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Updated Feb 12, 2025

In This Section

  
This section contains the topic “Supplemental Claims.”

1.  Supplemental Claims

Introduction

  
This topic includes information on supplemental claims, including

Change Date

   December 28, 2021

II.iii.2.B.1.a.  Definition:  Supplemental Claim

  
A supplemental claim is any complete claim for a Department of Veterans Affairs (VA) benefit on a prescribed application form where the claimant or his/her authorized representative disagrees with the decision VA made on an initial or supplemental claim for the same or similar benefit on the same or similar basis.
 
Notes:
  • A supplemental claim can be submitted at any time.
  • Claimants may file a supplemental claim on a decision issued before February 19, 2019, the date of implementation of the Appeals Modernization Act.
References:  For more information on

II.iii.2.B.1.b.  Definition:  Same or Similar Benefit on Same or Similar Basis

  
Generally, the same or similar benefit on the same or similar basis means VA has previously decided a claim for the same benefit type.
 
Examples of distinct types of benefits:
  • service connection (SC) for right knee arthritis
  • entitlement to compensation under 38 U.S.C. 1151
  • entitlement to individual unemployability
  • SC for cause of death, and
  • entitlement to non-service-connected pension
Important:  In claims for compensation, a claim based on a new theory of SC is a supplemental claim.  A new theory of SC (for example, when direct SC was previously denied, and secondary SC is now claimed) is sufficient new and relevant evidence to satisfy the evidentiary threshold discussed in M21-1, Part II, Subpart iii, 2.B.1.e.
 
Exception:  A claim under 38 U.S.C. 1151 for a disability that was previously denied SC under 38 U.S.C. 1110 (or vice versa) is not a new theory of SC and does not represent a supplemental claim for the same or similar benefit on the same or similar basis.  Instead, consider it as a new claim for a separate and distinct benefit type.
 
References:  For more information on

II.iii.2.B.1.c.  Prescribed Supplemental Claim Form

  
Supplemental claims must be submitted on the prescribed supplemental claim form, VA Form 20-0995, Decision Review Request:  Supplemental Claim.
 
Reference:  For more information on the definition of a complete supplemental claim, see 38 CFR 3.160(a).

II.iii.2.B.1.d.  Supplemental Claims Establishment

  
All supplemental claims must be established in Caseflow using the appropriate end product (EP), claim label, and any applicable special issues.
 
References:  For more information on

II.iii.2.B.1.e.  Requirement for Potentially New Evidence

  
To be considered a complete claim, a supplemental claim must identify or include potentially new evidence.
 
Potentially new evidence is evidence that may be new to the claim, thereby providing some potential basis for a supplemental claim.  When deciding if a supplemental claim is substantially complete, there is no need to determine that the evidence is non-duplicative or that it is relevant.  Any evidence must be accepted when making the complete claim threshold determination.
 
Note:  Once a claim is considered substantially complete, a decision must be issued on the basis of whether the evidence is new and relevant as described in M21-1, Part X, Subpart ii, 2.A.2.d.
 
Carefully screen all newly received evidence per the steps in the table below to determine the appropriate action.
 
Step
Action
1
Determine if there is potentially new evidence by reviewing for
  • evidence submitted or identified with the claim
  • additional treatment records found during an enterprise search in the Compensation and Pension Record Interchange per the instructions in M21-1, Part III, Subpart ii, 1.A.2.g, and
  • evidence submitted while the evidentiary record was closed, such as
    • during the processing of a higher-level review, or
    • after a final decision unaccompanied by a claim or decision review.
Is there potentially new evidence?
2
Does the new evidence warrant additional development action(s)?
  • If yes,
    • complete required development actions, and, when complete,
    • refer the claim for a decision.
  • If no, either
    • take authorization/award action (if no rating decision is needed), or
    • refer the claim to the rating activity for a decision once any applicable 30-day response period required under Section 5103 has expired.
 
References:  For more information on

II.iii.2.B.1.f.  Handling Incomplete Supplemental Claims

  
If the claimant submits a supplemental claim that is not substantially complete, follow the procedures in M21-1, Part II, Subpart iii, 1.C.2.b to notify the claimant.
 
Important:  A claimant must submit a complete supplemental claim within 60 days of notice by VA that an incomplete claim was filed, in order to preserve the filing date of the incomplete claim.
 
References:  For more information on