The Appeals Process & Hearings VFW Basic Training

Transcript:The Appeals Process & Hearings VFW Basic Training:
The Appeals Process & Hearings VFW Basic Training 1 If a VA benefits claim is denied, the claimant has the right to appeal the decision Currently, there are 3 decision review options to choose from which will be discussed later in this class Prior to the current appeals process (AMA), the Legacy Appeals process was in effect which offered a more limited approach to appeals 2 WHAT TO DO IF A BENEFITS CLAIM IS DENIED Character of Discharge/Status as a veteran Service connection Rating percentage Effective date Dependency & Indemnity Compensation Waiver of overpayment Entitlement to special monthly compensation/pension 3 EXAMPLES OF APPEALABLE DECISIONS Proposed actions – the most common are reductions of ratings and ratings of incompetency Proposed actions are not a “final” decision - All final decisions should include appeal rights in notification letter 4 ACTIONS THAT CAN NOT BE APPEALED Legacy appeals pertain to claims that were decided prior to February 19, 2019, when the Appeals Modernization Act (AMA) became effective The claimant must not have opted-in to the Rapid Appeals Modernization Program (RAMP) If the claim was decided on 2/19/19 or later or if the claimant participated in RAMP, legacy appeals no longer apply; instead they fall under the Appeals Modernization Act (AMA) 5 What are Legacy Appeals? Under the Legacy Appeals Program, veterans were able to select a Traditional or DRO Review Regardless of their choice, the veteran received a Statement of the Case (SOC) if their appeal was denied The veteran had 60 days to respond to a SOC or the appeal would be closed 38 CFR 19.52(b) and 38 CFR 19.52(b)(2) The veteran could respond with a VA Form 9 to proceed to the Board of Veterans Appeals, or with new evidence to have the Regional Office appeals team re-evaluate their decision If the claim was denied after submitting new evidence, a Supplemental Statement of the Case was issued and the veteran could respond with more evidence or the VA Form 9 within 30 days 6 What are Legacy Appeals? 7 LEGACY APPEAL LIFE-CYCLE Why are we learning about the Legacy Appeals process? Though most legacy appeals have either been decided or converted to AMA appeals, the VFW received more than 2500 Legacy Appeals at the Board of Veterans Appeals (BVA) in 2020. If your veteran is in the Legacy Appeals Process and receives a SOC, they can opt-in to the AMA process