Understanding New and Material Evidence 

If you are reading this, you might be one of the 300,000 to 400,000 veterans who have their VA disability claims denied every year. One of the main reasons this happens is a lack of documented evidence linking your condition to your military service.  

Now, if years later, a former commanding officer provides a detailed letter recounting a traumatic incident you both experienced during deployment, things can change for the better! 

This new evidence is important because it provides a firsthand account that can significantly change how your claim is evaluated. It also fills a gap by directly connecting your condition to a specific in-service event that was previously undocumented.  

If you’re reopening a claim, understanding, and presenting new and material evidence is a critical step. 

Definition of New Evidence 

New evidence is any information or documentation that wasn’t included in your original claim and wasn’t reviewed by the initial decision-making body. This can include: 

• New medical records 

• Witness statements 

• Additional service records 

• Newly declassified documents 

To qualify as new, the evidence must be genuinely fresh and have the potential to impact the outcome of your claim, like a recently diagnosed medical condition that connects back to your service. According to VA Claim Evidence Rule guidelines, such evidence must contribute to a more complete picture of your situation and offer a reasonable possibility of substantiating your claim. 

Definition of Material Evidence 

Material evidence provides information that can potentially change the outcome of a claim. It must be directly relevant and impactful, addressing unproven or weak elements of your case. For example, if you’re filing a disability claim, material evidence could include: 

• New medical records showing a worsening condition 

• A new diagnosis related to your claim 

Unlike other evidence that might just reiterate what’s already been said, material evidence brings something vital to the table. It must present a reasonable possibility of changing the decision in your favor, ensuring the claim is viewed in its most complete and accurate context under the VA Claim Evidence Rule. 

Best Evidence Rule and the Social Security Administration (SSA) 

While the VA requires new and material evidence to reopen claims, the Social Security Administration (SSA) follows the Best Evidence Rule. This rule dictates that the most reliable, highest quality evidence must be presented to substantiate a claim. Unlike the VA’s focus on new information, the SSA emphasizes the authenticity and completeness of the evidence submitted. 

Definition of the Best Evidence Rule 

The Best Evidence Rule requires original documents or the best available copies to ensure the accuracy and reliability of the evidence. This could include: 

• Medical Records: Complete, original medical records directly from healthcare providers. 

• Employment Records: Certified copies of employment history and earnings. 

• Legal Documents: Original or certified legal documents like birth certificates and marriage licenses. 

Comparison: New and Material Evidence vs. Best Evidence Rule 

While both the VA and SSA aim to ensure fair adjudication of claims, their requirements differ significantly: 

• VA (New and Material Evidence): Focuses on the introduction of new, relevant information that could impact the decision. 

• SSA (Best Evidence Rule): Prioritizes the highest quality, most reliable evidence to establish the facts of the claim. 

Understanding these differences is crucial for effectively navigating both systems. 

Appeals Modernization Act (AMA) Overview 

The Appeals Modernization Act (AMA), effective for claims filed after February 19, 2019, marked a significant shift in how veterans’ disability appeals are processed. Unlike the old system, the AMA offers three distinct avenues: 

• Supplemental Claim 

• Higher-Level Review 

• Board Appeal 

Each option is tailored to meet different needs and timelines. This restructuring aims to streamline the appeals process, making it more transparent and timely by setting stricter deadlines for the VA, which helps reduce the backlog of claims. 

Key Changes Implemented by AMA 

One change is the new standard for submitting evidence. Under the AMA, you can now submit “new and relevant evidence” at any stage of your appeal. This means you can contribute fresh information that wasn’t part of your original claim file, like new medical records or expert opinions, as long as it can reasonably impact the outcome of your claim. By lowering the threshold for what counts as evidence, the AMA ensures a broader range of information is considered, ultimately giving you a better chance at a favorable decision. 

Definition of New and Relevant Evidence 

“New and relevant evidence” is a key concept introduced by the AMA, differing from the old standard of “new and material evidence” in the legacy system. New evidence means any information that wasn’t previously part of your claim file. Relevant evidence is information that could help substantiate your claim by establishing facts important to the issues you’re disputing. This shift aims to simplify the process and lessen the burden on you, ensuring you have a fair chance to present evidence like new medical records, updated service records, or personal statements that could support your claim. 

Overall, the AMA replaces the outdated and complicated legacy appeals system with a more streamlined process, offering you greater flexibility and control. 

Process for Submitting New and Material Evidence 

Submitting new and material evidence under the legacy system involves a few important steps to ensure your claim is properly reviewed. 

1. Identify and Complete Forms: Identify and complete the appropriate forms—the VA Form 21-526EZ for initial claims or VA Form 20-0995 for supplemental claims. Accurate form completion is crucial to avoid delays. 
2. Gather Evidence: Gather comprehensive supporting evidence, including detailed medical records, service documents, and expert opinions that were not previously considered and can potentially change the outcome of your claim. Make sure to explain clearly how this new evidence relates to your disability claim. 
3. VA Review: Once submitted, the VA will review the evidence to determine if it qualifies as both new and material, which can take some time. Regularly follow up with the VA to stay updated on your claim’s status. 
4. Include Service Records: Ensure your submission includes any relevant service department records that were not available during the initial decision. 

By following these steps, you’ll navigate the process more smoothly and increase your chances of a successful outcome. 

Important Deadlines and Requirements 

When filing a claim under the Legacy System, it’s crucial to keep an eye on some critical deadlines and requirements to ensure your claim is processed smoothly. 

1. One-Year Deadline: Submit any new and material evidence within one year from the date of the VA’s decision notification. Missing this deadline could mean your claim becomes final unless you have a valid reason for the delay. 
2. Comprehensive Documentation: Gather all necessary documentation, like medical records, expert opinions, and personal statements, to support the new evidence you’re presenting. Detailed and specific paperwork is key to showing how this new evidence affects the original decision. 
3. VCAA Notices: Adhere to the Veterans Claims Assistance Act (VCAA) notices, which tell you what evidence you need and what the VA will help you get. Following these notices can make a big difference in how quickly and successfully your claim is processed. 

Understanding new and material evidence is crucial for veterans seeking to strengthen their disability claims. By effectively gathering and presenting this evidence, veterans can increase their chances of a favorable outcome.  

VSOs or accredited attorneys or agents may be able to help and Trajector Medical’s medical evidence development is sure to help you have the best possible medical evidence to support your claims.*   

*Trajector Medical is not an accredited attorney or agent and does not represent veterans before the VA. This article is provided as information only. For more information, see the Department of Veteran’s Affairs FAQs at https://www.va.gov/disability/how-to-file-claim/ or consult with a VSO or other representative. For expert medical evidence development in support of your VA claims, contact Trajector Medical today.