What this means
m21-5:5.2 explains initial actions upon requests for hlrs. In plain terms, the official guidance says when the actual date of the decision of which the veteran or claimant requested review, and the date listed on the VA Form 20-0996, Decision Review Request: It also addresses follow the steps in the table below to determine whether IU should be addressed in an HLR when expressly claimed or reasonably raised within the closed evidentiary record.
How this may help with a claim
Use m21-5:5.2 to audit how VA handled initial actions upon requests for hlrs. Start with the decision date, the issue being reviewed, and the evidence VA was allowed to consider, then compare the record with this rule: When the actual date of the decision of which the veteran or claimant requested review, and the date listed on the VA Form 20-0996, Decision Review Request: Follow the steps in the table below to determine whether IU should be addressed in an HLR when expressly claimed or reasonably raised within the closed evidentiary record. Cite the exact document and page when raising a factual or procedural error, and use the review rights in the actual notice for any deadline.
What to review in your file
- Check the file against this official condition: actions to take if an HLR is erroneously established
- Confirm that the record or notice addresses this source point: name of the veteran or claimant and the relationship to the Veteran, if applicable
- Document how this stated step or exception applies: When the actual date of the decision of which the veteran or claimant requested review, and the date listed on the VA Form 20-0996, Decision Review Request:
Important limits
m21-5:5.2 explains VA guidance for initial actions upon requests for hlrs; it does not guarantee an award or replace the statutes, regulations, binding decisions, and review instructions that control an individual claim. Conditions and exceptions still matter, including this source point: When the actual date of the decision of which the veteran or claimant requested review, and the date listed on the VA Form 20-0996, Decision Review Request: If a CUE is discovered during an HLR, VA is obligated to address the CUE.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Initial Actions Upon Requests for HLRs
- m21-5:5.2
- Initial Actions Upon
- Requests HLRs
- Initial Actions Upon Requests
- definition complete request
- initial actions take request
- handling requests conduct HLRs
Original VA guidance
The official VA text of this section
2. Initial Actions Upon Requests for HLRs
Introduction
This topic contains information on initial actions to take upon receiving a request for an HLR, including
- definition of a complete request for an HLR
- initial actions to take with an HLR request
- handling requests to conduct HLRs at specific offices
- actions to take if an HLR is erroneously established
- addressing IU in an HLR
- addressing unadjudicated ancillary benefits in an HLR
- HLRs and changes to the rating schedule, and
- HLRs and changes to law, regulation or judicial precedent.
Change Date
June 12, 2026
5.2.a. Definition of a Complete Request for an HLR
A complete request for an HLR includes the following:
- name of the claimant and the relationship to the Veteran, if applicable
- signature of the claimant, or a person legally authorized to sign for the claimant
- date of the underlying decision for which review is requested, and
- specific issues for which review is requested.
Important: When the actual date of the decision of which the claimant requested review, and the date listed on the VA Form 20-0996, Decision Review Request: Higher Level Review, do not match, VA should accept the HLR if VA can reasonably ascertain the issue involved and if VA timely received the HLR request. Further, the absence of the notification date on the HLR does not necessarily preclude the acceptance of the HLR request. If blank, claims processors should contact the Veteran and/or applicable representative for clarification of the date and document contact on VA Form 27-0820, Report of General Information.
For incomplete requests, follow the procedures in M21-5, Chapter 4, Topic 2.e.
Handle requests for HLR using a form not prescribed by VA as a request for the application. See M21-1, Part II, Subpart iii, 1.A.1.a.
Reference: For more information on
- completed requests, see 38 CFR 3.2601, and
- timeliness of review requests, see M21-5, Chapter 5, Topic 1.c.
5.2.b. Initial Actions to Take With an HLR Request
When a claimant requests an HLR after receiving a notification letter of a decision, follow the steps noted below.
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| Step | Action |
|---|---|
| 1 | Review the claimant's electronic claims folder (eFolder) to determine what issues VA previously decided. If any issue identified on the form is not eligible for HLR, send the claimant and any representative an HLR Rejection letter for that issue and upload the letter into the eFolder. |
| 2 | Check if the claimant or representative requested an informal conference. |
| 3 | The NWQ will refer the end product (EP) 030 to a higher-level reviewer for continued processing. |
| 4 | The higher-level reviewer will validate and classify the dispositions of the contentions in VBMS. |
5.2.c. Handling Requests to Conduct HLRs at Specific Offices
Generally, a different office than that of original jurisdiction will conduct the HLR. Requesters may ask that the same office that prepared the decision in question also conduct the HLR. VA may experience difficulty accommodating such requests unless the office of original jurisdiction is co-located at the office conducting the HLR, such as the DROCs in Seattle and St. Petersburg. However, exceptions to this rule may also apply for claims requiring specialized processing.
When unable to accommodate the claimant’s request regarding venue for the HLR, insert the following paragraph in the introduction of the decision document:
You requested to have your higher-level review conducted at the same office that decided your claim. Unfortunately, we were unable to fulfill your request because that office does not have personnel available to conduct higher-level reviews (see 38 CFR 3.2601(e)). Accordingly, we conducted your review at an office with the appropriate personnel available.
References: For more information on where VA may conduct HLRs, see 38 CFR 3.2601.
5.2.d. Actions to Take if an HLR is Erroneously Established
If a higher-level reviewer identifies an erroneously established EP 030, the reviewer should:
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| If... | Then... |
|---|---|
| An HLR EP 030 is erroneously established and NO action is required | Add a VBMS claim note explaining why the EP 030 should be cancelled and identify that no corrective action is needed. Cancel the EP 030 in SHARE and, E-mail supervisor to advise that the higher-level reviewer cancelled the EP 030, completed a VBMS note providing cancellation details and advise that no further action is necessary. |
| An HLR EP 030 is erroneously established, and action IS required | Add VBMS claim note explaining why the EP 030 should be cancelled and identify in the note any necessary corrective action, such as sending out a letter. E-mail supervisor to advise that the higher-level reviewer documented the necessary action to take in a VBMS claim note. The supervisor will then assign that necessary action to a claims processor on the pending EP 030. |
5.2.e. Addressing IU in an HLR
Follow the steps in the table below to determine whether IU should be addressed in an HLR when expressly claimed or reasonably raised within the closed evidentiary record.
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| If... | Then... |
| IU has been expressly claimed, or reasonably raised, and that documentation and/or evidence falls within the scope of the closed record review | Consider IU as a contention within the HLR and render a decision accordingly |
| IU has been expressly claimed, or reasonably raised, but that documentation and/or evidence does not fall within the closed record review | IU cannot be considered as part of the HLR because it falls outside the scope of the closed record review. If the underlying condition(s) are all outside the scope of the HLR, IU must be developed and decided under a separate EP in VBMS. If all of the underlying conditions are within the scope of the HLR, Advise of the prohibition of considering new evidence outside the closed evidentiary record If there are multiple underlying conditions with some, but not all, falling within the scope of the HLR, Advise of the prohibition of considering new evidence outside the closed evidentiary record. The issues outside the scope of the HLR should be adjudicated in accordance with M21-1, Part VIII, Subpart iv, 3.B. |
References: For information on
- the role of VA Form 21-8940 in development of IU claims, see M21-1, Part VIII, Subpart iv, 3.B.1.b, and
- reasonably raised claims for IU, see M21-1, Part VIII, Subpart iv, 3.B.1.f
5.2.f. Addressing unadjudicated ancillary benefits in an HLR
A claimant may contest a VA decision for failure to grant an ancillary benefit. The decisionmaker should consider these issues as within the scope of an expressly claimed issue in the rating decision identified on the VA Form 20-0996.
Some of these ancillary benefits include, but are not limited to:
- Dependents' Educational Assistance, or Chapter 35
- SMC(s) based on statutory housebound under 38 CFR 3.350(i)(1)
- SMC(k) based on loss of use or anatomical loss under 38 CFR 3.350(a)
Follow the steps in the table below to determine whether an unadjudicated ancillary benefit should be addressed when the VA Form 20-0996 lists failure to grant a benefit as an issue:
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| If... | Then... |
|---|---|
| The benefit can be granted under the HLR | Grant the benefit in the HLR decision. |
| The benefit cannot be granted, but a DTA error or Difference of Opinion is discovered during the HLR review | Formally address the benefit in the HLR decision by citing a DTA error or Difference of Opinion and provide instructions for corrective action on the VA Form 20-0999. |
| The benefit cannot be granted based on the closed evidentiary record | Deny entitlement to the ancillary benefit. Note: If the claimant is not eligible for the ancillary benefit because the underlying disability is not service-connected, also send an RFA letter. |
References: For information on
- Issues within the scope of the claim, see 38 CFR 3.155(d)(2)
- Definition of an ancillary benefit, see M21-1, Part V, Subpart ii, 3.A.1.e
- Defining ancillary benefits as within the scope of a claim, see M21-1, Part V, Subpart ii, 3.A.1.c.
5.2.g. HLRs and Changes to the Rating Schedule
Use the table below when adjudicating an issue under HLR that was last decided prior to a change in the VA Schedule for Rating Disabilities, where the change is relevant to the disability evaluation of the issue under review.
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| If... | Then... |
|---|---|
| The evidence of record is sufficient to assign an evaluation both before and after the date of the regulatory change, based on all applicable criteria | Render the HLR decision using the previous criteria for the period before the regulatory change and the new criteria for the period after the regulatory change (see M21-1, Part V, Subpart ii, 3.D.2.h). |
| The evidence of record is not sufficient to properly assign an evaluation after the date of the regulatory change | A change in the rating schedule is not a duty to assist error. Assuming all other aspects of development and VA's duty to assist were met, return the claim using Difference of Opinion (DoO) as the rationale. Development (such as exams) will then be completed under the DoO return and a final decision issued following guidance in M21-1, Part V, Subpart ii, 3.D. |
References: For information on
- Difference of Opinion in HLRs, see 38 CFR 3.2601(j)
- Change of law or Department of Veterans Affairs issue, see 38 CFR 3.114 and 38 U.S.C. 5110(g).
5.2.h. HLRs and Changes to Law, Regulation or Judicial Precedent
HLR decisionmakers must consider changes to law, regulation or judicial precedent even if it occurs after the decision under review. The closed evidentiary record principle does not apply to changes in law, regulation or judicial precedent.
Use the table below when adjudicating an issue under HLR that was last decided before a change in law, regulation or judicial precedent.
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| If the issue is... | Then... |
|---|---|
| not affected by a change | generate a decision to grant, deny, or return the issue based on the evidence available at the time of the previous decision. |
| affected by a change, but the maximum benefit can be granted for service connection or for an evaluation from the earliest effective date | render a decision on the issue granting entitlement. |
| affected by a change and involves: service connection that can be granted, but not at the maximum benefit; or service connection that cannot be granted; or an increased evaluation that can be granted but not at the maximum benefit; or an increased evaluation that cannot be granted; or an effective date for service connection or evaluation where an earlier date may be warranted, and all required development related to the change was not previously undertaken or is otherwise incorrect | return the issue for development as a DTA error. |
| affected by a change, but all required development, including development related to the change, was previously and sufficiently completed | generate a decision to grant, deny, or return the issue based on the evidence available at the time of the previous decision. |
Note: The guidance to return as a DTA error applies even if the prior decisionmaker acted in accordance with the guidance in effect at the time of the decision.
Example 1: A Veteran with verified military service in Somalia in October 1993 has confirmed active bladder cancer. Rating decision dated December 10, 2024, denied service connection following sufficient development and examination based on a negative TERA medical opinion. VA amended 38 C.F.R. § 3.320a on January 2, 2025, adding bladder cancer as a presumptive condition for Somalia service after 1990. The Veteran filed an HLR on March 9, 2025. The higher-level reviewer will grant service connection effective January 2, 2025, the date of the regulation change.
Example 2: Rating decision dated June 12, 2025, continued the 10 percent disability evaluation for lumbosacral strain based on an April 2, 2025, examination. The Veteran filed an HLR on December 2, 2025. The April 2, 2025, examination did not address the effect of the Veteran’s medication as required by the September 19, 2025, decision in Ingram v. Collins. The higher-level reviewer will return the issue as a DTA error for the missing information in the VA examination.
References: For information on
- Evidentiary record, see M21-5, Chapter 5, Topic 1, Block g.
- Definition of maximum benefit, see M21-5, 5.5.b.
- Maximizing benefits with effective date determinations, see M21-1, V.ii.4.A.1.i.
- Change of law or Department of Veterans Affairs issue, see 38 CFR 3.114 and 38 U.S.C. 5110(g).
5.2.i CUEs Discovered During an HLR
If a CUE is discovered during an HLR, VA is obligated to address the CUE.
Use the table below when addressing a CUE found during an HLR.
If the CUE is discovered during an HLR and the issue is…
Then…
part and parcel of the HLR (e.g., the issue is one claimed by the Veteran, the issue is inextricably intertwined, etc.)
the CUE should be addressed under the existing EP 030.
not part and parcel of the HLR (e.g., the issue is not one claimed by the Veteran, the issue is not inextricably intertwined, etc.), but can be addressed in full without any further development (e.g., assign an earlier effective date, propose to reduce with subsequent due process under an EP 600, etc.)
the CUE should be addressed under the existing EP 030.
The following paragraph must be added to the rating decision narrative and notification letter unless the higher-level reviewer proposes adverse action:
A clear and unmistakable error has been found related to a previous VA decision on [insert contention]. Because this issue is not part and parcel of your higher-level review, any of the three decision review options are available to you if you disagree with our decision on this issue. Please refer to the enclosed VA Form 20-0998 for more information.
If the higher-level reviewer proposes adverse action because of the CUE, then follow procedural guidance contained within M21-1.
not part and parcel of the HLR (e.g., the issue is not one claimed by the Veteran, the issue is not inextricably intertwined, etc.), and cannot be adequately addressed without further development.
Example: The Veteran is denied service connection for diabetes mellitus, type II because there is no evidence of agent orange exposure. No exam was requested and the evidence of record only notes a diagnosis, without any additional information. Four years later, during an HLR for an unrelated condition, the DRO identifies Vietnam service is in fact shown in the personnel record. This manifestly changes the outcome of the diabetes mellitus, type II claim (service connection should have been granted as a presumptive), yet the evidence of record is insufficient to adequately assign an evaluation.
an EP 930 is required.
- Establish an EP 930 with a date of claim corresponding with the claim in question (see M21-4, Appendix B, Topic 2).
- The EP 930 claim label should be RATING CONTROL or NON-RATING CONTROL, as appropriate.
- Add a detailed VBMS claim-level note explaining why the EP 930 was established and what steps are required to resolve the claim.
Note: The evidence of record at the time of the CUE in a prior decision is part of the record and subject to review.
References: For Information on
- Applicability of due process, see M21-1, Part X, subpart ii.3.
- CUE, see M21-1, Part X, subpart ii, 5. A.
- Due process and authorization issues for CUE, see M21-1, Part X, subpart ii.5.C.