VA Form 20-0996: Decision Review Request: Higher-Level Review

What VA Form 20-0996 is for

Use this form when you think VA got a decision wrong based on the evidence it already had. A more senior reviewer looks again using only the evidence in your file when VA sent the decision notice. VA must receive the form within one year of the date on that notice.

Have a new medical report or other evidence VA has not seen? A Higher-Level Review cannot consider it. That is a Supplemental Claim on Form 20-0995. Fill out Form 20-0995.

Parts someone else completes

Section VII (Items 20A to 20C) is for your VA authorized representative, who can sign instead of you only if a VA Form 21-22 or 21-22a naming them is on record or included. 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 2: Social Security number
• Item 3: VA file number
• Item 4: date of birth
• Item 5: VA insurance policy number
• Items 10 and 11: the claimant's Social Security number and date of birth
• Items 6 to 8 when someone else is filing
• International phone numbers (Items 7 and 13)
• More than 13 issues
• Items 19A and 19B: signature and date

Where to send it

• VA must receive the form within one year of the date on your decision notice.
• Send it to the local VA office or processing center named on your decision notice. For compensation, VA lists Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547.
• Disability compensation: you can also request a Higher-Level Review online at VA.gov, or file in person at a VA regional office.
• If you skipped the conference, you can attach a written statement that points out what VA misread or how it misapplied the law.
• Keep a copy of the signed form 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 20-0996 on VA.gov
• VA Form 20-0996 example and how to fill it out

This filler uses the March 2024 edition of the form.