If you’ve submitted a Supplemental Claim to the VA and received a notification that a reviewer is now examining your new evidence, you’re entering a critical phase of the VA disability claims process.
Naturally, you might be asking, “What does this mean for my claim, and what should I expect next?”
Let’s walk through this step-by-step, so you can clearly understand what’s happening, how this stage influences your Supplemental Claim, and what impact it could have on your VA disability benefits.
We’ll also explain key terms like “new” and “relevant” evidence and how they play a crucial role in determining your VA appeal.
Let’s begin!
Table of Contents
Summary of Key Points
- Supplemental Claims Reevaluate Your Case with New Evidence: A Supplemental Claim allows veterans to challenge a previous VA decision by submitting new and relevant evidence. This process involves a re-examination of your claim with fresh information not previously considered, such as new medical records, treatment notes, or nexus letters.
- New and Relevant Evidence is Essential: For a Supplemental Claim to be processed, the evidence submitted must meet the criteria of being both “new” and “relevant.” New evidence is defined as information that wasn’t part of the original record, while relevant evidence helps to prove or disprove a key issue in the claim.
- A Reviewer is Examining Your New Evidence: When the VA notifies you that a reviewer is examining your new evidence, this means your Supplemental Claim is actively being reviewed. The decision reviewer will compare the newly submitted evidence with existing records to determine if there’s sufficient reason to change the original decision on your VA claim.
- Reviewer Examination and Potential Outcomes: When a VA reviewer examines your new evidence, the claim could result in one of three outcomes: approval of the claim, a request for additional development (such as a C&P exam), or denial. The evidence you provide will play a crucial role in determining whether the VA changes its prior decision.
- Strengthen Your Claim with Medical and Lay Evidence: The key to winning a Supplemental Claim is the quality of the new and relevant evidence you provide. Medical evidence, such as updated VA or private medical records, DBQs, and nexus letters, alongside lay evidence (personal and buddy statements), can significantly strengthen your case and improve your chances of success.
What is a Supplemental Claim?
A Supplemental Claim is a way to challenge a VA decision on your claim by submitting new and relevant evidence as part of the VA appeals process.
This new evidence is key—it’s something that wasn’t previously considered by the VA during their initial review of your claim.
This is your opportunity to present new medical records, new treatment notes, new DBQs or Nexus Letters, or other pieces of evidence that could potentially change the outcome of your VA claim.
Filing a Supplemental Claim is a way to challenge a prior rating decision (claim denial or low-ball rating), as it allows the VA to re-examine your case with the new evidence without starting from scratch.
What is “New” and “Relevant” Evidence for a Supplemental Claim?
For a supplemental VA claim to be readjudicated, both “new” and “relevant” evidence must be provided.
What is New Evidence?
As defined by 38 CFR 3.2501, new evidence is information that was not part of the original record during the initial adjudication of the claim.
It must be information that the VA did not previously consider when making its decision.
What is Relevant Evidence?
Relevant evidence is any information that has a bearing on the claim, meaning it helps prove or disprove the matter at hand.
It could support a different theory of entitlement or strengthen an existing one.
Importantly, relevant evidence does not need to prove a previously unsubstantiated matter, but it can also affirm information already deemed favorable to the veteran.
Example of New and Relevant Evidence:
A veteran previously denied service connection for a low back condition might file a supplemental claim after obtaining new medical records.
If those new records show continued treatment for the low back condition, even though they don’t directly link the condition to military service, they would still be considered both new and relevant because they add to the body of evidence on the current severity of the condition.
In this case, the claim would be substantially complete, and the VA would be obligated to reconsider it based on this new evidence.
Even though the evidence may reaffirm established facts, it is still relevant because it impacts the overall assessment of the veteran’s condition.
The Two-Part Determination Process for Supplemental Claims
The VA requires a two-part determination process, including an evidence review, for Supplemental Claims that have already been decided, whether they were denied or underrated.
Here’s the steps in the process and what it means for you:
#1. Conditional Two-Part Determination
For a previously decided claim that’s now a Supplemental Claim, the VA must follow a two-part process:
- Step 1: New and Relevant Evidence: The first task for the VA is to determine whether the veteran has submitted new and relevant evidence. This means the VA reviews the evidence to see if it was not considered in the initial decision and if it has the potential to change the outcome of the claim (i.e., is relevant to the matter in question).
- Step 2: Merits of the Claim: If the evidence is determined to be new and relevant, the VA proceeds to the second step, which involves making a decision on whether to grant or deny the claim based on the merits of the new evidence. This could result in either a new favorable decision or reaffirming the previous denial.
#2. Completeness of the Supplemental Claim
- If the veteran submits or identifies new evidence with their supplemental claim, the claim is considered complete, meaning all necessary documentation is available for reevaluation, and a decision on the claim must be issued.
#3. Types of Evidence Decisions
- Duplicative, Not Relevant, or Not New Evidence: If the evidence provided is repetitive, irrelevant, or not new, the VA will issue a decision stating that there is insufficient evidence to readjudicate the claim.
- New and Relevant Evidence: If the evidence is both new and relevant, the VA must issue a merits-based decision, reevaluating the claim based on this new evidence.
The VA Supplemental Claims process involves a two-stage review of the claim pl: First, to ensure the evidence meets the threshold of being new and relevant, and second, to reevaluate the claim’s merits based on that evidence.
Pro Tip: If no new evidence is found, the claim will not be reconsidered.
Example #1: New and Relevant Evidence
A veteran files a Supplemental Claim for a previously denied claim for hearing loss. The original claim was denied because the veteran’s medical records didn’t show evidence of hearing loss during service. However, the veteran submits new private medical records showing significant hearing loss diagnosed after service, and a new Nexus letter from an audiologist stating that the condition is “more likely than not” related to noise exposure during service.
- Step 1: New and Relevant Evidence: The new medical records and Nexus letter are both new (not part of the original claim) and relevant (related to the hearing loss and service connection).
- Step 2: Merits-Based Decision: The VA will reevaluate the claim, considering this new evidence. The decision could result in approval of the claim if the evidence sufficiently demonstrates service connection.
Example #2: Duplicative or Not Relevant Evidence
A veteran previously filed a claim for service connection for a knee condition, which was denied due to lack of evidence linking the condition to military service. In the Supplemental Claim, the veteran submits additional VA treatment records that show continued treatment for knee pain but do not provide new information on how the knee condition is related to service.
- Step 1: New and Relevant Evidence: The submitted records are new but not relevant because they do not provide any new information that supports service connection.
- Step 2: Insufficient Evidence: Since the evidence is not considered relevant, the VA will issue a decision stating there is insufficient new evidence to warrant readjudication of the claim. The previous denial would likely stand.
What It Means When a VA Supplemental Claim Reviewer is Examining Your New Evidence
When the VA notifies you that a reviewer is examining your new evidence, it’s an indication that your Supplemental Claim is in the hands of a VA decision reviewer.
This is a VA employee who has the authority to overturn a previously denied claim.
Here’s what this step generally involves:
- Review of New and Relevant Evidence: The VA decision reviewer will evaluate all the new evidence you submitted with your Supplemental Claim. This could include additional medical records, buddy statements, or new nexus letters that weren’t previously part of your file.
- Reevaluation of Prior Evidence: Along with the new evidence, the reviewer will also reconsider the existing evidence in your claim. They’ll compare it against the new evidence to determine if there’s a compelling reason to change their initial decision.
- Potential for a New VA Exam: Depending on the new evidence provided, the reviewer may order a new Compensation & Pension (C&P) exam. This exam allows the VA to gather more up-to-date information about your condition. If the new evidence shows that your condition has worsened or provides clarity that wasn’t there before, this step could be pivotal in getting a higher rating or service connection.
- Final Decision Process: Once the reviewer has gone through all the evidence, they’ll either uphold the original decision, change the disability rating, or approve service connection. If the new evidence is strong enough to demonstrate that the original decision was incorrect or incomplete, you could see a favorable outcome.
What Happens After the Decision Review is Completed?
After the reviewer examines your new evidence, you will receive one of three outcomes:
- Approval of Your Claim: If the reviewer finds that your new evidence establishes a service connection or warrants a higher disability rating, they will grant the Supplemental Claim in your favor. This could mean you receive back pay dating from your initial claim filing.
- Request for Additional Development: Sometimes, the reviewer might determine that more information or clarification is needed. In such cases, you could be asked to provide additional documentation, or the VA might schedule another C&P exam.
- Denial: If the new evidence doesn’t change the VA’s decision, the Supplemental Claim may still be denied. In this case, you have the option to do a Higher Level Review (HLR) of the denied Supplemental Clam or you escalate your appeal to the Board of Veterans’ Appeals.
Who is a Decision Reviewer for a VA Supplemental Claim?
A Decision Reviewer in the VA Supplemental Claim process is a VA employee responsible for re-evaluating a previously denied VA disability claim after new and relevant evidence has been submitted.
Here’s a breakdown of who the Decision Reviewer is and their role:
Who is a Decision Reviewer?
A Decision Reviewer is a trained VA claims adjudicator tasked with reviewing the new and relevant evidence presented in a Supplemental Claim.
This individual holds the authority to either uphold the original denial, change the disability rating, or grant service connection based on the newly submitted information.
What is the Decision Reviewer’s Role?
The Decision Reviewer’s job is to assess the supplemental evidence in the context of the existing record and determine if the new evidence impacts the initial decision.
Under 38 CFR 3.2501 and M21-1, Part X, Subpart ii, Chapter 2, Section A – Revision Based on Specific Types of Submissions, Including Supplemental Claims, this involves a careful evaluation of “new” and “relevant” evidence:
- New Evidence: Information not previously considered by VA adjudicators at the time of the original decision.
- Relevant Evidence: Information that has a direct impact on proving or disproving a claim.
The Decision Reviewer’s role is to:
- Ensure the Supplemental Claim is complete.
- Assess the validity and impact of the new evidence in relation to the veteran’s claim.
- Request additional VA exams if necessary.
- Provide a merits-based decision after reviewing all evidence.
How Long Does a Supplemental Claim Take?
The average time for a VA Supplemental Claim is 5-6 months from beginning to end.
While the VA’s official goal is to process Supplemental Claims in 125 days (about 4 months), many claims take longer due to several factors, such as:
- Complexity of the case: If your case involves multiple conditions or a significant amount of new evidence, it may take longer for the VA to assess everything.
- Amount of new and relevant evidence: Submitting substantial new and relevant evidence can require the VA to take additional time to thoroughly review it.
- Additional C&P Exams: If your new evidence suggests worsening conditions or new symptoms, the VA may order a new Compensation & Pension (C&P) exam, which adds time to the process.
- Workload at the VA: The backlog of claims and the number of claims processors available at any given time can also affect how quickly your Supplemental Claim is processed.
Pro Tip: Evidence Types to Strengthen Your Supplemental Claim
From my experience working with thousands of veterans, the key to winning a VA Supplemental Claim lies in the type and quality of the new and relevant medical evidence you submit to VA.
Here’s how you can maximize your chances of success with two main types of evidence:
#1. New Medical Evidence
Medical evidence is mission critical for your Supplemental Claim, especially when it comes to proving the existence, severity, and connection of your disability to your military service.
Some common examples of medical evidence include:
- Private Medical Records: These can be medical notes, diagnosis reports, or treatment plans from civilian doctors or specialists who have treated your condition post-service. It’s essential that these records explicitly document your condition’s symptoms, treatments, and any relation to service.
- VA Medical Records: These are health records from any treatment you’ve received from a VA hospital or clinic. Keeping these updated and comprehensive is crucial, as they are directly linked to your VA healthcare and are often the first records the VA reviews.
- Nexus Letters: A Nexus letter is a statement written by a doctor that provides a medical opinion linking your current condition to your military service. This letter is powerful evidence when it includes specific language such as “more likely than not” in describing the connection between your service and your disability.
- Disability Benefits Questionnaires (DBQs): DBQs are standardized forms that allow veterans or their doctors to provide the VA with vital medical information regarding the severity and impact of their disabilities. They are designed to streamline the evaluation process and ensure that the VA has all the necessary details to make an informed decision. When filled out by a qualified healthcare provider, DBQs offer a detailed snapshot of your condition, including symptoms, treatment, and functional limitations, and are often used to confirm both the diagnosis and the degree of your disability. A well-completed DBQ can significantly bolster your VA claim by providing clear, organized evidence of your condition.
#2. New Lay Evidence
Lay evidence refers to non-expert testimony or statements from individuals who can provide valuable information about your disability and how it affects your daily life.
It is often used to supplement gaps in medical records or when official documentation is lacking.
Examples of lay evidence include:
- Personal Statements: You can submit your own written account describing your symptoms, when they began, how they have progressed, and how they affect your ability to function. It’s vital to be as specific as possible, detailing the severity and frequency of your symptoms.
- Buddy Statements: Fellow service members who witnessed your in-service injury or can attest to events during your military service can provide written statements to support your claim. Buddy statements are particularly valuable when service records are missing or insufficient.
- Family and Friends Statements: People close to you who have observed the impact of your disability on your life can provide statements. For example, they can describe changes in your behavior, how the disability affects your work or daily activities, and the emotional toll it has taken.
Conclusion & Wrap-Up
The review of your new and relevant evidence by a VA Supplemental Claim reviewer marks a critical turning point in your VA claims journey.
While patience is important, being proactive is equally essential.
Remember that familiar military saying, “hurry up and wait”?
It rings true for the VA claims and appeals process as well!
Stay on top of your claim by following up with the VA when necessary, and promptly address any additional requests for information or exams.
With well-prepared evidence and persistence, this phase could be the breakthrough that leads to the VA disability benefits you rightfully earned.
And never forget the golden rule: “If it’s not written down, it didn’t happen!”
Make sure your new evidence is detailed, thorough, and leaves no questions unanswered.
This level of diligence could be the key to success in securing your benefits.
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.