The first step in the appeal process is for a claimant to file a written appeal with the local VA regional office or medical center that made the decision. The VA says you must file an appeal on a VA Form 21-0598 (Notice of Disagreement).
Submit your appeal to the same local VA office that issued the decision you are appealing. If you have moved and your claims file is now maintained at a local VA office other than the one where you previously filed you claim, submit your appeal to the new location.
If you have received notice of determinations on more than one claim issue, be specific about which issue or issues you are appealing. For example, if your local VA office made claim decisions on your pension and a medical payment, but you only want to appeal the decision on your medical payment, be sure to note that.
You may have the option elect a Decision Review Officer (DRO) instead of the traditional full board of appeals review. In most "clear error of omission" cases, the DRO process tends to save time and processing for both the you and the VA.
This is an informal appellate process within the regional office. The DRO has the authority to reverse or modify a VA rating board decision. We recommend that you seek DRO review before you request a BVA appeal. The DRO process is frequently successful and is generally faster than going straight to the BVA. If you do not receive a better decision from the DRO, you can still appeal to the BVA.