High level Discussion time! To request a call or no?

[ShuMan]

Hey Fellow Vets, 

Let's talk about high level reviews! Once your claim is denied or you think you should of been rated higher, you can request one of three appeal lanes (HLR, Supplemental, BVA).

One of those appeal lanes is called a high level review. You can add no new evidence to a high level review (No new med records, IMO's)  but  you can request an INFORMAL CONFERENCE WITH THE HIGHER-LEVEL REVIEWER.

This is what I want to debate! Do you do the Informal conference or not?

In my option, No! The word Informal makes that entire call questionable. When dealing with the VA, you do not want anything informal! 

Also that call push's your timeline out on your appeal plus are you really going to be able to articulate yourself correctly in under 15 minutes? 

What you should do instead is when turning in your high level review form you can add a VA Form 21-4138 explaining why you deserve a higher rating or why you think it should be service connected.  This will be official and will be reviewed by the rater.  You can take your time and craft your argument based on things like CFR's,  probative value and outline the evidence in your file. 

LETS DEBATE! 

 

[GBArmy]

ShuMan I agree pretty much with all you said. A good friend that has been in the system for a long time told me not long ago that asking for a conference will delay your claim a little.  But the real reason you don't ask for the conference is what are you going to say that isn't already in the file? Remember you can't add any new evidence. That DRO's that she has asked told her they have yet to have a conference call that made any decision in the appeal. The info was already there.The nature of HLR is to get the decision correct based on evidence already submitted. If you have a "iffy" claim, add more evidence and resubmit in Supplemental claim. Or maybe BVA, if you think it is a 50/50 deal. Unless there is an obvious omission error which would be a CUE on the VA, I usually don't recommend HLR for most appeals.

[broncovet]

Im not a fan of HLR.  And, Im not a fan of hearings or "conferences", video or otherwise, in no small part because I am hard of hearing and very uncomfortable in situations where Im expected to hear and understand the speaker.  

I pretty much "skip" HLR/SCL and go right to the BVA.  Reason:  Its been my experience that the HLR rater picks it up, and says, "Yep, I agree with the last rater.  You are denied, again.  Next."  

Its been my experience only about 10-20 percent of claims at the VARO are awarded.  The other 80 percent or more are denied.  This holds whether its a "new" claim or HLR/SCL.

But, look at your odds at the BVA.  If you like pull the BVA chairmans report which has all the numbers over the years.  

https://www.bva.va.gov/Chairman_Annual_Rpts.asp

AT the BVA, these odds are actually reversed.  Just 20.7 percent of claims are denied at the BVA level, which means almost 80 percent are awarded or remanded. (35 percent awarded and another 38 percent remanded)  I like my odds at the Bva.  I have personally had about 12 VARO decisions, and 5 trips to the BVA, and those numbers hold for me.  I was only awarded 2 of the 12, 10 were denied at the VARO level.  

[pacmanx1]

Shuman a good debate is when you have good arguments on both sides. I may be wrong, and someone may chime in and correct me, but I think it is all one sided. Most of the time the HRL, DRO, Supplemental will result in the same old rubber stamp denial and cause the veteran more wait time. Now please, do not get me wrong there are some claims that get through and are granted but those claims are far and few. 

I try to explain to veterans, why ask for a HRL, DRO, or Supplemental when that individual works with the raters in the same building drinking coffee, eating lunch, and having holiday parties and yes maybe even exchanging gifts. Yes, I know that this may be the extreme but most of the time the claims must go to a higher level to be granted or approved.  Even then the claims may have to go even to the CAVC to be approved for what the VARO and the BVA has denied. It is no real debate; we must do what we feel we must do.  No one really knows what the veteran is going through, and we do not have all the evidence in our hands to review it or give an honest good opinion. Even the rater does not always review the entire records like they supposed to do that cause the hardships and denials.

[deedub75]

I say use all of the avenues available to you. I’ve had failures and successes with both HLRs and supplementals.

After years of denials and my claims being remanded by BVA back to the examiner who kept denying me, I used an HLR but it was denied. I had asked for the informal conference but I missed the calls. I then used a supplemental with a letter from my doctor and my claims were finally granted but the effective dates were incorrect. I then used an HLR to get the effective dates corrected. I asked for an informal conference because I had all of my records showing that I had continuously pursed some of these claims for nearly a decade. My informal conference consisted of the DRO telling me she agreed that my effective dates were wrong and she was correcting them. Had she not agreed I at least would have been able to point out records she may have overlooked.

Everyone’s case is different though. 

[ShuMan]

Very interesting! I'm seeing that many people choose to go right to the BVA and I do understand that for sure. In my option since they changed the appeals system to this new HLR/Supplemental/ BVA path it benefits the Veteran more to go HLR or supplemental before the BVA route. Why? Time of claim. On average supplemental and HLR's take about 4-5 months, why not get some additional evidence or write a great rebuttal letter and try the HLR/Supplemental route before the BVA? I know the BVA stats are better but there is a chance the Veteran can win at one of the lower levels before going to wait in line at the BVA. If the HLR or Supplemental route does not work they can always go BVA?

[Buck52]

I agree with broncovet  however 

In the HLR if there's not any favorable findings to reverse the denial it will be denied again by the DRO

A Veteran or his Rep can submit NEW evidence  and the DRO can accept it but is not allowed to use it so its useless to use any new evidence a veteran has during the HLR, in other words they can look at it but can NOT consider it....

 I have always used the Informal conference in person meeting.  face to face with the DRO.

you can give your side and if you can convince the DRO  to see it differently  from what the rater decided then that's your only real chance of getting an approval.  you will need to show why you think the rater was wrong in his decision.

Remember an Informal Conference is recorded and placed in your records.

An informal conference is contact, typically by telephone, but also using other means that VA determines appropriate, for the sole purpose of allowing a claimant and/or representative the opportunity to identify any errors of law or fact in the prior decision.

When requested by the claimant or representative, VA will conduct one informal conference during a higher-level review, unless both rating and non-rating issues are present.  The presence of the requester is not required if his/her authorized representative can attend instead.

The VA will call you from the following phone number: 1-800-827-1000. You can choose to have a legal representative speak on your behalf at the informal conference, but I am a strong advocate in speaking for yourself in this matter. The VA has been moving a lot of claims through this process.

At the local option, the higher-level reviewer or the Informal Conference Coordinator will arrange the conference, while the reviewer with decision authority over the issue will actually conduct it.  VA will not accept any new evidence to support the issue(s) under review during the informal conference.

While VA will typically conduct informal conferences telephonically, VA may make an exception on an individual basis.  VA may conduct the informal conference in person when good cause is shown as to why telephonic communication cannot or should not occur. 

The claimant or representative typically requests an informal conference on the HLR form, although VA will accept a separate request provided VA receives it with that form.  The reviewer or Informal Conference Coordinator will make a total two attempts to contact the claimant or his/her representative to schedule.  The reviewer will hold the informal conference within seven business days of the successful contact.  However, VA may individually grant extensions beyond the seven business days from contact if the pending review is still within established cycle-time goals.

During an informal conference, a requester or representative may wish to add to the evidentiary record or request review of evidence outside the scope of the HLR.  If so, inform the requester of the closed evidentiary record.

If the requester or representative insists on submitting the evidence, the higher-level reviewer may accept it but will inform the requester or representative the reviewer cannot consider it.  The  requester or representative may submit a supplemental claim after receiving the HLR decision.

so my opinion the HLR is nothing but a waist of the veterans time.  move on to the BVA.  IN WHICH HAD THE VETERAN CHOOSE TO DO THAT IN THE FIRST PLACE  HIS CLAIM WOULD BE DECIDED MORE EFFICIENTLY AND FASTER,,,,BUT REMEMBER JUST BECAUSE A VETERAN GOES TO THE BVA DOES NOT GUARANTEE A WIN.