Higher Level Review: How Long Will You Really Have To Wait?

Higher Level Review: Navigating the Waiting Game

A Higher Level Review (HLR) is a process that allows veterans to have a more senior reviewer at the Department of Veterans Affairs (VA) re-examine their denied benefits claim. If you’re considering this route, understanding the potential timeline is crucial. This article breaks down what influences the wait time and what to expect. It also addresses the question: How long does a higher level review take?

Understanding the Standard Timeline

While the VA aims for efficiency, processing times can vary significantly. There isn’t a fixed, guaranteed answer to the question of "how long does a higher level review take."

Official VA Stance

The VA’s official guidance often mentions a target processing time. Generally, they aim to complete HLRs within several months. However, this is just a target, and real-world experiences often diverge.

Factors Affecting Processing Time

Several factors can influence the actual time it takes to receive a decision:

• Complexity of the Claim: Simple claims with clear evidence tend to be processed faster than those involving multiple medical conditions or complicated legal arguments.
• Backlog at the VA: The VA handles a high volume of claims. Backlogs can occur, leading to delays. Regional variations in workload can also impact processing times.
• Availability of Records: If the VA needs to request additional records (military service records, medical opinions, etc.), this will extend the processing time. Even if you’ve already submitted them, the reviewer may need to confirm they have all pertinent documents.
• Need for Informal Conference: If you request an informal conference with the reviewer, scheduling this call will add time. While the conference itself is brief, the scheduling process can contribute to delays.

Breaking Down the Process & Potential Delays

To better understand the potential wait time, let’s examine the steps involved in a Higher Level Review:

1. Application Submission: You submit your request for a Higher Level Review (VA Form 20-0996).

2. Initial Review and Assignment: The VA receives your request and assigns it to a senior reviewer. This internal process can sometimes take a few weeks.

3. Record Review: The reviewer examines your original claim file and any previously submitted evidence. They are looking for errors of fact or law in the initial decision.

4. Informal Conference (Optional): If you requested an informal conference, the reviewer will contact you to schedule a brief phone call. This is your opportunity to highlight specific issues with the previous decision.

   • Note: Keep your comments during the informal conference focused on why the previous decision was incorrect. The reviewer cannot consider new evidence at this stage.

5. Decision: The reviewer makes a decision. They can:

   • Uphold the previous decision: Meaning your claim remains denied.
   • Grant the benefit: Meaning your claim is approved, either partially or fully.
   • Remand the claim: Meaning the claim is sent back to the regional office for further development (e.g., to obtain a new medical opinion). This essentially restarts part of the claims process and adds significant time.

Potential Delay Points Summarized

Stage	Potential Delay Factors	Impact on Timeline
Assignment	Backlogs, staffing issues	Weeks
Record Review	Difficulty accessing records, complexity of records	Weeks to months
Informal Conference	Scheduling conflicts, reviewer availability	Weeks
Decision Making	Complexity of the case, reviewer workload, need for clarification	Weeks to months
Remand	Claim essentially restarts, adds significant time (months or even years)	Significant increase, unpredictable

Managing Expectations and Taking Action

While you can’t directly control the VA’s processing speed, you can take steps to manage your expectations and potentially expedite the process:

• Understand the Scope of an HLR: An HLR is not the place to submit new evidence. Make sure you understand this limitation before filing.
• Be Prepared for the Informal Conference: If you request an informal conference, have a clear and concise explanation of why you believe the original decision was incorrect.
• Track Your Claim Status: Regularly check the VA’s website or call the VA hotline to monitor the status of your claim. This allows you to identify any potential issues early on.
• Consider Legal Assistance: If your claim is complex or you are experiencing significant delays, consider consulting with a VA-accredited attorney or claims agent. They can provide guidance and advocacy.
• Be Patient: While frustrating, the VA system can be slow. Understanding the potential delays and managing your expectations will help you navigate the process more effectively.

Alright, hopefully, you have a much better idea of how long does a higher level review take now. Remember, every case is different, but knowing what to expect can definitely help ease the stress. Good luck with your review!