HLR Denied - what next?

Following a denied Higher-Level Review (HLR), your remaining administrative appeal option is to file a Supplemental Claim with **new and relevant evidence** (38 CFR 3.2501) or to appeal to the Board of Veterans’ Appeals (BVA). Given the HLR reviewer's stated reasons for denial, your immediate strategic focus must be on a Supplemental Claim to directly counter the specific errors. To overcome the "no diagnosis" assertion, submit a current, in-service medical record or a private/VA treatment note explicitly diagnosing pes planus (flat feet) and plantar fasciitis; this satisfies the requirement for a current disability under 38 CFR 3.303. To refute the "congenital defect" and "not disabling" rationales, you must provide a strong, independent medical nexus opinion. A podiatrist or orthopedist should review your file and state it is "at least as likely as not" (a 50% or greater probability per *Buchanan v. Nicholson*) that your current foot conditions are either (1) **not congenital** but acquired in or aggravated by service, or (2) a **congenital condition** that was **permanently aggravated** by service, making them compensable per 38 CFR 3.303(c). This opinion directly addresses the missing nexus and the legal error in the congenital defect assessment. For rating, refer to Diagnostic Code 5276 for flat feet and 5276 (analogous) for plantar fasciitis under 38 CFR 4.71a, evaluating based on pain, limitation of motion, and whether orthopedic appliances are required, with potential secondary ratings for painful scars if surgeries occurred. Your actionable next step is to gather this new medical evidence and file VA Form 20-0995 (Supplemental Claim) within the requisite one-year timeframe from your HLR decision notice. *Disclaimer: This information is for educational purposes regarding VA procedures and is not legal or medical advice; for personal guidance, consult an accredited VA attorney or claims agent.*