VA Form 10182. Decision Review Request: Board Appeal (Notice of Disagreement)

Form 10182 is a document used in the context of appealing decisions made by the Department of Veterans Affairs (VA) in the United States. It is specifically used when a veteran or their representative disagrees with a VA decision and wishes to appeal that decision to the Board of Veterans' Appeals. This form allows the appellant to outline their appeal and choose how the appeal should be reviewed by a Veterans Law Judge.

Purpose:

The purpose of Form 10182 is to provide a structured way for veterans or their representatives to initiate the appeal process if they disagree with a VA decision. This form ensures that necessary information is provided to the VA and the Board of Veterans' Appeals to facilitate the review of the decision and resolve any disputes regarding VA benefits or claims.

Usage Case:

This form is used in the following context:

• Veteran's Appeals: When a veteran or their representative disagrees with a VA decision related to benefits, eligibility, or other matters, they can use Form 10182 to initiate the appeal process. The form allows the appellant to specify the issue(s) they are appealing and choose how they want the appeal to be reviewed.

Structure:

Form 10182 is structured into several parts and sections, each serving a specific purpose. Here is an overview of the key sections:

Part I - Personal Information:

• Collects personal information, including the veteran's name, file number, date of birth, and preferred contact details.
• Allows for indicating homelessness status.
• Provides space for the name and date of birth of the appellant if they are not the veteran.
• Collects the name of the representative.

Part II - Board Review Option:

• Provides three options for the review process, allowing the appellant to choose how they want the appeal to be handled.
• Options include direct review by a Veterans Law Judge, review with additional evidence submission, or review with a hearing with a Veterans Law Judge.
• Offers details on how each option affects the timeline for receiving a decision.

Part III - Specific Issue(s) to be Appealed to a Veterans Law Judge at the Board:

• Asks the appellant to list each issue decided by the VA that they want to appeal.
• Requests the date of the VA's decision for each issue.
• Provides the option to include additional sheets for explanations or good cause extension requests.

Part IV - Certification and Signature:

• Contains a space for the appellant or their appointed representative to sign and date the form.
• Certifies that the information provided is true and correct.

Privacy Act Statement:

• Informs the appellant about the privacy and confidentiality of the information provided on the form and underlines the potential disclosure of this information in certain situations.

OMB Approved No. 2900-0674:

• Provides information about the Office of Management and Budget approval and respondent burden.

The form includes guidance and detailed instructions to help appellants complete it correctly and submit it to the appropriate VA office. It also highlights the consequences of willful submission of false information.

Form 10182 is a critical document for veterans and their representatives to initiate the appeal process and request a review of VA decisions. It ensures that the appeal is handled in the manner preferred by the appellant and within the prescribed timeline.