Yes! You can use AI to fill out VA Form 20-0995, Decision Review Request: Supplemental Claim
VA Form 20-0995 is the Department of Veterans Affairs (VA) “Decision Review Request: Supplemental Claim” form used to seek a new review of one or more issues from a prior VA decision you disagree with. A Supplemental Claim requires new and relevant evidence, or enough information for VA to locate and obtain relevant records on your behalf. It is important because only the issues you list on the form will be reviewed, and filing within applicable time limits can help preserve eligibility for the earliest possible effective date if benefits are later granted. The form must be submitted for only one benefit type per filing (separate forms are required for multiple benefit types).
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Form specifications
| Form name: | VA Form 20-0995, Decision Review Request: Supplemental Claim |
| Number of pages: | 7 |
| Language: | English |
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Follow these steps to fill out your VA FORM 20-0995 form online using Instafill.ai:
- 1 Confirm this is the correct review option: you are disagreeing with a VA decision and you can submit (or identify) new and relevant evidence; choose Supplemental Claim rather than Higher-Level Review (20-0996) or Board Appeal (10182).
- 2 Select the single Benefit Type in Item 1 (e.g., Compensation, Pension/DIC/Survivors, Education, VR&E, etc.); if you need multiple benefit types, start a separate VA Form 20-0995 for each.
- 3 Enter identifying information in Section I (Veteran) and, if applicable, Section II (Claimant if not the Veteran), including SSN/VA file number and current contact details.
- 4 If applicable, complete Section III homeless/risk-of-homelessness items (20A–20D) to help VA prioritize contact and processing; otherwise skip this section.
- 5 In Section IV, list each specific issue you want reviewed (Item 21A) and provide the date of the VA decision notice for each issue (Item 21B); include court decision details and attach a copy if the supplemental claim is based on a qualifying court decision.
- 6 Complete Section V by attaching your new and relevant evidence and/or identifying where relevant records exist (VA facilities, DoD, private providers, Vet Centers, etc.); if VA must request private/Vet Center records, prepare and include required authorizations (VA Forms 21-4142 and 21-4142a).
- 7 Complete any applicable acknowledgments/consents (Section VI 5103 notice acknowledgment if required; Section VII MST-related VHA notification option if applicable), then sign and date the certification (or use witness/alternate signer/POA sections as needed) and submit via VA’s electronic upload tools (recommended) or mail to the correct intake center for your benefit type.
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Frequently Asked Questions About Form VA Form 20-0995
VA Form 20-0995 (Decision Review Request: Supplemental Claim) is used when you disagree with a VA decision and want VA to review the issue again based on new and relevant evidence. It starts a supplemental claim review for issues VA has already decided.
You should use this form if you received a VA decision and you disagree with it, and you can submit (or identify) new and relevant evidence. Veterans or eligible claimants (such as a spouse, child, parent, or fiduciary) may file, depending on the benefit.
Don’t use this form if you’re only seeking a higher disability rating because your condition worsened (use VA Form 21-526EZ). Don’t use it if you want a Higher-Level Review (use VA Form 20-0996) or a Board appeal (use VA Form 10182).
Yes—your supplemental claim must include new and relevant evidence, or you must identify existing relevant records you want VA to obtain. Unless your claim is based on a change in law, new and relevant evidence is required for the application to be complete.
New evidence is information not previously submitted to VA. Relevant evidence is information that tends to prove or disprove something important to the issue you’re claiming.
No. This form can only cover issues related to one benefit type per submission (for example, Compensation OR Education). If you need review for multiple benefit types, you must submit a separate VA Form 20-0995 for each.
You must submit it to the intake center/address that matches your benefit type (for example, Compensation Intake Center in Janesville, WI for compensation-related issues, or the Education regional processing office for education claims). VA also recommends electronic submission as the fastest option, including uploading through AccessVA QuickSubmit.
Yes. VA recommends submitting electronically because it is typically the fastest method of receipt. You can upload documents using VA’s online tools such as AccessVA QuickSubmit, and you can find guidance at VA.gov (including the “upload supporting evidence” page).
VA can generally identify you if you provide key identifiers such as your last name and Social Security Number or VA file number. Other details (like address or phone) are helpful but may not be required for VA to consider the request complete.
Complete Section I with the veteran’s identification information, and complete Section II only if the claimant is not the veteran. In Section II, you’ll also indicate your relationship to the veteran (for example, spouse, child, parent, fiduciary, or other).
List each specific issue you want VA to review, and include the date of the VA decision notice for each issue if possible. Only the issues you list on the form will be considered as part of your supplemental claim.
Issues not listed on this form won’t be reviewed as part of this supplemental claim. You generally still have one year from the date of the decision notification letter to file a supplemental claim on other issues to preserve eligibility for the earliest possible effective date.
You may choose to continue in the legacy system or opt into the modernized review system using this form. To move issues from an SOC/SSOC into the modernized system, you must submit VA Form 20-0995 within 60 days of the SOC/SSOC date and list the issues you want reviewed.
In Item 22, check where you received treatment (such as VAMC/CBOC, DoD MTF, private provider, Vet Center, or community care) and provide the facility name/location and approximate dates if you can. If you don’t know the dates, you can check the “Don’t have date” box.
Yes. If you want VA to request private provider records (excluding VA-paid community care) or VA Vet Center records, you must provide consent using VA Forms 21-4142 and 21-4142a. VA can access VA medical center and many federal records without those releases, as long as you adequately identify them.
Compliance VA Form 20-0995
Validation Checks by Instafill.ai
1
Benefit Type Selection Is Exactly One Option (Item 1)
Validate that exactly one benefit type checkbox is selected in Item 1, since the form may only be used for a single benefit type per submission. This prevents routing/processing errors and ensures the correct intake center and business rules are applied. If none or multiple are selected, flag the submission as invalid and require the claimant to select one (or submit separate forms for multiple benefit types).
2
VHA Benefit Type Detail Required When VHA Is Selected (Item 1)
If 'Veterans Health Administration (VHA)' is checked, validate that the free-text field specifying the VHA benefit type (e.g., travel reimbursement, clothing allowance) is populated and not just whitespace. This is necessary to determine what VHA issue is being reviewed and to route the claim correctly. If missing, reject or pend the submission for clarification because the benefit type is ambiguous.
3
Veteran vs. Non-Veteran Claimant Section Completeness (Sections I & II)
Validate that Section II (claimant information) is completed only when the claimant is not the veteran, and that at least one of the identifying keys is present for the relevant party (Veteran: last name + SSN or VA file number; Claimant: last name + SSN or VA file number). This ensures VA can match the submission to the correct record and avoids duplicate or misfiled claims. If both sections are partially filled in a conflicting way or the minimum identifiers are missing, fail validation and request corrected identifying information.
4
SSN Format and Plausibility (Items 3 and 12)
Validate Social Security Numbers for correct format (9 digits, allowing hyphens if the system supports them) and reject known invalid patterns (e.g., all zeros, 000-xx-xxxx, 666-xx-xxxx, or 9xx-xx-xxxx if your ruleset includes SSA constraints). Correct SSN formatting is critical for identity matching and record association. If invalid, block submission or route to manual review depending on policy.
5
VA File Number Format (Items 4 and 13) When Provided
If a VA file number is entered, validate it matches expected VA file number formatting rules used by your system (e.g., numeric length constraints, no illegal characters). This reduces mismatches and prevents downstream system rejections. If the format is invalid, prompt for correction or ignore the field and require an alternate identifier (SSN) per business rules.
6
Date of Birth Format and Reasonableness (Items 5 and 14)
Validate DOB fields are in MM/DD/YYYY format and represent a real calendar date (including leap-year handling). Also validate the date is not in the future and is within a reasonable human age range (e.g., 0–120 years) to catch keying/OCR errors. If invalid, fail validation and require correction because DOB is a core identity attribute.
7
Mailing Address Completeness and Postal Validation (Items 8 and 17)
Validate that the mailing address contains the minimum required components for delivery: street/PO box, city, state/province, and ZIP/postal code; and that country is present when non-US. For US addresses, validate ZIP is 5 digits (optionally ZIP+4) and state is a valid USPS abbreviation; for international, ensure postal code rules are not incorrectly enforced. If incomplete or malformed, flag for correction because VA correspondence and notices depend on deliverable addresses.
8
Phone Number Format Validation Including International Option (Items 9, 18, 20D)
Validate phone numbers contain valid digits and allowable separators, and meet length requirements (e.g., US 10 digits with area code; international E.164-like patterns if 'international phone number' is used). This is important for time-sensitive contact, especially for homeless-risk prioritization and evidence development. If invalid, do not necessarily reject the entire form (phone is optional in some sections), but flag the field and request correction when it is required (e.g., Item 20D when homeless is 'Yes').
9
Email Address Format Validation (Items 10 and 19)
If an email address is provided, validate it conforms to standard email syntax (local@domain) and does not contain illegal characters or spaces. This reduces failed electronic communications and prevents data quality issues. If invalid, flag the email field and either require correction or treat it as not provided, depending on channel requirements.
10
Homeless Section Conditional Logic (Items 20A–20D)
If Item 20A is 'Yes', validate that at least one living situation option is selected in 20B (or 'Other' specified) and that a point of contact name (20C) and phone number (20D) are provided. If Item 20A is 'No', validate that 20B–20D are blank to avoid contradictory data. If the conditional requirements are not met, fail validation or route to manual review because homelessness status affects prioritization and outreach.
11
Issue List Required and Structured Per Issue (Item 21A/21B)
Validate that at least one issue is listed in Item 21A and that each issue entry is not empty, overly vague (e.g., 'all issues'), or purely duplicative without differentiation. For each listed issue, validate an associated decision notice date is provided in Item 21B when the form design captures it per issue, or otherwise ensure at least one decision date is present when required by your workflow. If issues are missing or unparseable, reject/pause processing because VA can only review issues explicitly identified on the form.
12
Decision Notice Date Format and Not-in-Future (Item 21B)
Validate Item 21B uses the expected date format and is a valid calendar date, and ensure it is not in the future. This date is used to determine timeliness (e.g., within one year for effective date protection, or 60 days for SOC/SSOC opt-in) and to associate the correct decision. If invalid, flag for correction or manual review because timeliness determinations may be impacted.
13
New and Relevant Evidence Requirement Satisfied (Section V / Item 22)
Validate that the submission includes either attached new and relevant evidence or identifies evidence sources in Section V (Item 22) sufficient for VA to attempt retrieval (e.g., facility name/location and treatment dates or 'Don’t have date' checked). This is a core completeness rule for supplemental claims unless the claim is explicitly based on a change in law (if your system captures that indicator). If no evidence is attached and no retrievable evidence is identified, fail validation as incomplete and request evidence details.
14
Treatment Source Details Required When a Source Is Checked (Item 22A–22D)
For each checked treatment source type in Item 22A, validate that the corresponding facility name/location (22B) is provided and that either treatment dates (22C in MM-YYYY) are provided or the 'Don’t have date' box (22D) is checked. This ensures VA can locate records efficiently and reduces development delays. If a source is checked without sufficient details, flag the specific source line as invalid and require completion.
15
5103 Notice Acknowledgment Required When Applicable (Item 23)
If the benefit type is Compensation, Pension, DIC/Survivors, or Accrued benefits and the claim is indicated/derived as being filed more than one year after the decision notice (per your system’s timeliness logic), validate that Item 23 has either 'Yes' or 'No' selected. This confirms whether the claimant reviewed the required evidence notice online or needs it mailed, supporting due process. If neither is selected when applicable, fail validation and request a selection.
16
Signature and Date Requirements with Alternate Signer/Witness Rules (Items 25–29)
Validate that the form is properly signed and dated: Item 25A and 25B must be present for a standard submission. If the claimant used an 'X' signature, require both witness signatures and printed names/addresses (Items 26–27); if Item 25A is blank, require alternate signer signature/date (Items 28A–28B) and enforce the rule that a valid VA Form 21-0972 is attached or on file. If a POA signs (Item 29A), validate the POA date (29B) and that required appointment forms (21-22/21-22a, and for insurance scenarios the noted alternatives) are on file; otherwise reject or pend for missing authorization.
Common Mistakes in Completing VA Form 20-0995
People often use this form when their condition has worsened, but they don’t actually disagree with a prior decision—this is a common mix-up with an increased evaluation claim. The consequence is delay or denial because VA may treat it as the wrong type of request. Use VA Form 20-0995 only to disagree with a prior decision and pursue a supplemental claim; use VA Form 21-526EZ for an increase due to worsening.
Item 1 allows only one benefit type, but applicants sometimes check more than one box or pick a category that doesn’t match the decision they’re challenging (e.g., Compensation vs. Pension/DIC). This can route the claim incorrectly and slow processing or require resubmission on a new form. To avoid this, match the benefit type to the decision notice you’re disputing and submit separate 20-0995 forms if you need review for different benefit types.
A frequent error is completing Section II (Claimant) when the veteran is the claimant, or leaving out critical identifiers like SSN/VA file number while providing only partial name/address. This can cause misidentification, delays, or requests for clarification—especially when names are common. Complete Section I for the veteran, and only complete Section II if the claimant is not the veteran (e.g., survivor, fiduciary), ensuring SSN or VA file number is accurate.
Applicants often enter dates in the wrong format (not MM/DD/YYYY where required, or not MM-YYYY for treatment dates) or provide inconsistent dates across sections. Incorrect dates can prevent VA from matching the request to the correct decision or records and may trigger development letters. Always follow the form’s specified date format and cross-check against your decision notice and medical records before submitting.
Many people write broad statements like “all conditions” or list new issues that were never decided, instead of naming each specific adjudicated issue exactly as shown on the decision notice. VA will only review the issues you list, so missing or vague issues can be excluded from the supplemental claim and may risk effective-date protections if not filed timely. Use the decision notification letter as your checklist and enter each issue separately with clear, decision-matching wording.
A common mistake is leaving Item 21B blank or entering the rating decision date instead of the decision notice letter date (or mixing multiple decisions). This can slow down identification of the exact decision being challenged and may lead to follow-up requests. To avoid this, use the date on the VA decision notification letter for each issue, and if responding to a court decision, include the court decision date and attach the decision as instructed.
People often assume a supplemental claim is just a re-argument of the same record, but the form requires new and relevant evidence (unless based on a change in law) or identification of records VA can obtain. Without qualifying evidence, the supplemental claim may be considered incomplete or denied because it doesn’t meet the threshold for readjudication. Attach new documents (e.g., new diagnosis, nexus opinion, updated testing) or clearly identify where VA can obtain relevant records.
Applicants frequently list private providers or Vet Center treatment in Section V but don’t submit VA Forms 21-4142 and 21-4142a, which VA needs to request those records (community care paid by VA is treated differently). The result is VA cannot legally obtain the records, causing delays and shifting the burden back to the claimant. If you want VA to gather private or Vet Center records, submit the signed 21-4142 and 21-4142a with complete provider contact details.
In Section V, people often check a treatment source but don’t provide the facility name/location (Item 22B) or usable date ranges (Item 22C), or they forget to check “Don’t have date” when dates are unknown. This prevents VA from locating the correct records, especially when there are multiple facilities with similar names. Provide the full facility name, city/state, and approximate month/year ranges; if you truly don’t know dates, check the “Don’t have date” box rather than leaving it blank.
For certain claim types filed more than one year after the decision notice, applicants must indicate whether they reviewed the 5103 evidence notice online (YES) or need it mailed (NO). People often leave Item 23 blank because they assume it’s informational, which can trigger additional outreach and delay. If Section VI applies to your benefit type and timing, select YES or NO explicitly so VA can proceed without follow-up.
A very common rejection reason is a missing signature/date in Item 25, or an alternate signer/POA signing without the required supporting documentation (e.g., VA Form 21-0972 for alternate signer, or valid 21-22/21-22a on file for POA). This can make the submission invalid and require resubmission, losing time and potentially affecting deadlines. Ensure the veteran/claimant signs and dates the form; if using an “X,” complete witness sections; if an alternate signer or representative signs, confirm the required forms are on file or attached.
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