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"MILITARY.COM”
"In
what Department
of Veterans Affairs officials
are calling the biggest change to its appeals process in decades, the
department will launch a new system for veterans challenging their
disability claims decisions.
"The
new process gives veterans three options for contesting their claims,
with an eye toward drastically reducing the time it takes to receive
a final decision.
At
the height of the VA appeals backlog in 2013, some veterans had
waited years for a decision and more than 610,000 claims sat
unadjudicated. To tackle the backlog — defined as cases that
weren’t decided within 125 days — the VA hired new employees,
instituted mandatory overtime and introduced new processing systems.
Still,
the problem persisted with an average wait time for a decision
reaching up to three years and the number of backlogged appeals
climbing to roughly 300,000 by 2017, when
Congress passed the Appeals Modernization Act, or AMA.
Under
the AMA, veterans
will have three choices if
they want to appeal the decision on their disability compensation or
other VA claim.
The
first option is the “supplemental claim lane,” in which they can
introduce new evidence in their case and have a regional specialist
review it and make a decision.
Or
they can choose the “higher-level review lane,” in which they
request that their case be reviewed by a senior adjudicator rather
than the regional office. This review will consist largely of looking
for errors or mistakes made in interpreting VA policies or laws
governing the claim. If a problem is found, the senior claims
adjudicator can require that a correction be made.
And
finally, they can appeal the decision to the Board of Veterans’
Appeals — basically the same as the current system, although there
will be several paths to consider if they request a board review.
These paths include:
- A direct review, in which they don’t submit any additional information and waive their right for a hearing;
- Submission of extra evidence without a hearing;
- Or a full hearing, in which they can submit more evidence and testify before a judge.
When
veterans receive their initial claims decision, they also will get a
letter explaining the reasoning for it, as well as the appeal options
“in clear language,” said Cheryl Mason, chairwoman of the VA’s
Board of Veterans Appeals.
“What
the AMA was built and designed to do was create a simplified process
for veterans. … [Officials] realized that veterans were confused by
the process; it was a complex system and it simply took too long,”
she said.
The
new system will be used throughout the VA for any claim that requires
a decision, according to Dave McLenachen, director of the Veterans
Benefits Administration appeals management office.
This
includes education and insurance decisions, vocational rehabilitation
and caregiver benefits applications, he said.
VA
leaders hope that the new system will reduce the time it takes for
veterans to receive a decision on their appeal to 125 days.
Currently,
the VA’s claims backlog is 265,000 cases, while an additional
136,000 cases are under review by the Veterans Board of Appeals, for
a total of more than 400,000 cases. VA officials said Thursday that
the goal is to clear the backlog by 2020.
A
pilot version of the new system, called the Rapid Appeals
Modernization Program, or RAMP, was introduced shortly after the AMA
was signed. According to McLenachen, more than 70,000 veterans with
84,000 claims appealed through RAMP. The VA has adjudicated 70
percent of those appeals, awarding about $250 million in retroactive
benefits, he added.
RAMP
will stop accepting new appeals on Friday. Veterans whose claims were
filed through RAMP will continue to be processed.
Veterans
whose claims are currently in the system and who don’t apply for a
decision through RAMP by Friday can opt into the new system if they
receive a statement of case from the VA or supply supplemental
evidence and receive a supplemental statement from the VA.
Legislators
and veterans service organizations helped craft the new system and
have largely been supportive of it, although some have voiced
concerns over legacy claims and the information technology
infrastructure needed to support the new program.
VA
officials said they are ready, having hired 605 new employees to
handle the appeals.
Mason
called the new system a “veteran-friendly change.”
“It
gives veterans a choice and control over their process instead of
getting stuck in the legacy system for three to seven years, on
average,” she said.”
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