File another supplemental or HLR?

File a Supplemental Claim. Your situation—where the VA failed to obtain and consider your private medical records in the original decision—is a classic Duty to Assist error under 38 CFR 3.159(c)(1). A Higher-Level Review (HLR) of either the original or supplemental decision is not the optimal path because an HLR, per 38 CFR 3.2601, is restricted to the evidence already in the record; you cannot submit new evidence during an HLR. Since your core issue is that crucial evidence (your private records) was never made part of the record, you need a lane that allows you to submit it. The Supplemental Claim lane, governed by 38 CFR 3.2501, is designed for this exact purpose: to submit "new and relevant" evidence, which your previously unconsidered private records clearly constitute. In your new Supplemental Claim, you must explicitly identify and submit the missing private records, linking them to your claimed condition with a statement. Cite the diagnostic code (DC) for your condition (e.g., DC 9200 for schizophrenia, DC 9400 for generalized anxiety disorder under 38 CFR 4.130) and reference the Duty to Assist error. Actionable next steps: 1) Gather all private medical records, 2) Write a brief statement noting the VA's prior failure to obtain them, 3) Complete VA Form 20-0995 (Supplemental Claim), and 4) File the form and all new evidence together. *This information is for educational purposes only and is not legal or medical advice; for guidance on your specific claim, consult an accredited VA attorney or claims agent.*