Supplemental Claim vs. Higher-Level Review: Which Should You File in 2026?

After a denial or a rating that is lower than you expected, you face a decision that will shape the next several months of your claims journey: should you file a Supplemental Claim or request a Higher-Level Review? Choosing the wrong path can cost you months of wasted time and potentially thousands in back pay.

Both options exist under the Appeals Modernization Act (AMA), but they serve fundamentally different purposes. Understanding the differences, success rates, and ideal use cases for each option is critical to getting the rating you deserve as efficiently as possible.

Supplemental Claim: The New Evidence Path

A Supplemental Claim (VA Form 20-0995) lets you submit new and relevant evidence that was not part of your file when the VA made its previous decision. A different rater -- not the person who denied you -- reviews your entire case from scratch with the new evidence included.

When to Choose a Supplemental Claim

• Your condition has worsened since your last rating and you have new medical records documenting the change
• You obtained a private medical opinion (IME or nexus letter) that contradicts the VA's findings
• You have new buddy statements describing worsened limitations
• Your denial cited insufficient evidence -- this is a signal that you need to strengthen your documentation
• You need a new C&P exam because the previous one was incomplete or did not accurately capture your condition
• You discovered secondary conditions linked to your service-connected disability

How It Works

When you file a Supplemental Claim, you must identify at least one piece of new and relevant evidence. This can be as simple as a recent doctor's note or as comprehensive as a full independent medical evaluation. The VA reviews all the evidence -- old and new -- and makes a fresh determination. If warranted, they will order a new C&P exam.

Supplemental Claim Strengths

• Highest success rate: Approximately 35-40% approval rate because you are actively strengthening your case
• Flexibility: You can submit any type of new evidence -- medical records, opinions, lay statements, test results
• Duty to assist: The VA must help develop your claim, including ordering new exams if your evidence raises new questions
• Repeatable: You can file Supplemental Claims as many times as needed, each time with new evidence
• Effective date protection: If filed within one year of the denial, you may preserve your original effective date

Supplemental Claim Drawbacks

• Longer timeline: Typically 4-8 months, sometimes longer if a new C&P exam is needed
• Requires new evidence: You must submit something new -- you cannot simply re-argue the same case
• C&P exam risk: A new exam could potentially show improvement rather than worsening (though this is rare when you have strong evidence of decline)

Higher-Level Review: The Legal Error Path

A Higher-Level Review (VA Form 20-0996) asks a senior VA rater to look at the same evidence that was already in your file and determine whether the original rater made an error. No new evidence is allowed. No new exams are ordered.

When to Choose a Higher-Level Review

• The VA misapplied the rating criteria -- Your documented symptoms clearly meet a higher rating percentage under 38 CFR, but the rater assigned a lower rating
• The C&P examiner made errors -- Factual mistakes, failure to review your records, or conclusions unsupported by the examination findings
• The decision ignored evidence -- The rater overlooked favorable evidence that was in your file
• The VA failed its duty to assist -- They should have ordered development (like a new exam) but did not
• Speed matters -- You need a faster decision and believe the existing evidence supports your case
• You want to avoid a new C&P exam -- Perhaps your previous exam was actually favorable but the rater misinterpreted it

How It Works

A senior rater who was not involved in your original decision reviews your file. They look only at the evidence that existed at the time of the original decision. You can request an optional informal conference -- a phone call where you or your representative point out specific errors to the senior rater.

Higher-Level Review Strengths

• Faster decisions: Typically 3-5 months since no new evidence or exams are involved
• Preserves effective date: If you win, your effective date goes back to your original claim
• No C&P exam risk: Since no new exam is ordered, there is no chance of an unfavorable new examination
• Informal conference: The optional phone call lets you make your case directly to the decision-maker
• Clear-cut errors: Excellent for situations where the rater obviously misapplied the law

Higher-Level Review Drawbacks

• Lower success rate: Approximately 15-25% because you cannot add new evidence
• No new evidence: If your case needs stronger documentation, an HLR cannot help
• Limited scope: Only useful when specific errors exist in how the evidence was evaluated
• No duty to assist: The VA will not order new exams or request additional records

Head-to-Head Comparison

Real-World Scenarios

Scenario: Your symptoms clearly meet 70% criteria but the VA rated you 50%

Best choice: Higher-Level Review. This is a classic rating criteria error. Your C&P exam documented symptoms that meet the higher criteria, but the rater assigned the wrong percentage. Request an informal conference and walk the senior rater through how your documented symptoms satisfy each element of the 70% criteria in 38 CFR.

Scenario: Your condition has worsened since your last C&P exam

Best choice: Supplemental Claim. You need new evidence showing the worsening. Recent treatment records, a private medical opinion, or updated buddy statements documenting increased limitations are exactly the kind of new evidence that wins Supplemental Claims.

Scenario: The C&P examiner did not review your records

Best choice: Higher-Level Review. This is a duty-to-assist error. The examiner had a responsibility to review your complete file before forming an opinion. An HLR can identify this flaw and potentially result in an order for a new, adequate examination.

Scenario: You just got a private medical opinion contradicting the VA

Best choice: Supplemental Claim. A private medical opinion is new evidence. File a Supplemental Claim and explain why the private opinion is more thorough or credible than the VA's examination.

Scenario: You are at month 11 after your denial and still gathering evidence

Best choice: File an HLR now, continue building evidence. The HLR preserves your effective date and gets a faster decision. While it is pending, keep gathering evidence. If the HLR is denied, immediately file a Supplemental Claim with your newly completed evidence package.

Scenario: You have new evidence AND the VA made errors

Best choice: Supplemental Claim. When you have new evidence, choose the Supplemental Claim. You can still argue that the previous rater made errors as part of your submission -- you are not limited to discussing only the new evidence.

The One-Year Rule and Effective Dates

Understanding how effective dates work with each option is crucial for maximizing back pay:

• Supplemental Claim within 1 year: If approved, your effective date may go back to the original claim date
• Supplemental Claim after 1 year: Effective date is the date you file, and you lose the months in between
• Higher-Level Review: If approved, effective date always goes back to the original claim date
• Board Appeal: If approved, effective date goes back to the original claim date

This creates a strategic consideration: if you are approaching the one-year mark without strong new evidence, filing an HLR first (to preserve the date) and then a Supplemental Claim later (if the HLR is denied) can be a smart two-step approach.

What If You Lose?

Neither a Supplemental Claim denial nor an HLR denial is the end of the road:

• After an HLR denial: File a Supplemental Claim with new evidence, or appeal to the Board of Veterans' Appeals
• After a Supplemental Claim denial: File an HLR if you believe errors were made in the new decision, file another Supplemental Claim with additional evidence, or appeal to the Board
• Board of Veterans' Appeals: A Veterans Law Judge reviews your case. Three docket options -- Direct Review (fastest), Evidence Submission, and Hearing (allows testimony)

The AMA system is designed to be flexible. You are not locked into one path, and many veterans ultimately succeed after combining multiple strategies.

When to Get Professional Help

• VSOs (free): Helpful for understanding which path to choose, preparing informal conference arguments, and gathering evidence
• VA-accredited attorneys (contingency): Best for complex cases, Board Appeals, or situations where large amounts of back pay are at stake. Typically take 20-33% of past-due benefits only if you win.

For straightforward cases with clear evidence, many veterans successfully handle their own Supplemental Claims. Consider professional help when your case involves legal complexity, you have been denied multiple times, or the potential back pay justifies the cost.