- Today, we're going to be discussing
some of the differences, advantages, disadvantages
between the old legacy appeals system
for disability compensation claims
and the Appeals Modernization Act, the AMA.
My name's Zack Evans with Woods and Woods attorneys
in Evansville, Indiana.
Let's start off talking about the legacy system.
So in the old legacy system,
you would file a claim.
You sometimes get an exam.
Sometimes you don't get an exam,
then you'll get a rating decision.
And then you file the notice of disagreement.
And then after a period of time,
you'll get what's called a statement of the case, or an SOC.
And then after your SOC,
you file the form nine.
And then after the form nine,
you'll get a certification letter
from the Board of Veterans Appeals,
also known as the BVA.
And then they'll tell you that you've been docketed,
which means they're getting ready to decide your case,
and you get a BVA decision.
So that was the old system.
Claim, rating decision,
Notice of disagreement, appeal.
Statement of the case.
Form nine, which is an appeal to the board.
And the board sends you a couple of letters,
certification and docket, and you go to the board,
they give you a decision.
The big deal with the Appeals Modernization Act, the AMA.
'Cause that's kind of a mouthful
is that there's an opportunity
to preserve your effective date.
So the biggest difference
is that there's no statement of the case.
There is no form nine that you have to file to the board.
The forms are different.
We have several videos that discuss that,
but this video is primarily about
weighing whether I should leave the legacy system,
stay in the legacy system, or move into the AMA.
So, it's not as simple as if this, you do this,
and if that, you do that.
There's a lot of moving parts,
especially if you have more than one claim open.
So, let's go through a quick wrap up of the AMA system.
So in the AMA, you've got three lanes.
You do your initial application.
Sometimes you get an exam,
sometimes you don't.
And then you get a rating decision.
The VA regional office will make a decision on your claim.
And then at that point,
if you want to appeal your rating decision,
it's time to pick a lane.
And you have three lanes that you can choose from.
So you have what's known as the supplemental claim lane,
which is handled at the VA regional office level,
and it's a line-level decision.
Sometimes you get an exam,
sometimes you don't.
There's another.
The second one is higher level review,
also known as an HLR,
and that's also handled by the VA regional office,
but that is a closed record.
So it's only considering the evidence that was of record
as of that rating decision.
You can't add new stuff to that.
If you wanna add new stuff
and have the regional office consider it,
you gotta go supplemental claim.
And then there's a third option.
And there's three options underneath that
if that wasn't confusing enough.
So we have the AMA NOD,
which is a whole bunch of letters,
and it's Appeals Modernization Act Notice of Disagreement.
And what this essentially does is it forwards the case
to an administrative law judge
at the Board of Veterans Appeals.
So you're taking this out of the hands
of the regional office,
and you're sending it to an administrative law judge,
a trained lawyer to take a look at this,
weigh your evidence and give you a decision.
The first lane that you can choose
underneath the AMA option,
the AMA NOD option where you're sending it to a BVA judge
is the hearing lane.
You have a right to be heard.
You can appeal to this lane,
and you can appear physically at a hearing.
And there's also virtual hearing options
that you have available.
The second option when you file an AMA NOD
is to select the direct lane.
The direct lane is again,
similar to the HLR, the higher level review,
no new evidence is allowed
that has not previously been considered.
So, there is an option for you to send new evidence
directly to a judge,
but that's your third option.
That's called the evidence lane.
The evidence lane is where you submit new evidence
that has not previously been considered.
So, which of these is better, AMA or legacy?
Well, that depends a lot.
AMA was initially promised to streamline
the process of VA compensation claims.
There was a lot of outrage related to delays.
It used to take a lot of time
to get a statement of the case.
So, think back to the timeline I told you about you,
file a claim,
you get your initial rating decision,
and then within a year,
you had to file your notice of disagreement.
This is the legacy system,
and then you might wait a year and a half, two,
two and a half years,
even longer for a statement of the case to show up.
It would just sit at the regional office
until they're ready to send you your notice of the decision,
which is oftentimes a denial,
and then your appeal rights attached to it.
And unfortunately, we saw a lot of veterans pass away
or who weren't properly notified
that the SOC had been issued.
So, sometimes it was mailed to the wrong address,
sent to a previous address,
or it was transmitted,
and there was no address on it at all.
We don't know where some of these SOCs went.
So there were a lot of problems with the legacy system.
AMA promised to fix some of that
and streamline it, simplify it.
So you don't have all of these different
lengths of deadlines
for all of these different appeal documents.
You don't have all of these layered levels of review
just to get to a judge,
because previously the problem was,
you have to wait forever on your SOC
before you even have the right to file
to get in front of a judge.
Before you can file that form nine.
Previously, you could not get in front of a judge
until you filed the form nine.
Now it's not like that.
You get your rating decision,
boom, you can file the AMA NOD straight to the board
and you can go right to a judge,
either closed record,
you do a hearing,
or you can file in the evidence lane.
The AMA was promised to streamline this process,
but remember, this is the VA.
It hasn't really lived up to the hype.
Initially when the AMA was first launched,
there weren't a lot of claims being adjudicated.
There weren't a lot of claims that were pending
within the AMA process.
They rolled out the RAMP program.
Some of you probably got those RAMP letters saying,
hey, we've got this new fangled system.
We want you to try this out.
Understandably, some folks were skittish
about being the guinea pigs
on this new legislative framework.
Our office wanted to see a little bit more of a track record
from the VA in particular
before we agreed to move into the AMA.
We were a little bit fearful.
And I think the VA has earned
some of that mistrust from veterans
based on their inability to get it right for so many people.
The VA previously said,
they'll be prioritizing legacy claims.
So, the legacy claims didn't go away.
You still have legacy claims,
they're still in the legacy system.
They're still being pushed through.
And then you have the AMA claims
that are being pushed through
within that legislative framework.
In 2020, we saw a lot of these legacy claims move.
A lot of 'em.
We saw them resolved.
Well, not resolved.
That's not the same as awarded.
Lemme say it that way.
So in 2020, we saw a lot of these claims resolved,
but that's not the same as being awarded.
They were just decided.
So, they were moved on to the next desk.
You got some notice in the mail
that said you were either awarded or denied,
and here are your options.
If you're in legacy,
you get a rating decision and you file the NOD.
And then you wait for your statement of the case.
Legacy cases are still moving,
just not as fast right now,
not like they were last year in our experience.
And AMA cases.
Initially, when the AMA framework first came out,
we were really seeing some movement in some of these lanes.
Well, now there's a lot more veterans that are in the AMA,
and there's just a lot more work to be done by the VA.
So again, we're not seeing those move nearly as fast.
The promises of faster decisions under the AMA
appear to be drying up.
The backlog is growing,
whereas the backlog used to be at the SOC level,
and you're waiting on the regional office
to get your chance to jump in front of a judge
and present your case.
Now it's primarily at the board.
So a lot of these,
the regional offices are still swamped with a lot of work,
but you're also seeing a lot of cases
that would, in the legacy system,
be waiting on a statement of the case or skipping that step.
The regional offices don't have to do that now.
So, we're just waiting on the board.
They were just forwarded right to the board.
And these folks at the BVA,
these administrative law judges,
there's just a lot of work to be done.
There's a lot that they're trying to clean up
from the regional offices.
There's a lot of decisions that need to be made.
There's a ton of evidence that needs to be reviewed.
And we're not sure when these timelines
are gonna change if ever,
but all of these things impact whether you stay in legacy
or you move to AMA.
Legacy does contain a big risk.
If you stay in legacy,
you may get a faster decision.
It might not be the decision you want,
especially if you're unrepresented.
In legacy, these are final decisions
after the BVA decides them.
Now, you still have your CAVC,
your court of appeals for veterans claims,
appellate remedies.
You still have your appeal rights to the next level,
but if you lose,
and if you either don't appeal or you lose an appeal
at the higher level,
that is final.
The only way to revisit that is to file a new claim.
And if you go back to our videos
where we talk about effective dates,
remember, your effective date is later the two.
So you've got the date entitlement arose,
or the date of the claim.
So if you're in a position where you have to refile,
even if you were diagnosed in 1998,
you went through a whole appeals process and you lost,
'cause you didn't have enough evidence.
The VA didn't weigh things correctly.
And let's say you didn't appeal to the next level
and your period lapsed, unfortunately,
and you have to refile,
well, that's gonna be your effective date.
All of that previous adjudication
is gonna be out the window.
In AMA, the Appeals Modernization Act,
you can continue that same claim,
even after a BVA denial with a supplemental claim.
The only thing is you need to include new relevant evidence.
So it needs to be new relevant evidence
that hasn't been weighed before.
We call that in NRE in office.
That's one of our acronym terms that we use.
So, as long as you're advancing something new
about something that you've been arguing,
this condition, this issue that you've been arguing,
then the VA regional office has to start you over again
with an opportunity to reach back
to that older, effective date.
So, let's talk about some of the considerations
moving between legacy and AMA.
When I am working cases,
the biggest consideration is chronic and terminal illness.
If you do not have much time,
you are looking for a decision.
You're looking for a decision like yesterday.
If you stay in legacy,
you are somewhat likelier to receive a decision faster.
Again, we can't predict exactly
when that decision will occur.
We do see legacy cases,
even though they've slowed down a bit,
AMA slowed down a bit.
We see them moving faster than AMA most of the time.
Another consideration is
financial hardship and homelessness.
If you're a veteran or if you know a veteran
that is living on the street,
this is a dire situation.
This is a crisis situation.
And a faster decision is definitely advantageous,
but all of these are merely cogs in the wheel.
They're just pieces of the decision.
It really is decision calculus,
because you have to weigh all of these things
against what's in the file.
What does the evidence say?
What of the previous decisions from the BVA
or from the regional office said,
have there been any experts
that have submitted reports?
Has there been expert testimony?
Has there been hearing testimony?
So, there's a lot of moving pieces
where you're really trying to hedge risk
from multiple different angles.
And it becomes very difficult for a veteran
to assess all of that,
digest everything in the C-file,
digest what all of these doctors and psychiatrists
and psychologists have said,
maybe vocational experts in some cases,
and make a decision for themselves without any help
and hope that it's the right one.
Another thing is where you are in your appeal, that matters.
So, whether your legacy claim is pending before the board,
let's say you've gotten a certification letter,
you've gotten a docket letter.
The board is ready to look at it,
whether you're still for whatever reason,
pending a statement of the case,
some of those are still pending out there.
There's not nearly as many as there was
before AMA went live,
but they are out there.
And then where's your AMA lane?
If you have multiple lanes of appeals open,
did you just file?
Have you been submitting supplemental claims
for a couple of years now?
Have you had multiple evidence submissions?
Have you submitted an HLR?
Are you waiting on another rating decision
from your higher level review?
All of these impact
whether you move something out of legacy into AMA.
And timeline is affected,
the strength of your evidence impacts that decision,
and your likelihood of winning based on what you have.
Another thing that impacts that
is the availability of expert testimony.
Do you have a doctor or a psychologist
that can go to bat for you,
and that can review your evidence
and give a good sound opinion
about what's going on in your life.
If that's the case and you can get this evidence together
like we do for our clients,
then that significantly impacts
whether you have new evidence to submit.
It significantly impacts
whether you may want the regional office
to take another look at your case.
All of these are reasons why you'd be wise to seek help
when making these decisions.
These decisions are difficult for professionals
that handle these claims every day, day in day out.
There are so many moving parts that can impact this decision
and can impact your ability to win or lose.
And it can significantly stretch your timeline
if you move a claim from legacy into AMA,
and it's not the right claim to do that on.
In some cases,
it makes sense that it truly is a case by case analysis.
And we really need to see your file.
We really need to see your procedural history.
We need to see all of your decisions
and make a good sound decision for you,
so that we're giving you the best chance to win.
So, my name is Zack Evans.
I work with Woods and Woods attorneys in Evansville.
Give us a call or go online,
and let Woods and Woods help you navigate.
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