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VA Higher Level Reviews Explained by an Accredited Claims Agent

VA Higher Level Reviews

Veterans, their families, and advocates often find navigating the intricacies of the 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 a passionate legal advocate for veterans. Together, we aim to unravel the complexities of HLR and empower veterans to understand their options in the appeals process.

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.

While the Legacy process faced challenges, including timeliness issues, the AMA aimed to streamline the appeals process, providing veterans with more options and a clearer framework.

In-Depth Exploration of VA Higher Level Reviews (HLR)

1. Identifying Errors in Fact or Law

The journey into the Higher Level Review (HLR) process commences when a veteran receives a denial from the VA. In such cases, veterans believe there was an error in fact or law within the decision. This could encompass misinterpretations, misapplications, or even a failure to apply relevant laws to their specific case.

2. The Significance of Correct Forms

Under the AMA, Garen notes that adherence to using correct forms is paramount. Departing from the informal nature of the past, where claims could be submitted on a variety of platforms, today’s system demands precision. Failure to use the designated forms might result in the VA returning the submission, underscoring the necessity for standardization.

3. Navigating the HLR Submission

Garen further details that opting for the HLR avenue involves veterans sending their case back to the VA for reconsideration. This process includes completing the appropriate form, clearly outlining the identified errors, and affording the VA the opportunity to rectify them. The HLR submission becomes a critical juncture for veterans seeking a fresh evaluation of their case.

4. Exploring Informal Conferences

A distinctive feature of HLR is the provision for informal conferences. While no additional evidence can be introduced during this phase, veterans can engage in telephonic or video conferences with the senior rating veteran service representative overseeing their case. This personalized approach facilitates direct communication and a better understanding of the nuances involved.

5. The Limitations on Additional Evidence

Crucially, the HLR process focuses on reevaluating existing evidence and arguments, with no provision for introducing new evidence. It serves as a pathway for veterans who believe their case merits another review based solely on the information previously submitted.

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 and AVET in guiding veterans through the complex landscape of benefits.

Beyond HLR: Unpacking the FAQ Sheet

While we’ve delved into the intricacies of VA Higher Level Reviews, Leah Bucholz and Garen Cone’s discovered FAQ sheet serves as a treasure trove of additional insights. As veterans navigate the appeals process, this comprehensive resource provides clarity on the nuances and intricacies of the AMA.

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.

Also read: Bruxism and PTSD in Veterans Disability

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.

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Danielle McClaskey

Client Relations Specialist U.S. Navy Veteran

In her active-duty service in the United States Navy, Danielle undertook a variety of responsibilities, ranging from essential administrative duties to providing crucial medical care. Her multifaceted contributions played a pivotal role in enhancing her fellow service members’ operational effectiveness and well-being.

As a disabled veteran, she developed a profound understanding of the unique challenges faced by her fellow service members. Now, in her civilian role, Danielle is a valued member of the Prestige Veteran Medical Consulting team, where she continues to leverage her extensive background and educational achievements to provide exceptional support to veterans.

Leticia

LETICIA

ADMINISTRATIVE ASSISTANT

Leticia has been in the medical field for nearly 14 years. She has always had a passion for medicine and caring for her community. Leticia has spent the last 4 years caring for veterans and first responders with alcohol and substance abuse in a medical rehabilitation setting whilst continuing her education working towards a degree in software development.

Someday she hopes to develop medical software that further enhances the patient’s experience in medical care. Leticia has a deep respect and love for those who have served as she comes from a family of law enforcement and military veterans.

Alan Bucholz

ALAN BUCHOLZ, PA-C:

U.S ARMY VETERAN, CHIEF FINANCIAL OFFICER

Alan enlisted in the US Army as a combat medic, where he deployed in support of Operation Iraqi Freedom.
Influenced by his time as a combat medic, he attended the Interservice Physician Assistant program while on
active duty, was commissioned as an officer, and subsequently deployed to Afghanistan.  

Alan’s military and medical background inspired him to form Prestige Veteran Medical Consulting with his
wife, Leah Bucholz, a Physician Assistant and Army Combat Veteran.  He has devoted himself to using his
knowledge gained in the military as a medical professional to serve the Veteran community.

Alan Bucholz

ALAN BUCHOLZ, PA-C:

U.S ARMY VETERAN, CHIEF FINANCIAL OFFICER

Alan enlisted in the US Army as a combat medic, where he deployed in support of Operation Iraqi Freedom.
Influenced by his time as a combat medic, he attended the Interservice Physician Assistant program while on
active duty, was commissioned as an officer, and subsequently deployed to Afghanistan.  

Alan’s military and medical background inspired him to form Prestige Veteran Medical Consulting with his
wife, Leah Bucholz, a Physician Assistant and Army Combat Veteran.  He has devoted himself to using his
knowledge gained in the military as a medical professional to serve the Veteran community.

Julie Pereira

JULIE PEREIRA:

ADMINISTRATIVE ASSISTANT

During her Active-Duty time in the US Navy as a Hospital Corpsman, Julie provided medical administration
and patient care services in the field, the hospital, and base medical office settings.  This military medical and
administrative background has given Julie the hands-on experience and extensive knowledge necessary to
provide unparalleled service to her fellow Veterans through the Prestige Veteran Medical Consulting team.

Julie’s educational achievements include a Bachelor of Arts with a minor in Human Services and a pre-nursing associate in arts and science.

Julie has been inspired by her firsthand knowledge of navigating the VA Benefits process. She has dedicated
most of her adult life to serving Veterans through her knowledge derived from her military and civilian medical
education and training.

Jennifer Januta

JENNIFER JANUTA

U.S ARMY VETERAN, CHIEF OPERATIONS OFFICER

During her Active-Duty service in the Army, Jennifer supported various research efforts centered on combat casualty care and Soldier performance. Her military background gave her unique insights into veterans’ distinct challenges, ultimately inspiring her to join the Prestige Veteran Medical Consulting team.

Jennifer’s educational achievements include a master’s in molecular biology from George Washington University and a master’s in data science from Texas Tech University. Jennifer wholeheartedly dedicates herself to utilizing her knowledge and expertise gained from 15 years of healthcare experience to impact the well-being of those who have served positively.

Alan Bucholz

ALAN BUCHOLZ, PA-C:

U.S ARMY VETERAN, CHIEF FINANCIAL OFFICER

Alan enlisted in the US Army as a combat medic, where he deployed in support of Operation Iraqi Freedom.
Influenced by his time as a combat medic, he attended the Interservice Physician Assistant program while on
active duty, was commissioned as an officer, and subsequently deployed to Afghanistan.  

Alan’s military and medical background inspired him to form Prestige Veteran Medical Consulting with his
wife, Leah Bucholz, a Physician Assistant and Army Combat Veteran.  He has devoted himself to using his
knowledge gained in the military as a medical professional to serve the Veteran community.

Leah - Meet the Team

LEAH BUCHOLZ, PA-C

U.S ARMY VETERAN, MEDICAL EXPERT & FORMER C & P EXAMINER

Meet Leah, the founder, and leader of our organization. ​​A combat veteran herself, she understands the unique challenges veterans face, making her mission about much more than running a successful business. It’s about the opportunity to provide a legacy of exceptional service for our heroes.​

​“It is essential to remember that there is no greater honor than caring for service members on the battlefield. Continuing to care for Veterans after separation is an opportunity that I have been afforded to extend that care in this new battlefield related to service-incurred disabilities.”

Her inspiration comes from years of military experience working alongside her fellow servicemembers, particularly key leaders who have influenced her journey, applying their wisdom to her path. She values her team deeply, most of whom are also disabled combat veterans, each member a trusted individual sharing her vision.

 “Driven by passion and purpose, I aim to create a sustainable change that empowers veterans and future generations.”

Leah’s journey hasn’t been without challenges. From overcoming and living with her service-related disabilities to navigating work-life balance, she’s learned to face each hurdle head-on with resilience.  Like many of her veteran brothers and sisters, her early background consisted of limited resources and opportunities. Her military service has helped shape her into a steadfast leader, offering relatable inspiration to others.

Join us in celebrating Leah, a compassionate leader, and resilient veteran, driving our mission to serve those who served our nation.