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The information in this document replaces va forms 4107, 4107c, 4107 ins, 4107 vha, and 4107 vre. This form provides information on the different types of reviews available and outlines the steps needed to initiate these reviews. This form requires several documents to support your claim
These include a final medical record, a certified copy of the original claim, and an authorized letter from a va administrator Consult your decision notice for specific limitations. If you are denied benefits, you can request an independent medical examination.
Your right to seek review of our decision this document outlines your right to seek review of our decision on any issue with which you disagree
You may generally select one of three different review options for each issue decided by va However, you may not request review of the same issue using more than one option at the same time Below is information on the three different review options. This form informs veterans, service members, and their families of their right to challenge a va decision on benefits
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