Legacy issue opt in eligibility requirements

When a veteran fills out their AMA form, they have the option to opt-in issues from their legacy appeals to move them from VACOLS to AMA.

When a claims assistant is first intaking an AMA review, they indicate whether the veteran selected the SOC/SSOC opt-in option. Next when they add issues, they'll get the option to connect each issue to a legacy issue if the veteran has matchable legacy appeals. This is not available for unidentified issues.

The legacy issues that are matchable and appear for selection depend on whether the veteran select yes to opt-in, or not.

When a request issue is connected to a legacy issue, the regular timeliness requirement that the decision date is within 372 days of the receipt date is waived, and instead the request issue is subject to the legacy issue eligibility requirements below. See Request issue eligibility requirements for more information.

Matchable legacy appeals

The matchable legacy appeals shown depend on whether the veteran selected to opt-in their legacy issues or not. In both cases, the user will not see legacy appeals that have no legacy issues on them, and they will see issues for all legacy appeals that are still active.

Veteran did not select to opt-in their legacy issues

Only issues on active legacy appeals will be shown to connect to request issues. If an AMA issue gets connected to a legacy issue, the AMA issue is marked as ineligible with the reason: "legacy_issue_not_withdrawn". This is to prevent the active issue from being processed in both systems.

Veteran selected to opt-in their legacy issues

In this case, the claims assistant will see all issues on legacy appeals that are active as well as issues on inactive legacy appeals that are eligible for opt-in. VBA users may see more issues for a veteran because of extensions to eligibility that are available to them with a good cause flag due to COVID-19.

If a legacy appeal is matchable, all of its issues will be presented although some individual issues may not be eligible. Both the legacy appeal and issue have to be eligible for opt-in. If so, the issue will get closed in VACOLS when it's added to the AMA claim. Otherwise the AMA issue will be closed as ineligible with the reason: "legacy_appeal_not_eligible".

Eligibility

If the veteran did not opt-in their appeals, and a request issue is connected to an active issue in VACOLS, it will automatically be closed as ineligible to prevent the issue from being processed in both systems.

If they chose to opt-in their appeals, the following additional eligibility rules apply.

Appeal level eligibility

• The appeal's eligibility can be determined with the SOC date OR the NOD date.
  • SOC date
    • The appeal is eligible if the SOC date was within 61 days before the receipt date, but not before AMA was launched on February 19, 2019.
    • If there's no SOC date, it is eligible if any SSOC dates meet this requirement.
  • NOD date
    • The appeal is eligible if the NOD date is within 372 days before the receipt date.

Issue level eligibility

• Active issues are eligible
  • An issue is considered active if it's parent legacy appeal is still active (it does not have a status of "Complete")
  • AND the issue does not have a disposition, or it's remanded and the legacy appeal is remanded
  • To be in remand, the issue needs a disposition of "remanded" or "manlincon_remand", and the parent legacy appeal needs a status of "Remand"
• Closed issues
  • If the issue's disposition is "failure to respond", then it's eligible if the close date is after the legacy appeal's SOC date.
  • If there's no SOC date, it is eligible if any SSOC dates meet this requirement.
  • All other closed issues are ineligible.

Weekends and holidays

If the eligibility for an issue expires on a Saturday, Sunday, or holiday (observed), it is extended to the next available business day. For example, if a legacy appeal has an SOC date of 12/31/2019, 61 days later falls on Sunday 3/1/2020. If the form receipt date is on Monday 3/2/2020, it will still be considered eligible.

Holidays

• New Year's Day - January 1
• Inauguration Day - January 20 of every fourth year or, if the 20th falls on a Sunday, the next succeeding day - selected for public observance of the inauguration
• Birthday of Martin Luther King, Jr. - Third Monday in January
• Washington's Birthday - Third Monday in February
• Memorial Day - Last Monday in May
• Independence Day - July 4
• Labor Day - First Monday in September
• Columbus Day - Second Monday in October
• Veterans Day - November 11
• Thanksgiving Day - Fourth Thursday in November
• Christmas Day - December 25

Actual dates used are based on when the holiday is observed. When a holiday occurs on a Saturday, the Friday immediately before is the legal public holiday. When a holiday occurs on a Sunday, the Monday immediately after is the legal public holiday.

Timeliness exemptions

Currently, timeliness exemptions do not usually apply to legacy issue opt-in eligibility unless they are requested for "good cause". There is currently one good cause timeliness exemption.

Good Cause related to COVID-19

This applies to Higher Level Reviews and Supplemental Claims, but not Appeals. If a timeliness exemption is requested for reasons related to COVID-19, the following timeliness eligibility changes occur:

Legacy Appeal

• If the NOD date is greater than 372 days old, the legacy appeal is still eligible if it is on or after March 1, 2019.
• If the SOC or SSOC dates are older than 60 days old, the legacy appeal is still eligible if one of those dates is on or after January 1, 2020.

Legacy Issue

• If an issue has a disposition of "failure to respond", it is eligible regardless of when that disposition was added relative to the SOC or SSOC dates.

Otherwise all the same eligibility checks still apply.

Processing opt-ins

After an issue is opted in, we may also close the parent legacy appeal with the "AMA SOC/SSOC Opt-in" disposition, disposition code "O". This depends on more information about the legacy appeals:

Active Appeals

After an issue is opted-in, if there are no other issues on the legacy appeal that are still active, then we also close the parent legacy appeal. The other issues may have been opted-in with the "O" decision, or may reflect other dispositions such as "Allowed". As long as they're all decided, and the last one to get decided was an AMA opt-in, the parent appeal is also opted-in.

Remand Appeals

If the parent legacy appeal has a status of "REM" (Remand), before the legacy appeal is opted-in to AMA, first we revert the opt-ins for each of the issues on the appeal back to the remanded disposition, then we close the legacy appeal with the "O" disposition.

Currently, if the legacy appeal has a remanded disposition, but a closed status instead of a remand status, we do not opt-in the legacy appeal.

Decided Appeals

If the legacy appeal was previously closed with the "Advance Failure to Respond" disposition, disposition code "G", then we currently only opt-in the parent legacy appeal if none of its issues still have the "G" disposition. Since the legacy appeal is already closed, this mainly involves updating the disposition, the decision date, and the user.

Rollbacks

If the parent legacy appeal is opted-in to AMA, and one of the request issues gets removed, we rollback the opt-in on the parent legacy appeal.