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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.

136 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?

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    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?

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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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    2. Thank for replying. I am receiving SSD due to my sc disabilities. I am 70% but none of them are 40%. The VA examiner stated my disabilities are preventing me from being gainfully employed. Could this be the reason for the extraschedular? Sorry it took so long.

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    3. That would definitely be a contributor. Without a single condition rated at 40%, you technically don't meet the requirements for IU. Maybe upon deeper review they'll find an exception, but it's likely you'll still be denied since you don't meet the requirements. Luckily, they are taking a deeper look since it seems you have significant evidence that says you are unemployable because of your conditions. Maybe that extra look will work in your favor.

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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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    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.

      Delete
  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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    2. Tricky situation. Inguinal hernias is not on the list of chronic conditions that are automatically approved if diagnosed within a year of discharge, however, only a month after service should still be sufficient evidence that they were present while in service.

      It's odd that the VA is noting their reason for denial as the fact that it was not noted on the exam. If the exam didn't even exist, which exam are they referring to? You shouldn't have to prove that the Guard didn't do an exam. If there is no record of the exam, then there was no exam, and so of course it wasn't noted on the exam.

      Was there another exam conducted around the same time that the VA is actually referring to? If so, then clarifying what that exam was and why they didn't record the hernias is important.

      Ultimately, this isn't a clear-cut case. As far as RAMP is concerned, it is likely that they'll end up sending your case to the BVA anyway, so it may be best to stay where you are. It's a tough call. It would be a risk to use RAMP, but if there is clearer evidence than I am aware of, it might be worth the risk. However, it could ultimately prolong the process. Tough call.

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    3. When do they ever get it all right

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  11. I am a Blue Water Navy Vietnam Veteran who was denied service connection for prostate cancer caused by exposure to Agent Orange. The current VA policy is that only those with "boots on the ground" qualify for presumptive exposure to Agent Orange. I have since found evidence that my ship tied up to a pier where Agent Orange barrels were leaking. Also, as a student naval aviator, I underwent survival training at Eglin AFB in Florida where Agent Orange testing took place. My intention is to present this as new evidence for my appeal. My question is, is it possible to know where I am in the appeals process at this time? I appealed in March, 2016. If accepting the invitation to the RAMP and selecting the lane that allows new evidence, how can I know if this will allow me to submit my new evidence sooner than I could if I stay in the legacy appeals process? Thank you for taking these questions about RAMP.

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    1. There isn't a way to know where you currently are in line. However, if you switch to RAMP it is likely that your case will get sent back to the BVA anyway. Blue Water Veterans are not currently on the Presumptive List, since that bill stalled in the House last year, so your case is not straightforward. In order to win this one, they would have to make an exception to the laws based on the quality of the evidence you have, and that would have to go through the BVA. You can always give it a shot, but it's probably best to stay where you are, at least until a bill is passed that puts you on the list officially.

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    2. Thank you for the reply. My new evidence, however, has nothing to do with being Blue Water Navy, but shows exposure to Agent Orange at two other locations. It would not be an exception to the law as I see it. Rather than presumptive, it would be more in line with direct exposure. I spoke with my Regional Office in Roanoke, Virginia yesterday and you are correct in that there is no way of determining where I am in the queue. I was told that I am at least a year out of being able to present new evidence to a Decision Review Officer. Opting into RAMP may allow me to present my new evidence sooner, but as the program is so new, there is not enough data upon which to rely to know how much sooner.

      Delete
    3. Gotcha. Yes, as long as you can show proof of that exposure, then it should qualify, so that's not an issue.

      I agree with the Regional Office. RAMP may get you there sooner, but no guarantee.

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  12. Yes, that's what the Regional Office told me: No guarantee. As the invitations from Roanoke had been sent out the first week of March, there was no way to know if opting in moves one up sooner or not. I'm thinking of giving it a shot as my appeal was going to be presented to the Decision Review Officer at Roanoke and not the BVA. One thing I did inquire about was if by opting into RAMP, does that just make those in the queue wait any longer? I didn't want to make those who have been waiting much longer than I have to have to wait even longer. I was told that there were probably many who would not opt to join RAMP and be content to simply wait. Many VSOs are posting that RAMP isn't a good thing, but like most things, it depends on one's individual circumstances. Thanks again, Dr. Johnson. I appreciate your taking questions and responding so quickly.

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    1. Wanted to add, if the Blue Water Navy Act is passed before any of this transpires, then all this is moot.

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    2. No, you jumping into RAMP won't affect anyone else. Those still in line will stay in line for the BVA. If RAMP ends up sending you back to the BVA, you'll end up at the end of the line, not the beginning. It's a different path, not cutting in line.

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    3. Thanks. From my understanding, I'm not in line for the BVA now anyway. I'm merely waiting to present my new evidence to the DRO in Roanoke. If that does not go my way, then I end up in line for the BVA.

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  13. Dr.
    I just received an invitation to participate in the Ramp program. I looked on line and found articles from different Lawyers who represent veterans, and they all basically say stay out of Ramp. There reasoning is sound, in one cause you cannot submit new evidence, and if denied you have to wait until Feb 2019 to appeal. Another reason was va has never been good at estimating how long it takes to do anything, yet they claim an average of 125 days and you will have an answer under ramp. And the third reason for remaining with he old system is because if you find you do not get your claim approved you cannot get back into the old appeal system. Finally, if you do go to ramp it is very possible that you will receive the same denial that you already received since the same people will be making the decision on your appeal. I don't trust the va to do anything correct. I've been dealing with the va since 1986 so, and I was a service officer for about 3 years, I understand the system, and I still don't trust the va to do anything right. Are you for or against the option to opt into Ramp, or do you thing as I do, that the sooner I opt in the sooner I become a VA guinea pig, because until the do ramp for a while they really have no idea if it will work better or be worse. thanks

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    1. Rick b, the third reason you cite is that once you are denied in RAMP, you cannot get back in the "old appeal system." Just what exactly is the old appeal system? If you see my circumstances above, my claim has not yet been looked at again as I have new evidence I want to present. If I fail at that, what is the new appeal system in Feb of 2019 and how does it compare to the old one? Thanks in advance.

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    2. The " old " appeals system is the system that is presently in effect, and will be changed over in Feb 2019, all new appeals after Feb 2019 will be under the new Ramp system. The only reason some of us are receiving an invitation to use Ramp now is because the VA needs guinea pigs because they have no idea how it will work when it actually goes into effect in Feb. The say it will take 129 days to finish an appeal under the new system, how in the world do that know that, when few if any claims have been processed under ramp.

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    3. Thanks, Rick b. That's what I understood as well. From what my VA rep at my RO told me, I'm not likely to be able to present my new evidence before Feb 2019 as it is, so maybe opting in just gets me before the Decision Review Officer sooner than Feb 2019. The only thing that would make decisions faster is if someone decides them faster because they're under a deadline. From what I have heard, there are no repercussions for missing deadlines anyway. Also, it's easy to deny claims and put them in the appeal lane, the result of which gets them off someone's desk and helps them clear out their inbox. Bingo! Deadline met...bonus secured! I'm on the fence but may opt in to be a guinea pig. If HR 299 gets funded and passed, nothing I do now will matter anyway.

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    4. Rick, you bring up some good points. The reality is this system is untested and so we don't know just how it will go.

      However, for simple cases that are straightforward, it should be effective. These are cases with clear errors made by the VA (not ones that you'll have to fight), or that just needed new evidence.

      Now you mentioned that they don't take new evidence. Actually, they have an entire lane for cases with new evidence to consider. So if your case has new evidence that will clearly change their decision, then this could definitely be the way to go.

      As for the timeline they are giving, yes, their wait times for appeals is atrocious, but you have to give them credit for the changes they made to the initial claims system a few years ago. They have fixed their wait time for original claims. Most are now determined in the time frame given. And that is the goal of RAMP--to fix the wait times. So they should have it done in the promised time. Hopefully.

      Yes, if you jump ship, you can't go back. But in the current system, you may wait until Feb 2019 (or longer) anyway.

      It's really just a risk. For simple, straightforward cases, it's probably worth it. For others, maybe not, especially if your appeal has been pending in the system for multiple years already.

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    5. Veterans will be able to appeal to another lane if they disagree with their initial RAMP decision. If you receive an unfavorable decision within the RAMP system, you will have a one year appeal period to take your case to another RAMP lane (the Supplemental Claim Lane, the Higher-Level Review Lane, or the Board/NOD Lane), and your effective date will be protected.

      The Board of Veterans’ Appeals (BVA, or the Board) will begin deciding RAMP appeals in October 2018. Previously, VA planned to open only the Supplemental Claim Lane and the Higher-Level Review Lane to RAMP participants, leaving any appeals to the Board until VAIMA (the new appeals system) was fully implemented in February 2019. But at a March 2018 conference for veterans’ advocates, Chairman of the Board Cheryl Mason announced that the Board will open to RAMP participants in October of this year.

      The new appeals system calls for three dockets at the Board, separate from the legacy appeals docket currently in operation. Veterans who appeal a RAMP decision will be first in line in the Board’s new dockets.

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  14. Greetings Dr,
    I opted-in on March 6th, all new evidence were added before Feb 15th and I called to confirm it has been posted. My condition is Pes Planus with Plantar Fasciitis/callous/spurs. I selected Higher-Level Review with Informal Conference. Lets see what happens. I dropped my NOD on Dec 7th 2017. So I have nothing to lose. Let the 125 day countdown begin, I'm on day 5.

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    1. Great. Definitely keep us updated. It'll be good to hear about the experience directly from someone going through it.

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  15. I received a RAMP letter. I have had 5 back surgeries, a nuerostimulator, and right hip replacement. All paid for by the VA. I submitted my appeal back in June. Since that time I’ve had to have a new neurostimulator put in, left hip replacement, and many injections in my back. Due to the amount of surgeries I’ve had I developed CAS catastrophic a antiphospholipid syndrome and now have to get bi weekly infusions. So I do have new evidence to submit. I’m currently at 70% fighting for 100%. My biggest question is do you still get back pay through RAMP? I feel a lot of the article written online are by attorneys which they seem to be against. My guess is the new program is cutting them out in some way. Do you think it’s a Roth it for me to try?

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    1. Since you just submitted in June, it probably won't make your situation worse to try RAMP. The current wait time is years, so at only a few months in, it probably is worth the risk to give it a try. We don't really know at this point.

      However, new and secondary conditions aren't added to your disability through appealing. You need to submit brand new claims for the new conditions, even if they are secondary to your currently service-connected conditions. So since CAS is a new diagnosis, just submit a new claim for that as secondary to your service-connected surgeries.

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  16. My claim has been on appeal since 2013...waiting for a DRO...had very favorable C&P exam 4months ago and decided to opt into ramp Feb.21...my logic is that I've submitted all information from my personal doctor so why not opt in and choose Higher Level Review, just recently having a favorable C&P should make it easy for them to rate me correctly this time around....i hope! We shall see

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    1. Question, when you login to ebenefits, can you see anything that tells you the current status of your RAMP?

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    2. Ebenefits shows my claim complete as of March 16....i call the 800# and they informed me that is it's not necessarily complete but that it's officially into Ramp and claim will be complete not later than Aug.16 .....

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    3. I am wondering if the 800# gave a generic completion date (125 days) or if the date is actual to your appeal. I have been searching to find out a link to check RAMP status but am unable to locate. I truly wish the VA would of made RAMP more veteran customer service oriented instead of calling 800#

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    4. I'm sure they gave the generic date hince the "not later than" Aug. 18 date they gave me....reports have said they've been completing them in 33 days...ill post whenever that time comes

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    5. VA posted this article about checking your appeal status just last week:

      https://www.blogs.va.gov/VAntage/46761/new-va-appeals-status-tool-provides-tracking-transparency-veterans/

      Any dates they give you are going to be generic and an overestimate of the actual time they'll take. They do this so that you are prepared to wait longer, but then happy when it comes back before that date.

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  17. I'm wondering the same thing, Corey. I visited my local DAV chapter yesterday and they emailed my application for RAMP along with my new evidence. I'll be checking periodically to see if the status shows up in eBenefits. I imagine it will show the same as regular claim status, i.e., received, in process, being reviewed, etc. If I see something, I'll post it here.

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    1. I was able to see on vets.gov (not eBenefits) that my RAMP claim had moved into the "evidence gathering" phase on July 5, 2018. On July 12, 2018 I received a phone call from a VARO rep in Waco, TX. He asked a few questions about my claim and then sent it on to Washington that afternoon. From his tone, I think he has recommended that I receive service connection for my prostate cancer. I think that the VA in Washington, D.C. takes his recommendation and then begins the process of assigning the rating, etc., and then sends out the notification letter. I'm not really sure how the procedure works, but I think that a regional office (RO) makes the decision and forwards it to DC and the VA in DC sends out the official notifications. Perhaps Dr. Johnson can weigh in on that. Oh, as a reminder, my official opt in date for RAMP is March 27,2018.

      Delete
  18. AHH-HAA - found more an update March 2018

    Article Link - https://cck-law.com/news/rapid-appeals-modernization-program-ramp-open-to-all-veterans-april-

    Beginning on April 1, 2018, VA will allow any veteran with a pending appeal to opt into its Rapid Appeals Modernization Program (RAMP). This is a major pivot from VA’s original enrollment strategy, in which veterans had to receive a RAMP invitation letter before opting into the pilot program.

    The Rapid Appeals Modernization Program (RAMP) is a pilot program designed by the Department of Veterans Affairs (VA) to test the new appeals system scheduled to launch in February 2019. Signed into law in August, the Veterans Appeals Improvement and Modernization Act (VAIMA) of 2017 required the creation of a new appeals process that would allow veterans to choose one of three appeal “lanes.” VA refers to the pre-VAIMA appeals process as the Legacy Appeals system.

    As of March 1, 2018, the number of veterans who chose to opt into RAMP since its start in November 2017 was lower than VA expected, with only 2,462 veterans opting in out of the 84,546 veterans invited. That’s about a 3 percent opt-in rate, which falls well below VA’s projected 10 percent rate.

    In a presentation last week, however, VA indicated it will be quietly abandoning the invitation-only plan for RAMP. At the Waco, Texas VA Regional Office, officials said that, starting April 1, 2018, any veteran with a currently pending appeal will be able to opt into RAMP by using a publicly available RAMP Opt-in Election form and bar code cover sheet.

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    1. Thanks for sharing, Donna. This is an interesting article, as I've been unable to find support for what it claims from any official VA source.

      Did the VA really open RAMP up to any applicant starting April 1st? If so, they haven't officially announced it, and there are no instructions on how to apply anywhere on their site.

      Do any of you see an option to apply when you check your appeal status? If so, please let me know so I can further look into this and be able to report what's really happening.

      Delete
  19. Dr. So I received a letter from VA with most of the claims denied. Will I have the opportunity to do the ramp, or just stay in the old system. I did receive my decision fairly quickly ( less than 4 months). Also is my discharge physical a good enough nexus for the VA? I am still going to the Seattle VA hospital for the same problems yet they said in the letter I need "new & material evidence". Honestly I'm at a loss here because I'm not sure what else they need. All my records are at the VA hospital they have access to them.

    ReplyDelete
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    1. How to appeal and what evidence they need depends on exactly why they denied the conditions.

      Did they say they were not service-connected? If so, then you need to show evidence of them having been originally diagnosed and treated while in service. If you do not have this evidence in your military medical records, then you'll need evidence that supports one of the other requirements of service-connection or supports that you qualify via the Presumptive List.

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

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

      Them asking for new and material evidence means that whatever you submitted did not show enough proof that your conditions were service-connected. Once you figure out how your conditions qualify for service-connection, then you need to provide as much evidence as possible that supports it.

      As for RAMP, you'll receive an invitation if you can apply, but go ahead and apply via the old system first. Then you'll be invited to switch over.

      Delete
  20. I also received an invite I am at the DRO level since last Sept for Sleep Apnea secondary to Tinnitus and Rhinitis I have submitted and I M O from a doctor which makes the nexus on both issues I also show on c-file in military with many trips to sick bay for many E N T issues as well as epitaxies including where the doctor states on my exit medical check states E N T issues with epitaxies I also have been diagnosed with deviated septum if I choose the ramp program which lane would I choose and do I have to submit the entire N O D over again??

    ReplyDelete
  21. Also there is an entry in my c-file that states I was seen by a doctor for insomnia

    ReplyDelete
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    1. Hi Angelo -

      If you have new evidence that you did not submit with your original claim, then you need to pick the New Evidence lane. If you submitted everything you noted above with your original claim, then you do not have new evidence and need to pick the local higher level review.

      You don't need to submit the NOD, but follow directions on the invitation. They'll tell you exactly what you need to submit to them.

      Delete
  22. My question is my file is now at my regional office at the DRO level since June 2017 Sleep Apnea and MTSP, which is a appeal in which they said it could take about 394 days. Now my question is it best that I wait or try to do the ramp. Don't know much about this process.

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    1. That's the big question, Andrea Blair. No one, posting on this board at least, has gone all the way through the new process yet. I had new and material evidence for my claim, so I figured I'd jump in and submit it now rather than waiting to see my DRO at the Roanoke, Virginia, Regional Office. I haven't found out yet if my RAMP claim will be sent to my regional RO or if it will be seen somewhere else. I guess it doesn't really matter at this point, but like others have said, I wish there was a way to monitor the progress as it goes along. I'll know when I know, and I'll post here when I get word. My official opt-in date is 31 March 2018, so I still have a way to go yet.

      Delete
    2. Hi Andrea -

      Yes, we don't really know how long things will take and how this program will really end up working. However, if your appeal time was really quoted at 394 days, that will have your appeal finished this August. There is no evidence that RAMP will have it finished sooner than that, so it's probably best to not switch over, but just wait it out. Many appeals take YEARS, so RAMP is a great option for those, but if the 394 day estimate for you is really accurate, then switching to RAMP could be a risk.

      Delete
  23. Is MSRA worth claiming for disability?

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    1. Hi Martin -

      MRSA is a ratable condition as long as it is service-connected. It is usually rated on any lasting symptoms/conditions that it causes.

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

      Delete
    2. You are referring to the condition MRSA, correct? I'm not aware of an MSRA. Just want to make sure I'm answering your question correctly.

      Delete
  24. What is MSRA? It's customary to define acronyms that aren't that common.

    ReplyDelete
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    1. MRSA is methicillin-resistant staphylococcus aureus, a form of staph infection.

      Delete
    2. Yes, that's what I figured. Like you, I figured the MSRA was a typo. My admonition still applies in my opinion. While you are an MD and most likely know all of the acronyms, most of us don't,so rather than making the rest of us look them up, it would be helpful if posters would spell them out when they use them initially.

      Delete
  25. I just received an invitation and opted for higher level review as the only new information is located in my medical records. I am currently at 70% and was forced to resign from state corrections due to their refusal to provide accommodations. I have severe nerve damage in both feet, my right being worse. I asked to use cam boot and asked that on days with severe pain, that I be allowed to leave without being penalized. I was denied and did file and EEOC complaint, but unfortunately the EEOC stated that the prison was short staffed and could not afford to have an employee leave. I have had a heck of a time trying to find new employment with accommodations. I filed for IU, which is in appeal. Oh, and I used my husband's profile, my name is Rebecca Glorioso. Is there anyone who has had an appeal decision from RAMP yet? Just wondering if it was worth opting for. Thank you.

    ReplyDelete
    Replies
    1. An appeal for Individual Unemployability is not the "standard" appeal that RAMP is directly targeted for. Because of this, I would be hesitant to suggest that you opt in. RAMP is for straightforward appeals to basic disability, not specialized benefits like Unemployability.

      Tough call, though. If your case is really strong and the VA made a definite error, then maybe it is worth it. However, for things like Unemployability, the strength of a case is hard to determine. Based on the little information I have, I feel like it is a judgement call by the VA, so not a clearly strong case, but one that could go either way.

      Again, I'm hesitant to recommend it, but the call is yours.

      Delete
  26. Rebecca, so far no one posting on this page has had a decision as far as I know. I think I read somewhere that some have been decided in as little as 33 days, but they could have been very simple claims. My claim is in the Supplemental Lane, which may or may not be quicker than the Higher Review Lane. Every claim is unique. Good luck with yours.

    ReplyDelete
  27. Recieved two service connected ratings of 0% for depression and siezures secondary to neuro sarcoidosis.The statement of claim stated no compensatory symptoms .clearly incorrect ratings for each.VA guidelines read that just being diagnosed requires a minimum 10% rating for each.I requested a reconsideration and got the same results.I recieved the RAMP invite my question is should I enter the program and take a third bite of the apple with the same reviewers or continue in the current appeals process.just looking for opinions.By the way in my case the VA moved pretty quickly the initial claim 6mo the recosideration 3mo.

    ReplyDelete
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    1. If you do not have any new evidence, I would not opt in to RAMP. You need a higher level of review by the BVA. Going through the same people won't make a difference.

      As for your claim, I just wanted to point out that there is not a minimum 10% for diagnosed depression. The minimum for that is 0%.

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

      You are correct, however, that an official diagnosis of epilepsy with a history of seizures is rated 10% minimum. To diagnose epilepsy for rating purposes, however, a seizure must be witnessed by a physician and neurological testing performed during the seizure. As long as you have evidence of this in your medical records, then you do qualify for the 10%.

      http://www.militarydisabilitymadeeasy.com/centralnervoussystem.html#epilepsy

      Delete
  28. I opt into ramp this month April I been tring to get a rating for PTSD since 2016. I'll keep you all up dated, pray for me plz for a positive rating outcome in this RAMP!!

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    1. Very interested to see how it goes. Good luck!

      Delete
  29. Hello, I was diagnosed with ED while on active duty. Received a 0 percent rating from VA for this condition with no SMC K for loss of power of a reproductive organ. Is this considered a CUE? How can I apply for the SMC K? Thanks.

    ReplyDelete
    Replies
    1. SMC-K is awarded automatically to anyone who qualifies. You can't apply for it.

      If your ED makes you completely infertile (unable to perform at all), then the VA did make an error. Your first course of action would be to submit an appeal.

      http://www.militarydisabilitymadeeasy.com/isyourratingwrong.html#va

      If too much time has passed and you can no longer submit an appeal, then you can submit a CUE claim. CUE claims can only be submitted if an appeal cannot be.

      Delete
  30. Doc. I was diagnosed with glaucoma while on active duty it was over looked on my original C&P exam. It has since gotten worse I submitted a claim and it was denied saying it wasn’t service connected. I filed an NOD along with the evidence that I was diagnosed with it while on active duty. I was then given a C&P exam for that. It’s been since 2015. I recently received an invite to the RAMP process and choose the higher authority option. Even though it says no new evidence can be submitted, will they still look at the evidence & C&P exam that was submitted 3 years ago. Or will it just be what they based it on the first time. If not how do I go about changing it to a different option?

    Thank you Larry

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    Replies
    1. Since the new evidence is key to the success of your claim, my instinct is that you need to be in the New Evidence lane, not higher level review. The new evidence wasn't considered in the original decision, so it is still considered new evidence (although submitted 3 years ago) until it is officially reviewed.

      Since this is a new system that is untested, I'm not sure the best way to choose the new evidence option if they aren't giving you the choice. You may need to contact them directly if they don't give you the choice during the application process.

      Delete
  31. I received my 2nd invitation from the Baltimore VA. I am currently rated at 100%. I disputed the dates that my compensation went from 40% to 60%. I was medically retired at 40% from US Army in 1990. My initial filing for my conditions getting worse was August 2009. I was increased to 60% effective in March 2010 after my VA Exam. Eventually I was increased to 100% in October 2010.

    I informed the VA and provided medical evidence of me receiving treatment from a civilian provider since 2008. My question is: when this new claims official gets into my file, will he/she look at what my dispute is (effective date for increase from 40 to 60%), or will they be going over the whole ball of wax? What I am asking is: am I putting my 100% rating at risk of being changed when the new eyes look at it?

    Again, I am disputing the starting date of my compensation increase frm 40 to 60%. I felt it should have been when I first filed for a new review in August 2009, not March 2010 after my visit with VA doctor. Thanks in advance for you comments and advice.

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    1. No, your rating shouldn't be at risk. Appeals usually only address the issues you are disputing, not the entire case.

      You are correct, though, that the effective date should have been the first date of the month after you filed. Should be a fairly straight forward correction.

      Delete
  32. I opted into RAMP, effective 31 March 2018. Periodically I check vets.gov to check the status of my appeal. So far, it says that a status is not available for those in RAMP. However, a few days ago, the following was on the page: "On March 01, 2018, VA sent you a letter to let you know about a new program called the Rapid Appeals Modernization Program (RAMP). However, this appeal isn’t eligible for RAMP because it is active at the Board of Veterans’ Appeals. If you have other appeals, they may be eligible for RAMP." I called the number listed for the BVA and the lady said that I was not active at the BVA and she showed that I was in RAMP, which is still at the Decision Review Officer (DRO) level. She said that another veteran had called with the same issue. Apparently there is a glitch with what is being put on the page. Has anyone else in RAMP seen the same notice?

    ReplyDelete
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    1. Mine says the same thing

      Delete
    2. My husband had that on his page, too, but it had disappeared by this morning. Hopefully, just a minor glitch.

      Delete
    3. Thanks MS and Debsus. This morning mine still had the same box saying my appeal wasn't eligible for RAMP. I did speak to someone at the VA and they said that I was still indeed in RAMP, so it must be a glitch, which isn't that surprising with so many veterans and different databases. I did read somewhere else that so far those in RAMP had their decisions around the 37-day mark and that 61% had their claims approved. The normal rate of approval is 25% it said. Keeping my fingers crossed as my 37 days are up next week.

      Delete
  33. Jas72 awesome. I am getting close to the mark as well! Best of luck and thank you for the information.

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    1. Good luck to you as well, MS. I hope you will share your results with this board when you find out. I will as well.

      Delete
  34. I had a undiagnosed AVM in the military. He of chronic migraines and a pop on left side of my head that caused me to pass out. They missed it on my MRI. So I was denied compensation and I had a statement from head of nuerosurgery starting it was as likely as not it was there. According to regulation of it is as likely as not there are to rate in favor of veteran. Now I have a Ramp letter. Previously and waiting review based on my notice of disagreement. Should I opt in the ramp program

    ReplyDelete
    Replies
    1. Did you submit the neurosurgeon's statement with your original claim? If so, then RAMP may not be as easy as hoped. If it is new evidence that hasn't been seen yet, definitely submit it to the New Evidence lane of RAMP.

      While they are supposed to decide in favor of the veteran, they still have to have fairly irrefutable evidence. While nexus letters are definitely helpful, they are not always irrefutable, especially if you only have a single letter and there isn't any solid evidence to support it otherwise. Depending on the quality of other evidence you have, yours may be a more difficult case that needs a higher review anyway.

      That being said, if the letter is new evidence, it is worth a shot to give RAMP a try.

      Delete
  35. Just posted an update article on the RAMP program. Check it out.

    http://news.militarydisabilitymadeeasy.com/2018/05/official-ramp-update.html

    ReplyDelete
  36. I am trying to get service connection for menieres disease. How likely is it that I can do so? I have seen a doctor for vertigo issues while I was in as well as have an Otolaryngology specialist connect it via letter from diving and TBI while I was in. Is this something that could be truly connected with this evidence? I am having vertigo spells about twice a week right now and losing hearing progressively. Also shows hearing loss from start of service till discharge from military.
    Thank you

    ReplyDelete
    Replies
    1. Sounds like you have fairly strong evidence. It's impossible to say definitively without having reviewed your entire case, but you definitely have a strong chance. Since you have service-connected evidence of hearing loss and vertigo in service that will help. And your nexus letter connecting it to the TBI while in will help as long as your TBI is also considered service-connected. Seems like you've put together a fairly strong case, so hopefully it will go in your favor.

      Delete
  37. I applied for PTSD August 2015. I was denied because the initial C&P exam was not finished and they denied for me for a reason that I NEVER claimed. I was denied because Bi-polar is not from the military??? I was to be evaluated for PTSD and was diagnosed in the initial exam. I filed my appeal and did a new C&P exam and the new eval clearly showed 15 errors made and I should hae been awarded PTSD and be service connected. I was sent a RAMP offer and i joined. My claim now says "Claim closed?" Will the Higher Review officer look at the new C&P exam? I submitted my RAMP papers 5-17-2018 and the Re Evaluation was conducted in April 2018. Will I get back pay from 8-2015? It says no new evidence but I pray they look at the mistakes made in the initial eval and the new evaluation. Thanks

    ReplyDelete
    Replies
    1. Hi Rich - Sorry for the delayed reply. Google got a bug, and we weren't notified of your post.

      It is very odd that they would deny you for a condition that wasn't listed on your original exam, so it definitely seems that they made an error that should be easily corrected in RAMP.

      When they reviewed your case, they should have looked at all evidence that you submitted with your appeal. Since you submitted the appeal before the new C&P exam in April, then that will not be considered with the claim unless you submitted it as new evidence. You would need to submit it under the New Evidence lane in RAMP in order for it to be considered.

      If you did, then you should be on the right track. Hopefully they'll review everything and get it done correctly for you.

      If they do decide in your favor that the VA made a definite error in their original decision, then yes, you should qualify for back pay to the date of your original claim submission.

      Delete
  38. Hello Dr. Johnson; my question is twofold. I had an evaluation the other day done by the VA’s new evaluation contracting group called; VES (Veterans Evaluation Services). This evaluation was for an ongoing appeal for a claim I put in back in 2013. The person doing the exam was very new to the exam field and only started working in this field back in December 2017. Here are my questions; 1) if the examiners write-up shows too favorable towards me, do you think the VA will not accept the examiners write-up/findings and request that I go see another examiner? Secondly, I was sent an invitation to have my appealed case heard in RAMP, but I haven’t yet accepted that invitation. So will this hurt my appeal status, negatively, in the VA’s eyes?

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    1. Hi Boris - Sorry for the delayed reply. Google got a bug, and we weren't notified of your post.

      1. Absolutely not. The exam is just data, and the VA can't decide if data is "too good." It is what it is. The VA will look at all of your data, favorable or not, and rate you based on the evidence of your condition.

      2. And no, you do not have to choose RAMP. It is completely optional. And the timing is up to you. The people ultimately doing the ratings will probably not even be aware of your choices/timing. Even if they did, it wouldn't factor into their decisions. As long as you meet required deadlines, the rest doesn't matter to them.

      Delete
  39. Dr. Johnson, My case is fairly complex so I will just break it down to the basic facts. I had a radiation exposure while on a sensitive assignment (documented, not dosimeter). I was diagnosed with Hairy Cell Leukemia (HCL) and received Chemotherapy (VA) in 2009.
    Since the incidence of Hairy Cell Leukemia is three out of a million, I felt that the exposure caused the HCL. I have submitted proof of the exposure, proof of my presence and radiation levels, as well as a strong supporting letter from a VA Hematologist. The claim was denied twice stating I did not file within prescribed time limits and that here was no record of any in-service treatment. VA's own regulations state there is no time limit for leukemia to manifest and I was retired from active duty before it did manifest. Certainly if there is no time limit on claiming Leukemia, the reasons for denial of the claim of not filing with in the time limit and no record of in-service treatment are invalid. My local Veteran Service Office doesn't understand why the denials and told me that claims with much less supporting evidence have been approved. I have been advised that VA is simply running a check list and is not actually reviewing the claim. I Filed a Notice of Disagreement a month ago and submitted a RAMP request two days ago. Several people with experience in processing this type of claim advised me to get a lawyer and request a hearing and that the hearing board would most likely approve the claim very quickly.
    I think that my frustration is that its apparent that the evidence submitted is not being reviewed or taken into account. I have high hopes that RAMP will if not approve, at lease give some valid reason(s) for not doing so.

    ReplyDelete
    Replies
    1. Yes, a definite mistake was made. There aren't any time limits on leukemia after radiation exposure, and it sounds like you have all the necessary evidence to prove exposure.

      I think your case is too straight forward to spend money on a lawyer yet. RAMP should fix this. It is fairly simple and should be an easy fix on their part. They do review evidence, so you should have a favorable outcome.

      Delete
    2. Doctor Johnson, To summarize my issue. I filed a RAMP Opt-In on 22 May 2018. No status or update has been posted on EBENEFITS or Vets.gov since filing.I called the VA 800 number several times and was told that they had the Opt-In. I notice that every other RAMP Opt-in was getting posted on EBENEFITS within two weeks. After 72 days with no update and seemingly the only Veteran that didn't have any kind of status posted, I call the VA 800 number again to try and get some type of status. I did! My RAMP Opt-In had not been processed, there was no reason known as to why it hadn't been posted. The person I was speaking to was very courteous and seemed very knowledgeable. He pulled up my Claim and his exact comment was "GOD" what a mess", he said that nothing had been done since 2 July, that I wasn't in RAMP and that he couldn't tell what had been done or who had worked on the file, further that the claim notes didn't make sense. He said he was embarrassed that my claim had been handled so incompetently and after a 40 minute conversation in which he still couldn't find out what was going on, he said that he would get to the bottom of the situation and get it back into the system. Since my RAMP-Opt-In hasn't been processed yet I'm guessing that the 125 day clock hasn't started. If I don't get some answers by next Week I'm going to file a Congressional. My thoughts are that since an initial mistake was made in denying my claim and it would most likely exceed the 125 day goal, that it got ratholed/buried or placed in the lie until they die file.

      I am definitely seeking advice? If I hit a dead end with this, is their anyone in the VA system that I can contact for help. I know that there is a White House hotline and during my career have worked on several congressional investigations. I'm very frustrated and while a few people have advised me to be patient because the RAMP Opt-In was only received by the VA on 22 May. This has been going on since 2009. The claim is fairly complex and has some security issues involved. I can't help but think it was sidelined deliberately.

      Thank You Very Much
      FLCoyote

      Delete
    3. It sounds like the person you got on the phone was trying to do his job right and help out, so that's at least a good sign amidst this mess. Let's hope that he is able to figure out what is going on and get this fixed.

      The VA doesn't punish people for making a mistake (maybe unfortunately). But that means that there really isn't a logical reason for them to choose to bury it when going to RAMP. They would get in more trouble via the supervisor for a lost or buried case than just having a late one.

      This is definitely a mess, though, and an inexcusable one. They had no reason not to process the appeal properly the first time. I'm really hoping this last guy you spoke to will be able to correct things and get things moving for you. Did you get his direct number? I'd follow up with him in a few days since he was so responsive.

      If you still get the run around in a few weeks and no progress is made, you can try to reach out the head of your Regional VA. Congress reps are also an option. I hope you are keeping records of all your interactions as those could help.

      Delete
  40. I agree with your evaluation of what happens at the VA, FLCoyote. Yours seems to be a case of a clear error on the part of someone at the VA. Too often it seems as if in order to clear a full inbox, an examiner will deny a claim and get an "attaboy" from the supervisor for decreasing the backlog. What happens to the dolt who denied you in the first place? My guess is absolutely nothing. There is no accountability at the VA apparently. If a person denied and claim that was clearly valid and got in a heap of trouble, then claims might get the attention to detail that they deserve. This is most likely a reason for the huge backlog of appeals.

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  41. ok can anyone please answer me this ? i put in a claim for pseudofolliculitic in 2002 i was denied because they assume i had it before i enter active duty which is not true and that i enter 7-17-79 and was seen in the clinic 7-25-79 basically they say it wasnt enough time for me to bump up or manifestation. ok am i to believe that we all have the same skin help please.

    ReplyDelete
    Replies
    1. Hi Kenneth -

      Unfortunately, your evidence is fairly weak as far as the VA regulations are concerned. In their view, it is "less likely than not" that the condition was directly caused by your 8 days of military service. This condition is known to be directly caused by shaving, and that is not a practice that is solely military.

      Now maybe you only shaved because you had to for the military and never shaved a day before then, but I can see why they determined it not service-connected. If you can show that you only shaved for the military, then maybe you'd have a case. But it would still be somewhat weak. Unless there is a definite event (training accident, etc.) that causes a condition, there needs to be enough time in the military before a condition is connected. 8 days is pretty short, so it's a tough call.

      Delete
  42. Dr. Johnson, my husband was a marine in the 70’s stationed at Camp LeJeune for over 3 years. He was diagnosed with Polycythemia Vera in 2012 and sees a specialist at MD Anderson Hospital in Houston. He is treated at the Leukemia Center, this blood cancer is in the leukemia family. There are 5 different blood cancer families they specialize in and 4 of those were automatically entered into the Camp LeJeune conditions for disability in March of 2017. Naturally his group is more rare and he was automatically turned down the first time. We received the RAMP invite this week, we submitted personalized medical information and reference information connecting benzene and other chemicals to this condition. I believe it was not even looked at, because he was not on the official “8” automatic conditions. Do you believe the Camp LeJeune cases such as this will benefit from RAMP or will be have to go to the Board in the Feb 2019 wait group?

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    Replies
    1. It will probably have to wait to go to the Board, but I could be wrong. RAMP is only good for straightforward cases, and those would be the ones on the list.

      Polycythemia vera is not officially on the list as it is not leukemia, but has the potential to become leukemia in rare cases. Because of this, in order to make a favorable decision, the case would have to be reviewed by a higher authority that has the ability to make exceptions. The lower authorities have to abide by the letter of the law as much as possible. Only higher authorities can look deeper and make bigger judgment calls like this.

      Delete
  43. Dr. Johnson I have a claim that says "Authorization Review Claim." This is a follow up to another question I posted in Jan. 18. I have an appeal pending since 2002 and I received a letter to verify my dependents in May of this year. When I check ebennies or Vet.gov it says decision has been made and wait for a letter but 800 and my VSO says it just a response to my dependents letter.I was told I was at administrative review before I elected ramp. Can you tell me what's possibly going on? Thanks in advance.

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    1. I'm unsure from your comment if you did officially opt into RAMP or not. If you did elect RAMP, then it's hard to say. They are still working kinks out of the RAMP notifications system, and we've seen some veterans have odd things being said in the system, but ultimately their claim wasn't affected.

      Otherwise, I'd say it's still being reviewed and all you can do is wait, unfortunately.

      Delete
  44. Hi. I am new to this site but I see a lot of interesting information. I applied in 2008 and was granted 10% for radicular symptoms of the bilateral feet. Fast forward to June 2018 I am 100 percent and just got awarded smc RT2 which is the highest SMC from a DRO appeal. Needed that but while the DRO was doing the appeal he found a cue from the 2008 decision about my feet. I didn’t understand and he opened up a claim. I went into ebenefits and it says “Bilateral Lower Extremity Radiculopathy (New) from 2008”. I called the va 1800 and they said they couldn’t tell me much but one of them let me skip saying that she thought that it might of been because I should of been rated differently because when I injured my left foot my right foot had to overcompensate. I was wondering what you opinion was and why couldn’t the DRO officer just fix the cue if he found it or he couldn’t if it was going to get rid of one of my disabilities ? He did approve my appeal. Please your opinion

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    1. Hi David -

      If I understand the situation correctly, then radiculopathy was not originally on your claim, but you were diagnosed with it. Radiculopathy can be rated separately from other conditions, so it sounds like the DRO started a new claim so that the radiculopathy can also be rated.

      All conditions must be applied for (included on the claim) in order to be rated. DROs can't just add conditions. That's why it is important to include all of your diagnoses on the claims to make sure that all of your conditions that are eligible are rated.

      If I'm interpreting what you said correctly, then you are actually pretty lucky. Most DROs won't go above and beyond like this, but will just ignore any conditions they see that are not included on the claim.

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  45. So case closed. Didn’t get my brown envelope but checked ebenefits and checked on disabilities and they added another disability from 2007 for radiculapath of my right foot at 10%. I didn’t get my 100 percent title til 2013 so would they be giving me a retro from 2007 to 2013 of the additional percentage that they added on? I know it’s not a lot but I know anything matters and for all those years could add up or because they initiated the CuE then I won’t? I would think that since from 2007 -2013 I was rated at 40%. Then they just added in this approval for cue for 10% of bilateral radiculaphy of right foot that I should get retro for the difference 6 years?

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    1. You will probably not qualify for back pay. The VA will only pay back pay to the date you submitted the claim unless they made a definite error. Since the claim for this was just submitted now, it's very unlikely that they'll give back pay.

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  46. Hi. Thanks for replying. I ended up getting backpay. Just got it today. I never put in the claim. The DRO officer put in the CUE when he did my appeal and granted my appeal for SMC rt2 and he saw a CUe from 2008 and then he submitted it back to Reginal and they approved it from 2007-2013 when I became 100 percent so I got the 10 percent of bilateral added for those 6 years because the DRO officer initiated it and they found in favor of me. Very rare to find in favor of me and I didn’t have to submit anything and very rare for a DRO officer to go beyond his duties to submit something for a veteran but I am grateful.

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    1. That's great. Yes, with the earlier evidence that made the difference. Glad to hear you have a good DRO that's on it!

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  47. I am new to this site, but the information you are providing is extremely informative and thank you in advance for helping everyone out. I got out of the military in March of 2015 and didn't apply for disability until June 2017. I was trying to get a job in my old MOS as a flight engineer for helicopters(CSAR). I didn't want to my application to show I was broken. I was unable to secure a job in that market. I was denied all my physical ailments. I was diagnosed with Iliotibial Band Friction Syndrome (denied knee pain), diagnosed Temporomandibular Joint Pain (denied), diagnosed hydrocele (denied), diagnosed carpal tunnel syndrome and given surgery (denied), and sleep apnea (which I was just diagnosed for and will include diagnoses with appeal). If I was diagnosed by the military as having something, how can they deny that I have that issue now?

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    Replies
    1. Do you have medical records with these diagnoses from your time in the service? Were you active duty or Reserves?

      If you were active duty and have medical records showing proof of these conditions in service, then they should have granted the claim.

      Did you apply for exactly what was diagnosed in service? For example, was carpal tunnel syndrome officially diagnosed while in the military, and if so, did you list it exactly like that on your claim? Or did you just have wrist/hand pain in service but carpal tunnel wasn't officially diagnosed until more than year after, but you still applied for carpal tunnel?

      The conditions on the claim should reflect exactly the condition in service in order for the VA to be unable to deny service-connection. If you are claiming conditions diagnosed after service, they have a stronger case to deny you.

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    2. I was active duty during that time. I however was not diagnosed with Sleep Apnea until two week ago. The active problems on my medical record read as follows:
      Iliotibial Band Friction Syndrome on 26 Jan 2009
      TMJ pain on 18 Dec 2012
      Hydrocele of Male Genital Organs on 21 May 2013
      Carpel Tunnel Syndrome on 05 Aug 2013
      Patellofemoral Syndrome on 10 Oct 2013
      I applied for:
      Left Leg Pain
      Right Leg Pain
      Temporomandibular Joint Pain (TMJ)
      Hydrocele
      Carpal Tunnel Syndrome, Upper Left Extremity (claimed as left wrist carpal tunnel)
      Carpal Tunnel Syndrome, Upper Right Extremity (claimed as right wrist carpal tunnel)
      Sleep Apnea ( which I didn't have documented at the time)

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    3. The only one that should have been denied is the sleep apnea since it was diagnosed so long after service.

      What did they say was the reason for denial? Everything else should have been good enough, so I'm trying to figure out the best way to proceed.

      On their decision letter, they should have stated the exact reason for denial when discussing each condition. That should give us an idea on how best to appeal.

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    4. Sorry for not having gotten back to you sooner. I had to wait to receive another copy of the VA's last finds. The first document I received on Aug 21st had several conditions deferred. The following conditions were deferred:
      -Hydrocele
      -Carpal Tunnel Syndrome, right upper extremity (claimed as right wrist carpal tunnel)
      -Strain, right knee (claimed as pain)
      -Carpal Tunnel Syndrome, left upper extremity (claimed as left carpal tunnel)
      -Strain with trapezius muscle strain, right shoulder (also claimed as limited range of motion)
      -Strain with iliotibial band syndrome, left knee (claimed as pain)
      -Strain, left shoulder (also claimed as limited range of motion)
      -Bilateral pes planus (flat foot) (claimed as bilateral foot pain)

      The letter I received on Oct 19th (copy just sent to me Saturday)stated the following for all of the above conditions:
      -Service connection for "name of condition" is denied.

      No further explanation is given. The other conditions were rated on in my first letter Aug 21st and state the following:

      -Temporomandibular joint dislocation (TMJ): The evidence does not show a current diagnosed disability. While your service treatment records reflect complaints, treatment, or a diagnosis similar to that claimed, the medical evidence supports the conclusion that a persistent disability was not present in service. We received your medical evidence which does not discuss symptoms of this medical condition. The evidence also does not show that any arthritis developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection.

      -Sleep apnea: The evidence does not show a current diagnosed disability. Although your service treatment records show that you were prescribed medication for sleep, this was due to insomnia type symptoms. Your service treatment records do not contain complaints, treatment, or diagnosis related to sleep apnea. We received your medical evidence which does not discuss symptoms of this medical condition. Please note that a diagnosis of sleep apnea must be confirmed by a sleep study.

      -Right leg pain: The evidence does not show a current diagnosed disability. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We received your medical evidence which does not discuss symptoms of this medical condition. The evidence also does not show that any arthritis or nerve disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. Pain in and of itself is not considered to be a disability under the law for which compensation can be made without objective medical evidence of an underlying disease process.

      -Left leg pain: The evidence does not show a current diagnosed disability. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We received your medical evidence which does not discuss symptoms of this medical condition. The evidence also does not show that any arthritis or nerve disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. Pain in and of itself is not considered to be a disability under the law for which compensation can be made without objective medical evidence of an underlying disease process.

      Thank you again for your time and help.

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    5. Was the first list of conditions deferred or denied? Deferred usually means that they are still trying to get enough evidence to support these conditions. If you have more evidence to show that these existed in service or can submit statements from your docs stating that they were caused by service-connected conditions, this could help for those.

      Remember, to prove service-connection, you have to show undeniable proof that the condition existed in service. This can't just be a single visit to the doctor for foot pain and then you're claiming flat foot. The medical records have to show that flat foot caused recurring and regular pain during service and became a chronic condition in service (many people with flat foot have no symptoms at all).

      This is why it is important to claim what can be clearly proven by your medical records.

      You also must still have a condition in order for it to be considered a disability. Very few conditions recur after a significant break (though some do), so continuity is important for it to be clearly caused by your military service.

      Looking at the evidence you have, is there a way to submit additional evidence or show further proof that your conditions existed in service? Can you claim the conditions differently so that the claimed condition is more fully supported by your military medical record? If not, you may just not have enough evidence to successfully claim some of these conditions.

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    6. The first list of conditions was originally deferred (8-21-17), they were later denied for not being service connected (10-19-17)

      The TMJ was only diagnosed once. I was given a mouth guard to sleep with and was told that was all that could be done. I didn't bring it up again to medical, because I was already doing all that could be done.

      I brought up my poor sleep (gets less than 5 hours of sleep on three or more consecutive nights) two years apart while in the military. I was just diagnosed with severe Sleep Apnea (43 episodes per hour)and issued a CPAP machine.

      I was diagnosed with Iliotibial Band Friction Syndrome (ITB) in 2009. Went to physical therapy and went back to physical therapy in Oct 2014. At that time I took a Ninety-ninety SLR test, Step Down Test, and Ober test (tested positive for all 3 test).

      The left leg condition has caused pain in my right leg/knee ( I guess do to compensating).

      My knees hurt if I sit for too long and my hydrocele also makes sitting uncomfortable. As a result I spend a lot of time at work standing, which causes bilateral leg/foot pain.

      The Carpal Tunnel I just deal with, because again I was told that was just how my hands were going to work/feel going forward.

      I feel like a punk complaining about all these little things. My body however won't let me do a lot of the things I used to do. I'm ok with that reality, but the military telling me it wasn't because of them is inaccurate. Working/dealing with physical problems while in the service without complaint is doing me a horrible disservice, despite pushes by leadership to do so.

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    7. You are right that the culture of not getting your medical conditions properly seen and treated while in the military is causing many problems for veterans. We are starting to see a change in that culture, but it isn't enough yet.

      The VA basically said that they do not have enough evidence of your condition either in the service or currently. If you submitted everything you have, then you may just not have enough. If you do have definite evidence, then you can try to appeal. Opinions from physicians that claim the disease must have developed during your time on active duty could also help if you could get those.

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    8. Thank you for all the information and help.

      Greatly Appreciated

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    9. I am filling out my VA Form 21-0958 and section 11 asks for a list of each specific issue of disagreement. Please let me know if the following makes sense or needs adjustment:

      6847: Sleep Apnea (have CPAP machine) - Service Connection @ 50%

      9905: Temporomandibular Joint Disfunction - Service connection @ 10%

      8715: Neuralgi of Median Nerve (Right hand - Dominant hand) - Service Connection @ 30% (Crepitation)

      8715: Neuralgi of Median Nerve (Left hand - Non-dominant hand) - Sevice Connection @ 20% (Crepitation)

      4.45: The Joints (f) Pain of Motion (Left knee - iliotibial Band Syndrome) - Service Connection @ 10% (Crepitation)

      4.45: The Joints (f) Pain of Motion (Right knee) - Service Connection @ 0% (Crepitation)

      5322: Neck - Service Connection @ 0% (Crepitation)

      5319: Back - Service Connection @ 0% (Crepitation)

      5201: Right Shoulder (Dominant Arm) can't raise above 90 degrees @ 20% (Crepitation)

      Not sure if the Crepitation matters, but I thought I would throw it in since it is there.

      Also not sure if I should put the percentage sought, but it is on the form to be filled out if known.

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    10. Either in the first box of item 11 or in item 12, be more specific about what you are disagreeing, specifically addressing their reason for denial.

      For example, you know that they do not feel there is enough evidence that your TMJ was a ratable service-connected condition and still a serious enough of a disability now, so you can be more specific like this:

      "TMJ is service-connected and ratable at 10% due to the Painful Motion Principle. See attached medical records that provide full evidence of painful motion diagnosed while in service and continuing to present day."

      They told you why they denied you, so address those reasons exactly. Again, this can be done in item 12 instead of 11 since there is more space in that box.

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  48. What is the percentage of appeals been over turn with the RAMP Program?

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  49. The VA has not yet released detailed statistics of the success of the RAMP program yet. So far, all we really know is that claims are taking an average of 52 days to complete.

    We have heard a number of success stories, but again, no definitive statistics as yet.

    Here is the most recent update:

    http://news.militarydisabilitymadeeasy.com/2018/05/official-ramp-update.html

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  50. I posted an update, but it is sort of buried in the middle of the comments, so I am repeating it here. I entered the RAMP on March 27,2018 (some places say March 31 "officially") in the New Evidence lane. I was able to see on vets.gov (not eBenefits) that my RAMP claim had moved into the "evidence gathering" phase on July 5, 2018. On July 12, 2018 I received a phone call from a VA Regional Office (VARO) rep in Waco, TX. He asked a few questions about my claim and then sent it on to the VA in DC that afternoon. From his tone, I think he has recommended that I receive service connection for my prostate cancer. I think that the VA in D.C. takes his recommendation and then begins the process of assigning the rating, etc., and then sends out the notification letter. I'm not really sure how the procedure works, but I think that a regional office (RO) makes the decision and forwards it to DC and the VA in DC sends out the official notifications. Perhaps Dr. Johnson,you can weigh in concerning the normal sequence of events. So, while I have no final decision as of today, you can see that I received a phone call 107 days from March 27,2018.

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  51. Hi Doc! I have an ongoing case. I won my initial denial with a NOD for contracting Hep-C in bootcamp from the air injections. I had a liver transplant in 2013 and they gave me only 30% (minimum) for the transplant and have hearing loss in one ear(10%) and periphreal nueropathy (10% in each foot)so I have a total of 60% service connected. I filed another NOD 6 months ago and want to go with the RAMP program. I also have submitted a claim for sleep apnea which I have letters from my VA Dr.s stating it is medically required. My new liver now has NASH and I was wondering if I could get a 10% increase for that which would open the door to unemployability for me. My nueropathy is also 5 times as bad as it was when they first examined me for the original claim... What are your thoughts? Thanks!

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    1. You can easily apply for an increased evaluation for your neuropathy (not an appeal) since the VA will definitely increase your rating for conditions that worsen over time. You don't submit an appeal because their original decision was correct based on the symptoms at that time. Instead, submit a new claim for an increased evaluation.

      As for NASH, you can only receive a single rating for your liver, whether the 30% for the transplant, or another rating if your symptoms (like NASH) qualify you for a higher rating.

      NASH is rated under code 7345:

      http://www.militarydisabilitymadeeasy.com/thedigestivesystem.html#t

      Check your symptoms against the ratings. If they qualify it for a higher rating, then definitely submit a new claim for increased evaluation of the liver.

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  52. I was exposed to Agent Orange while serving in the Coast Guard in Thailand during the Vietnam war. The government released in 2010 the information that they did in fact spray Agent Orange at our location. After waiting for a year for a decision, The VA rejected my claim, because I didn't show my service in Vietnam, even though I served in Thailand. I appealed the decision, and was invited to use the ramp program. Last month I check status on ebenefits, and it says closed, not service related, but I never got a letter, or any notification as to why it was refused. What now?

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    1. Did you submit the evidence from the government that showed proof of your Agent Orange exposure? The VA will automatically follow the laws regarding the Presumptive List unless you show definite proof that you are an exception. Then you must appeal it to a higher level in order for your case to be reviewed by someone with enough authority to make exceptions. If you did submit full evidence of your exposure to the BVA through RAMP, then your next recourse is to appeal to the US Court of Appeals:

      http://www.militarydisabilitymadeeasy.com/isyourratingwrong.html#va2

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  53. Hi Doc, I have an appeal in progress and decided to opt into the ramp system and trying to decide between higher or Supplemental. I have nerves issues and dignosis with pain in right ankle. 14 times seen active duty. followed up through va 10 yrs post service. right knee meniscus tear with chronic pain major sprain documented 2 active duty with braces issued and again followed up on thourgh va off an on during 10 yrs post service. Degenerative disk c5 medium nerve down right shoulder along with chronic pain down right shoulder. i injured shoulder post service at work 7 yrs later systems complained about and observed to be exactly the same. So my right ankle had proper diagnosis while in service. i have had issues ongoing post service and right as i was filling my claim doctors were able to give actual diagnosis of my other issues with MRI and MRIs with contrast to give the diagnosis regarding the neck, the right shoulder to date is 50% or greater bicep tendon tear, labrum scaring and still tear, possible rotocuff small tear. righ knee meniscus bi later tear and additional abnormality not clearly explained . i have 14 sited medical for the ankle active duty, 2 main events medical documented active duty, neck and shoulder injured on guard status once performing organized PT off base and once working patrol duty on guard wkend. both tech and shoulder seen either through VA and or person chiro. i also filled DBQ's on everything private doctor with a final opinion stated on last page of DBQ's that more likely then not service connected with the dates of injuries listed. so my claim had all my active military medical files, private care fils, MRI reports , current day diagnosis, DBQ's even on fellow soldiers statement to witness accident during PT off base. And was rule non service connected on everything. i'm not sure if i missed something to add to my claim or what and my current lawyer says more then enough evident and timelines nicely with follow up care and diagnosis and that the DDBQ were a nice final touch. possible i missed something? should i go strait to higher level ramp and hope there was an error?

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    1. Sounds like there was an error since you have all the necessary supporting evidence. If you don't have any new evidence, then go the higher level route. Hopefully that will be all you need.

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