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Saturday, November 4, 2017

The New VA Appeals Process - RAMP

The VA has officially started their renovation of the VA appeals process—hooray!

However, it isn’t quite time to celebrate for everyone. The VA’s new RAMP (“Rapid Appeals Modernization Program”) will only be available by invitation until the full program is implemented sometime before February 2019.  

Starting this month (November 2017), the VA will be sending out RAMP invitations to eligible veterans with pending VA appeals. The invites won’t go out to everyone, so even if you are “eligible” and have had your appeal pending for a while, it doesn’t mean you’ll get one.

The VA’s goal is to slowly grow this program over the next year or so until it can support the full load of every veteran’s appeal. Thus, they’ll be regularly sending out invites throughout the year, and once their infrastructure is solid enough, they’ll open the RAMP program up for everyone.

So what does this mean for you?

If you have not yet submitted an appeal, then you can submit your appeal using the current VA appeals process. You cannot yet apply directly to the RAMP program as invitations are only going out to veterans who already have their VA appeals pending. Sometime before February 2019, the VA will open up the RAMP program to new appeals as well, but there is no way to know exactly when, so you have to still apply via the current system. Although, once your appeal is in the system and pending, you might get a RAMP invite.

If you have already submitted a VA appeal, then just sit back and wait. You might receive a RAMP invitation sometime this coming year, but there is nothing that you can actively do right now.

If you receive a RAMP invitation, then you have the option to choose whether to participate in the new RAMP process or to leave your appeal in the old process. Either way could be fine, depending on your case, and it is completely up to you.

The goal of RAMP is to make the VA appeals process faster, so it may be in your best interest to switch to RAMP. However, if you’ve been pending for awhile and your case is more complicated, it may be better to stay.

Under RAMP, you have the ability to choose one of three “lanes” to put your appeal in. If you pick the best lane for your type of case, then it will be reviewed much more quickly than the current system. If, however, you pick the wrong lane or it is too complicated for a particular lane, it will then be transferred to the other lane or the BVA’s longer line.

Even under RAMP, more complicated cases must go to the Board of Veterans Appeals (BVA), but the BVA will not be reviewing any RAMP cases until February 2019. Until then, the BVA will simply focus on the pending appeals in the current system.

It’s important that you understand the types of cases that should be put in each lane so that you make the best decision for your VA appeal:

1.     Local Higher Level Review.  This lane is for cases that don’t have any new evidence and are fairly straightforward. If the VA made an error and the evidence in the claim clearly proves their error, then this is the lane for you. The majority of appeals that don’t have new evidence will be fine in this lane.
2.     New Evidence. This lane is for claims that have new evidence that wasn’t submitted with the original claim. If the VA made a decision about your case, but didn’t have all the evidence and you’d like to submit additional evidence, then this is the lane for you. Only submit to this lane if you have new evidence regarding your conditions that the VA has not yet seen.
3.     The Board. This lane sends a case directly to the Board of Veterans’ Appeals (BVA). Again, however, the BVA will not be reviewing cases under RAMP until February 2019 as they are already overwhelmed under the current system and need to focus on that.

So until the RAMP program is fully implemented, only the first two lanes will be beneficial. If you decide to participate in the RAMP program under one of the first two lanes, and disagree with their decision, then you can appeal directly to the BVA.

As the BVA will be focusing on the current appeals, it is definitely fine to choose to not participate in the RAMP program. Depending on your case, however, the RAMP program may be a godsend. In reality, the majority of VA appeals are fairly straightforward cases that are simply bogged down in the overload of the current system. This new RAMP system will allow those cases to be separated out and reviewed more quickly. 


Ultimately, the VA’s new RAMP program should make the VA appeals process much better in the long run by dividing the labor among three lanes instead of it all landing on the BVA. However, it will take some time to fully implement and be available to everyone. Hopefully during that time, they’ll be able to work out the kinks and have a solid system ready to go by February 2019.

24 comments:

  1. Quick question on heart arrhythmias -- I am on active duty and currently seeing a cardio specialist for episodes of possible arrhythmia (racing of the heart, accompanied by occassional light headedness). Echocardiogram shows MILD regurgitation; Stress test shows some arrythmia; CAT Scan of heart and circulatory system shows some calcification (score of 56) and the heart monitor shows arrhythmia but not close enough in episode to cause concern; however referred to electrophysiologist. What questions should I ask, what should I look for? And, what is the potential for disability rating; more importantly how COULD this affect my active duty status?

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    1. I don't have enough information to really know just how much this condition affects your ability to do your job. Are you able to fully perform all the duties of your MOS? Are you able to be deployed? Since the condition is recorded as mild, the arrhythmia may not yet be severe enough to limit your performance, and so you may still be considered fit for duty for some time. Only if you have episodes regularly which limit your ability to work would the docs (or your commander) feel that your condition is severe enough to make you unfit for duty.

      http://www.militarydisabilitymadeeasy.com/unfitforduty.html

      As for a disability rating, it will qualify as long as it is considered service-connected.

      http://www.militarydisabilitymadeeasy.com/service-connected.html

      To make sure you receive a fair rating, it is vital that your physicians record the extent of your condition as thoroughly as possible, including ECG tests of episodes. Supraventircular arrhythmia is rated on the number of episodes/year, but each episode must be documented by an ECG to qualify.

      http://www.militarydisabilitymadeeasy.com/theheart.html#p

      Ventricular arrhythmias are rated on a number of factors. Make sure that the medications used, MET test scores, imaging test results, ejection fraction scores, and all symptoms/episodes are thoroughly recorded in your medical records. This will ensure that the condition is properly rated when the time comes.

      http://www.militarydisabilitymadeeasy.com/theheart.html#f

      With the very limited knowledge I have of your condition, it probably would not receive a very high rating at this point. However, if it worsens in the future, the VA can increase your rating to reflect the severity of the condition.

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  2. I sent in my appeal back in 2013 had a hearing in Feb2016 took the hearing officer until Dec.2016 to get it to the rating office. have not heard one thing from the rating office and it has been a year now do you feel I should enter the RAMP program? My main question is if the hearing officer decided in my favor and is just waiting a rating to be assigned will the Ramp program, just take the hearing officers decision and assign the rating ? or will it get a whole new review? Please let me know
    Jtruscott171@gmail.com

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    1. Have you received an invite to use the RAMP process? If your case has already been decided, then it is unlikely that they will send you an invite. So if you receive an invite, then it won't hurt you to switch over unless you case is fairly complicated. If it isn't and clearly fits into one of the two fast lanes, then it might be best to switch. If it is more complicated, then just stay where you are.

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  3. What is my chances in getting high rating with COPD Gulf War or environment related to it. I have service records for SOB from deployment and till this day I still take meds such as albuterol, steroids albuterol, nebulizer and allergies shots and periodically doctors visits f/u. My last PFT was normal however it does says patient unable to exhale for 6 seconds on FVC he appeared to be short of breath albuterol was given. Mild air trapping was diagnosed. Thanks for the help.

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    1. Hi Carlos -

      COPD is rated on the Respiratory Rating System based on your test results. Since the records state that your PFTs were normal, then you would only qualify for a 0% rating. Your tests would have to be limited (not normal) in order to qualify for a rating for COPD. You can check out our rating chart under the Respiratory Rating System:

      http://www.militarydisabilitymadeeasy.com/therespiratorysystem.html#system

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  4. I have a cam and pincer impingement in both my left and right hips. This was not diagnosed while I was in the service but manifested itself with significant hip pain after PT and sitting for extended periods of time "Indian Style". Sitting in the position was required in boot camp and At times it was difficult for me to stand up and move when instructed too. I recently had to have surgery to repair my left labrum after a very minor fall to my knees. Speaking with the orthopedic doctor he indicated that my labrum had been beaten up over a very long period of time and that the fall was basically the straw that broke the camel's back so to speak. More than likely my right hip is in the same condition due to the same bone structure of my hip and femur.

    I filed a claim but was denied. I read that a genetic issue could not be rated but if there is a condition that was aggravated by military service it could be rated. I was denied for a "hip strain" bi-lateral. Would there be a better way to file the appeal or would it be better to refile under a different claim? What would be the best approach to get this service connected?

    ReplyDelete
    Replies
    1. The issue is that there is no evidence of these conditions while in service. Did you ever see a physician for pain in these areas at all while serving?

      If a condition isn't officially diagnosed within 1 year of service, then it is not service-connected unless it is included on the presumptive list.

      http://www.militarydisabilitymadeeasy.com/vapresumptivelist.html

      Without medical records from service even showing the symptoms or qualifying on the presumptive list, it is highly unlikely that you'll be able to get service-connection.

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  5. My appeals is a an administration level that I was told by the 800 number is at extraschedular. I am applying for IU do to Reiner's syndrome, multiple joint issues. My question, is this a good thing for a positive outcome?

    ReplyDelete
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    1. Extraschedular just means that your case wasn't very straightforward and they needed someone to take a closer look at it.

      Individual Unemployability has fairly plain requirements to qualify.

      http://www.militarydisabilitymadeeasy.com/permanentandtotalunemployability.html#iu

      Since it's extraschedular, I'm assuming that it's difficult from the evidence you submitted to determine whether or not you really are entirely unable to work. They could definitely still decide in your favor, they just needed someone to take a deeper look at everything.

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  6. Dr. George P. Johnson I denied for liver disease secondary for ptsd and migraines meds. I just found out that I have new evidence for HEP B and HEP C records while in service in which can overturn the previous to decision. What is the chances in winning my appeal since I was treated in service and having hemochromatosis diagnosed as well. Thank you.

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    Replies
    1. I was denied I meant. Thank you.

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    2. If your current liver disease is connected to the hepatitis, then you have evidence that it existed while in service and you should be successful. Hemachromatosis can also cause liver disease, so depending on its service-connection and the details of your liver disease, it could also be the cause.

      A letter from your physician stating that your liver condition is "more likely than not" caused by your hepatitis or hemochromatosis could also help your case.

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  7. Dr Johnson,

    I retired in 2005 after 21 years. I injured my Thoracic spine early in my career, it healed and I thought all was fine. On my retirement physical, the x-rays revealed 3 compression fractures in my thoracic spine. Over the past few years, I have had several for compression fractures in the Thoracic spine. I found out 2 years ago that I have osteoporosis and it runs in my family , 2 of my brothers have it also. I do have a 10% rating for my back but believe it should be higher since I literally cannot do any type of impact exercises or lift anything heavy for fear of more injuries. 9 of the 12 Vertebrae are compressed, I have been hesitant about trying to claim the Osteo, but my initial injury occurred in my 1st 4 years in the Army during a field exercise. Is there any any to claim the Osteo? Thank You Sir, John

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    1. There is definitely nothing against claiming osteoporosis, although if it is only manifesting in your spine, you are unlikely to get a second rating for it. The VA will only give a single rating per body part, so only one rating can be given for the cervical spine and a second for the lumbar.

      Since the osteoporosis was diagnosed after service, however, you'll have be able to prove service-connection, most likely that it was caused by another service-connected condition, like your spine. If you can so service-connection, it definitely can't hurt to apply.

      As for the 10%, that is probably the correct rating, unfortunately. Spine conditions are rated on limited motion, and the range of motion has to be pretty limited to get a rating higher than 10%. Take a look at your medical records, however, and compare your range of motion measurements to the Spine Rating chart to determine if your rating is correct. If not or if your range of motion has worsened since then, definitely submit to have your rating increased.

      http://www.militarydisabilitymadeeasy.com/thespine.html#form

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    2. Thank You Sir, I really appreciate it.

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  8. I have been at 10% since 1977. I have had 3 knee scopes and I am still at 10%. It has been appealed since 2013. Do I need to wait it out or try to talk to someone in Washington, DC?

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    1. The VA rates knee conditions based on the main symptoms: usually limited motion an pain. If your knee does not have severe limited motion, then the minimum 10% rating is given for pain. The knee scopes are not evidence of a severe disability themselves and so do not contribute to rating consideration. Instead things like limited motion, pain, and instability are considered when rating. If your range of motion qualifies for a higher rating than 10% or if you have instability, cartilage dislocation, etc., that would qualify you for a higher rating, then you have a case for appeal. If not, then you were rated correctly.

      You can't surpass the appeals process, unfortunately, so you just have to hang in there. The higher courts will not review your case without you having gone through the appropriate appeals procedures first.

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    2. Check out our Knee page to see if your symptoms qualify for a higher rating:

      http://www.militarydisabilitymadeeasy.com/kneeandleg.html

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  9. Dr. Johnson,
    I received the invite to the RAMP and have read all the pros and cons to the program though I can't find anything on the pros and cons of staying as a legacy. Do you know?

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    1. Basically, you'll just stay in the line that goes directly to the BVA, which is the incredibly long one that is taking years to get through currently. The benefit of staying is if your case is more complicated and wouldn't be able to completed in one of the other RAMP lanes. This would mean it would still end up in the BVA line, but you'd lose your place. So if your case is more complicated and unable to be completed by the RAMP lanes, then it is more beneficial to just stay.

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  10. Hello! My husband was denied for bilateral inguinal hernias that were diagnosed 40 days after discharge from active duty service. The VA states the condition should have been caught at the return exam. Problem is - he is National Guard! They didn't do return exams at that time, the exam was scheduled with the VA. It's my understanding that now it is customary for this exam to happen on re-entry to the US, but it was NOT then. We have been waiting for BVA appeal since 2016. We are being offered RAMP, however, we're terrified it will push us back so much farther. What would you recommend? And how do you get the VA to understand the exam opportunities for national guard at that time (2013)

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    1. Replying to add - the condition was diagnosed at the "First Exam back" at the VA. and was within a year of discharge.

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