VA Form 4107 Your Rights to Appeal Our Decision

What Is VA Form 4107?

VA Form 4107, Your Rights to Appeal Our Decision is a document explaining how to start an appeal with the aid of a Notice of Disagreement. If the Department of Veterans Affairs (VA) was not able to grant some or all of the VA benefits, a veteran, a Veterans Service Organization representative, an attorney-in-law, or an «agent» can begin an appeal process. Additionally, a veteran may give the VA evidence they do not possess that may lead them to change their initial decision.

VA 4107 states that a veteran can get someone to help with the appeal. However, veterans are not required to have representation. Veterans Service Organizations will represent the applicant for free; however, it might be necessary to pay to an attorney or an agent. The VA only recognizes attorneys licensed to practice law in the United States and/or its territories. An agent is an individual who the VA recognizes as someone who knows veterans' law.

VA Form 4107 points out that the appeal must be started on time. Once the VA decision is final, it is not possible to get the benefit.

The latest version of the notice was released by the VA in June 2016 with all previous editions obsolete. A printable VA Form 4107 is available for download below.


Download VA Form 4107 Your Rights to Appeal Our Decision

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Your Rights to Appeal Our Decision

In accordance with the provisions on the VA 4107, if you disagree with the VA decision, you can start an appeal and give the VA new evidence to change the decision. It is in veterans' best interest to provide the VA with that evidence as soon as possible. The evidence will be considered, and the VA will let you know if it changes their decision. Only the evidence that the VA has not already seen and relates to the claim will be considered. It can be provided either at a personal hearing at the local VA office at any time or in writing. A veteran may choose to speak, bring witnesses, and hand the VA written evidence. The VA decision appeal form stipulates that the VA arranges a time and place for a hearing, provides the room, assigns an official to hear the evidence, and makes a written record of the hearing.

VA Form 4107 Series

The appeal form - formerly known as VA Form 21-4107 - has four other related forms:

  1. VA Form 4107c, Your Rights to Appeal Our Decision - Contested Claims instructs the claimant to send a Notice of Disagreement when denied a claim for a benefit;
  2. VA Form 4107VHA, Your Rights to Appeal Our Decision applies to the Veterans Health Administration claims;
  3. VA Form 4107VRE, Your Rights to Appeal Our Decision applies to claims for vocational rehabilitation and employment benefits;
  4. VA Form 4107INS, Your Rights to Appeal Our Decision is used in cases when the VA denies applications or claims for different insurance policies.