Understanding the Veterans Appeals Improvement and Modernization ActUpdated September 30, 2020 Veterans Disability
With the passing of the Veterans Appeals Improvement and Modernization Act of 2017, the U.S. Department of Veterans Affairs made a concerted effort to make the VA disability appeal process more streamlined, modern, and user-friendly for those who need to engage in it. If you’re in the process of applying for VA benefits, or you already are involved in the appeal process, there are several key facts about the changes to the process that may help you be successful with your claim.
5 Facts About the Appeals Modernization Act
- Veterans choose how to appeal
- Veterans keep their effective date
- VA provides appeals status tracker
- Decisions and notifications come more quickly
- Resources are available to learn
The Veterans Appeals Improvement and Modernization Act of 2017, officially implemented in February of 2019, intends to give veterans more voice and control over VA disability claims decisions that result in disagreement. The revamped VA appeal process seeks to more quickly provide veterans with both information and decisions regarding their claims.
This act represents collaboration among the U.S. Department of Veterans Affairs, Congress, and Veteran Service Organizations to help meet some of the appeals-related needs identified by veterans. We’ve outlined below everything you need to understand the new process and how it can work to your benefit when appealing a VA disability claim denial.
What is Appeals Modernization?
The short answer is that appeals modernization is a revamping of the way appeals are submitted and reviewed to make it more modern and streamlined. Recognizing the cumbersome and often frustrating nature of the VA disability appeal process, the Veterans Appeals Improvement and Modernization Act of 2017, known more commonly as the Appeals Modernization Act, established a completely restructured process for filing and tracking the appeal of a VA claim denial. This new decision review process allows for faster decisions, improved delivery of VA benefits, and a better user experience for veterans and their families.
All communications are written in plain language, and veterans have much more control over how the process unfolds. Overall, the process is designed to be more timely and fair than the previous review process, and it also results in a more transparent experience for veterans. Let’s talk about how.
5 Facts About the Appeals Modernization Act
Now let’s take a more detailed look into some of the key facts about the new modernized process for appealing VA disability claim denials.
1. Veterans Choose How To Appeal
Under the new process, eligible veterans have three options when it comes to choosing how they’d like their VA disability appeal to move forward.
Your first choice is to put your claim in the higher-level review lane, which entails your claim being reviewed by a more senior claims adjustor and generally results in a new claim decision within 125 days.
This process essentially is a brand new review by someone with more seniority and experience than the reviewer who rendered the rating decision on your original claim. With this type of review, you will not be allowed to submit any additional evidence or documentation, and the previous VA decision regarding your claim will only be overturned if the adjustor determines that there is a substantial difference of opinion between reviewers or there is a clear and unmistakable error in how your original claim was reviewed.
At this point, the new reviewer may send your claim back down to your regional office for correction. You and/or your Veterans Service Officer or qualified veterans disability attorney can request an informal telephone call to discuss specific issues with your claim’s review at this point. This is a good option for you if you don’t have any new medical evidence in your possession, but you believe an error of fact or judgment was made in your initial review. If this higher-level review finds that there was a mistake in judgment in your original claim decision, it will send your claim back down to your regional office for correction.
With the second option, you can choose to submit a supplemental claim, which means that you are allowed to provide additional and/or new medical evidence or documentation that could help strengthen your claim. The VA will even offer assistance in helping you identify and locate the information you need. This is the ideal option if you have additional medical evidence that was not available when you submitted your initial claim. But note that this additional evidence must be deemed by the VA as both new and relevant to your original claim.
This is a new standard, meant to be more flexible than the VA’s previous standard of new and material. New simply means that the evidence wasn’t available earlier in the process, and relevant means that it must clearly either support or refute an element of your original claim. Choosing this option allows you to present a more comprehensive snapshot of your condition, which could affect the VA’s ultimate rating decision. Those who choose this option typically receive a final decision within 125 days.
The third option allows you to appeal your claim directly to the VA’s Board of Veterans Appeals. This choice also brings with it three distinct paths. First, you can request that the BVA review your claim without providing any new evidence or choosing to convene a hearing. Again, this is a good route to take if you have no new, relevant information that you’d like to provide for the BVA’s consideration, and you can generally expect a decision within 365 days. Second, you can provide any new evidence that pertains to your original claim, but you forego the step of having a hearing. If you choose this option, you will have 90 days from the filing of your Notice of Disagreement to submit any and all additional medical evidence that you would like the BVA to consider.
You may choose to not only submit new evidence but also to provide personal testimony before a veterans law judge at a formal hearing – this is considered the supplemental claim lane. If you choose this option, a formal hearing will be scheduled for you – you can either present any new evidence or testimony during your hearing, or you can provide it in follow-up as long as it’s within 90 days of your hearing’s conclusion. It’s important to make note of the timeline regarding evidence submission; the VA will not accept supplemental evidence if it’s submitted outside of the allowable window.
If You Disagree with the Decision
No matter which option you choose, you still have recourse if you disagree with the decision. If, for example, you disagree with a higher-level review, you may resubmit your claim either as a supplemental claim or as an appeal to the Board of Veterans’ Appeals. If you disagree with the decision regarding a supplemental claim, you may resubmit a second supplemental claim with additional evidence, or as a higher-level review or an appeal to the Board of Veterans Appeals. And if you disagree with a BVA decision, you may appeal to the U.S. Court of Appeals for Veterans Claims. If you’re working with a trusted and qualified VA disability lawyer, she can help guide you through the best options that position your claim for success.
You should also know that, at any time during the process, you can change which “lane” you’ve chosen for your review, especially if new medical evidence comes to light. If you already have a pending appeal within the legacy appeals process, the VA will allow you to request changing your claim over to the AMA structure.
2. Veterans Keep Their Effective Date
The effective date is the official date the VA uses to determine when VA disability compensation should begin accruing. This is most often tied to the date of an initial VA disability claim, and under the AMA, a veteran can keep her original effective date, even when a decision is appealed. This has the potential to translate to additional disability back pay for the veteran if and when his VA disability compensation claim is approved.
3. VA Provides Appeals Status Tracker
In an effort to provide timely and transparent information about the status of a VA appeal, the VA has implemented an appeals status tracker. This tracking system allows a veteran to see exactly where her appeal is within the process, along with the next steps and what to expect in terms of an appeal timeline. You can get alerts for upcoming deadlines and reminders when action is needed on your part.
4. Decisions and Notifications Come More Quickly
The new system is set up to allow the VA to provide decisions to veterans more quickly, but do keep in mind that the VA is currently straddling two systems – the new approach and the legacy system. In some cases, the VA needs to prioritize legacy appeals in order to clear out that backlog. Across the board, you can expect decisions under the AMA to come much more quickly at the regional office level. During the VA’s 2019 fiscal year, it added 605 additional appeals employees to help clear out this legacy inventory, establishing decision review operation centers in the Seattle and St. Petersburg regional offices.
However, when it comes to BVA decisions, the track you choose may affect how quickly you hear a rating decision. For example, the BVA currently prioritizes the direct docket, followed by the evidence docket, with the hearing docket coming in at third priority. You should keep this in mind as you work with your VSO or VA disability attorney to determine which path is the right one for your claim.
5. Resources Are Available to Learn
Although the new process is designed to be clearer and more streamlined than the legacy appeals system, the VA recognizes that change can be difficult. Recognizing this, the VA has made available many resources to help veterans learn the new system and make decisions about which appeals track makes the most sense for them. From infographics and videos like the one seen here, you have a wide variety of tools to help outline the system and how it can work best for you.
Appeals Modernization Act
The VA has made a concerted effort in recent years to make the VA disability claims process easier, clearer, and less frustrating for U.S. veterans. The changes in process afforded by the AMA are just one step in that direction and represent some of the most sweeping statutory changes intended to help veterans in decades.
Is the new system better or more favorable to veterans? That’s hard to say since the decision you receive still comes down to the strength of your claim and the details of your specific medical situation. You still should seek counsel from either a VSO or a qualified VA disability attorney as you begin your claims process, but the information presented here should also help give you a clearer picture of what you can expect with the new VA appeals process, along with making it just a bit easier to navigate.