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Department of Veterans Affairs Launches New Disability Claims Appeal Process

In February, the VA rolled out a new system for veterans with disability benefit claims that promises quicker decisions for those waiting for disability compensation or other benefits. In addition, the new system provides several “paths” for veterans who want to appeal their low rating decision or who were denied their disability claim outright.

According to the Department of Veterans Affairs (VA), the new system will be utilized for all veteran claims that require a decision, which includes education and insurance, vocational rehabilitation, and caregiver benefits applications.

On average, veterans waited anywhere from 3 to 7 years to have their appeals reviewed and decided upon, under the previous system. VA officials promised the new system could provide a final decision on veterans claims appeals within 125 days.

Within the past four months, the VA has hired 605 new employees to help handle the backlog of appeals, as well as new disability benefit claims.

The number of unadjudicated claims by the VA skyrocketed to over 600,000 cases in 2013. The VA defined cases that had not received a decision within 125 days as ‘backlogged’. Congress passed the Appeals Modernization Act (AMA) in 2017 to provide veterans with three choices to appeal their rating decision for disability compensation.

As of today, over 400,000 cases are awaiting a VA decision. There are 265,000 claims sitting in ‘backlog’ and another 136,000 cases are waiting to be reviewed by the Veterans Board of Appeals. The goal, according to VA officials, is to clear the agency’s backlog by 2020.

The Rapid Appeals Modernization Program (RAMP) was launched soon after the AMA was signed, as a pilot version of the new system. Be advised that RAMP stopped accepting new appeals on February 15th, 2019. Veterans whose claims were filed through RAMP will continue to be processed.

If you are a veteran with a current claim in the system and you did not opt for a decision through RAMP, you can opt into the new system. To do so, you will need to have received a statement of case from the VA or you will have to supply supplemental evidence and receive a supplemental statement from the VA.

The new process provides veterans with three paths to contest their disability benefit claims, as well as expedite the final decision process.

Path 1 is the “supplemental claim path” that allows the veteran to submit new evidence supporting their case and request a regional specialist to review the case and make a decision.

Path 2 is the “higher-level review path” that empowers the veteran with the ability to request a case review by a senior claims adjudicator, as opposed to the regional office. No new evidence is submitted, as the review is primarily looking for errors or mistakes made in interpreting VA policies or laws governing the claim. The senior claims adjudicator can mandate that a correction be made, if any errors are found.

Path 3 is the final option. Veterans can appeal the VA’s decision directly to the Board of Veterans’ Appeals for a full hearing. At this juncture, there are several options to pursue that are similar to the current system. These options are:

  • A direct review, in which the veteran does not submit any additional information and waives their right to a hearing;
  • The veteran submits additional evidence without a hearing;
  • Or a full hearing, in which the veteran may submit more evidence and then testify before a judge.

Veterans will receive a letter, when they receive their initial claims decision, that explains the rationale for the decision, as well as the appeal options “in clear language,” according to Cheryl Mason, chairwoman of the VA’s Board of Veterans Appeals.

If a veteran disagrees with a decision, they have one year to select another path to be able to appeal again. Even though the law changes how veterans appeal, it does not alter the system that the VA uses to determine eligibility for veterans disability benefits.

The amount of time it takes a veteran to traverse these paths will be monitored by the VA, so the agency can make this information public in order to help veterans decide which path to pursue. The Appeals Modernization Act requires the VA to submit quarterly reports to Congress about the new process for the next seven years.

The Injured Veterans legal team at Gordon & Partners is here for military veterans and their families. Please contact us immediately, if you are having difficulty with your claim or you are not receiving the disability benefits to which you are entitled. Call us at 1-888-231-9144 or fill out the pop-up form on this website.

Read the full story here: https://www.military.com/daily-news/2019/02/14/va-roll-out-new-claims-appeals-process-next-week.html