Changes coming to disability claims process

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Changes coming to disability claims process

by Rick Maze

Lawmakers have high expectations that they can reduce the backlog and processing time for veterans’ benefits claims through a combination of new procedures, including two pilot projects.

The Veterans Benefits Improvement Act of 2008, which passed Congress on Saturday and is being prepared for submission to the White House for President Bush’s signature, pushes the Department of Veterans Affairs to use electronic filing and processing of claims to try to improve the speed of claims decisions, reduce the disparity in decisions involving similar issues and cut the number of claims decisions that end up being overturned.

The bill also creates a new authority to provide a temporary disability rating for some veterans who have severe and multiple disabilities that are not fully healed. Stabilized and unstabilized disabilities that have an impact on employment could be considered in assigning the temporary rating that would be used to provide disability compensation during the first year after leaving the military.

     

One of the pilot projects ordered by the compromise bill requires special, expedited treatment for disability claims where the veteran had the help of a veterans’ service officer to prepare the paperwork. This one-year test would be carried out in at least 10 regional offices.

A second pilot project, to run over three years in at least four regional offices, would have processors and veterans use a checklist when submitting claims in an effort to bring more organization and uniformity to the claims process.





The bill also gives VA one year to develop a program using information technology to process claims that would allow veterans to file applications and to track the progress of their claim online.

Several provisions in the bill were drawn from a claims modernization bill sponsored by Rep. John Hall, D-N.Y., and Sen. Hillary Clinton, D-N.Y., that attempts to improve training for VA workers who are processing claims and to change how employees are evaluated.

“Improving VA procedures so that claims can be processed and benefits delivered quickly, fairly and accurately for our veterans, their families and their survivors is the least we can do,” said Clinton, a member of the Senate Armed Services Committee.

“America’s disabled veterans cannot afford to wait a moment longer,” said Hall, chairman of the House Veterans’ Affairs subcommittee on disability assistance, Hall said processing a first-time claim by a disabled veteran can take 180 days, and even longer if a veteran appeals the initial decision. The long processing time is part of the reason there is a backlog of about 400,000 claims awaiting a decision by VA.

Over the last two years, members of the House and Senate veterans’ affairs committees have tried to push VA to process claims more quickly while also complaining about the rate of mistakes in claims and evidence that similar claims are decided differently between VA regional offices.

In the report accompanying the benefits bill, the two committees say they want a process that is perceived as fair by veterans, but realize “it is unreasonable to expect states to have exactly the same average compensation or percentage of veterans receiving compensation.”

The bill requires a report — due one year from now — that looks at variances in benefits between regional offices and between veterans of different states to determine whether the differences are justified.

Once again I am overwhelmed at the lack of outside the box thinking and just more of the same.  More computer usage, more training, employee evaluations, give a year to make up some more crap as to why it takes so long; and on and on with the same diatribe stuff we have heard for who knows how long.  I wonder how many millions will be spent on some creative software that will never work without millions more being poured into the system – that is never going to work.  Have not we been there already on this issue?

It is just beyond comprehension that Veterans and their family’s have to suffer because of failed VA philosophy and processes for timely Service Connection and the failure of our own government to mandate some logical common sense processes that are non-adversarial.  Which most on the VAC’s have agreed the process and philosophy of Veterans Affairs is nothing but adversarial.

Congressman Hall —-“America’s disabled veterans cannot afford to wait a moment longer,” said Hall, chairman of the House Veterans’ Affairs subcommittee on disability assistance, Hall said processing a first-time claim by a disabled veteran can take 180 days, and even longer if a veteran appeals the initial decision. The long processing time is part of the reason there is a backlog of about 400,000 claims awaiting a decision by VA.

How many of the above in this mythical 180-day decision was nothing but a denial?  Does anyone really believe VA can actually make a positive decision in 180 days when their philosophy and even reward system is based on denials.  Presumptive disorders take at least that long if not longer and those should be automatic within minutes of hitting the door of the VA office, at least Service Connection should be established immediately.

Senator Clinton —“Improving VA procedures so that claims can be processed and benefits delivered quickly, fairly and accurately for our veterans, their families and their survivors is the least we can do,” said Clinton, a member of the Senate Armed Services Committee.

Then by God do something positive with action that mandates some level of common sense and repercussions for those that do not follow the mandates.  Talk talk talk….TALK.

Congressman Hall —… reduce the disparity in decisions involving similar issues and cut the number of claims decisions that end up being overturned.

My Presumptions:
    *I am assuming that Congressman Hall is discussing the disparity of C & P ratings for the same disorders or similar.
    *I am assuming that Congressman Hall is discussing the thousands of VA claims that get overturned at the Board of Veterans Appeals (BVA).  Which should include those claims at VA that are consistently being denied and then when the claim gets to the BVA they are commonly overturned.  (Meanwhile four years has passed)
    *I am assuming that Congressman Hall is discussing that computer information shareable, searchable, and criteria based.

Certainly we can consider the Board of Veterans Appeals computerized decisions as Information Sharing Technology.  Is this used for anything but posting on the Internet…NO!  Even the BVA does not use this searchable data for their decisions to expedite claims that are similar or even exactly the same.

Veterans or widows cannot even use this data as pointing to prior overturns that are exactly the same issues and Service Connected scenarios.

Make any sense?  It does if your intent is to delay or stall in an adversarial VA setting that is supported by White House after White House and some members of our own Congress.

Example:

·        You have Veterans that served in Vietnam which are presumptive to exposures to Agent Orange. (This by itself is a joke when you look at the congeners that these men were actually exposed and tested positive for years after the war.  In looking at the great work done by the POINTMAN Project I and II early after the war and recognizing the congeners found and the data put out by Hatfield last year of those congeners still found in the hotspots that still exist today; these are very very similar.  So AO in and by itself seems to be more of a government perpetrated myth as to causations.)
·        These Veterans either die or become disabled from presumptive exposures while serving in theatre.
·        All of them meet the requirement for presumption.
·        The only decision factor is the association to either the toxic chemical exposures or Service in that Environment for Service Connection.  (Do Veterans really care which one since they are dying and/or disabled?)
·        The Veterans or Widows put in the same claim to VA, which is disapproved.  (Knowing full well that BVA in many cases has overturned the exact same decisions for the exact same scenario.  Overturned for the exact same reasons.  (It is on the Internet for heavens sakes.)
·        This continues on by VA day after day year after year knowing full well they are denying a claim that will be, in due time if the Veteran lives long enough, overturned by BVA.  (Make any Sense?)

Do not get me wrong folks.  This year for Veterans has been the Year of the Veterans.  Thanks to Congressman Filner and indeed Congressman Hall and his hard work.

However, if Congress is going to start introducing pilot programs to reduce the backlog of claims or get disabled Veterans at least partial support then…

I would suggest that Vietnam Veterans have waited long enough and many are dying from AO issues.  (ABC report 400,000 Vietnam Veterans are dying from AO issues.  Not new to us… we already knew this.)  Vietnam Veterans and their Widows have faced government-corrupted studies, politicians who could care less that scientific fraud is and had being committed against them, and White House after White House of nothing but self cover up indifference to the massive issues created by their own arrogance.

Congressman Kagen a medical doctor has concluded the additional cancers should be presumptive.

See HR 6798

http://www.opencongress.org/bill/110-h6798/show

You will notice that only 8 congress folks have cosponsored this bill.  Where is all the support of those in Congress who go home to you every two years and tell you they support Veterans/Widows/Orphans.  Where is the support from that only talk and do nothing!  Do not let them lie to you any longer?  This bill is a primary target to look at to see who in congress is for Veterans and those that passively say they are for Veterans and then do nothing.

http://www.washingtonwatch.com/bills/show/110_HR_6798.html

The above link documents constituent comments also and everyone should contact their political leaders (cough) to support this bill.

But I digress.

If we are going to do pilot programs, the one I have suggested has very little risk/chance for any claim to be approved that should have been disapproved.  At this time we are denying based on not letting one single claim get through that should not be approved thus the adversarial nature of VA.  Of course this puts undue hardship on the dying Veteran Family’s denied VA claim…then overturned by BVA.  Much is being lost between denial and overturned including some level of comfort for the dying Veteran.

Why the VSO’s are not supporting this as a way to get these dying or disabled Veterans approved and widows the support they need with existing computerized data, already accumulated and searchable; is a real question.  That is if the real intent is get the help needed and stop this dumb process of VA denying clams that at least as likely as not will be overturned at BVA.   Overturned claims that are fully documented.

How can one Veterans claim or a Widow’s claim for the exact same thing and the exact same presumption be approved for 20 and then denied for 20 for others?

Should the data and facts of an overturned disapproval mean nothing when considering similar approvals at VA?

Should we have a pilot program that looks at BVA overturned decisions and then establish criteria for similarity and then demand these claims get immediate approval and reduce the backlog of claims within six months.  YES!

I can think of nothing else that would reduce the backlog within months with little risk to the government as to validity of claims being approved.  This would also free up time to work on newer claims and those claims that are unique and do not fit the denial/BVA overturned scenario that exists.

The other issue I would like to comment on is the massive amount of Veterans with diabetes that have secondary damages or at least according to science and medicine today that have well established associated disorders with the diabetes and insulin resistance.  These are not just some subjective list of associated maladies but are listed and medically treated as common with the diabetic process and time of disease.

Veterans with these secondary issues already known to be associated should not have to prove over and over again to VA clerks what every medical university or college has already agreed with and recognized as medical fact and physician treated as fact.

There are some very common issues and some issues that may or may not be associated to every case of diabetes.  However, would it not make sense to establish an already approved list of known secondary disorders that must be approved by VA or BVA and then get the Veteran his C & P for his rating for his new associated disorder to diabetes in a timely manner.  More time is spent trying to convince what medicine has already concluded a half century ago than the actual rating.    Common sense and medicine/science clearly has stated that if you have diabetes then these other disorders or symptoms are indeed associated.

Even a standardized form/check list for these secondary disorders could be used for the Veterans doctor to check off one time and one time only with no discussion or denial by VA clerks the doctor checked as "at least as likely as not associated to the diabetic condition" and did not say “the exact words deemed needed so the VA clerk instead denies the claim.”

How much time would that save?  I would suggest a bunch since the claim now would only need one form, no delays and no bickering between the doctor and the VA clerk; claim association as secondary is automatically approved with that form and then over to C & P scheduling for rating.

No we do not need more talk talk talk with no actions that certainly define that nothing is being done but the same discussions over and over and over.

Thanks folks,

We need to get going on HR 6798 and now!  Make sure your congressperson and senator supports this bill.  It has been long enough.  And the reasons for the long enough are despicable at best. 


ORIGINAL STORY: http://www.navytimes.com/news/2008/10/military_va_disability_100108w/

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