Federal agency ยท U.S. Department of Veterans Affairs
Veterans Affairs clinical appeals and decision reviews
How a veteran asks Veterans Affairs (VA) to review a treatment decision (a clinical appeal) or a decision about a VA benefit, including health care benefits, with the review options and what to send.
Know before you go
A clinical appeal is for a decision your VA care team made about your treatment, such as a medicine or therapy; you send a written request to your facility's patient advocate. A decision about a VA health care benefit, such as eligibility, travel reimbursement or the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), uses the decision review process instead. The clinical appeals page was last updated in March 2024, and the main decision reviews page prints October 2026, so check the main page for current options.
- Cost
- Not stated. The page lists no fee.
- Where
- Nationwide
- How to start
- For a treatment decision, write to your facility's patient advocate saying what you disagree with, why, and what evidence you have. For a benefit decision, use the decision reviews page to choose a review option.
- Phone
- 1-877-222-8387, as printed on the provider's page
- Have ready
- The VA decision you disagree with; Your reasons in writing; Medical records or published studies that support your view
Where this comes from
- Provider
- U.S. Department of Veterans Affairs
- Source we read
- https://www.va.gov/decision-reviews/clinical-appeals/
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- 2024-03-29
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
From Centers for Medicare & Medicaid Services
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
From Center for Medicare Advocacy