Instructions To Va Form 4107, Your Rights To Appeal Our Decision printable pdf download

YOUR RIGHTS TO APPEAL OUR DECISION

After careful and compassionate consideration, a decision has been reached on your claim. If we were not

able to grant some or all of the VA benefits you asked for, this form will explain what you can do if you

disagree with our decision. If you do not agree with our decision, you may:

Start an appeal by submitting a Notice of Disagreement.

Give us evidence we do not already have that may lead us to change our decision.

This form will tell you how to appeal and how to send us more evidence. You can do either one or both of

these things.

I A

PPEAL THE

ECISION?

How do I start my appeal? To begin your appeal, you must submit VA Form 21-0958, "Notice of

Disagreement," if that form was provided to you in connection with our decision. If we denied more than one

claim for a benefit (for example, if you claimed compensation for three disabilities and we denied two of

them), please tell us in Part III of VA Form 21-0958 each of the claims you are appealing. A filed VA Form

21-0958 is considered your Notice of Disagreement. If you did not receive VA Form 21-0958 in connection

with our decision, then write us a letter telling us you disagree with our decision or enter your disagreement on

VA Form 21-0958 in questions 10 or 11A. If you did not receive VA Form 21-0958 in connection with our

decision, then either your statement or VA Form 21-0958 is considered your Notice of Disagreement. Send

your Notice of Disagreement to the address included on our decision notice letter.

How long do I have to start my appeal? You have one year to start an appeal of our decision. Your

Notice of Disagreement must be postmarked (or received by us) within one year from the date of our letter

denying you the benefit. In most cases, you cannot appeal a decision after this one-year period has ended.

What happens if I do not start my appeal on time? If you do not start your appeal on time, our decision

will become final. Once our decision is final, you cannot get the VA benefit we denied unless you either:

Show that we were clearly wrong to deny the benefit or

Send us new evidence that relates to the reason we denied your claim.

What happens after VA receives my Notice of Disagreement? We will either grant your claim or send you

a Statement of the Case. A Statement of the Case describes the facts, laws, regulations, and reasons that we

used to make our decision. We will also send you a VA Form 9, "Appeal to Board of Veterans' Appeals," with

the Statement of the Case. If you want to continue your appeal to the Board of Veterans' Appeals (the Board)

after receiving a Statement of the Case, you must complete and return the VA Form 9 within one year from the

date of our letter denying you the benefit or within 60 days from the date that we mailed the Statement of the

Case to you, whichever is later. If you decide to complete an appeal by filing a VA Form 9, you have the

option to request a Board hearing. Hearings often increase wait time for a Board decision. It is not necessary

for you to have a hearing for the Board to decide your appeal. It is your choice.

Where can I find out more about the VA appeals process?

You can find a "plain language" pamphlet called "How Do I Appeal," on the Internet at:

You can find the formal rules for the VA appeals process in title 38, Code of Federal Regulations,

Part 20. You can find the complete Code of Federal Regulations on the Internet at:

A printed copy of the Code of Federal Regulations may be available at your

local law library.

OUR

IGHT TO

EPRESENTATION

Can I get someone to help me with my appeal? Yes. You can have a Veterans Service Organization

representative, an attorney-at-law, or an "agent" help you with your appeal. You are not required to have

someone represent you. It is your choice.

Representatives who work for accredited Veterans Service Organizations know how to prepare and

present claims and will represent you. You can find a listing of these organizations on the Internet at:

4107

VA FORM

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JUN 2015

Instructions To Va Form 4107, Your Rights To Appeal Our Decision

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