When the VA issues a rating decision, you receive a notification letter and a rating codesheet. Understanding these documents is essential for identifying errors and planning your next steps.
The notification letter summarizes the decision for each claimed condition: whether service connection was granted or denied, the percentage assigned, and the effective date. It also explains your appeal rights and the one-year deadline to file a decision review.
The rating codesheet (sometimes called the rating narrative) provides the detailed reasoning. For each condition, it lists: the diagnostic code used, the evidence considered (C&P exam reports, medical records, lay statements), the findings of fact, and the rationale for the assigned percentage.
When reviewing the decision, check for these common issues: Was the correct diagnostic code applied? Did the rater consider all relevant evidence, including buddy statements and private medical opinions? For musculoskeletal conditions, did the rater address the DeLuca factors (pain, flare-ups, functional loss)? Was the benefit of the doubt properly applied when evidence was in approximate balance? Is the effective date correct based on your filing date or Intent to File?
If a claim was denied, the decision letter tells you which element was not satisfied — current diagnosis, in-service event, or nexus. This tells you exactly what evidence to target if you file a Supplemental Claim.
If the rating is lower than expected, compare the C&P exam report to the rating criteria. If the exam findings support a higher rating than what was assigned, a Higher-Level Review may be appropriate because the error is in how the evidence was evaluated, not in the evidence itself.
You have one year from the date of the decision to file a decision review (Supplemental Claim, Higher-Level Review, or Board Appeal) without losing the effective date. After one year, the decision becomes final and a new claim typically resets the effective date.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).