Form 20-0995 is VA Form 20-0995, Decision Review Request: Supplemental Claim, the form the U.S. Department of Veterans Affairs (VA) uses to start a supplemental claim, a new review of an issue VA has already decided. You use it when you disagree with a decision and have new and relevant evidence, or want VA to gather such evidence for you. On FillingPDF you can fill out the form online and download or print the completed PDF; the VA publishes the official PDF, and the claim reaches VA only through the channels described below.
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What is 20-0995?
VA Form 20-0995, Decision Review Request: Supplemental Claim, is the Department of Veterans Affairs (VA) form used to submit a supplemental claim: a new review of one or more issues VA previously decided, based on new and relevant evidence.
The form's instructions define the two key terms. New evidence is information not previously submitted to VA. Relevant evidence is information that tends to prove or disprove a matter at issue in the claim. To make the claim complete, you either submit that evidence or identify existing relevant records you want VA to obtain.
The form is organized in sections: benefit type (Item 1), veteran's and claimant's identifying information (Sections I and II), homeless information (Section III), the issues to review (Section IV, Item 21), new and relevant evidence (Section V), the 5103 notice of acknowledgment (Section VI), an option for VBA to notify VHA about certain upcoming events in MST-related compensation claims (Section VII), and certification and signatures (Sections VIII to XI). Only the issues you list in Item 21 are considered.
It is one of three decision review options. A higher-level review uses VA Form 20-0996, Decision Review Request: Higher-Level Review, and an appeal to the Board of Veterans' Appeals uses VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement). A claim that a condition has worsened uses VA Form 21-526EZ, not this form.
Who needs to file 20-0995?
Veterans and other claimants who disagree with a VA decision they received use Form 20-0995 to ask for a supplemental claim review of that decision. The form is for review of issues in one benefit type only: Compensation, Pension and Survivors Benefits, Fiduciary, Life Insurance, Education, Loan Guaranty, Veteran Readiness and Employment, Veterans Health Administration or National Cemetery Administration.
- If you want to file for more than one benefit type, complete a separate Form 20-0995 for each.
- Section I is for the veteran. Section II is completed only if the claimant is not the veteran, and asks for the relationship: spouse, child, fiduciary, parent or other.
- If you are responding to a Statement of the Case (SOC) or Supplemental Statement of the Case (SSOC) in the legacy appeals system, you may use this form to move those issues to the modernized review system.
Do not use this form if you feel your condition has worsened and the disability level VA assigned no longer reflects it; the instructions point to VA Form 21-526EZ for an increased evaluation. Use Form 20-0996 for a higher-level review or Form 10182 for a Board appeal.
An accredited representative can help you complete the form. An alternate signer or a power of attorney may sign only under the conditions in Sections X and XI.
When to file 20-0995
File Form 20-0995 after you receive a VA decision you disagree with. For issues you do not list on the form, you still have one year from the date of the decision notification letter to file a supplemental claim and keep eligibility for the earliest effective date for any granted benefits.
- If you are filing within one year of a decision from the U.S. Court of Appeals for Veterans Claims, the U.S. Court of Appeals for the Federal Circuit or the Supreme Court of the United States, enter the court decision date in Item 21B and attach a copy of the decision.
- If you are responding to an SOC or SSOC in the legacy appeals system and want to enter the modernized review system, submit the form within 60 days from the date of the SOC or SSOC and list those issues in Item 21.
- For Compensation, Pension, DIC and Accrued benefit claims filed more than one year after VA gave notice of its decision, review the 5103 information online and answer Item 23.
The instructions give no processing time for the claim.
Documents you need
- New and relevant evidence you have in your possession, attached to the form; list your name and file number on each page.
- VA Form 21-4142, Authorization to Disclose Information to VA, and VA Form 21-4142a, General Release for Medical Provider Information to VA, if you want VA to obtain private provider (not VA-paid community care) or VA Vet Center health records.
- A copy of the court decision, if you file within one year of a decision from the U.S. Court of Appeals for Veterans Claims, the U.S. Court of Appeals for the Federal Circuit or the Supreme Court; enter its date in Item 21B.
- VA Form 21-0972, Alternate Signer Certification, of record or attached, if an alternate signer signs for the claimant in Item 28A.
- VA Form 21-22 or VA Form 21-22a, of record with VA when the claim is submitted, if a power of attorney signs in Item 29A (not for insurance claims).
- For insurance appeals with an alternate signer: VA Form 21-22, 21-22A or 21P-555, Certificate of Legal Capacity to Receive and Disburse Benefits and Fee Authorization, must be of record.
How to fill out 20-0995
Select one benefit type
In Item 1, check only one benefit type. For Veterans Health Administration, also specify the VHA benefit type in the space provided, such as Travel/Mileage Reimbursement or Health Care Eligibility.
Enter the veteran's information
In Section I, enter the veteran's name (Item 2), Social Security number (Item 3), VA file number (Item 4), date of birth in MM/DD/YYYY (Item 5), service number (Item 6), VA insurance policy number (Item 7), mailing address (Item 8), telephone (Item 9) and optional e-mail (Item 10).
Complete claimant details if not the veteran
Only if the claimant is not the veteran, complete Section II, Items 11 to 19: name, SSN, VA file number, date of birth, relationship to the veteran (spouse, child, fiduciary, parent or other), address, telephone and optional e-mail.
Answer the homeless information questions
In Item 20A, answer Yes or No. Complete Items 20B to 20D, the living situation and a point of contact with telephone number, only if you are homeless or at risk of becoming homeless; if No, skip to Item 21.
List each issue to be reviewed
In Item 21A, list each issue VA decided that you want reviewed, using your decision notice. In Item 21B, enter each decision notice date in MM/DD/YYYY, or the court decision date if that applies.
Identify treatment and evidence sources
In Item 22A, check where you were treated. In Items 22B to 22D, give the facility name and location and approximate treatment dates in MM-YYYY, or check the box if you do not have dates. Dates are not needed if treatment began from 2005 to present.
Respond to the 5103 notice
Item 23 applies to Compensation, Pension, DIC and Accrued benefit claims. If VA's decision was more than one year ago, review the linked VA.gov evidence page and check Yes, or check No to receive the notice by mail.
Choose the VHA notification option
Item 24 applies if you are filing a compensation claim for a condition due to military sexual trauma and are registered or enrolled in VHA health care. Check A, B, C or D; a response is not required.
Sign and date the form
The veteran or claimant signs Item 25A and enters the date in Item 25B. Two witnesses (Items 26 and 27) are used only if an "X" was used as the signature.
Add alternate signer or POA signature if needed
If Item 25A is blank, an alternate signer completes Items 28A and 28B, and a valid VA Form 21-0972 must be of record or attached. A power of attorney signs Items 29A to 29D, with a VA Form 21-22 or 21-22a already of record.
Review and download the completed PDF
Check that one benefit type is selected, every issue is in Item 21 and your name and file number are on any attached evidence. Download or print the completed PDF from FillingPDF and submit it through the channels described under How to submit.
How to submit 20-0995
You can submit Form 20-0995 electronically, by mail or in person at a VA regional office. VA recommends electronic submission as the fastest method of receipt. Keep a copy of the completed form and everything you give to VA.
- Online: the VA website lets you file a Supplemental Claim online at this time only for disability compensation claims. You can also upload documents through AccessVA using QuickSubmit, or see www.va.gov/disability/upload-supporting-evidence.
- By mail: use the address for your benefit type. Compensation and Loan Guaranty: Compensation Intake Center, P.O. Box 4444, Janesville, WI 53547 (fax (844) 531-7818). Pension and Survivors: Pension Intake Center, P.O. Box 5365, Janesville, WI 53547 (fax (844) 655-1604). Fiduciary: Fiduciary Intake Center, P.O. Box 5211, Janesville, WI 53547 (fax (888) 581-5826). Insurance: ATTN: Insurance Center, P.O. Box 5209, Janesville, WI 53547. Veteran Readiness and Employment: VR&E Intake Center, P.O. Box 5210, Janesville, WI 53547. National Cemetery Administration: NCA FP Evidence Intake Center, P.O. Box 5237, Janesville, WI 53547.
- Education claims: Buffalo Regional Processing Office, P.O. Box 4616, Buffalo, NY 14240-4616, or Muskogee Regional Processing Office, P.O. Box 8888, Muskogee, OK 74402-8888. Determine jurisdiction at https://benefits.va.gov/gibill/regional_processing.asp.
For help or claim status, call VA at 1-800-827-1000. FillingPDF lets you fill out and download the PDF; submission follows the VA channels above.
Common mistakes to avoid
- Checking more than one benefit type in Item 1; the form allows one, and each additional benefit type needs its own Form 20-0995.
- Leaving an issue off Item 21; only the issues listed there are considered as part of the supplemental claim.
- Submitting without new and relevant evidence or without identifying records for VA to obtain, unless the claim is based on a change in law.
- Asking VA to obtain private provider or Vet Center records without VA Forms 21-4142 and 21-4142a.
- Omitting the court decision date in Item 21B, or not attaching the decision, when filing within one year of a court decision.
- Waiting past 60 days from an SOC or SSOC when you want to move those legacy appeal issues to the modernized review system.
- Having someone else sign without a valid VA Form 21-0972 (alternate signer) or VA Form 21-22/21-22a (POA) of record or attached.
- Using this form to claim a worsened condition; the instructions direct that request to VA Form 21-526EZ.
- Mailing the form to the wrong intake center for your benefit type.
Frequently asked questions
What is Form 20-0995 used for?
Form 20-0995 is VA's Decision Review Request: Supplemental Claim. You use it to ask VA for a new review of an issue it already decided, supported by new and relevant evidence or by records you identify for VA to obtain. It is meant for decisions you disagree with.
How long do I have to file a supplemental claim?
For issues you do not list on the form, you have one year from the date of the decision notification letter to file a supplemental claim and keep the earliest effective date for any granted benefits. Other windows apply for court decisions and for an SOC or SSOC.
Can I file Form 20-0995 online?
VA says you can file a Supplemental Claim online at this time only for disability compensation claims. You can also fill out the PDF on FillingPDF and download it, but FillingPDF does not file it; you submit the form to VA by mail, in person or electronically.
Do I need a separate Form 20-0995 for each benefit type?
Yes. The form may be used for issues in only one benefit type, and Item 1 allows one box. If you want review in more than one benefit type, such as Compensation and Education, complete a separate form for each.
What counts as new and relevant evidence?
New evidence is information not previously submitted to VA. Relevant evidence is information that tends to prove or disprove a matter at issue in the claim. You can attach it or identify records for VA to obtain, unless your claim rests on a change in law.
Where do I mail Form 20-0995?
Mail it to the intake center for your benefit type, such as the Compensation Intake Center, P.O. Box 4444, Janesville, WI 53547 for Compensation and Loan Guaranty. Pension, Fiduciary, Insurance, VR&E, NCA and Education claims have their own addresses listed on the form.
Should I use Form 20-0995 if my condition has gotten worse?
No. The instructions say to use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, to request an increased evaluation when your condition has worsened. Form 20-0995 is only for disagreeing with a decision you received.
Who can sign Form 20-0995 for the claimant?
An alternate signer, such as a court-appointed representative or caregiver, may sign in Item 28A if the claimant is under 18, incompetent or physically unable to sign, and a valid VA Form 21-0972 is of record or attached. A power of attorney signs in Item 29A if a Form 21-22 or 21-22a is of record.
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