U.S. Department of Veterans Affairs (VBA) Edition VA Form 20-0995, MAY 2024 (OMB No. 2900-0886, expires 05/31/2027) 7 pages

VA Form 20-0995 — Decision Review Request: Supplemental Claim

Ask VA to decide an issue again because you have new and relevant evidence, or can tell VA where to find it.

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VA Form 20-0995 · Decision Review Request: Supplemental Claim
The official U.S. Department of Veterans Affairs (VBA) form, edition VA Form 20-0995, MAY 2024 (OMB No. 2900-0886, expires 05/31/2027) — blank
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What is VA Form 20-0995?

VA Form 20-0995 starts a Supplemental Claim: a new review of an issue VA already decided, based on new and relevant evidence. The instructions say to use it only when you disagree with a decision. If your condition has got worse, VA points to Form 21-526EZ for an increased rating instead, and for a review without new evidence or an appeal to a judge, to Forms 20-0996 and 10182.

The form runs to four pages after three pages of instructions: the benefit type (one per form), the veteran's and any other claimant's details, a homelessness section VA uses to prioritize claims, up to seven issues with decision dates, the places you were treated, the 5103 notice acknowledgment, a choice about VHA notifications on military sexual trauma claims, and signatures, with spaces for witnesses, an alternate signer and a power of attorney.

FileIt walks through each section, pre-fills the veteran's details from your vault, prints capitals one letter per box on VA's own PDF (MAY 2024 edition), and keeps parts you don't need switched off. The finished form goes in the person's vault folder, and you can sign it by hand or send it for eSignature in FileIt. You send it to VA yourself; FileIt never files anything.

Who fills it
The veteran, or a survivor, parent, fiduciary or other claimant, with help from a representative if they like.
Evidence
Unless the claim rests on a change in law, you need to send or identify new and relevant evidence for the claim to be complete.
Send to
The intake center for your benefit type on page 1, for example the Compensation Intake Center, P.O. Box 4444, Janesville, WI 53547, or upload it electronically.
Private records
For VA to request private or Vet Center records, the form says to add Forms 21-4142 and 21-4142a.
Pages
7: three pages of instructions and four pages of form.
Edition
VA Form 20-0995, MAY 2024 (OMB No. 2900-0886, expires 05/31/2027)

Who needs to fill out VA Form 20-0995?

  • Veterans with a new medical opinion, test result or record that bears on an issue VA denied.
  • Survivors and other claimants with new evidence about a pension, DIC or accrued benefits decision.
  • Claimants whose claim can be decided again because of a change in the law.
  • Anyone opting a legacy appeal issue into the modernized review system after a Statement of the Case.

When to use VA Form 20-0995

  • When you have, or can point VA to, evidence it didn't have when it decided.
  • After a Higher-Level Review or Board decision, when you now have new evidence to add.
  • For one benefit type at a time: the instructions call for a separate form per benefit type.

What you need before you start

  • Your decision notice, for the wording of each issue and the decision date.
  • The veteran's Social Security number, date of birth, and VA file, service and insurance numbers if they apply.
  • Mailing addresses and phone numbers for the veteran and any other claimant.
  • The new evidence itself, or the names, locations and approximate dates of treatment at each facility.
  • Forms 21-4142 and 21-4142a, if you want VA to request private provider or Vet Center records.
  • If a representative signs, a VA Form 21-22 or 21-22a on record, and their accreditation number.

What’s on VA Form 20-0995

The 2024 edition has 7 pages. FileIt asks for it in 11 parts, and it is signed by Veteran or claimant:

  1. Item 1: Benefit typeVeteran or claimant
  2. Section I: Veteran's identifying informationVeteran or claimant
  3. Section II: Claimant's identification information (only if the claimant isn't the veteran)Veteran or claimant
  4. Section III: Homeless informationVeteran or claimant
  5. Section IV: Issues for the Supplemental ClaimVeteran or claimant
  6. Section V: New and relevant evidenceVeteran or claimant
  7. Sections VI and VII: 5103 notice and VHA notificationVeteran or claimant
  8. Section VIII: Certification and signatureVeteran or claimant
  9. Section IX: Witnesses to signature (only if the signer used an X)Veteran or claimant
  10. Section X: Alternate signer (only if item 25A is blank)Veteran or claimant
  11. Section XI: Power of attorney signature (not for insurance claims)Veteran or claimant

How to fill out VA Form 20-0995, step by step

1 Item 1 and Section I

Pick the benefit type, with a short description if it's a Veterans Health Administration claim such as travel reimbursement. Then the veteran's name, SSN, file number, date of birth, service number, insurance policy number, address, phone and email.

2 Section II: Other claimant

Only when the claimant isn't the veteran: name, SSN, file number, date of birth, relationship to the veteran (spouse, child, fiduciary, parent or other), address, phone and email.

3 Section III: Homeless information

Optional. Say whether you are homeless or at risk, tick each living situation that applies, and give a point of contact VA can use to reach you.

4 Section IV: Issues

Up to seven issues, each with the date of VA's decision notice. Answering a Statement of the Case withdraws those issues from the legacy appeals system.

5 Section V: New and relevant evidence

Tick where you were treated (private provider, Vet Center, community care, VA medical centers, military facilities or other), then name up to three facilities with the month and year of treatment, or tick that you don't have the date. Dates aren't needed for treatment from 2005 on.

6 Sections VI and VII

Confirm whether you have reviewed the 5103 notice of the evidence needed, and choose whether VBA may notify VHA about upcoming events on a claim related to military sexual trauma. Item 24 needs no answer.

7 Sections VIII to XI: Signatures

The veteran or claimant signs 25A. Witnesses sign only if the signer used an X. An alternate signer or a power of attorney signs only if 25A is blank, with the paperwork the form names.

Common mistakes to avoid

  • Filing without new and relevant evidence, or without telling VA where to find it.
  • Using this form for a condition that has got worse. The instructions point to Form 21-526EZ for an increase.
  • Naming a private doctor without sending Forms 21-4142 and 21-4142a, so VA can't request the records.
  • Mixing benefit types on one form.
  • Leaving item 25A blank without an alternate signer or POA signature.

After you fill it out

Attach the evidence you have, with your name and file number on each page, and any 21-4142 and 21-4142a forms.

Sign the form, by hand or with FileIt eSignature, and send it to the intake center for your benefit type or upload it as the instructions describe.

Keep the filed PDF and copies of the evidence in your vault, as VA's instructions recommend keeping copies of everything you send.

Fill out VA Form 20-0995 online with FileIt

  1. Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
  2. Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 90 fields in all. Your answers save as you go.
  3. Check the live preview. Watch your answers land on the real U.S. Department of Veterans Affairs (VBA) form, and let FileIt do any worksheet arithmetic.
  4. Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

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VA Form 20-0995: frequently asked questions

What counts as new and relevant evidence?

The form describes it as evidence VA didn't have before that relates to the issue. VA's decision reviews pages explain the standard in more detail. You can send it yourself or identify it so VA can try to get it.

Do I need dates of treatment for every facility?

No. The form says you don't need to give dates in item 22C if treatment began in 2005 or later, and you can tick that you don't have the date.

What is the 5103 notice?

A notice explaining the evidence needed to support a compensation, pension, DIC or accrued benefits claim. If you file more than a year after the decision, the instructions ask you to read it on VA.gov and tick Yes, or tick No to have it mailed.

Can someone else sign for me?

An alternate signer can sign Section X with VA Form 21-0972 on record or attached, and an accredited representative can sign Section XI with a 21-22 or 21-22a on record.

Where do I send it?

Page 1 lists an intake center for each benefit type, and VA recommends sending it electronically as the fastest option.

Official sources

FileIt is not affiliated with or endorsed by U.S. Department of Veterans Affairs (VBA) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-19.

Fill out VA Form 20-0995 online