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HadIt.com Anniversary 24 years on Jan 20, 2021
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Looking for some advice...


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Hello everybody, 

I wanted to post this under the RAMP program but seems to be disabled or discontinued area to post. Anways short background is I a filed claim for anxiety and PTSD in Sept. 2016 was denied, appealed to DRO Aug. 2017, accepted to be put into the RAMP program Aug. 2018 in Supplemental claim with the initial completion date to be June 8th 2019. Called PEGGY yesterday to find out if they have had any movement and was told by individual that he really doesn't see anybody in RAMP anymore. Asked if he could dig a little deeper and he stated he would send an inquiry to the RO dealing with my claim (assuming its still in Phoenix AZ). So I checked VA.gov today and now my estimated completion date was pushed out from a completion date of tomorrow to July 10th, 2020. I thought that RAMP was a pilot program that basically the VA was attempting to complete most claims submitted for the results and find out if this new appeals process would work? Maybe I'm wrong but it seems like I should have just stayed in the DRO and not taken the risk if they are going to take the same time to complete if I didn't opt into RAMP. 

I was initially denied for mental health disabilities due to my psychologist doing the C and P exam (in 2016) stating "I cannot answer whether the disabilities started in service without mere speculation." Then the VA asked her to give an answer along the lines of most likely or not, direct, less likely, etc. She wouldn't answer and I was denied benefits. I had an IMO which gave me a an "at least likely as not" for service connection and filed an appeal. Then during this RAMP in March 2019 VA sent me to another C and P exam offsite and was given the same "at least likely as not" for anxiety service connection. I was diagnosed with anxiety, insomnia, shortness of breath/panic attacks during service which seemed kind of straight forward when applying for anxiety but I guess not. 

I guess I am asking is there anybody else out there that has a RAMP with a completion date of July 2020 or later? Does the claim seem relevant, meaning diagnosed with anxiety in service and given diagnosis of anxiety from VA mental health/private provider within few months of recent C and P? Is RAMP a long term appeals process or should I be hounding my back burner DAV rep. who seems to be busy all the time? Also I have been in a preparation for decision phase since the last C and P exam which was March 2019, for all my other claims once it hit this stage it went a lot faster. Any advice would be great, thanx!

 

Edited by CH88
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Paul, you know its a real challenge when you have to type 5 number and several letters in the proper order.! Geeze, ya gotta give me i was close!

It seems the RAMP program has had positive and negative results, and the lack of consistency makes it hard to give a definitive answer.  On the one hand, many veterans have been able to resolve claims

yep it is. It gets harder (IMO) if the VA refuses to look at your entire service record and just flat out denies service connection. My decision letter on that amounts to "Yep you are deaf but we

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ram-esq, 

Thanks for the advice, I do believe that RAMP being a pilot program was risky and therefore seemingly getting a decision prior to the new appeals process is what was anticipated. I am disappointed in the VA and how they continue to give us false hope in believing that they are truly here to assist, when this whole process is not only new but beginning to get quite frustrating. I was already a little over a year into my DRO appeal prior to opting into RAMP and would seem as though I lost my place, having to start over into the new appeals process. I really hope not but I am not getting any responses to individuals that are still in RAMP from my DAV office, speaking with PEGGY they don't have much if any at all from what representative is saying, nor on this site. I may just have to reach out to DAV on Monday and start asking for them to do more than just a status update. 

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13 hours ago, rsm-esq said:

I generally advise clients to steer clear of any government process that limits appeal rights and the ability to submit additional evidence

@rsm-esq

Hey  not trying to hijack this thread. Just was wondering if you would mind reviewing a post I just put up under the AMA forum and chime in on my questions.  Your profile says you are an accredited VA attorney so you might know the answer.

here is the post link

https://community.hadit.com/topic/74841-interesting-little-blip-under-ama-maybe/

thanks and sorry to intrude on this thread

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The correct lanes for Veterans to choose from in the RAMP /AMA

Would be nice if the Veteran was informed with this process, if the veteran chooses the wrong lane  or review choices..say the higher lane  then they can't go back  and if they chose the higher lane then they lose out on submitting new evidence if some was to surface.

A lot of the AMA/RAMP is mis- understood by the veterans so more information for the veterans would help a great deal. 

 

rsm-esq quote

''I generally advise clients to steer clear of any government process that limits appeal rights and the ability to submit additional evidence - which is in large part what RAMP did

 

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 the VA Appeals.

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1 hour ago, Buck52 said:

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. 

@Buck52

I think for many vets like myself the application of the requirement "new and relevant" (formerly New and Material) is a sticking point in understanding what to present and or how we expect it to be received.

I have a personal example. It is a bit convoluted and the post is long but very relevant.

In 2012/2013 in my initial claim for PTSD, Hearing Loss and Tinnitus, I was awarded for PTSD and Tinnitus. Denied for SC for Hearing Loss but Audiologist said I did have a loss that would meet VA SCing but she could not SC based on the records she looked at.

The actual Award Letter says. Veteran served from and too which included all of my years of service.

The PTSD award and C&P is based on events in my SECOND enlistment so they had my full record and STR's available.

The section of the letter and evidence section denying Hearing Loss gave lots of numbers and made the statement that they could not SC based on my military record. No in service evidence of an OSHA STS (significant threshold shift), no evidence of marked hearing loss in service.

Sadly I trusted that they had looked at my entire record because the letter said they did. This was a major mistake on my part.

Skip to 2018, I get notice of a PTSD review. I had stopped considering any possible bump in rating as I was tired of VA Benefits and all the hoops. This was another major mistake on my part.

I ordered my C-file and started digging into the VA again. More sites and information were available in 2018 than in 2013, which is great!

I get the C-file and start looking through and I find the DBQ for the Hearing Loss claim and the Audiologists write up.

DING DING DING DING... I found a problem in that report that should SC my hearing loss.

In her actual report and the DBQ, the Audiologist doing the C&P EXPLICITLY states that she only reviewed the records from my FIRST 4 Years of Service..She went on to say there was no OSHA STS or indication of hearing loss in those 4 years. She stated explicitly she looked at my "discharge" physical from that enlistment and found no record of a hearing problem.

Which is accurate, the STS occurred in my SECOND enlistment and from then on my hearing degraded significantly until my actual "discharge" physical. What she said was a "discharge" physical is actually marked as a "re-enlistment" physical.

So I filed (under legacy) to reopen that claim based on New and Material evidence. I submitted the records and a thorough write up.

To me it seemed obvious that a C&P examiner who states specific things were missing then affirmatively defines reviewing only part of my medical record instead of the part that has those things, should fall under New and Material review.

I was denied reopening that claim and the VA said the evidence was NOT NEW and NOT MATERIAL.

Now how can that be true? It cannot, so I did a deeper dive into my C-file.

This is where things get really convoluted!!!!! I swear everything below is relevant to this post.

In my initial claim 2012/2013 for hearing loss, the VA on its own decided the record showed I had dizziness and vertigo issues. I did NOT make any such claim. Not knowing anything about how the VA worked, when VAMC  Audiology said I needed to have an MRI and VNG I did what they said. It seemed strange for a Hearing problem but I assumed (wrongly) that VAMC knew what it was doing.

I took the tests. A VNG is basically being masked, spun around in a chair and tipped every which way and then having warm water blown into your ear. (there is a version that uses warm air, just not at my VAMC back then).  I call it being waterboared through the ear. The VAMC sent me to an outside provider for an "open" MRI as I could not take being in their closed MRI machine.

The doctors never called me for followup and I (wrongly) assumed there was no problem in the results.

They also did the same for Sleep Apnea and the sleep study I had around the same time.

The initial rating decision was made in October 2013. The VNG and MRI (along with a Sleep Study and CPAP issuance) were all done in May and June 2013.

All the entries in my C-file for those tests are marked as the test results having the results attached as an addendum.

The 2013 rating decision denying me SC for Hearing Loss is SILENT on Vertigo and Sleep Apnea.

I did not know any better and by this time my VSO was dealing with his own pancreatic cancer issues so I was  not about to bother him.

When the 2018 denial for New and Material happened, I dug into my C-File and found the references to Vertigo and other tests.

I dug further to find those test results that were supposedly added as an addendum to my file.

They DON"T exist in my files. I also found that the Sleep Study was supposed to have the results added as addenda and they were missing too!

I contacted VAMC New Orleans and was told they were "lost". I sent FOIA requests (4 of them so far) and have gotten no answer at all from any of them! I asked VAMC Puget Sound Audiology to help me. They came up empty.

I submitted a claim for Vertigo in this process. I still have it and have had it for all this time and I now knew it was ratable.

Now we skip back to the 2018 denial to reopen my hearing loss.

A vertigo claim includes a hearing test and a C&P by an OTO Dr. In the hearing test I told the audiologist about the missing tests and that they had NOT SC;d my hearing loss because they failed to look at my entire record. I gave her the things they said were missing. She informed me that the Hearing test she was doing was not a direct C&P, it was just to inform the OTO of what was going on.

The VA goes back and forth with the OTO (another long story) and finally issue an order for a Hearing Loss C&P. very odd. I had not asked for another one at this point so I assumed the Audiologist made note of the fact that my HL should be SC'd.

I went to that exam. I was in the office for exactly 5 minutes. I timed it. The only question was how long did I serve in the Military. I had all the records of the bad 2013 decision and the hearing tests and OSHA STS that that C&P said did not exist and were in my file in 2013. She said "wow, that's all I need. Have a nice day". There was no hearing test done this day.

The VA then awarded me SC for Hearing Loss and 30% for Vertigo.

The problem I now have is they awarded those as of 2018 instead of back to 2012.

VARO Puget Sound has refused to give me copies of those C&P's and exams. My VSO is useless and to add to it, I now have a third C&P I need the results from.

As of last friday I am out of the Wheel Chair so i will soon go down again and tap dance on some desks to see if I can get my records.

I will also send in a request for a new copy of my C-file.

I am in the process of writing a CUE on the 2013 denial of HL SC based on 4.2 and 4.6 and I am looking up the affect of Cushman v Shinseki on SC being a property right. I know it was affirmed by the First Circuit, but modified by a couple other cases.

I am also looking for the best path to getting an EED on my vertigo. Once I get VAMC Puget Sound to issue the new CPAP I will put in a claim for SA SC and then have to fight for an EED on that.

I think the trick to getting the EED's on Vertigo and SA will be getting VA to cough up those supposedly "lost" files. ...how do you lose an electronic record?

The importance of the EED's on HL and Vertigo is that under the MR21 rating for Tinnitus, HL, and Vertigo combined can be rated as Meneire's Disease at 100%. That would represent a serious recalculation of compensation from 2012 to 2018.

I love idea of that. In the 2013 award I was 70% ptsd (bumped to 100% in 2018). If I am successful with the EED's and getting combined to Meneires for 100% back to 2012, that would mean adjusting pay to reflect the difference between 70 and 100 plus statutory SMC (s). 

getting that outcome would net in the 100K range for back pay.

That's the end of this long post. My saga will continue when I get any changes.

 

[EDIT].. I just realized this might hijack the thread. I did not mean to and I apologize to @CH88

Edited by GeekySquid
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