Hi Insiders! Recently we did a YouTube video about the Veterans Appeals Improvement and Modernization Act of 2017. I would like to touch on some key points from that and ensure you have a clear understanding of your options. One thing I would like to point out is that the advice and opinions I share are from a VA Claims Professional standpoint and is not legal advice in any way, having said that, let’s get started.
The NEW VA Appeals Process
The Veterans Appeals Improvement and Modernization Act of 2017 was passed in Aug of 2017. However, it was implemented on February 19, 2019. The changes that were put into effect are as follows:
- Modernizes the current claims and appeals process
- Includes three (3) review options for disagreements with decisions
- Requires improved notification of VA decisions
- Provides earlier claim resolution
- Ensures veterans receive the earliest effective date possible.
With this new Act, you can CHOOSE which route would be best for you to proceed, by coming up with three options. They are as follows:
Option 1: Higher-Level Review
With this option, you can request a “new look” at your current appeal. Basically, you are saying “hey I think you have messed up and I want someone else to take another look.” The VA is giving you an opportunity to have a new set of eyes look over your claim and see if the previous rater was wrong with the decision or there was a Clear and Unmistakable Error a.k.a. A CUE.
With this option NO NEW EVIDENCE CAN BE SUBMITTED, this is important.
When choosing this route, one of two things can happen. The rater will assess your claim and possibly say, “the previous rater was just wrong” and overturn the decision and grant you your compensation. Or they will see that there was an unmistakable error and return it to the VA regional office for corrections.
It is VA Claims Insider professional opinion that this option very seldom works out for most Veterans. Our reasons for why?
- Not many VA raters will overturn a decision from a fellow peer.
- Your claim was previously denied because you did not have enough evidence to approve it, to begin with.
- And you are unable to submit additional evidence to give to the rater for new material to base a decision on.
Again, we are voting a “thumbs down” for Option 1, UNLESS you have a solid CUE and can prove it, then this option is for you!
Option 2: Supplemental Claim Lane
With this option these are the pros:
- You can submit new evidence
- VA’s statutory duty to assist veterans in gathering evidence and developing the claim in full effect
- Goes into the National Work Queue for distribution to the various VA Regional Offices, much like an initial claim does now.
- Processing time goal is 125 days give or take to give a response from the VA to the Claimant in developing evidence.
Now, here is our take on this option, you will not have a chance to have your case heard by BVA (Board of Veterans Appeals) or a judge. This means you will not get a hearing if you do not like the outcome of the appeal. However, new evidence can be submitted up to 90 days and will be reviewed by the rater just like an initial claim would. So there is some pros and cons, but still a new option.
Option 3: Appeal Lane for Appeals to the Board
This option has three sub-parts to choose from, and they are as follows:
- Lane 1: Direct Review – No personal hearing, no right to add new evidence into the record, processing time goal of 365 days to return an answer from the BVA to the claimant.
- Lane 2: Additional Evidence Review – No personal hearing, can add new evidence into the record with ninety days after submitting the Notice of Disagreement a.k.a NOD, processing time will likely be longer than one year for the claimant to receive an answer from the BVA.
- Lane 3: Hearing Review – Personal hearing before the Veterans Law Judge, can add new evidence into the record, very long waiting times guaranteed.
Insider info on Lane 3: currently there are 67,000 Veterans nationwide waiting for a hearing with one of the BVA’s 98 Veterans Law Judges. We have Inside sources such as DRO’s, VSR’s, and VA rating officials that we talk to to get the best insider insight, this is how we are able to give very sound professional advice. This is NOT a good option!
So to break these down, Lane 2 is going to be your best option. Another insider tip: DRO’s (Disability Rating Officers) are who will handle the NOD’s, and from inside information, it is known that they can operate under a little bit more liberal structure, in granting Veterans Service Connection and ratings at certain levels. VRO’s (Veterans Rating Officers) have their hands tied by the statutory authorities and by the regulations levied by the VA. The chances of them overturning a previous raters opinion is slim unless there is a clear CUE, just as I stated earlier.
I would like to add that instead of an Appeal you can always file a “Reconsideration.” This is recommended if you have “new and material evidence” that was not previously considered. Examples for “new and material evidence” is listed below.
Medical Evidence is a Slam Dunk for any claim, whether it is in appeals or you are just starting or you are looking for an increase or filing a Reconsideration. Most claims are DENIED due to the lack of medical evidence, no diagnosis, and there is no proven Nexus ( link to your service). In the options above it is clear the new Act allows very few options for you to submit new evidence. You have got to choose an option that gives you an opportunity to submit what was missing from the first go around, EVIDENCE.
Here at VA Claims Insider, this is what we do folks! We have a medical team that we can get you access to get the evidence you absolutely have to have.
Here is a list of ideas to obtain clear evidence in support of any claim:
- Medical Diagnosis
- Medical evidence of current conditions
- In-service stressors: was there something that occurred or made worse by your active-duty service? The “Nexus” ladies and gentleman.
- The statement in Support of Claim (VA Form 21-4138): you need to have one of these for every condition you are claiming on. If it is ten claims, you need ten 21-4138 Forms.
- Buddy Letters (“lay evidence”): a witness that can back up the injury, how it happened, when it happened and so on. This also establishes a Nexus. They can also be good for showing any worsening of your service connected conditions. Good people to ask for Buddy letters are your wife, children over 18, etc.
- Medical Research: upload articles that show specific links from one condition to another for secondary claims. A good website is pubmed.gov. Search for articles that pertain to what you have going on. Show proof.
- Disability Benefits Questionnaires (DBQ’s) (HIGHLY RECOMMENDED)
- Medical Nexus Letters (HIGHLY RECOMMENDED)
Our team of VCE’s are experts on streamlining the claims process and the best way to compose, gather, submit, and weed out the best evidence for your claim. Our med team is experts in writing DBQ’s and Nexus letters to support your claim. We have a 90% success rate with the clients we help, a 5-star rating on Google with 80 positive reviews, and we are medically accredited with the BBB. We have a lot of information throughout the social media hubs; we have a lot of different topics on YouTube to check out for more information as well.
The Elite service, this is the full-service option, we do this with you and for you from start to finish. You are assigned a VCE to walk you through every step. We have the highest success rate with the clients who have chosen this option, due to the experience and the insider information our VCE’s bring to the table. This is the pay after option. You only pay VA Claims Insider if you get the increase and it is after the claim is said and done.
Please note: this gives you access to our med team, and they decide and collect their own fees at the time of service.
The Mastery service, this is the “do it yourself option,” you pay up front for the Mastery Program and are given all of the needed material to file on your own. This option gives you access to our med team at extremely discounted rates and evaluations are free! You owe us nothing at the end of your claim with this option.
Please contact us through our website with any questions or needs, we very much welcome hearing from you. Thank you all for your service and God Bless.