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VA preparing to launch major overhaul of claims appeals process

Medical Cost Reimbursement Program paralegal specialists, review medical reimbursement cases at Langley Air Force Base, Va., July 24, 2013. Funds collected by the MCRP are given directly to Military Treatment Facilities and TRICARE to help support the cost of medical treatment for Service members, both on and off base. (Airman Areca T. Wilson/U.S. Air Force)

Hundreds of thousands of veterans, some of them trapped indefinitely in a complex system of trying to obtain benefits from the Department of Veterans Affairs, will get new options next week promised to deliver decisions in days or months, instead of years.

The VA is set to implement a new process Tuesday for veterans to appeal their claims for VA disability compensation – a system devised by the VA, veterans organizations and lawmakers and approved by Congress in 2017. Under the current system, veterans wait three to seven years to reconcile their appeals. The new one could get veterans through the process in as little as 125 days, VA officials vowed.

“This is the biggest change to appeals for decades,” said Cheryl Mason, chairman of the Board of Veterans’ Appeals. “It was designed to give veterans choice and control over their process instead of getting stuck like they do now. VA realized that veterans were confused by the process, that it was a complex system and that it simply took too long.”

The new system involves multiple avenues for veterans, including an option to appeal their claims with a higher-level adjudicator or directly with the Board of Veterans’ Appeals. Another option is to add information to their claim and appeal it with the same adjudicator who reviewed it.

David McLenachen, director of the VA’s appeals management office, said the VA will track the amount of time it takes veterans to get through each option. The agency will make that information public to help veterans decide which route to take, he said.

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With the new process, VA officials have the goal of cutting down the backlog of appeals, which stands at 402,000 cases.

“We’re very proud of this process and we really think it will make a significant impact to our veterans going forward,” Mason said.

President Donald Trump signed the Veterans Appeals Improvement and Modernization Act in August 2017 at the American Legion National Convention in Reno, Nev. During the ceremony, he touted the law as “historic” and promised it would allow veterans to receive decisions on their claims for VA benefits “in a fraction of the time.”

After 18 months of implementation work, McLenachen said Thursday they’re confident that will be the case.

The agency has hired 605 new employees in the past four months to help with claims. For over a year, the VA has operated a pilot program to test the new system.

Through the program, titled the Rapid Appeals Modernization Plan, or RAMP, veterans with appeals stuck in the old system were allowed to opt into the new one. Over that time period, about 70,000 veterans with 84,000 claims opted in. The VA had granted decisions on 70 percent of those claims as of Thursday and gave out nearly $250 million in retroactive benefits, McLenachen said. On average, it took 130 days to get veterans their decisions.

“We’re convinced we have the right approach,” he said.

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The RAMP pilot program ends Friday, ahead of the new system launching nationwide next week. In a statement Thursday, VA Secretary Robert Wilkie encouraged veterans with appeals stuck in the old process to opt in before Friday. Otherwise, they must wait to opt in to the new system until the VA sends them a statement of their pending claim.

The VA is expected to hold an event Tuesday to launch the system.

“It was almost three years ago that we were in a room with all of our stakeholders trying to come to an agreement that we had a problem and then figure out how to fix it,” McLenachen said. “It took only three years from that point to getting legislation, implementing it and having it go live. Which, in my view, is an extraordinary thing.”

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