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Latest News

New VA Appeals Process: What to Expect in 2019

New Appeals Proc

 

As the number of appeals filed with the VA increases, the average wait time for Veterans to receive decisions increases exponentially. In order to try and rectify the clogged up system, President Trump signed into law the Veterans Appeals Improvement and Modernization Act of 2017 which introduced the RAMP program. This Act revamps the entire VA disability benefits appeals process and will replace the current appeal system. The new appeals system is set to replace the current “legacy” system on February 19, 2019.

Any claims filed on or after February 19, 2019, will be worked under the new appeals system. If you currently have pending appeals in the legacy system and you did not opt your appeals into the RAMP program, they will continue to be worked under the legacy system. The plan is for the VA to work all of the legacy appeals until all appeals are under the new system, though this process could take years to complete. The VA will be conducting reviews of appeals in the legacy system and new system simultaneously.

Under the new system, once a Veteran receives a decision, he or she still has one year from the date of the decision to appeal it. If the Veteran decides to appeal the decision, he or she must choose between three appeal avenues or lanes: Higher Level Review, Supplemental Claim, or file a Notice of Disagreement (NOD) directly to the Board of Veterans Appeals.

Higher Level Review

Currently, there are two Regional Offices conducting Higher Level Reviews: Seattle and St. Petersburg. In the Higher Level Review lane, a more senior VA adjudicator (called Decision Review Officers in the Legacy system) will perform a de novo review of your file and make a decision based on the evidence already of record. De novo means that they will review your appeal without regard to prior decisions and make a decision based on their view of all of the evidence. In this lane, you are basically getting a different person to review the same evidence because you cannot submit new evidence in this lane. There is no duty by the VA to assist in gathering additional evidence or records; the decision is made based on the evidence in the record. This lane in the RAMP program could potentially be utilized for extremely blatant and obvious errors that could be easily rectified without the need for additional evidence.

Supplemental Lane

The Supplemental Lane will be conducted at various Regional Offices throughout the United States. In this lane, new evidence is required to reopen a previously denied claim or file for an increased rating of a service-connected condition. The evidence must be “new and relevant” to the claim; “new” meaning not previously submitted or received by the VA and “relevant” meaning significant and related evidence to the issue you are claiming. For example, the new and relevant evidence could be evidence of symptoms warranting an increased rating or a nexus opinion for service connection. In the Supplemental Lane of the RAMP program, the VA has a duty to assist the Veteran in developing or finding evidence for their claim. For example, if you send correspondence stating that you have been receiving treatment at a specific facility and give details of the time period, providers, and other related issues, the VA has a duty to try and find these records for you. The more specific you are, the easier it will be for the VA to find the records. However, it may be better for you to get the records and send them to the VA as new and relevant evidence so that you know they will be added to your file.

NOD Direct to the Board

I find this to be the most interesting change in the new system. In the legacy system, a Veteran had to wait to get a rating decision and then appeal it with an NOD. Then the Veteran had to wait to receive a Statement of the Case and then file a VA Form 9 to get in line for review at the Board. This process could take an average of at least 3+ years. The new RAMP program cuts out Statement of the Cases and VA Form 9s allowing Veterans the ability to appeal directly to the Board after receiving a rating decision. This could potentially save a lot of time for more complicated issues that would likely not get granted at the Regional Office, like non-presumptive Agent Orange conditions.

If a Veteran chooses to file an NOD directly to the Board, there are three review options to choose from:

  • Direct Review: This lane will most likely be the fastest lane at the Board. It is a review by the Board based on the evidence of record at the time of the prior decision. This means that additional evidence cannot be filed and there is no request for a hearing. The Board makes a decision based solely on the evidence of record.
  • Evidence Submission: This lane allows for submission of additional evidence but within 90 days of filing the NOD. There is no request for hearing so the Board makes their decision based on the evidence of record and any additional evidence filed within the 90 day period.
  • Hearing: This lane will most likely be the slowest lane as additional evidence can be submitted and there is a request for hearing. This means that evidence can continue to be submitted until the Board schedules and conducts a hearing with the Veteran.

There are many similarities but also differences between the legacy system and the RAMP program’s appeals system. It is important to know your options moving forward with your current appeals and any future appeals. These changes are expected to go into effect February 19, 2019, and we will continue to update on these changes as we enter this new chapter in VA appeals.

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