If Your BDD Claim Is Denied or Rated Lower Than Expected

Read the decision before choosing a lane

A rating decision packet contains the decision itself, the evidence VA considered, and the reasons and bases for each determination. The reasons and bases section identifies which element VA found unmet — a current diagnosis, an in-service event, or the link between them — or, where service connection was granted, which rating criteria VA found satisfied.

Which review lane fits depends on what the decision says. A decision that overlooked evidence already in the file raises a different issue than a decision that correctly weighed a record missing a required element.

Note that VA routinely recharacterizes claimed conditions using its own diagnostic terminology. A decision that addresses a differently named condition than the one you filed is generally VA applying the rating schedule, not an error in itself.

The three AMA review lanes

The lanes are not sequential and can be chosen in different orders, subject to the rules for each. What matters for retroactive pay is the continuous-pursuit provision in 38 CFR § 3.2500: filing a review within one year of the decision generally preserves the effective date of the original claim.

• Higher-Level Review (VA Form 20-0996) — A more senior reviewer looks at the same evidence of record. No new evidence may be submitted. An informal conference with the reviewer may be requested. Governed by 38 CFR § 3.2601.
• Supplemental Claim (VA Form 20-0995) — New and relevant evidence is submitted with the filing. VA's duty to assist reattaches. Governed by 38 CFR § 3.2501.
• Board Appeal (VA Form 10182) — Review by a Veterans Law Judge, with three dockets: direct review on the existing record, evidence submission, or a hearing. Governed by 38 CFR Part 20.

Deadlines that matter

• One year from the date of the rating decision notice to file an HLR, Supplemental Claim, or Board appeal and preserve the original effective date under 38 CFR § 3.2500.
• For a decision by the Board, 120 days to appeal to the U.S. Court of Appeals for Veterans Claims under 38 U.S.C. § 7266.
• A Supplemental Claim may be filed at any time, but one filed more than a year after the decision generally carries an effective date based on the date of that filing rather than the original claim.

Where paid representation becomes lawful

38 U.S.C. § 5904(c)(1) and 38 CFR § 14.636(c) prohibit accredited agents and attorneys from charging fees for services provided before VA issues an initial decision on a claim. Once that initial decision — including a BDD rating decision — has been issued, a fee agreement for representation on a review or appeal may be entered into, subject to the requirements in § 14.636, including the filing of the fee agreement with VA.

38 CFR § 14.636(f) addresses when fees are presumed reasonable and § 14.636(i) addresses payment directly from past-due benefits where the criteria are met. Fees are charged only on past-due benefits resulting from the represented work, so no fee arises where no retroactive award results.

Free accredited assistance from VSOs and county or state veterans service officers remains available at the appeal stage as well. Whether to use a free representative or a paid accredited agent or attorney is the veteran's choice.

Things worth verifying in the decision

• Whether every condition you claimed was addressed — an unadjudicated claim is a separate issue from a denied one.
• Whether the effective date assigned is consistent with 38 CFR § 3.400 for a pre-separation claim, which is generally the day after discharge.
• Whether all evidence you submitted appears in the list of evidence considered.
• Whether the rating percentage corresponds to the criteria in the diagnostic code cited, as printed in 38 CFR Part 4.
• Whether any secondary conditions reasonably raised by the record under 38 CFR § 3.310 were addressed.

Procedural errors after a BDD decision

• ×Letting the one-year window under 38 CFR § 3.2500 lapse, which affects the effective date on any later filing.
• ×Filing a Higher-Level Review while intending to submit new evidence, which the HLR lane does not accept.
• ×Filing a Supplemental Claim without new and relevant evidence, which is what 38 CFR § 3.2501 requires.
• ×Treating VA's recharacterization of a condition as the error, when the shared rating criteria often make the label immaterial.
• ×Not updating a mailing address after separation, since the one-year clock runs from the date of the decision notice regardless of whether it reached you.

Frequently Asked Questions

References & sources

1. 38 CFR § 3.2500 — Review of decisions — eCFR
2. 38 CFR § 3.2501 — Supplemental claims — eCFR
3. 38 CFR § 3.2601 — Higher-level review — eCFR
4. 38 CFR § 14.636 — Payment of fees for representation — eCFR