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VA Claims: Disabled Veterans Community|Hadit.com

Understanding Decisions from RAMP

Background

Guest Post from Hill & Ponton


RAMP (Rapid Appeals Modernization Program) is the VA’s pilot program for the new appeals system created by the VA Appeals Improvement and Modernization Act of 2017. RAMP is an optional program, available to veterans with claims that are currently on appeal. If a veteran does not want to opt into the RAMP program, they do not have to submit anything to the VA; their appeals will continue to be processed in the current appeals system now referred to as the Legacy Appeals System.

Information on RAMP Rating Decisions

Now that the RAMP program has been in effect for several months, veterans who opted in are receiving rating decisions. It is important to understand the information included in these decisions, and also what your options are if you are not happy with the decision.
The appearance of rating decisions hasn’t changed much with the RAMP program. However, the information that must be included in the rating decision has changed slightly. RAMP rating decisions must list all favorable findings that the VA identified when reviewing the case, including listing what evidence was considered as favorable. The VA must also identify the evidencethey considered to be unfavorable. In the narrative part of the rating decision, the VA must explain how the favorable and unfavorable evidence was weighed in coming to their ultimate finding. In addition to listing the evidence, the VA also has to include a list of all regulations and laws that were applied in making their decision.

Forms Included in RAMP Rating Decisions

In addition to the explanation and the list of evidence and regulations,  RAMP decisions will have two forms attached. These two forms are the RAMP Review Rights form and the RAMP Selection form.
The RAMP Review Rights form gives information about how to appeal the decision. The different ways to appeal a decision from RAMP are based on the different lanes that make up the RAMP program.  The appeal options include:

  • Supplemental Claim: If you are unhappy with the rating decision and would like to submit new evidence, this is the appeal option to select. Once the new evidence (must be new and relevant) is submitted, a different rater will review the case.
  • Higher Level Review: This appeal option can only be selected if the decision being appealed was issued out of the supplemental claim lane,  and you do not have any additional evidence to submit. (Note: if opting into RAMP, the only requirement is that no additional evidence can be submitted.) A higher-level VA employee will review the decision that is being appealed based on the evidence of record.
  • Board of Veterans’ Appeals (BVA): If you are unhappy with the rating decision and want to take your appeal straight to the BVA, use this appeal option (Note: the BVA will not begin deciding RAMP appeals until October 2018). If you choose to appeal to the Board of Veterans’ Appeals, you will have to select one of three options. These options are:
  • Direct Docket: Select this if you have no additional evidence to submit, and you do not want a hearing. The BVA will issue their decision based on the evidence of record.
  • Evidence Only Docket: Select this if you would like to submit additional evidence, but do not want a hearing. After submitting your appeal, you will have 90 days to submit additional evidence.
  • Hearing Docket: Select this if you would like to have a hearing with a Veterans Law Judge. You will also be able to submit additional evidence up to 90 days after submitting your appeal.

The second form that will be attached to a RAMP rating decision is the RAMP Selection form. After deciding which appeal option is best for you, fill out the RAMP Selection form. This form requires you to specify which issues you are appealing, and which appeal option you are choosing.

Veterans Appeals Improvement and Modernization Act

The new VA appeals process explained by Matt Hill, grab a cup of coffee and a notepad, as to be expected from VA, it’s not a simple straightforward line.

The final rule has been published you can view it here.

The VA appeals process is going through its biggest change since the 1980s. In 2017, Congress passed the Veterans Appeals Improvement and Modernization Act. This act takes apart the current appeal system and replaces it with a new process aimed to improve the experience for all involved in the process.

First, let’s recap what the system currently looks like. Ready?

Claimant files a claim. The VA regional office, RO, sends VCAA letter. After that, RO mails notice of its decision. Claimant files notice of disagreement. The claimant must file NOD within one year of mailing of rating decision.

The claimant has the option of requesting a DRO review, but the claimant must request DRO review within 60 days of VA letter offering it. If the claim is denied, VA mails a statement of the case, SOC. Note, if the VA grants the claim, then you go back to the beginning of this process. The claimant has 60 days to file the Substantive Appeal VA Form 9 from the date of the SOC or a year from the date of the rating decision, whichever is later.

Board of Appeals decides the case, appeals to the CAVC within 120 days. Of course, if a claim is granted at any point, then it goes back to the beginning of this cycle, and the appeal process starts all over again. Ugh.

Let’s take a brief look at what stays the same and what is changing. Then we can talk about how the process works.

There will still be a rating decision after every claim is filed. A claimant will still have the opportunity to have a more seasoned adjudicator review the decision in the regional office. The claimant can still appeal to the Board of Veterans’ Appeals.

What’s gone?

State of the case, gone.

VA Form 9, gone.

Reopened claims? Not anymore.

The need for new and material evidence, gone.

DRO decision, gone.

What is replacing these? Supplemental claims, relevant evidence, higher level review, one NOD filed directly to the Board of Veterans’ Appeals.

The middleman is gone.

In the current system, when a veteran is dissatisfied with a decision and wants to preserve the date of the claim, he has only one route: file an NOD. Forgot to file a necessary document? File an NOD. Missing a piece of evidence? File an NOD. The VA made a mistake of law? File an NOD.

Veterans Appeals Improvement and Modernization Act

Now, when a veteran files a new claim, the VA will issue a rating decision that must contain the following: what issues were decided, summary of evidence considered by the VA, summary of applicable laws and regulations, identification of findings favorable to the claimant, explanation of why claim was denied, explanation of how to get evidence used in making the decision, and identification of criteria that must be satisfied to grant service connection or the next higher level of compensation. After this rating decision, you have one year to take action. You are to appeal for a higher review at the RO, file new evidence or file an NOD to go to the Board of Veterans’ Appeals.

Higher Level Review

You have one year from the initial claim to seek this route. This lane allows for a quality check on the original opinion while still at the VA regional office. Now, you cannot submit additional evidence or request a hearing here. The review is de novo, which is fancy Latin meaning review without giving weight to the prior decision. If the decision is favorable, your original claim date is preserved. If it is unfavorable, you have an option to file a supplemental claim or to file an NOD to appeal to the board.

Supplemental Claim

Welcome to the new evidence lane. You have one year from the date of your decision to file additional evidence. Under the new law, this is now referred to as a supplemental claim. In this lane, you may submit additional evidence that is new and relevant. Upon receipt of your new evidence, VA will attempt to make a decision within 125 days. Your effective date, the day from which the VA will pay your benefits, will be the day you file the first claim.

Once the adjudicator makes a decision, you must ask yourself, are you satisfied with this decision? At this point, you get to choose from the three options again: one, as you’ve already done, you can submit additional evidence within a year and preserve the date of your claim; two, you can request a higher level review; or three, board review lane.

Board Review Lane

This is where you file an NOD and your case moves from the regional office to the Board of Veterans’ Appeals. Here, there will be three lanes to choose from: one, fully developed appeal, a claim that is ready for decision by the BVA and there is no further evidence to submit; two, hearing request with the chance to submit additional evidence; or three, request to submit evidence but not hold a hearing. If the decision is favorable, your original claim date is preserved. If it is unfavorable, you have an option to file a supplemental claim within a year, or you can file an appeal to the Court of Appeals for Veterans Claims. You only have 120 days to file this appeal though.

File an appeal with the CAVC and win, and your original claim date is preserved. If you do not prevail, then you have a year to file a supplemental claim. Should you win after that, you still preserve your original claim date.

Reprinted with permission from Hill and Ponton Disability Attorneys

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