Legacy, RAMP, AMP? where do I fit?

[GeekySquid]

Hey all I have been out of here for a while dealing with issues and am now in a wheelchair from leg surgery which just happens to coincide with my latest C&P results finally showing up. Before this latest I was at 100% plus  few miscellaneous 10 and 0 %'s.

The situation is complicated and I need to figure out my options in light of the changes between the legacy system, ramp and AMP (?).

The first hurdle, is my original award in 2013 did not show evidence they evaluated my OSA even though it was documented, diagnosed in May 2013 and should have been in my medical records by the time they did the award. VAMC New Orleans claims to have "lost" those records but Tulane Hospital has provided them to me and I have notes in my record that I had one, that the records were annotated in my file (supposedly in my file) and that a CPAP was issued.

I was never notified this was a compensable condition or that a C&P should be requested. I did not find this out until Aug 2018.

There is also my tests done for Vertigo, including being waterboarded through the ear and having MRI's performed to find out if I had tumors causing the vertigo. VAMC New Orleans says they don't have these records but the same issue arises as with the OSA. I have the MRI, and my record has notes that the VNG was done. The award letter is silent on this issue.

I have sent the VAMC FOIA requests on both issues multiple times and they don't even bother to answer me. When I call they just say there are no records and hang up on me.

How can I reopen that original claim, and would it keep the original dates?

To add complexity the original award denied me for hearing loss. The C&P examiner failed to look at my entire service record, instead she only looked at my first enlistment. I informed her of the Vertigo also but she made no mention of it in the report. On this particular issue, and the vertigo, the VA just rated me for 30% on vertigo and 0 for hearing loss. The dates for both were August 2108. At a minimum I want the hearing loss to be corrected back to the original date. It would also set up the argument for failing in their Duty  to Assist and Notify on the Vertigo.

I have my c-file and the notes and exams from external providers (sleep study and MRI).

I believe this all constitutes New and Relevant (I guess that is the new term) Information.

I just need to know how I process this under the new system? Is it a supplemental claim? will I get an EED?

 

Other Factors:

I will be filing a NOD on the recent 30% rating for Vertigo, the award letter has not yet arrived, it is over due, but the C&P doc was incompetent and my medical file shows that I am more in line with a rating of 60 or 100% for Meniures. I have VA treatment records recording my "drunk gait", nystagmus, and passing out from the vertigo. In 2013 time frame I would experience this 3 to 4 times a month in the worst months. Now it is 4 to 6 times a week, every time I roll over quickly or have any type of rapid head movement.

So on the NOD, since it was for the August, 2018 claim,  am I supposed to just file a typical NOD?

can I ask for backdate (EED) based on the previous VNG and MRI from 2013 where they lost the records and failed to Notify or Assist me in filing a claim? My Vertigo has gone untreated and unassisted by the VA until 2018. It has grown significantly worse. This seems to constitute harm to me from their negligence.

I want to note again in the decision about the August 2018 claim they did grant me SC for the hearing loss. Their error is clear and unmistakable. It is also tied to the Vertigo so the EED hearing would also seem to affect that; The VA does not send us for MRI's and VNG's (waterboarding) just for hearing loss, so they knew and started the process, they just dropped the ball in getting that info to the raters.

Thanks for any help on the new processes.

 

 

 

 

[Buck52]

This may help you about the NOD Filling.

A Notice of Disagreement (NOD) is filed when a Veteran receives a rating decision (RD) that they do not agree with. The rating can be either a denial, a continuation of a current rating, or a rating that the Veteran does not feel is high enough.  The NOD contains specific language that tells the VA what the Veteran disagrees with and why.  The specific parts of the NOD that are required by the VA are:

The Rating Decision date that the Veteran is responding to;

The specific issues the Veteran disagrees with;

The Veteran may file an NOD to all or some of the issues in the rating decision, it is not required to file an NOD to all of the issues listed if only one or some are being contested

What is the area of disagreement (are you stating the issue should be:

Service-connected

Have a different Effective Date

Have a different Rating Level (evaluation of disability)

Or “other” issue

What is the percentage (%) of rating the Veteran is seeking

An explanation of why the Veteran feels that the VA incorrectly decided their claim (lack of evidence, did not review private records, etc.)

How do I file an NOD?

Because of inconsistencies in the past, laws regarding what needs to be included in the NOD form have been passed to ensure that Veteran’s are not misunderstood and that claims are not dropped when the Veteran was trying to file an NOD but did not include all the correct information. In an effort to reduce the amount of errors and lack of correct information often found on NODs; the VA has now made it mandatory to use the correct NOD Standard Form to file your Notice of Disagreement to any rating decision a Veteran may receive.

Streamlining processes is something the VA has been working on for a while to try to decrease the backlog and time Veterans have to wait for claims to be processed. By utilizing the standard form, the VA is able to decrease the time it takes to process an NOD and reduce errors considerable, thus reducing the time it takes for an NOD to be processed for the Veteran.

Why Should I File an NOD?

You don’t have to file an NOD when you receive a rating decision. If you feel that the rating decision you have received is fair based on your condition, then you can certainly accept it and close your claim. However, if you do not feel that the rating decision is correct based on your situation, then filing an NOD lets the VA know that you want them to review your situation again. This can be done several ways.  First, after filing the Standard Form 958 , the Veteran has to choose how his or her claim is to be reviewed. There are two main options; either the traditional appeal process or the Decision Review Officer process.

Traditional Appeal Process entails the person who originally reviewed the claim to re-review the claim.

Decision Review Officer (DRO) review moves the claim to a higher level within the regional office for review by the DRO.

You may also choose to have a hearing to state your case to the review officer. Once the hearing is held, the DRO will make a decision on the claim and either grant the appeal in full, in part, or issue a Statement of the Case (SOC) on the issues that were not granted.

When Should I File an NOD?

NODs are very time sensitive and ensuring that you file one on time will ensure that y our original effective date is secure. You will have one (1) year from the date of the rating decision to file your NOD. Make sure that when you file the NOD you receive confirmation from the VA that they have received it by written correspondence. This ensures that your effective date is secured and your appeal is safe. Also, if you have filed and NOD and received a new decision with an SOC, you then have 60 days to file an appeal, a VA Form 21-9, a Substantive Appeal, to keep your appeal going. This will take the appeal to the Board of Veteran Affairs for review. If either of these deadlines is missed, the decision becomes final. Then, in order to reopen the claim, new evidence not already reviewed must be submitted and the original effective date will be lost, decreasing the potential for retroactive benefits. Time is money……

:Source; Hill & Ponton Disability Attorneys

[Buck52]

Here are the Lanes Veterans can choose which way they go with the New RAMP Process. see which one is right one for you.

Higher-Level Review: This lane is the most frightening lane to our VA disability lawyers. Once you are in this lane, you cannot submit new evidence. That means you cannot obtain new doctors reports, lay statements, reports from psychologists, reports from vocational experts, or any another other new evidence. You will be tying your hands and will not be able to develop your claim any further.

Supplemental Claim Lane: This review will be done by the same people that either denied your claim or rated you too low. You can submit evidence, but the claim will be decided by the people who didn’t believe your claim in the first place. You won’t get an impartial judge like you will with the Board of Veterans Appeals. If you trust VA bureaucrats, then by all means, opt-in to this lane.

Appeal Lane for Appeals to the Board: This lane will exist, but we don’t know enough about it yet to tell you any information. There may be a couple of different options here, but no one really understands the process yet.

Edited May 6, 2019 by Buck52

[Buck52]

Just make sure you send in 21-0958 ..as long as your Appeals are in its time limit  so the claim or claims won't be closed.

[GBArmy]

You call the White House and tell them you have tried 2 FIOA attempts and no response. If you have the dates you did them, all the better. Guaranteed they will respond as soon as they are called out on it. FIOA's are not to be taken lightly; they have to respond. They won't like it at the White House because the VA is actually breaking the law.

[GeekySquid]

6 minutes ago, Buck52 said:

Appeal Lane for Appeals to the Board: This lane will exist, but we don’t know enough about it yet to tell you any information. There may be a couple of different options here, but no one really understands the process yet. 

@Buck52

Thanks the response. In relation to my 2018 SC for hearing loss, when I get that award letter (it is like 20 days since it was supposed to be mailed) I will NOD that for an EDD back to 2013. I think I will use the Appeal Lane to the Board just to see. The facts around it are really a CUE IMO. The doctor did not use my entire medical record in her review. I am going to hold the cue in reserve at this point, as this particular claim will not generate any back pay.

In that same 2018 award letter it will include my Vertigo claim that they approved at 30%. In 2013, the Audiologist C&P and the PTSD C&P were told of my vertigo, and the VA had sent me for the MRI and VNG tests (which they subsequently lost) and the rater knew that they had happened.

The rating decision for the 2013 claim contained no mention of either test or vertigo. They should have had a duty to Infer and I think that should have triggered a Duty to Assist Letter and/or a Duty to Notify.  The hearing loss SC is relevant in that The audiology department sent me for the VNG and MRI in relation to my Hearing loss claim. This is not typical for hearing loss testing and evaluation. It seems to indicate they should have been aware of it when the C&P was done and the rater reviewed my record.

It is this one of the two I am most torn on as to the process. Do I NOD to the Board, citing Duty to Assist, Duty to Infer, and give them the chance to fix it? holding the CUE in reserve? or do I go the Supplemental Claim Lane process, which just seems to be a monkey-f'ing-the-football route?

 

any opinion Buck?

 

[GeekySquid]

13 minutes ago, Buck52 said:

send in 21-0958

I don't know the form numbers, is this the "new" AMA form or the "old' legacy form?