In the summer of 2017, President Trump signed into law the Appeals Modernization Act establishing a new process for the Department of Veterans Affairs in the way they handle benefit processing for VA disability claims and VA decisions. The Act is designed to improve timeliness, provide more transparency, and be fairer in an effort to improve benefits for veterans. The Act went into effect in early 2019.
VA RAMP, the Rapid Appeals Modernization Act, was an invitation for veterans to enter into the program earlier than the February 2019 date and gives two options for veterans to participate, either the Supplemental Claim or a Higher-Level Review Claim. From April 1, 2018, all veterans who had a claim on appeal were eligible to participate in RAMP. However, the question is, how beneficial has it been to veterans?
VA Supplemental Claim Lane
The Supplemental Claim Lane is one option, available from different lanes, designed specifically to allow veterans to submit new evidence to support their claim. The VA is under obligation to provide “Duty to Assist” by law with these appeals. In order to be eligible, a veteran must have an active appeal for a disability claim at one of the following levels:
- Have filed a Notice of Disagreement (NOD);
- Have filed a VA Form 9 (Appeal to the Board of Veteran’s Appeals – BVA)
- Have been certified to the BVA (Board of Veterans Appeals); or
- Have a remand from the BVA.
Veterans were able to “opt-in” by sending in a signed opt-in form which allows them to transfer their claim to the RAMP program and submit new and relevant evidence in support of the claim. The longer it takes for the new evidence to be submitted, the longer it will take for a VA ratings decision to be made. The VA is stating they expect to complete supplemental claims within 125 days.
New and Relevant Evidence
One of the big questions is what exactly “new and relevant” evidence is. The terminology is different than what the VA required previously; new and material evidence, and no ruling has yet to be made on what makes “material” different from “relevant.”
Material evidence was defined previously as “relevant and related to an unestablished fact necessary to prove the claim. It must have a legitimate influence or bearing on the decision, and cannot be cumulative or redundant.” In the legal world, material evidence is offered to prove an issue is true.
Relevant evidence seems like it should be the same as material. However, in the legal world, relevant evidence must be material or have probative value, which means it must show the issue is more or less likely true, it does not necessarily have to prove anything. This seems like a lesser degree of weight required for additional evidence, but again, there is no official ruling by the VA as of yet. This is actually more in line with the VA’s policy of siding towards the veteran, but is still something we will be watching closely as decisions are rendered.
Once a claim has been denied due to evidence not being new and relevant, an appeal will come forth to request a definition from the VA. However, we are still waiting on definitions for and clarification on so many other legal terms used by the VA, it may be years before a clearer understanding of the difference in required evidence is made.
One of the most important things to remember is to gather all your evidence PRIOR to opting into the RAMP Supplemental Claim Lane. The VA still has to develop evidence at their end, and waiting to submit evidence after you have opted in will only slow things down.
What Can Be Submitted as New and Relevant Evidence?
First, the evidence must be new, something the VA has not seen before that is not redundant or a repeat of records already reviewed. For example, new records from treatment provider showing the same diagnosis will not be considered new, but records showing an increased level of severity or a new diagnosis concerning the same issue will be considered new. An independent medical evaluation is considered new evidence. Relevant means, for the sake of this article, that it has to do with the issue(s) on appeal. Filing evidence of a psychiatric diagnosis is not relevant to a back condition, unless there is a diagnosis of pain syndrome that is causing the mental health condition. In other words, the evidence submitted must be linked to the condition on appeal, even if it is a secondary condition due to the original issue claimed.
Evidence can come in many forms:
- Lay evidence: a statement from a non-professional that attests to the veteran’s behaviors or physical conditions that has not been previously submitted and the VA has no previous knowledge of. For example, on a PTSD claim, submitting a statement from a parent stating how the veteran’s behaviors have changed from prior to service compared to after service.
- Medical treatment records: from a treatment provider, private or the VA, that includes new information such as a new diagnosis, an increased level of severity, or a secondary diagnosis related to the issue on appeal.
- Independent medical opinion: an opinion from an objective provider who has nothing to gain from or investment in either the veteran or the VA. The provider is presented with documented evidence of the claim, the same evidence the VA has reviewed, and provides their unbiased opinion of the facts.
- Service Records/Service Medical Records: Any service records the VA has not already reviewed that have new evidence of the issue such as treatment records showing the veteran received treatment for the condition in service where no records had been reviewed prior or of an event that is related to the condition. This can also include the service records of other service members who served with the veteran. For example, if a veteran is appealing a denial of PTSD and another service member in their unit received a purple heart for being injured while they were stationed together due to an IED, that would be new and relevant evidence.
As with any new program, there are always bugs to work out. The VA’s claims of decisions in 52 days are not coming to light as of yet for most veterans, and many are not meeting the 125 day deadlines either. Ask your representative or attorney to review everything before you submit it because as the laws are written to make things faster and simpler, they seem to always make them more complicated when it comes to new systems.