The short answer
For most CHAMPVA decisions, you have 1 year from the date on the decision letter to request a Higher-Level Review or a Board Appeal. A Supplemental Claim with new and relevant evidence can be filed anytime. A preauthorization denial gives you 1 year to send a written clinical appeal. If your decision letter states a different deadline, follow the letter.
Is there one deadline for every CHAMPVA appeal?
No. The deadline depends on what VA decided and which review option you pick. Here is how the current timelines line up:
| Review option | Deadline | When the clock starts |
|---|---|---|
| Higher-Level Review | 1 year | Date on the decision letter |
| Board Appeal | 1 year | Date on the decision letter (initial, Supplemental Claim, or Higher-Level Review decision) |
| Supplemental Claim | Anytime | No cutoff, but waiting can affect an effective date |
| Preauthorization clinical appeal (first level) | 1 year | Date of VA's preauthorization denial notice |
| Preauthorization second-level review | No separate deadline published | Follow the first-level decision letter and act promptly |
| Legacy reconsideration (38 CFR 17.277) | 1 year, then 90 days for further review | Legacy claims only |
The VA family member reviews and appeals page and the CHAMPVA Guidebook are the two VA sources that set these out for CHAMPVA.
Has the clock actually started?
Only if VA made a decision. A request for missing documents, an Other Health Insurance (OHI) Explanation of Benefits, or proof of payment is not a decision, and VA says you do not need a decision review to answer it. Send what VA asked for instead.
Before you count days, look at what you received. It might be:
- a payment decision on a claim (usually an EOB);
- an eligibility decision;
- a Higher-Level Review or Supplemental Claim decision;
- a preauthorization denial for care that has not happened yet; or
- a letter asking for more information.
Only the first four start a review clock. For help reading an EOB, see How to Read a CHAMPVA Explanation of Benefits.
How long do I have for a Higher-Level Review?
One year. VA's family member guidance says a Higher-Level Review must be requested within 1 year of the decision, and VA's general Higher-Level Review page says the year runs from the date on the decision letter. You file it on VA Form 20-0996. A Higher-Level Review does not accept new evidence. See CHAMPVA Higher-Level Review for the full process.
How long do I have for a Board Appeal?
Generally one year from the date on the decision letter. VA's Board Appeal page allows a Board Appeal after an initial decision, a Supplemental Claim decision, or a Higher-Level Review decision. The form is VA Form 10182. For CHAMPVA, the Board can only hear certain kinds of issues, so read CHAMPVA Board Appeals before choosing this option.
Is there a deadline for a Supplemental Claim?
No hard deadline. VA's family member page says Supplemental Claims may be submitted anytime. But timing can still matter. VA's decision review FAQs recommend filing within 1 year of the decision if you want to keep the earliest possible effective date, and the CHAMPVA Guidebook says a late Supplemental Claim generally ties any resulting award to the date VA receives it. You file it on VA Form 20-0995. See CHAMPVA Supplemental Claims.
How long do I have to appeal a preauthorization denial?
One year from the date of VA's notice. The CHAMPVA Guidebook says to send a written explanation of why the decision is wrong, any new supporting records, and a copy of the denial. If the first-level clinical appeal is denied, VA allows a second-level clinical review in writing. VA does not publish a separate deadline for that second step, so follow the first-level letter and send it soon.
This process is for care that has not happened yet. If the care already happened, VA treats the request as retroactive and it goes through the regular decision review options. See How to Appeal a CHAMPVA Preauthorization Decision.
Does the 90-day rule in 38 CFR 17.277 still apply?
Only to legacy claims. The text of 38 CFR 17.277 describes an older process: ask for reconsideration within a year, then ask for another review within 90 days of that result. The section now opens by saying it applies only to legacy claims. Modern CHAMPVA decisions use the Supplemental Claim, Higher-Level Review, and Board Appeal options instead. VA's Form 20-0998 explains review rights for VA decisions dated on or after February 19, 2019.
Many older guides still quote the 90-day rule. If you are working from one, check it against your decision letter.
What if my letter shows a different deadline?
Follow the letter for your case unless VA corrects it. To protect yourself:
- Keep the full decision letter or EOB.
- Note the date printed on it.
- Note which review options VA says are available.
- Use the current version of the form.
- File well before the last day.
- Keep a copy of everything you send and proof of when you sent it.
- Call CHAMPVA at 800-733-8387 if the deadline or review path is unclear.
The deadline to file the original claim is a different rule. See CHAMPVA Claim Filing Deadlines for that.
What if I already missed the deadline?
You may still have options. The CHAMPVA Guidebook names two:
- a Supplemental Claim with new and relevant evidence, which can be filed anytime; or
- a request to revise the decision for clear and unmistakable error, which has strict requirements.
Which one fits depends on the decision and its history. If you are not sure, Where to Get Help With a CHAMPVA Dispute walks through the next steps.