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2018, Got my Docket #

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Oceanbound

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Will post my appeal journey in this thread. Here starts the road to victory. 

Sept 2017 - hired GloverLuck since I HADIT with getting denied by the VA with the injuries I have documented in my file. I was homeless, lost my marriage, and 15 years of my life.

April 2018 - Got my Docket #.

Hopefully it does not take 5 years, but I expect it for the traditional route, and not RAMP.

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  • HadIt.com Elder

I read  some where  all traditional claims will fall into RAMP After Feb 19th 2019 on a first filling .

  claims already filed before Feb 19th 2019  will stay in legency process or traditional process.

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You stay in legacy if you did not opt in prior to February 14th. You get another opportunity to opt in when you are issued a SOC or SSOC on your NOD. 

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  • HadIt.com Elder

Asknod is correct too!

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

In the Supplemental Lane, new evidence is required to reopen a previously denied claim or file for an increased rating of a service-connected condition.

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.

Tags: higher level review, RAMP, Rapid Appeals Modernization Program, supplemental lane, veterans appeal improvement and modernization act

Source: Hill &Ponton Attorney's

Edited by Buck52
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Yesterday received the SOC in the mail. But spoke with my attorney over the phone, prior to having her file on Feb 19th, so we are going to the Board on all the NODs faster than legacy. 

Tomorrow I have an IME appointment with an orthopedic surgeon for two of my main disabilities. Following this, as soon as I get the report back in two weeks, I am able to set up another full IME that's (include the records review, and opinion) with another local qualified specialist--a Physiatrist. Spoke with the physiatrist over the phone and looking forward to that IME, that will include the rest of my conditions.

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The BVA made the decision of your claim on April 2, 2019. Letter mailed out on April 11th. And picked it up on the 17th.

Denied.

In order to establish secondary condition, the evidence must show a disability, which is proximately due to, or the result of a service connected disease or injury (specified in 38 CFR 3.310).

We have denied your claim because we connected it to the wrong injury but it was close enough to tell you how to make apple pie cookies or carrot cake cookies if you actually read these things.

Laws and Regs applied

38 USC 1110 & 1131 Basic entitlement 

38 USC 5107 Claimant responsibility; benefit of doubt

38 CFR 3.1 Definitions

38 CFR 3.6 Duty periods

38 CFR 3.102 Reasonable doubt

38 CFR  3.103 Procedural due process and appellate rights

38 CFR 3.104 Finality of decisions

38 CFR 3.156 New and material evidence

38 CFR 3.159 Dept of VA assistance in developing claim

38 CFR 3.303 Principles relating to service connection

38 CFR 3.304 Direct service connection; wartime and peacetime

38 CFR 3.307 Presumptive service connection for chronic, tropical, or POW related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminates in the water supply at Camp Lejeune; wartime and service on or after Jan 1 1947 (Would have been nice to see the Roswell Crash would had better care by those little gray dudes than at the VA, where i tried to get better, to be at Zero %, and they made things worst.)

38 CFR 3.309 Disease subject to presumptive service connection

38 CFR 3.310 Disabilities that are proximately due to, or aggravated by, service connected disease or injury

Pub. L. No. 115-55 Veterans Appeals Improvement and Modernization Act of 2017 (Ramp)

 

That said it looks like they made it a tie with my Anaise IMO to a private hospital I went to for an emergency instead of the VA hospital. 

I'm going to the Court (CAVC)!!

So I made an appt last week to talk with Julie this Friday. Already had the local DO specialist to do an IME and waiting for the Heavy Metals Urine Test kit to have him finalize that and submit to her.

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