VA Form 20-0995: Decision Review Request: Supplemental Claim

What VA Form 20-0995 is for

Use this form when you disagree with a VA decision and have new and relevant evidence, or can name records VA should get, for an issue VA already decided. If your condition has gotten worse since VA rated it, the form says to file VA Form 21-526EZ for an increase instead.

No new evidence, and you think VA misread the file it already had? That is a Higher-Level Review on Form 20-0996. Fill out Form 20-0996.

Parts someone else completes

Sections IX to XI on the last page are for other people: two witnesses sign only if the claimant signs with an X, an alternate signer needs VA Form 21-0972, and a representative signs Section XI only if a VA Form 21-22 or 21-22a is on record. The VA date stamp box is for VA.

What you fill in by hand

The filler never asks for your Social Security number, VA file number, date of birth or signature. You write those in by hand. Leave these boxes for yourself:

• Item 3: Social Security number
• Item 4: VA file number
• Item 5: date of birth
• Items 6 and 7: service number and VA insurance policy number
• Items 12 to 15: the claimant's Social Security number, VA file number, date of birth and insurance policy number
• Items 8 to 10 when someone else is filing
• International phone numbers (Items 9, 18 and 20D)
• Items 25A and 25B: signature and date

Where to send it

• Attach the new evidence you have, with your name and file number on each page, as the form asks. For private provider or Vet Center records you want VA to get, include Forms 21-4142 and 21-4142a.
• Disability compensation: you can file online at VA.gov, or upload the form through QuickSubmit.
• Compensation by mail: Department of Veterans Affairs, Compensation Intake Center, P.O. Box 4444, Janesville, WI 53547.
• Pension and survivors benefits by mail: Department of Veterans Affairs, Pension Intake Center, P.O. Box 5365, Janesville, WI 53547.
• Other benefit types: use the address for your benefit type on page 1 of the form. You can also file in person at a VA regional office.
• VA recommends filing within one year of the decision letter to keep your effective date. Keep a copy of the form, your attachment list and your confirmation.

Claim Raven does not submit forms to VA. You review the filled PDF, sign and date it, and send it to VA yourself. Claim Raven is independent and is not affiliated with VA.

Official form and guide

• VA's page for Form 20-0995 on VA.gov
• VA Form 20-0995 example and how to fill it out

This filler uses the May 2024 edition of the form.