VA Benefits Rolls Out Biggest Appeals Changes In Decades Next Week
The biggest changes to VA benefits appeals in decades will roll out next week that will speed up some claims at the expense of increased complexity and due process rights.
Under the Appeals Modernization Act (AMA), Congress created three channels or lanes for veterans to select when contesting an adverse decision from VA that were originally referred to as RAMP, or Rapid Appeals Modernization Program. Veterans seeking to maintain their rights under the existing appeals system must file their appeal immediately.
Today, VA is shutting down RAMP applications to then roll out the new system next Tuesday, February 19, that will allow the following three lanes:
- Option 1: Called the Supplemental Claim Lane, this option gives a veteran the chance to introduce new evidence they believe is relevant to a claims specialist to review and make a new decision. VA says it will help develop the evidence.
- Option 2: Called the Higher-Level Review Lane, this option allows veterans to seek a review from a senior adjudicator but does not allow the veteran to present new and relevant evidence. The adjudicator is looking for errors in interpreting evidence, policies or laws. The adjudicator can correct errors in this de novo Duty to assist errors can be returned to the originating regional office. Veterans and representatives can request informal meetings to identify specific issues.
- Option 3: This is the traditional appeal to the Board of Veterans Appeals with a twist. In this option, veterans have another three review types.
At the Board, the three review types are as follows:
- Direct Review: This type of review waives the right to a hearing and the veteran will not be able to submit additional information.
- Evidence Submission: This option allows the veteran to submit extra evidence without a hearing.
- Hearing: In this review, the veteran can submit new evidence as well as testimony before the Veterans Law Judge.
In addition, the Board will issue the Statement of the Case for veterans seeking to appeal rather than the Regional Office. The Board recently contracted with a private company to provide a legion of paralegals to assist with the process.
Decisions coming from the Board will be simplified in what has been termed by Board Chairman Cheryl Mason “clear language.”
“What the AMA was built and designed to do was create a simplified process for veterans. … [Officials] realized that veterans were confused by the process; it was a complex system and it simply took too long,” she said.
The new lanes will apply to many other benefits, not just disability compensation claims. Dave McLenachen, director of VBA Appeals Management, said the new system will be used for education and insurance decisions as well as vocational rehabilitation and caregiver benefits applications.
While some groups have been critical of the change, Mason described the change as “veteran friendly.”
“It gives veterans a choice and control over their process instead of getting stuck in the legacy system for three to seven years, on average,” she said.
The critic of the new appeals system is the creation of more complexity that will inevitably require veterans, VSOs, and attorneys to evaluate evidence more thoroughly earlier in the process when selecting the specific lane.
In my experience, receiving a claims file, ie evidence, from VA can take many months. This means pro se veterans must be prompt when reviewing decision letters. For veterans using VSOs, it also requires non-lawyers to interpret evidence and render legal advice.
For the past five years, at least, VSOs nationwide have advised veterans to seek reconsideration or reapply for benefits rather than appealing adverse decisions. The supposed benefit was to push through a claim faster. However, most disabled veterans were never advised they gave up thousands of dollars in backpay by not appealing to preserve the earlier effective date of the claim.
The new system is the result of years of negotiation to decrease the appeals backlog, which has taken up to seven years for some veterans.
Currently, the existing backlog for claims is 265,000 with another 136,000 claims on appeal to the Board. Officials said the goal is to clear the backlog within the next two years.
Now, Vietnam Veterans of America was not invited to testify about the new appeals rules but provided the following comment concerning due process concerns.
“The bill creates a system where a Veterans Law Judge (VLJ) may deny a claim because she does not have the duty to assist in gathering additional relevant federal documents necessary to get the claim granted. Although the veteran will have the ability to file a supplemental claim at the AOJ [Agency of Original Jurisdiction or the Regional Office], it hardly seems like a pro-veteran system where an adjudicatory body knows of possible helpful information for a claimant, but is not able to act on this knowledge in a helpful way to the veteran. Under this new framework, the pro-claimant system would deteriorate and it is nonsensical for a VLJ to receive additional evidence for consideration, but not be able to act in the veterans favor once receiving this evidence.”
One negative aspect of the new system is that it strips out the agency’s obligation to assist veterans in gathering evidence after the appeal is sent to the Board. Since veterans, unlike practically every other American, are not entitled to discovery in prosecuting claims, the existence of far-reaching duty to assist requirements are vital.
Now, those requirements are truncated for impaired veterans who are reliant on support from VA for a fair shot at receiving the support they need.
Commander John Wells (retired), executive director of Military-Veterans Advocacy, Inc., has been very critical of the new appeals system. In The Hill, Wells critiqued not only the new system but also the VSOs that supported it, namely American Legion, Veterans of Foreign Wars, and Disabled American Veterans:
The support of the American Legion, the Veterans of Foreign Wars and the Disabled American Veterans for HR 2288 is disheartening. Notably, they participated in the working VA working group that drafted the legislation. While pride of ownership is somewhat understandable, their refusal to protect the duty to assist rises to the level of a betrayal of the veterans.
Now they support the bill because “appellate reform” is a popular sound byte. This ignores the reality of the problem. The reform should actually solve the systemic problems within the VA; this bill does not. Instead, it makes a bad system worse.
No doubt the process will be a mess to start with, and veterans will likely select lanes that are not advantageous to them.
At the end of the day, most claims fail because the evidence gathered is incorrect or incomplete. Selecting a lane that allows the opportunity to develop better evidence should benefit every veteran unless the error is truly obvious.
So, a traditional VA appeal is going from 1 option to 6 options. VA was unable to accurately adjudicate claims without creating a massive backlog with just one option. How it will handle six options is beyond me.
However, the burden now is being put onto veterans to make decisions without legal education or training. VSOs likewise have some training but are ill-equipped to develop evidence or legal argument incorporating new expert opinions to rebut bad decisions.
Proceed with caution, my friends.
Operations of each VA facility is set by the tone of the VA’s Hospital Director.
Most times victories come by each one pushing thru to obtain their desired VICTORY per rach issue or problem with VA care or benefits.
Sorry we’re each back.into.it again. We gotta each fight another ENEMY!!!
Sadly its the VA. And the VA leadership doesn’t get this or refuses to REALLY fix it.
32 years in the circle jerk and counting. Twice to the BVA. Remanded again on that evidence thing called “remand for development.” At least part got through to the CAVC but the CAVC Clerk wouldn’t follow through with his order on correcting the RBA. Filing to the CAFC tomorrow because the CAVC Clerk wouldn’t follow FRAP 3(d) and Circuit Rule 3 and forward my NOA to the CAFC promptly on his order to close the RBA dispute without retrieving the evidence from the DVA Medical Division.
Vet has 1 year max to develop. DVA AOJ can take 32 years and then stall until you are dead.
02/16/2019
Dear Benjamin Krause,
Really? 4 to 7 years wait?
Not one Veteran asked me about this “legacy system” while I ran for congress 6 times 1992-2010. Now it comes out in 2019.
Most looked at me funny about the dead veterans over at the Phoenix VA Hospital in 2008.
If you [the veterans] do not speak up —you get nothing. And that is what has happened until now. You want change—make it happen.
265,000 the existing backlog for claims
136,000 claims on appeal to the Board
____________
401,000
“…most claims fail because the evidence gathered is incorrect or incomplete…” On purpose by QTCM [Peake & Principi/Lockheed/Leidos]?
“…VA appeal is going from 1 option to 6 options. VA was unable to accurately adjudicate claims without creating a massive backlog with just one option. How it will handle six options is beyond me.”
.4 Million Veterans have been waiting for over 2 years to hear something from their cases.
The Veterans and their representatives are “ill-equipped to develop evidence or legal argument incorporating new expert opinions to rebut bad decisions.”
Obviously, putting more work on the Failing Structure—forcing it to collapse.
An act of White Collar Sabotage?
Just like the Suicide VA Swat teams to be dispatched when the B[VA]at Light is shining in the Sky!
Government to the rescue.
“We the People” but you have to speak up.
Sincerely,
Don Karg
What’s with the comments section getting closed on threads only a few days old. Just got out of the hospital this morning, and wanted to eply to a comment from Steven Ford High from a few days ago. Comments closed. What gives?
I stopped pursuing my claim – let it laps without appeal. I’ve crawled out of my deeper hole of PTSD derived depression to point where I can cope. The anger and frustration and resurrection of the past that haunts me would only shove me back into the bottom of the deep dark place that almost took my life. Closure is over-rated. Fuck America.
Would you consider writing me a affidavit that I could use in my “breach of contract” filing at the U S Court of Federal Claims? I’m claiming the CPT program kick outs that are kick outs of mental health therapy totally are at least part of the suicide problem. That and fighting to get your ER bills, and Choice bills paid as well as the problem with getting claims. I’m also trying to use Section 4 of the 14th to get these “lapsed appeals” and “late claims or appeals” overturned because of TBI and PTSD residuals that make it difficult to process especially when VSO representation seems to side too often against the veteran or not deliver on providing briefs in appeals often not even being familiar with the appeal exams and rating decisions. The exasperation of finding out those who are supposed to help and aren’t is also a problem.
Precisely what you just wrote above would be sufficient. It doesn’t have to be long winded and would probably be better if it isn’t.
“[email protected]”
The VA spends more time coming up with changes and gives them convoluted names. Who are they bull shitting. It’s all smoke and mirrors. I’m at Key West and sought out the VA here. It’s a staffed building with no services. They will put you on a list and ship you to Miami but that won’t be for a week or so. Tried to find out just what the place’s function is but just got a roll of the eyes. Vets down here are truly up the creek with out a paddle and a canoe .
President Reagan once said; *”Beware of someone calling you and saying: “Hi, I’m from the government and I’m going to help you!”*
What Reagan really meant was: *”Hi, I’m from the government and I’m here to’fuck over’ you!”*
So where are all the denominations ( of money ), we were told during a Congressional hearing, that a [ T ]rillion dollars is clearly unaccounted for, clearly the number is much higher; the sharks are in the water, they can taste the blood. As is clear to us all, the money disbursed from Congress, to within the V.A. CONstituency . . . choice of venues or avenues to hide, or give back to Congresspersons, nobody seems to ask about the accountability factors. Isn’t this taxpayer money that is being shuffled around ? The point I’m trying to make is this, they treat the revenue as though it’s their very own, in the sense of spending, but have absolutely no concerns as to where the rest is at . . . “hey, can I see the receipt for that, please” ? But knowing Hazel is getting into your seat about money, somehow removes the responsibility factor. Oh, seat meaning ass ! Someone needs to make the trek to correct, or sad things ( potentially ) – ( hypothetically ) could befall a nation, whom that feels, there’s nothing to lose.
Sincerely,
A concerned Vet –
New and Improved…..Costs more and you get less
Oh, gosh, this sounds like a very unpleasant process. It’s discouraging enough for many when working on a claim which is the step where I wish they’d get it right. Now, that could bring down appeals…big time. My claim as handled was ridiculous, like “reading was fundamental” did not fit at my VARO. Oh my, even C&P doc did not use reading skills, or straight up lied, that he’d read the file. No way he did that when his report did not match what was in the file. It bordered on a fraudulent doctor (lying) and an inept and bungled process.. Eventually, I was granted the claim, but FGS, it left me wondering if it was set up that way…on purpose. Now this…time will tell.
Oh, and the VSO was incompetent and lazy as they come. I have no idea why that job even existed for someone like that. When I first approached him, he attempted to dissuade me from filing at all. I didn’t listen and went on and filed. The supervisor in their office did not seem well informed, either, telling me I’d never get a certain claim granted. Impossible he said…I said watch me. Again, I did not listen and filed on my own. I was granted that claim. Then, when it was a simple adding “Additional for A/A spouse” which should have been simple enough…no help, guidance, or whatever from them since they had no clue, honestly.
Basically the same crap! It is already the VA’s responsibility to look for errors and anything else a veteran may be entitled to, most have been pushed to overlook and deny. No matter what they say it will be all evidence base and more so now. Already believing receiving too much money in programs like IU and looking to cut back. This is almost impossible with rulings being able to collect for chronic pain, expanding Agent Orange and now Burn Pit. It will be designed to deny faster, but usually waiting for BVA Judges to get a fair decision. A big problem is people who apply for additional compensation when really don’t have coming, but for many with nothing see as something can help. The talk to other vets and kind of talk themselves into deserving because some get angry finding out what some vets collect. So a lot of VSO’s will tell to call everything under the tree and will give to the VA to throw against the wall to see what sticks. Social Media also plays a huge roll with people connecting with others and with time go from seeing what sticks to being over zealous demanding benefits. When have nothing, you to try anything to keep living. Fortunately programs keep coming out with more help and if VSO’s explained, they would be better suited. It’s a shame that so many organizations exist, so many paid and either lack the knowledge or too lazy to help a veteran put his best foot forward where helping the best. It is an extremely stressful process if not documented correctly on the exit physical and they don’t ask anything that’s helpful. I have stories where I cried many months and still after 8yrs at 100% they are still in my hair. The only reason alive is because God has a different plan for me at this moment, otherwise a goner. It is ridiculous the stress put on veterans and dealing with depression, pain, anxiety and a shit full of others every single day. This is what causes suicides, you deal with most people who have no emotions and have become numb wanting to get off the phone to get a honey bun and a coffee. It’s pretty easy for them to see and if honest would moved forward quickly alone. We had the most hard working, wonderful person as the receptionist at the regional office, she was also a counselor and could have just signed people in, instead she helped everyone working her butt off. I respected her so much, if someone tried giving her shit when there, I quickly asked them to take a seat with that look on my face. One I asked why something was taking so long, she went on the computer for awhile kinda making me nervous. She finished asking to wait a few minutes while she went in back, came back saying no idea why was taking so long, personally located my file and placed on the correct person’s desk. You want to get things done? Boot the Union, you would not believe what’s in it with nothing to help the government. Once made responsible for working, get rid of a few and usually others fall in line quickly. Right now they have me ready to jump off a bridge from lack of compassion, but afraid of heights. You can rearrange turds all you want but only make piles of shit.
The wolf has put on sheep’s clothing again. The whole purpose of this change is to destroy the Pro Veteran Canon. The VA lawyer in the Procopio case admitted that in Federal Court. Take a look into VA Secretary Wilke’s eyes. Does he make you feel warm and fuzzy? Would you entrust him with your family’s welfare? Do you see any compassion or empathy in him? And as goes the Leader, so goes the VA.
Hey, the BVA RAMP option is the cat’s pajamas. I have three CUEs to 1970,83 & 93 and a couple of §3.156(c)s that are open and shut. What better path than a hyperdrive lightspeed jump to the VLJ? BVA Option #1 is designed for this. See you in Nashville. Bring your wife. She’s far more entertaining.
Ben, The DOJ finally got around to posting the case you cited a few days ago:
“https://www.justice.gov/opa/pr/department-veterans-affairs-official-sentenced-11-years-prison-2-million-bribery-scheme”
COME ON IN AND EXPERIENCE THE DIFFERENCE! 18 more ways to get screwed by the SCREWTOPS
I had an appeal hearing on April 25, 2018 before a Traveling Judge. American Legion was supposed to represent me, his name was Ibar Romero. From the outset while the Judge was taping the hearing . Mr Romero didn’t even know his own name responding to MR ROMANO- like the cheese man he is. This hearing was so oppressive it nearly caused a heart attack, the Judge refused to accept earlier effective date evidence clearly visible in my C-file which the VA has repeatedly concealed for almost 5 decades. Ok so i’m supposed to believe the Judge is Blind and the VSO doesn’t know his own name? NAh, what I believe is they had me carved up long before I ever went to the hearing which accounts for why they were stalking me with phone calls and letters saying ” you had better attend- they will look unkindly toward you if you don’t show up” SHOW UP? You have to be kidding, show up for a tribunal before Pontias Pilates’ Sister and her VSO partner in government corruption telling me when to speak and what not to say , confabulating stories of lawyers in DC who will sneer at my evidence if I demand it be entered to the record and then chop off 25 years of my treatment history at VAMCs. Well Glory Be! This is what the taxpayers are getting for their money: fancy veneers and cheap bustiers , VSO’s who don’t give a crap and who don’t even know their own name but are glad to take the taxpayers money. Then they remand your claim back to a VA- Dr Walker wannabe physician in Albuquerque who gives you the mal-de-ojo as soon as you walk in. Now you know what he’s going to say when you blood pressure is too high and you have an enlarged heart? Oh you need some Ranitidine and Pravastatin. Yum Yum that will make your chest pains go away, there is nothing wrong with you. Walker writes that crap in your file back to the VARO and your done with your appeal ( he makes 200K+ per year & you make zero) . Same old game its always been- the VA Doctors are told to make sure you the veteran cannot advance your claim. Ain’t nothing new except to refuse to go to their exams and take it to the Veterans Court of Appeals outside the VARO because somewhere in that VA Hospital you go to is a VARO-Rat watching your claim and interfering with your exam scheduling and every other benefit you should be getting. Now that may not be enough to deter you so they might leave your medical records in the Lades restroom on the first floor so everyone can see your stuff and poach. Or they might get the Campus police to start putting tickets on your windshield and accuse you of clipping a car in the parking lot to make you uncomfortable ( and then you will really see the rats come out to bear their teeth and lie to your face) This new system is going to be just another version of the same old system of the RATS protecting the RAT SYSTEM and the veterans get nothing but sub standard dangerous care. So dangerous you may have to leave town.
Why are the VSO’s not getting fired, sued or Both, this would help to start in keeping them honest. This is what they really need. Our local VSO refused to help keep the VA honest over my TBI, and other health issues. I would prefer to see both to happen.
I knew that selecting an attorney was the only way for me to go. I have no legal training, tell me to fix an airplane and that I can do, T.O’s are written so most anyone can understand, legalese is not.
Fact is getting an attorney is very difficult. The current barrel only wants slam dunk cases with big 20% awards for little work.
Experience: I used an attorney at the BVA to get back pay for TDIU from July 9, 2009 to May 11, 2017. $150,000 (in rough) which the attorney got $30,000.00. She dropped me on the issues appealed to the CAVC, all the CUE and back pay on TDIU to 1987 which isn’t a slam dunk because my 70% combined rating wasn’t established until the TBI rating of July 9, 2009. Another $500,000.00 potentially available but a lot of work for the attorney and it isn’t a slam dunk like the easy $30,000.00.
I haven’t been able to get an attorney to take the back CUE problems. What I was able to do last week was hire Research Specialists in Indiana to write my briefs to file in Pro Se.
“https://www.linkedin.com/in/lori-hepler-06b18724/”
Her fees are very reasonable and she may be assistance to you if you cannot find an attorney. I fully expect to win my back pay of TDIU to September of 1990 and possibly to October of 1987 with her help. I was only employed part time in a protected environment as a disabled veteran according to the employer’s statement to the BVA in May of 1990. After an MVA that was secondary to my TBI caused by a temporal lobe absence seizure confirmed and treated by a VA neurologist though with a corta indicated drug. Wasn’t finally treated for my temporal lobe seizures until August of 2015. And now at 77, as you can see on my posts, I’m more employable than I was at 33 when I got out of the Navy.
Getting screwed again
RAND reports: Veterans suggest a “Lane” of very busy traffic for the VA twits squeezing nickels out their dues-paying asses to play hungry, hungry hippos within, in order to pad their performance bonuses with rubber treads.
RAND also predicts: This will only drive-up Veteran Suicide numbers in “Lane Option 4”.
Rand Corporation probably recommended a fast lane for this option.
What difference does it make, what they name it, as long as they low ball ratings, deny, remand? I was exposed to nerve agents at RMA, was awarded mustard gas exposure, but have been fighting the VA with appeal after appeal, DRO appeal @ 28 months currently, filed a new claim in Dec and going to my 2nd C & P exam next Tuesday. My nephropathy, neuralgia, and headaches are so severe, I rarely leave my home. The VA has ignored 40 years worth of medical evidence and surgeries and treatments, so what chance do Veterans have of getting a fair shake under this new process?
Unless the CAFC steps in to grant summary judgements on appeals which are obviously the result of petty vindictive trashing of records, simply ignoring the facts presented, and other obvious maleficence the adjudication process will still be stuck in the “Remand Circle”. My TDIU claim has been to the BVA twice and never once had the required Director of Benefits review in a 32 year circle jerk.
Veterans are not equipped to understand what all of this means. How can a veteran gather evidence, when the va is hiding it and lie to the veterans as they did thousands of veterans who were told their official military records were distroyed.
Or the va employees shred paperwork or file 13 or place them in a file cabinet or throw them in a box and throw them in a basement.
How about veterans who have say a traumatic brain injury and suffering from PTSD.
This effects the reasoning of what is being told to them, they we don’t understand what is really happening and memory loss has a real impact.
Without an expert such as an attorney many veterans will know what to do and can’t defend themselves.
I agreeJames. Having PTSD along with the medication VA hands out to us has rendered me incapable of comprehending the legal mumbo-jumbo. The three VSOs sold us out,For what? I’m a life member of VVA and proud of it. Shame on the other VSOs for selling us out. I recently dropped my membership with the American legion because of this.
When has anything done gone the Veterans way?
To answer your question, NEVER!
Just another way to turn a bad situation into a disaster for the Veteran. The American Legion, the Veterans of Foreign Wars and the Disabled American Veterans did not act un the best interest of the Veteran! In no way am I qualified to choose the appropriate path, research, collect and present new and relevant evidence. Again the Veteran is damaged! A never ending saga!