Last Updated on 12 September, 2025
Veterans, their families, and advocates often find navigating the intricacies of the Department of Veterans Affairs (VA) benefits system a daunting task. Today, we embark on a detailed exploration of one critical aspect – VA Higher Level Reviews (HLR). Joining us is Garen Cone, a distinguished Air Force veteran, accredited claims agent, and passionate legal advocate for veterans. He offers invaluable guidance on understanding the HLR process and maximizing its potential to correct errors and secure favorable outcomes for veterans. Together, we aim to unravel the complexities of HLR and empower veterans to understand their options in the appeals process.
Table of Contents
Garen Cone and AVET Appeals: A Legacy of Advocacy
Garen Cone’s journey into advocacy stems from personal experiences as an Air Force veteran injured during the Grenada conflict. With over three decades of dedication, he has become an accredited claims agent and founded AVET Appeals. This organization plays a pivotal role in assisting individuals who have faced denials in their claims and seek redress.
The Evolution with Appeals Modernization Act (AMA)
To comprehend the significance of VA Higher Level Reviews, we must first understand the context within the Appeals Modernization Act (AMA). Introduced to address the shortcomings of the Legacy process, which applied to appeals before February 2019, the AMA ushered in a new era with three distinct lanes for veterans to pursue. This streamlined process with three decision review options provides faster resolutions and clearer communication.
- Higher-Level Review: A senior claims adjudicator conducts a de novo (new) review of the decision without the submission of new evidence. This option can overturn decisions due to a clear and unmistakable error or a difference of opinion. Veterans may also request an informal conference to discuss legal or factual errors.
- Supplemental Claim: Veterans can submit new and relevant evidence to support their claim, with VA assistance in developing the evidence.
- Appeal to the Board of Veterans’ Appeals: Veterans can opt for direct review, submit additional evidence, or request a hearing with a Veterans Law Judge.
The AMA aims to give veterans more control and faster outcomes, offering flexibility and a clear framework while ensuring the earliest possible effective date for their benefits.
Understanding VA Higher-Level Reviews (HLR)
A VA Higher-Level Review (HLR) is a “de novo” (new) review of a veteran’s disability compensation claim conducted by a more experienced VA claims adjudicator when they are unsatisfied with the original decision. This review process focuses on the original evidence, with no new submissions allowed, and re-evaluates the claim for potential errors or oversights.
The HLR process exists to identify:
- Clear and unmistakable errors (CUE)
- Legal or procedural misapplications
- Misinterpretations of submitted evidence
- A difference of opinion in evaluating medical records or the law
This is often the first formal appeal option veterans select when challenging a denied VA benefit claim or low disability rating. Unlike supplemental claims, which involve new evidence, an HLR strictly reviews an initial decision for accuracy and fairness.
How Higher-Level Review Differs from Traditional Appeals
The Higher-Level Review differs from traditional appeals in a few key ways:
- No New Evidence: HLR is based solely on the evidence submitted during the initial claim. This makes it a faster option compared to appeals that may require gathering additional documentation.
- Faster Decision Timeline: Intending to resolve cases within 125 days, HLR provides a quicker resolution than standard appeals.
- Informal Conference Option: Veterans can request an informal meeting with the senior reviewer to discuss potential errors in the original decision.
Best Times to Request a Higher-Level Review
Veterans should consider requesting a Higher-Level Review (HLR) when:
- They suspect the Department of Veterans Affairs (VA) made a legal, factual, or administrative error in the initial decision (e.g., incorrect disability ratings or missed evidence)
- No new evidence is necessary to support their claim
- The initial decision failed to consider existing evidence properly
- The VA failed in its duty to assist (e.g., failing to order a required medical examination or gather relevant records)
Veterans should also understand that a higher-level review cannot:
- Be filed after another HLR or a Board of Veterans’ Appeals decision on the same issue
- Include new evidence
- Be used for contested claims (e.g., disputes over divorce-related benefits)
However, if new information is available, a Supplemental Claim may be a better option. Understanding when and how to use the VA Higher-Level Review can help veterans navigate the appeals process effectively.
Advantages of VA Higher-Level Reviews
Opting for a VA Higher-Level Review (HLR) provides several key benefits for veterans appealing a disability claim decision.
- Faster Processing Time: A VA Higher-Level Review (HLR) typically offers a quicker resolution in around 125 days, making it one of the fastest appeal options.
- Straightforward Process: The HLR process is straightforward as it focuses on the review of existing evidence, eliminating the need for veterans to submit new documentation.
- Experienced Reviewers: Senior VA adjudicators handle HLRs which increases the likelihood of identifying errors or oversights made in the initial decision.
- Error Correction without New Evidence: Veterans can use HLR to address mistakes in their original claim without needing to introduce new evidence. This is particularly useful if they believe the denial or lower rating was due to an error in the initial evaluation.
These streamlined processes, combined with quicker decisions, make HLR an appealing choice for veterans seeking swift resolution of their VA claim appeals.
VA Higher-Level Review (HLR) Process
The VA Higher-Level Review (HLR) process offers veterans the opportunity to request a fresh review of their disability claims. This review is conducted by a senior adjudicator who focuses on the original evidence, aiming to identify any errors in the initial decision. Below is a step-by-step guide on what to expect when filing for an HLR, including the filing process, decision review, and optional informal conference.
Step 1: Filing for a VA Higher-Level Review
To begin the HLR process, veterans and/or their advocates must submit VA Form 20-0996 within one year of receiving the original decision letter. You can file the form online at VA.gov, by mail, or in person at a local VA Regional Office. Using the correct form for your benefit type is crucial under the Appeals Modernization Act (AMA), as failing to do so can result in the VA returning your claim.
During the HLR submission, veterans should ensure the forms are completed correctly, clearly identify any errors in the original decision, and request reconsideration for a detailed re-evaluation. It’s important to note that no new evidence can be submitted during the HLR, as the review will focus solely on the evidence presented in the original claim.
Step 2: Informal Conference (Optional)
Veterans have the option to request an informal conference as part of the HLR process. This telephonic call or video conferences allow you or your representative to discuss the case directly with the senior rating veteran service representative, helping clarify points of disagreement.
You can request it directly on VA Form 20-0996 by checking the box labeled “I would like an optional informal conference.” If requested, the VA will schedule the call early in the review process.
Keep in mind that the VA will only make two attempts to schedule this call, so timely participation is crucial. This personalized approach facilitates direct communication and a better understanding of the nuances involved.
To prepare, organize your evidence packet, outline the errors you’re contesting, and review your decision letter in detail. A sample 10-minute agenda might be:
- Minute 1–2: Introduce yourself and confirm the claim issues.
- Minute 3–5: Clearly explain the specific legal or factual errors.
- Minute 6–8: Reference key documents or diagnostic codes.
- Minute 9–10: Ask clarifying questions and summarize your requested correction.
The VA will review whether it made a duty-to-assist error in the prior decision, returning the claim for further development if necessary. Furthermore, it will notify the claimant if any new, unconsidered evidence is submitted, as it cannot be reviewed during the Higher-Level Review.
Step 3: Decision Review and Timeline
Once the review begins, a senior adjudicator, who was not involved in the original decision, will re-examine your case file. The process is known as a de novo review, meaning the reviewer will analyze all the evidence independently without considering previous conclusions. While the VA aims to complete reviews within 125 days, actual timelines may vary depending on the complexity of the case.
Step 4: Decision Notification
Upon HLR completion, you’ll receive a decision letter posted to your VA.gov account, outlining the results. If errors are identified, your claim could be adjusted, and benefits updated accordingly. If veterans disagree with a VA decision, they can file a Supplemental Claim or appeal to the Board of Veterans’ Appeals.
Read more about Higher-Level Reviews on the official VA website for Decision Reviews to get the most current instructions.
How to Complete VA Form 20-0996
VA Form 20-0996 is the official request form for a VA Higher-Level Review (HLR) that must be filed within one year of your decision letter. You can download it directly from the VA’s official website or access the PDF here. Below is a quick breakdown of all sections for veterans to understand:
- Section I – Veteran Information: Enter your name, SSN or VA file number, date of birth, and contact details. Make sure these match VA records to avoid delays.
- Section II – Benefit Type: Choose the type of benefit you’re appealing (Compensation, Pension, Education, Health, Loan Guaranty, etc.).
- Section III – Issue(s) to be Reviewed: List the specific decision issues or conditions you disagree with, exactly as they appear in your decision letter.
- Section IV – Informal Conference Request: Check this box if you want an informal conference with a higher-level reviewer. Provide the phone number and best times for VA to call.
- Section V – Authorized Representative Signature: If you have a Veterans Service Organization (VSO) or accredited agent, include their signature and details so the VA can coordinate directly.
- Section VI – Certification and Signature: Sign and date to complete.
A well-submitted VA Form 20-0996 ensures your HLR is processed without returns or delays, preserves your effective date, and indicates to VA exactly what issues you want reconsidered.
How to Navigate a VA Higher-Level Review Outcome
Veterans pursuing a VA higher-level review (HLR) should understand the three most common outcomes and how to respond strategically.
Grant of Benefits
You will receive a new rating decision letter, updated effective date, and, if applicable, retroactive back pay. Many VA higher-level review success stories show favorable findings when nexus letters clearly link conditions to service.
Next Steps – Review the new rating decision letter and verify any retroactive pay. Track how long a VA higher-level review takes to ensure timely payment.
Duty-to-Assist Error
If the VA determines it failed to fulfill its duty to assist, the higher-level reviewer may return the claim for further development or schedule a new C&P exam. This extends the higher-level review timeline but is not a denial.
Next Steps – Fully cooperate with any VA requests for records or examinations. Understand the timeframe for the higher-level review process correcting any errors.
Denial (No Change)
The original decision is upheld. Veterans may still pursue a supplemental claim or appeal VA compensation decisions to the Board of Veterans’ Appeals.
Next Steps – After a denial, file a supplemental claim with new evidence, consider a Board appeal, or request a VA higher-level review phone call or informal conference to discuss discrepancies.
Leah Bucholz and her team emphasize using regulation-based nexus letters and detailed medical evidence to strengthen appeals. Veterans who understand the VA higher-level review process and act promptly after an unfavorable decision significantly improve their success rates.
Expert Tips for a Successful VA Higher-Level Review
The VA Higher-Level Review (HLR) is a valuable option for veterans who believe errors were made in their initial disability claim decision. It allows a more experienced higher-level reviewer to reassess the claim based on the same evidence, without introducing new documentation. To maximize your success rate, Garren Cone offers essential tips to guide you through the process.
- Identify the Purpose of Higher-Level Reviews: The HLR is designed to correct errors in the original decision based on existing evidence. If new evidence is needed, a Supplemental Claim may be a more appropriate option.
- Examine the Initial Decision: Analyze your VA decision letter closely to identify where the VA may have misapplied the law or overlooked evidence. For instance, if your medical records suggest a higher disability rating, make sure to highlight these discrepancies.
- Craft a Detailed Written Statement: If you are not requesting an informal conference, submit a clear, well-organized written statement outlining specific errors and your disagreements with the VA’s decision.
- Explain Your Disagreements in Detail: Provide a detailed explanation of exactly which parts of the decision are incorrect and why, helping the higher-level reviewer focus on the critical errors.
- Keep Your Documentation Organized: Although no new evidence is allowed, organizing your current documents can streamline the review process and aid in clear communication during the review.
- Stay Updated and Record Everything: Keep track of your higher-level review status at VA.gov or call 800-827-100, and maintain records of all communication with the VA to avoid unnecessary delays.
How Long Does a VA Higher-Level Review Take?
A VA Higher-Level Review (HLR) offers veterans a faster alternative to traditional appeals. The Department of Veterans Affairs officially aims to complete HLRs within 125 days (about four to five months). However, real-world timelines often run longer due to workload, claim complexity, and requests for informal conferences.
Factors Influencing the Higher-Level Review Timeline:
- Official Goal: 125 days for a decision
- Average Processing Time: 6–8 months
- Informal Conferences: May add 2–3 months to the process
- Complex Claims or Backlogs: Can extend the wait beyond eight months
Despite these delays, VA Higher-Level Review timelines are still much faster than Board Appeals, which often take two to three years to resolve.
What Veterans Should Expect:
Realistically, most veterans should plan for a 180–240 day window for their HLR decision. Cases involving duty-to-assist errors, staffing shortages, or complex evidence may take even longer. Understanding how long do Higher-Level Reviews take helps veterans set realistic expectations and better prepare their documentation for a smoother review process.
Note: If your case goes well past the estimated timeline, contact your accredited representative or the VA directly to verify whether additional development was ordered.
VA Higher-Level Review Success Stories
VA Higher-Level Reviews provide veterans a faster path to correcting errors in their disability decisions. By understanding the key success factors, veterans can increase their chances of favorable outcomes.
Success Story 1: Air Force Veteran Wins Tinnitus Claim
Air Force veteran Daniel filed a VA Higher-Level Review after his tinnitus claim was denied despite years of base maintenance work near loud engines. The higher-level reviewer spotted that VA misclassified his MOS exposure and failed to apply the correct noise-hazard profile. Though Daniel initially worried about risking changes to his benefits, the review instead granted 10% service connection in four months, showing how VA higher-level review correcting errors can change outcomes without new evidence.
Success Story 2: VA Knee Rating Boosted for Army Medic
Army medic Lisa appealed her 20% VA rating for severe post-traumatic knee instability through a VA Higher-Level Review. She discovered the VA had mistakenly rated her under Diagnostic Code 5260 for limitation of flexion rather than 5257 for recurrent subluxation/instability, which better matched her condition after multiple ligament tears. In her informal conference, she highlighted medical notes showing frequent knee giving-way episodes and brace use. The higher-level reviewer agreed and corrected the code, raising her rating to 40% plus back pay.
Success Story 3: Navy Corpsman Gains Migraine Increase
Navy corpsman Andre received only 30% for chronic migraines despite multiple ER visits. He used VA Form 20-0996 to request a VA higher-level review, citing overlooked neurology records. Though the reviewer initially upheld the rating, Andre persisted and scheduled a VA higher-level review phone call to clarify evidence. Two months later, the reviewer reversed course, awarding 50% and significant back pay. Andre’s experience shows how higher-level reviewers can recognize clear errors when veterans actively engage in the process.
These higher-level review success stories show how persistence, clear error identification, and patience can lead to fairer decisions for veterans navigating the VA system.
Garen Cone’s Insights on VA Higher Level Reviews
Garen Cone, drawing from his extensive experience, emphasizes the significance of understanding these processes. He highlights the indispensable role of organizations like Prestige Veteran, specializing in independent medical opinion and AVET, in guiding veterans through the complex landscape of benefits. These organizations offer personalized support, helping veterans understand their rights, gather essential documents, and ensure the proper filing of appeals, including the correct use of VA Form 20-0996.
Cone also emphasizes the importance of filing HLR requests with precision, as errors or omissions can lead to delays or denials. He advises veterans to review their initial decision letters carefully, looking for any misinterpretation of facts or law and ensuring that all relevant documentation is organized before submission.
Disclaimer: This information is for educational purposes only and does not constitute legal advice. We are not a law firm or accredited claims agent. Veterans should consult a qualified representative for personalized guidance on their VA claims.
Conclusion
In conclusion, Garen notes that VA Higher Level Reviews represent a valuable option for veterans seeking redress after facing a denial. This avenue allows for a reevaluation of cases based on identified errors in fact or law. Garen Cone’s insights underscore the importance of comprehending these processes, emphasizing the collaborative role of organizations committed to guiding veterans through the intricate web of benefits.
Knowledge is a powerful tool, and sharing information is pivotal in supporting veterans on their journey to justice. Stay engaged, stay informed, and together, let’s ensure our veterans receive the benefits they rightfully deserve.
FAQs
Can a VA higher-level review lower my rating?
A VA Higher-Level Review will not lower your rating unless a clear and unmistakable error (CUE) is found, but technically, it can if unfavorable errors are discovered.
How long does a higher-level review take with VA?
The VA aims to complete Higher-Level Reviews within 125 days (4 to 5 months), though this timeline may vary for many depending on complexity and workload.
What is the HLR timeline for 2025?
Veterans should expect most Higher-Level Reviews in 2025 to take about 125 days, with informal conferences or complex cases potentially extending the timeline.
What is the Higher-level review success rate?
Success rates vary, but veterans improve their chances by identifying specific legal or factual errors and submitting a clear, well-organized request.
When to use VA Form 20-0996?
Veterans can use VA Form 20-0996 within one year of a VA decision to request a Higher-Level Review of their claim without submitting new evidence.
What does it mean when the VA says they are correcting an error?
It means the VA has identified a duty-to-assist or clear error in the original decision and is taking steps to fix it, often by reopening or remanding the decision.
What is a duty to assist error on a higher-level review?
A duty-to-assist error occurs when the VA fails to meet its obligation to help develop evidence for the veteran’s case, such as missing records or medical exams, prompting the higher-level reviewer to return the case for correction.
What is the VA rating scale?
The VA assigns disability ratings in 10% increments from 0% to 100%, reflecting the severity of a veteran’s service-connected condition and determining monthly compensation.
What is the VA Step 7 final review?
The VA Step 7 final review is the stage where a senior adjudicator issues the final Higher-Level Review decision letter and updates benefits accordingly.
Also read: VA Appeals to the Board (BVA) Explained by an Accredited Claims Agent
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
