Episode 11: Supplemental vs HLR vs Board Appeal

This episode breaks down the different VA Appeal Lanes veterans can use after a denial, and how choosing the right path can make the difference between moving your claim forward or wasting valuable time. 

In this episode, we cover:

• Supplemental Claims, HLRs, and BVA Appeals
 • When new evidence is needed to reopen a claim
 • VA errors and overlooked evidence
 • Secondary conditions like radiculopathy
 • Challenging underratings and denied conditions
 • Why BVA appeals take longer than other lanes
 • Common mistakes veterans make after a denial
 • How strategy and documentation impact your claim

This episode helps veterans better understand the VA appeals process, avoid common mistakes after a denial, and choose the lane that gives them the best chance at the correct decision and benefits they deserve.

Transcript

SPEAKER_02 0:00

Denied, delayed, underrated. That's the story for too many veterans, including me. Hey veterans and the families listening in, welcome. My name is Robert Pinero. I'm a Marine Combat Veteran and the founder of Veterans Educating Veterans. I've served two tours in Iraq, and like many veterans, I know how hard it is to get service connected and navigate the VA system. After service, I was frustrated, in pain, and told no more times than I can count. Even by VA attorneys. So instead of giving up, I decided to learn the VA process myself. That's what Veterans Educating Veterans is built on. We educate and guide veterans through the VA compensation process, step by step, helping you understand how the system works so you can move forward with confidence, not confusion. I do this work alongside my wife Jillian and for our two daughters because our families live with the impact of service long after the uniform comes off. You deserve the benefits you've earned, not just for yourself, but for the family that stands beside you. Welcome to the War Room.

SPEAKER_01 1:17

The War Room by Veterans Educating Veterans.

SPEAKER_02 1:25

Just a quick disclaimer: this is for education only and not for legal or medical advice. Every claim is different, so don't take this as an individual guidance.

SPEAKER_03 1:38

We are back here with the war room. Veterans Educating Veterans. Here we're here with senior coach James. My little brother, CEO. Big brother. My big brother. CEO Rob Pinero. And uh one of our coaches here, rookie of the year, uh Cody and Jesse. So they're gonna be talking about Supplemental, HLR, and Board of Rand's Appeal. BVA.

SPEAKER_02 2:10

A lot of veterans know they want to challenge a bad decision, but they don't know which lane actually fits their situation, right? So this is one of the biggest confusion points after a denial. Veterans hear the names of the lanes, but do not always understand what each one is for. So picking the wrong lane can waste time and momentum. So today we want to break down the three points, um, or the three paths actually, um, in simple language. So let's start with the basic questions. Um, why are there different lanes in the first place?

SPEAKER_00 2:48

Yeah, absolutely. This you know, these lanes exist depending on why they denied your claim to start with. Um, it could be that you need new evidence to support it. Um, you need there was an error in the mistake in the actual decision itself that needs to be reviewed, um, or even needs everything is there and it's gotta go to you know a BVA or a judge to make an official final decision on these claims.

SPEAKER_04 3:14

So the main difference is basically for supplemental that you're gonna be bringing new evidence that hasn't been brought to the table before for the VA to view. It has to be relevant to the to the claim, obviously. Higher level review means you're gonna uh correct an error that the VA screwed up on, something that they clearly missed. And then obviously a board board appeal is gonna be something that is a little bit more intricate, a little bit more advanced. It's just the a judge making a decision on your case, um, somebody that's a little bit more experienced, looking at the overall outcome of the case and seeing where either you don't have the evidence or where the VA screwed up at is kind of the overall of the three.

SPEAKER_02 3:53

And just to throw in some some additional information with the BVA, is laws, right? So the law says that you're service connected or or you deserve the increase or anything of that. Where there's an error of law, it's kind of more where the judge comes into play and says, Hey, you're right, that is the law. So before choosing a lane, the veteran has to understand the problem that they're trying to solve. Um now let's break into these lanes apart one by one so people understand when each makes sense.

SPEAKER_00 4:29

Yeah, so the first one we're gonna dive into is a supplemental claim. So a supplemental claim means you have originally been denied for this previously. So this is the only way you can reopen it to have them um relook at this case, uh, whether it be knee, back, whatever the whatever it is, if you filed for it previously was denied, this is the only way to have the VA re-examine it. With this, you must have new and relevant evidence um that pertains to that disability. Um, whatever the denial said, why it was denied, this is how you can combat that. So you were missing the diagnosis, that's new evidence. You were missing um a nexus, that's new evidence. New things to support your claim in a whole to get you service connected.

SPEAKER_04 5:14

These can be anything from, like you said, the new Nexus letter, um, new treatment records, uh new lay statements or medical records that are going to strengthen what you already have. Um, it's not to disprove anything, it's to strengthen what we've already proven. We're just we're just building your case even further. So um is kind of what a supplemental would be.

SPEAKER_02 5:36

So a supplemental claim has to be filed within that year that they give you to do an appeal, or can I just file a supplemental whenever?

SPEAKER_00 5:46

So to answer that, Rob, to keep um to keep it a continuation, you can file a supplemental within one year, the continuation of that claim. But if it's been denied previously in 10 years ago, you still have to file a supplemental because it was previously denied. Doesn't matter the time frame, that's the only way to open it back up for a new review um by the VA.

SPEAKER_03 6:09

Right. So if the missing piece is evidence, you know, the answer is not just you know arguing louder, it's actually just you know calm down. You know, you gotta read it into details. If you need the evidence, that's what you need to show. You know, it's not about uh trying to argue with the with the VA, you know, get louder with them, but it just means just get get what you need for your claim.

SPEAKER_02 6:34

So some denials are about missing evidence, right? Some are about the VA getting decisions wrong based upon what was already there. Um that brings us to the higher level review. So, James, you can give us some insight on the HLRs?

SPEAKER_00 6:49

Yes, yes. So the higher level review, there is no new evidence added to your claim. So whatever was submitted originally, it's based off of that evidence of record only. Um so if you feel that the VA made a mistake, they underrated you. Let's say, you know, you you had your own exam um done by a private physician on there, you know, hey, I talked about my flare-up uh for my knee and my lower back. And I mentioned that I had ridiculopathy going down my right leg that affects my day-to-day life. Um, it gets all submitted. The VA gave you the 40% for your lower back, but did not mention anything about the ridiculopathy. It's it's not mentioned, it's it's it's missing completely. You can then submit a higher level review for a more senior raider to take a look at it and say, hey, look, this is I my claim, I know I talked about ridiculopathy and there's no mention of it. So they'll take a review of it and correct that error if the evidence is there for you for sure.

SPEAKER_02 7:49

So I just want to further explain that actually, um, because he used the back as one of the examples. So just understand that when you file an increase and a DBQ is filled out for your back, the ridiculothopy does not need a Nexus letter in order to get added as a secondary condition. It's one of the conditions that we do not need a Nexus letter for. It's actually right in the DBQ. And if the doctor finds that you do have ridiculothopy, it automatically gets added into your claim as a secondary condition for ridiculothopy.

SPEAKER_04 8:33

So it's already doing the claims properly and reviewing them properly.

SPEAKER_02 8:36

Exactly. I just want to clear that up.

SPEAKER_04 8:37

Yeah, absolutely. And that's if like again, if they're reviewing them properly, which leads us to HLRs. So this has to be one of the most frequent ones that I deal with is HLRs because they like to one overlook evidence that has clearly been submitted, um, or two, just ignore it. Um, that's clearly in there. Um, one of the examples that I know of that comes to mind very clearly is one of the vets I submitted um was denied because we use Zoom as a method of communication with our doctor. And the VA said Zoom is not their preferred method. If you go right on the VA's website, Zoom is the number one preferred method of contact with their doctors. So it was an easy we just typed it up, resubmitted, and approved. It's it's just ridiculous the reasons they come up with to deny. But that's just one example of an HLR. Um, it's not anything of new evidence. We're just correcting what was wrong in the original evidence we submitted. We're not submitting any new evidence at all.

SPEAKER_03 9:35

If the evidence is already there, um the issue may be, you know, it would just be reviewed. Yes. Um there's no rebuilding. No. Um this is just going getting a second look on your claim from you know, fresh eyes. Uh, that's what basically um an HLR would be based on.

SPEAKER_04 9:57

And it is from somebody that is, I believe, more experienced, right? I think that's what it's like.

SPEAKER_02 10:01

They're they're basically a senior raider. Yes. So then um there are there are cases where the veteran needs to go beyond the fresh review lane, right? So now let's talk about the board path and why that is a different level of decision making.

SPEAKER_00 10:19

Yeah, so the BVA or the Board of Veterans Appeal path is, I want to say, uh, a last resort. Um, because once these judges and lawyers, lawyers a judge, um makes a final decision on this claim, it's it's closed completely. It doesn't mean that you can't file again showing that those symptoms have been worse, but that that claim in itself is done stopped at. Um, where the other avenues, as like a you know, a supplemental higher level review, it's a continuation of that claim. But once it makes that decision, you now you get that it's closed. You also got to take in account these cases are usually more complex cases that you you're looking at it and say, no, I the rules and regulations and laws that I qualify for this. I know I do. But you also got to take into account the time frame this takes. When you file for these BVAs, it tells you right on there on the forum, minimum of a year you're waiting. And that's without going in person if you if you want to be seen for an actual testimony. That's for them to just have a judge review everything that's there. Again, nothing new is added. It's based on the record of evidence and the current laws at that time. Yes, you may got a decision two years later, and the BVA has put new out rules and regulations, they do not apply to that claim because they were not affect at that time of when you filed. Um, but so just be mindful and and understand that it's it's you're not gonna get a decision in in six months, it's gonna take a lot longer for sure.

SPEAKER_04 11:56

Yeah, absolutely. And you hit on a lot of the stuff that I was gonna just say, so that's that's good. Um you're welcome. The good news is though, is that even with a BVA, your your intent to file should still apply with everything, so you should be getting back paid to that date. Um, so even though you're waiting a long time, it's for the correct decision. So patience is very key on this. Patience is not something that a lot of veterans have, including myself, ask my wife. Um it's just you have to have it when it comes to these types of appeals. Um, you want the correct decision, you have to be willing to wait for it. And if the evidence is there, it it will come out in your favor.

SPEAKER_02 12:37

So I also want to just go back a little bit and talk about the BVA. So the BVA has three choices of how decisions can be made. A, like James mentioned, no new evidence, basically a Del Novo uh review of the claim, which right now is I think a year and year three months. There's also the one where you get to add new evidence, which I think that one is about two years and some change. And then it's the in-person, which I think right now they're doing video, they're not actually doing um in person. I think only if it's specially requested, do you guys do in person? Because I think ever since COVID they changed everything. So that you're looking at more than three years. So uh the best results for service connection from articles I have read, and actually, this is these are locked-in numbers, is that in person is 50% and above. But remember, you're waiting three years, right? Yeah, so yeah, you get all this back pay, yeah. It's it's gonna be a long time till you have to show up, and then if you don't show up and you mistakenly forget your date, you know, that could count against you, and and then I don't know, you're waiting even longer because after that you're you have to do what's called the a veterans of uh it goes to the veteran courts of appeal, and that I wouldn't even suggest any veteran doing it, including ourselves, but to get a lawyer, because you're dealing with the courts, you're dealing with a lot of rules in place that they expect lawyers to know. So I wouldn't even jump into that, and I don't even want to get into that subject, but um, yeah, BVA's longest is about three years and a half, BVA's shortest is about a year and three months. So the best lane depends on what is wrong with the decision. And I'm gonna leave it there. I'd like to thank everybody for listening in as well. Like and subscribe and give us some topics that we can talk about. If not, I'll see you on the next one.

SPEAKER_01 14:56

The war room by veterans educating veterans.