What is a supplemental claim, and should you file one in your fight for VA benefits? In my oversimplified definition, the way I describe it is when you want the VA to redecide your claim with information that they didn’t have the first time around, or rather, the last time they made a decision.
When can you file it? Well, pretty much whatever you want, as long as you’re filing it in response to a VA decision. There are some instances where you can switch your appeal lane, but that’s a separate video for another day. For right now, if get a decision and you’ve got new evidence and relevant evidence, you can file a supplemental claim at any time. But the key here is that you do have to include new and relevant evidence.
If you don’t include that, the VA is just going to send you a letter that says they don’t have any new evidence so they can’t, re-decide your claim. And so they’re not going to do anything with it. And it makes sense because if you’re not giving the VA anything new, you’re essentially asking for a higher-level review. And if that’s what you want, then that’s what you should do if you don’t have new evidence.
So what is new and relevant evidence? New evidence is anything that was not before the VA when they decided your claim. It doesn’t have to be new in the sense that it’s a medical record that was created a week ago or a brand new statement from your buddy. It could have existed for a while. It just has to be something that the VA didn’t have in front of it when it made the decision on your claim.
Relevant evidence is something that tends to prove, or disprove one of the important parts of your claim. So for example, one of the elements of service connection, or the extent to which you are injured or your injury or disability affects you which gets to the percentage at which you’re rated.
Let me walk through an example. Let’s say the VA service connects you for PTSD, but they rate you too low. Let’s say you had a great lay statement from your spouse that talks about how you were a totally different person after you came back from deployment and it walks through in great detail, all the effects that PTSD has had on your life and your ability to function with your family, in society, everything. It’s a great statement, and you had it, but you just didn’t submit it with your claim. You can file a supplemental claim and include that last statement. And only that last statement and the VA will take that, look at that and say, is it new? Yes, because the VA didn’t have it before. Is it relevant? Yes, because it tends to prove, the effects of your PTSD on your life, which is going to get at, those percentage ratings that you’re trying to increase. So they will take that statement. And re-decide your claim.
That’s all you need for a supplemental claim. Now I’m not going to say that one statement is going to make a huge difference in the outcome of your claim. It may, it may not. That depends on the specifics of your situation. What I’m talking about is what you need to reopen a supplemental claim with the VA.
As another example, which speaks to relevant evidence, another thing you can do that’s relevant is present the VA with a new theory of service connection. Let’s say you’ve got sleep apnea and you file a claim for direct service connection. As in, your service caused your sleep apnea and that gets denied. You can file a supplemental claim and say, as an alternative, that your traumatic brain injury, caused your sleep apnea. That is a secondary condition. That’s a new theory. And that can be the basis of a supplemental claim.
If you want to keep your effective date, you have to file your supplemental claim within a year of the VA’s most recent decision on that issue. If you miss that, then the VA’s decision will be considered final, and you’re going to lose any past-due benefits you may have had on the table. But, 10 years down the road, 40 years down the road, whenever you’ve got new and relevant evidence, you can file a new supplemental claim. But your effective date is going to be the date you filed that claim. So be aware of that. Deadlines are critical, but I’m sure you already knew that.
Another thing about supplemental claims, the VA does have a duty to assist. So if you file a supplemental claim, new relevant treatment records. The VA has a duty to go get those, and then redecide your claim.
I hope this information was helpful as always, if you’d like help with your VA claim, feel free to reach out to me through my website.