veteran submits new evidence with his/her claim we will reconsider their decision. If the veteran submits additional evidence, but the evidence is duplicate evidence already considered And/Or submits no evidence with their claim, we will send him/her a letter informing them no further action will not be taken unless: ü ü ü New evidence related to the previously denied/decided issues is received. Notice of Disagreement is received. Identify a clear and unmistakable error in a prior VA decision. 3
Reopened claim(s) The one year appeal period has passed in regards to the Notification letter. Then the Veteran files a Reopened claim for the VA to render another decision on a specific issue(s). www.ebenefits.va.gov 4
Appeals Overview of the filing of the appellate process from the receipt of a Notice of Disagreement up to the point the appeal changes jurisdiction from the local VA Regional Office to the Board of Veterans Appeals in Washington, DC. 5
Notice of Disagreement (NOD) The appellate process begins with the filing of a NOD Effective 3-24-15, all NODs have to be filed on an official VA Form 21-0958. The VA will not accept a NOD via any other types of communication as in the past, such as a normal piece of paper from a notebook or a VA Form 21-4138. Appeal Process Request Letter, (60 day time limit) The Notice of Disagreement and appeal/case will be reviewed to determine if additional development is needed Appeal/case is ready for a decision 6
Example of a complete grant of benefits sought under appeal: The Veteran files a NOD with the denial of service connection for a chronic lumbar spine disability. Service connection is granted. 7
Example of a partial grant of benefits sought under appeal: If we grant an increased evaluation in a Veteran s lumbar spine disability from 10% to 20% this is considered a partial grant of benefits sought under appeal for this issue. 8
Timely VA Form 9, Substantive Appeal Automatic Waiver of Agency of Original Jurisdiction Review of New Evidence Board of Veterans Appeals Travel Board No Board of Veterans Appeals Travel Board requested 9