Many first-time applications for VA benefits are denied.Were you denied VA disability benefits? Here’s how to get started on your appeal.
If your initial application for benefits is turned down, know that you’re not alone. Don’t be discouraged and, if you believe you have a legitimate claim for disability benefits, our VA disability benefits lawyers can help you get approved.
What does the VA say is the purpose of the AMA and how does it affect you if you were denied VA disability benefits?
It is intended to speed up the settlement of VA disability cases and reduce the backlog of disability claims. On its website the VA says, “The Appeals Modernization Act establishes a new decision review process for disagreements with VA decisions that is timely, transparent and fair.”
What are the main elements of the Appeals Improvement and Modernization Act?
On February 19, 2019, the Veterans Appeals Improvement and Modernization Act (AMA) was officially implemented, thus ending the Rapid Appeals Modernization Program (RAMP) and phasing out what was known as the legacy appeals system. The VA says the AMA creates “a new decision review process that allows VA to improve the delivery of benefits and services to Veterans and their families. The new process gives Veterans choice and control, and all communications are written in plain language.” (There are still some active claims dating back to before February 19, 2019. Those cases will still follow the previous rules and procedures. All new decisions fall exclusively within in the new AMA system.) In this series of FAQs we’ll share what veterans need to know about the Appeals Improvement and Modernization Act.
If you choose to have your VA disability claim processed under the AMA you must choose one of the three processing “lanes”–Supplemental Claim Lane, a Higher-Level Review Lane, or an Appeal to the Board Lane.
What is the Higher Level Review Lane?
If you have no additional evidence to submit in support of your claim but you believe that there was an error in the initial decision, the Higher Level Review option may be your best choice. The Higher-Level Reviewer will only consider evidence that was in VA’s possession at the time of the prior decision. You or your attorney will not be able to add new evidence if you are in the Higher Level Review lane. You or your attorney can request an optional, one-time, informal telephone conference with the Higher-Level Reviewer to identify specific errors in the case, although this may cause a delay in the processing of your Higher Level Review.
What is the Supplemental Claim Lane?
If you have additional evidence that is new and relevant to support your benefit claim, then you may want to select the Supplemental Claim Lane. The VA’s review will include any new and relevant evidence submitted since the agency last decided your claim.
What Does the VA Mean By “New and Relevant” Evidence for an AMA Claim?
The VA says that “new” evidence is simply that—new evidence submitted to the VA for the first time. It cannot be information that is already in VA records. It cannot be evidence a veteran has previously provided to the VA or evidence the VA has legally acquired on behalf of the veteran.
“Relevant” evidence is a fact (or facts) that VA did not have enough evidence to verify at the time of their prior decision—a fact that is necessary to substantiate the claim.
The VA says that submitted evidence which was previously reviewed in a claim denial is cumulative or redundant. It is not considered new and relevant. Evidence previously reviewed in the decision that denied your claim can be found in your notification letter or rating decision. This may help you determine if the evidence you’re considering for submission is cumulative or redundant.
Here’s an example that may help clarify what is considered new and relevant evidence. Let’s say a veteran who is pursuing an Agent Orange claim has a private doctor’s medical report that lists non-Hodgkin's lymphoma as one of his diagnoses. If this veteran has never submitted this report to the VA, and his VA Claims File has no record of this disease, then this private medical report would be both new and relevant evidence.
What is the Appeal to the Board Lane?
If you prefer, you can appeal your case directly to the Board of Veterans Appeals. Like the old “legacy” process, you can appeal any decision for review by a Veterans Law Judge. But, the appeal process has a few changes.
First, to streamline the process, the VA has done away with the requirement to submit a Notice of Disagreement (NOD) and then wait for 12 to 18 months for a Statement of the Case (SOC) before filing an appeal notice. There is now only a single form which eliminates this lengthy wait time.
Second, the Modernization Act has created three options for board appeals: Direct Review, Evidence Submission, and Hearing.
- Direct Review: You do not want to submit additional evidence or have a hearing.
- Evidence Submission: You choose to submit additional evidence without a hearing. You will have 90 days from your Notice of Disagreement (NOD) to submit any additional evidence.
- Hearing: You choose to submit additional evidence and have a hearing with a Veterans Law Judge. You will be scheduled for a Board hearing and may submit evidence at the hearing or within the 90 day window following the scheduled hearing.
What if you still disagree with a VA decision?
If you disagree with a decision from the Supplemental Claim Lane, you may choose to resubmit the claim as another supplemental claim with new evidence, as a higher-level review or as an appeal to the Board of Veterans’ Appeals.
If you disagree with a decision from the Higher-Level Review Lane, you may choose to resubmit the claim as a supplemental claim or as an appeal to the Board of Veterans’ Appeals.
If you disagree with a Board decision you may either resubmit as a supplemental claim or through an appeal to the U.S. Court of Appeals for Veterans Claims.
Is AMA better for veterans?
The jury is still out on this question. There are definite advantages to the new system, but there are still inconsistent rulings from the VA. Although the number of backlogged appeals is lower (down about 8%) they are still higher than they were before the pandemic, so the VA staff still has work to do to better serve those who served.
Which lane is the best option?
Because each appeals case has its own unique set of facts and conditions, there is no “one size fits all” here. Choosing the best lane is best decided on a case-by-case analysis. While it’s good that veterans have options in pursuing their disability appeals, as you can see, choosing the most advantageous option can get complicated. Therefore it is best to consult with a VA-accredited attorney to talk about your options and get guidance in deciding what makes the most sense for your individual case.
VA Disability Attorneys in Your Corner
Call Cuddigan Law at 402.933.5405 to get a free-evaluation of your case and advice for your specific situation. We are accredited VA disability attorneys who have been supporting veterans for years. If you hire us to fight for your rights, we only get paid if you win your case.