Quick answer
There is not one universal CHAMPVA appeal deadline. The deadline depends on what VA decided and which review path you choose.
For a modern CHAMPVA decision, use the deadline in your decision letter and the current VA review instructions. The most important current deadlines are:
| Review path | Current timing rule | What starts the clock? |
|---|---|---|
| Higher-Level Review | Within 1 year | The date of the VA decision; VA's general HLR page says the 1-year period starts from the date on the decision letter |
| Board Appeal | Within 1 year in the ordinary modern review framework | The date on the decision letter for the initial decision, Supplemental Claim decision, or Higher-Level Review decision |
| Supplemental Claim | May be filed anytime | No universal filing cutoff, but delay can affect rights tied to filing within the review period |
| Prospective preauthorization clinical appeal | Within 1 year under the current CHAMPVA Guidebook | The date of VA's preauthorization-denial notification |
| Second-level preauthorization clinical review | VA confirms the option but does not publish a separate deadline on its current family-member appeals page | Follow the first-level decision letter and request review promptly |
| Legacy CHAMPVA reconsideration under 38 CFR § 17.277 | Initial reconsideration within 1 year; a further written VA review within 90 days after the reconsideration decision | Applies only to a legacy claim, not the modern AMA process |
The key distinction is that 38 CFR § 17.277 now says it applies only to legacy claims. Its old one-year reconsideration and 90-day follow-up sequence should not be treated as the filing procedure for a modern CHAMPVA decision.
Start with the date and type of the VA notice
Before calculating a deadline, identify exactly what VA sent you.
A notice may be:
- a payment decision on a CHAMPVA claim;
- an eligibility determination;
- a Higher-Level Review or Supplemental Claim decision;
- a prospective preauthorization denial;
- a request for missing information, an Other Health Insurance (OHI) Explanation of Benefits, or proof of payment; or
- a legacy decision that remains in the pre-AMA system.
Those situations do not all use the same process.
VA's current family-member decision review page specifically says you do not need a decision review just to submit missing documentation, an OHI EOB, or proof of payment. If VA is asking you to complete an existing claim rather than denying it, respond to that request instead of assuming an appeal clock has started.
Higher-Level Review deadline: 1 year
A CHAMPVA Higher-Level Review asks a higher-level VA reviewer to look again at the prior decision using the evidence already in the record.
VA's current family-member guidance says a Higher-Level Review request must be submitted within 1 year of the decision. VA's general Higher-Level Review page is more specific: the one-year period starts from the date on the decision letter.
Use VA Form 20-0996 for the request.
A Higher-Level Review does not allow new evidence. If you have new and relevant evidence, a Supplemental Claim may be the more appropriate lane.
For the full process, see CHAMPVA Higher-Level Review: How to Use VA Form 20-0996.
Supplemental Claim deadline: it can be filed anytime
VA's current family-member care page states that Supplemental Claims may be submitted anytime.
A Supplemental Claim is generally used when you have new and relevant evidence or are asking VA to review the issue because of a change in law. Use VA Form 20-0995.
“Anytime” does not mean there can never be a consequence for waiting. VA's decision review FAQ recommends filing a Supplemental Claim within one year of the decision when preserving an effective date matters, and the CHAMPVA Guidebook's section on timely review requests warns that filing a Supplemental Claim after the applicable review period can affect the effective date of a resulting benefit award.
For a CHAMPVA payment or eligibility dispute, read the decision letter carefully and file as soon as practical rather than assuming there is no reason to act within the first year.
For the full process, see CHAMPVA Supplemental Claims: How to Use VA Form 20-0995.
Board Appeal deadline: generally 1 year
VA's current Board Appeal guidance says a Board Appeal may be requested within 1 year of the decision on an initial claim, Supplemental Claim, or Higher-Level Review. The one-year period starts from the date on the decision letter.
A Board Appeal uses VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement). Use the current form and follow the filing instructions on it.
For CHAMPVA, Board jurisdiction also matters. Not every medical dispute is reviewable by the Board. The separate CHAMPVA Board Appeals guide explains the distinction between Board-reviewable legal or adjudicative questions and medical determinations that fall outside the Board's jurisdiction.
Preauthorization appeal deadline: 1 year for the initial clinical appeal
CHAMPVA uses a separate clinical-review process when VA denies preauthorization for a covered service or supply before the service occurs.
The current CHAMPVA Guidebook says that if you disagree with a preauthorization determination, you have 1 year from the date of the VA notification to submit a written explanation of why you believe the decision is incorrect and provide any new or relevant documentation. The Guidebook also says to include a copy of the denial notification.
VA's current family-member appeals page confirms that:
- a first-level clinical appeal must be submitted in writing; and
- if you disagree with that result, you may request a second-level clinical review in writing.
The current web page does not state a separate filing deadline for the second-level request. Because VA has not published a separate clock there, do not invent one. Follow any deadline in the first-level decision notice and submit the second-level request promptly.
If the service has already occurred, VA says retroactive preauthorization requests use the post-service decision-review process instead.
For the full clinical-review process, see How to Appeal a CHAMPVA Preauthorization Decision.
Why the 90-day rule in 38 CFR § 17.277 can be misleading
The text of 38 CFR § 17.277 contains an older CHAMPVA reconsideration process:
- request reconsideration in writing within one year of the initial determination; then
- if still dissatisfied, request another VA review within 90 days of the reconsideration decision.
But the regulation now begins by stating that the section applies only to legacy claims.
VA explained this change when it updated the CHAMPVA regulations in the 2022 final rule implementing the modern appeals framework. The rulemaking states that the Veterans Appeals Improvement and Modernization Act changed VA review procedures and that the old CHAMPVA reconsideration process was retained only for legacy claims.
That means the 90-day follow-up deadline in § 17.277 should not be copied into a modern CHAMPVA appeal as though it were the current AMA filing rule.
VA Form 20-0998, Your Right to Seek Review of Our Decision, explains the modern review rights for VA decisions dated on or after February 19, 2019.
What to do if the deadline in your letter looks different
The safest rule is to treat the actual decision letter as controlling for your case unless VA corrects it.
If the notice gives a deadline that appears inconsistent with a general VA webpage:
- keep the complete decision letter or EOB;
- identify the date printed on the notice;
- identify which review option VA says is available;
- use the current version of the required form;
- submit early rather than waiting for the last day;
- keep a complete copy of what you send and evidence showing when you sent it; and
- contact CHAMPVA at 800-733-8387 if the review path or deadline is unclear.
Do not assume that a deadline for filing the original medical claim is the same as a deadline for reviewing the resulting VA decision. Claim-filing deadlines are a separate issue.
What if the ordinary review deadline has already passed?
Missing a one-year review period does not always mean there is no possible next step.
VA's CHAMPVA Guidebook says that after the applicable time limit, review may still be available through:
- a request for revision based on clear and unmistakable error, where the strict requirements for that type of request are met; or
- a Supplemental Claim with new and relevant evidence, when applicable.
VA's current family-member page is explicit that Supplemental Claims may be filed anytime.
Which option is actually available depends on the decision, the issue, prior review history, and the instructions VA gave you. If the deadline has already passed, do not use the legacy 90-day rule as a substitute for the modern process.