Phase 1: Know What Denied You
Before filing anything, identify the exact basis for the denial. That means getting your Claims File and reading what the rater actually had in front of them.
The C-File Strategy
-
1
Request VA Form 20-10206
The master record of every exam, DBQ, and service treatment record the VA relied on.
-
2
Expect three to six months
Plan around it. Do not let the C-file request run out your one-year deadline; file the appeal first if you have to.
-
3
Read the exam request
If the rating specialist left records out of what went to the examiner, that is a Duty to Assist error and it is the strongest ground for a Higher-Level Review.
Key Rule · Ingram v. Collins
Where a diagnostic code does not itself account for treatment, the VA cannot rate your disability based on how well you function while medicated. The examiner has to evaluate the underlying severity without the masking effect of the medication.
Ingram v. Collins, 38 Vet. App. 130 (2025) (No. 23-1798, decided Mar. 12, 2025).
The rule was contested almost immediately. In February 2026 the VA issued an interim final rule rewriting 38 CFR 4.10 to let raters evaluate veterans as they function with medication in place. After heavy opposition the VA rescinded it ten days later, so Ingram remains the controlling standard.
Practical effect: when you obtain a private medical opinion, have the physician document your functional limitations, the frequency and severity of flare-ups, the impairment that would exist without medication, and the side effects of the medication itself.