VA expediting older claims; will it bite them later?

| April 23, 2013 | 14 Comments

While Jonn posted some praise for the VA earlier, I have some news that might not be so praiseworthy:

Is this the right move by a Department of Veterans Affairs that has come under fire recently for the massive backlog of claims, or is it too little, too late?

The Veterans Affairs Department is expediting compensation claims decisions for veterans who have waited one year or longer, VA officials announced April 19.

Effective today, VA claims raters will make provisional decisions on the oldest claims on hand, officials said, which will allow veterans to begin collecting compensation benefits more quickly, if eligible.

Veterans will be able to submit additional evidence for consideration a full year after the provisional rating, before VA issues a final decision.

“Too many veterans wait too long for a decision, and this has never been acceptable,” said VA Secretary Eric K. Shinseki. “That is why we are implementing an aggressive plan to eliminate the backlog in 2015. This initiative is the right thing to do now for veterans who have waited the longest.”

I see this backfiring in a big way.

Here’s my take:

Starting today, the VA will approve claims older than a year at the minimum level for each condition for which there is significant evidence. In order to get the proper rating, the veterans will have to submit more proof that the condition warrants a higher rating – after all, the evidence already in the claim was “reviewed” and a rating was “issued.”

So now, instead of veterans waiting for [mostly] proper ratings, they will get lowered ratings faster, and will have to wait through the appeals process for the ratings they should have gotten in the first place.

Here’s the proof:

If any increase is determined to be warranted based on the additional evidence received, benefits will be retroactive to the date the claim was initially filed. The initiative protects the veteran’s right to appeal the decision. If no further evidence is received within that year, VA’s Veterans Benefits Administration will inform the veteran that the rating is final and will provide information on the standard appeals process.

Additionally, chairman of the House Veterans Affairs Committee Jeff Miller, R-Fla., issued this statement:

“While this new approach sounds promising, we will be monitoring it closely to make sure it’s good policy rather than just good PR. Driving our skepticism is the fact that Sec. Shinseki and VA benefits officials have testified before our committee several times in just the last few weeks, yet the first official notice of this initiative didn’t come until today – minutes before VA issued its press release. Nevertheless, VA has a responsibility to make sure it doesn’t use this program as an excuse for letting average claims processing times continue their steady ascent indefinitely. Furthermore, the department must not shift resources and manpower away from processing new claims just to clear out old ones. Every veteran deserves a thorough, fair and timely evaluation of their claim, regardless of when it was filed. This policy should not interfere with that concept.

“The department’s haphazard rollout of this plan has left us with a number of important questions. So in the coming days and weeks, we expect VA to fully explain to Congress precisely how this program will improve the department’s claims processing efforts and help chip away at the mountain of backlogged benefits claims.”

The VA just put a band-aid on a sucking chest wound – and it’s going to come back to bite them big time.

TSO did point out that the approved claim will allow the veteran to seek medical care while waiting for the proper ratings to come back, rather than just waiting. Still, I think the VA is going to screw this up big time, and veterans still won’t be getting the benefits they’ve earned.

Cross-posted from After the Army.

Category: Veterans' Affairs Department

Loading Facebook Comments ...

Comments (14)

Trackback URL | Comments RSS Feed

  1. Hondo says:

    Rob: I agree with you. And IMO, this is going to end up being a Charlie Foxtrot in several different ways:

    1. As you point out, vets who got a “lowball” initial rating will end up having to jump through hoops to get it put right. If you think the initial claims process is fun, just wait until you get to go through the appeals process! Unless things have changed, that’s on the vet’s nickel for travel, outside medical exams to support the appeal, etc . . . . And the appeals board may well be elsewhere than your local VA clinic.

    2. VA claims processors will now get pressured to “move out”. Can you say “cookie cutter” approach?

    3. To avoid looking like idiots, many VA claims processors will start being “liberal graders” (who’s going to complain about and/or appeal a rating that’s higher than expected)? If you think we have a problem with bogus claims now . . . .

    I’ve got a bad feeling about this. It sounds good in theory, but in practice I fear it’s gonna be a train wreck.

  2. raul duke says:

    So a claim gets approved, even if it is BS? How about use common sense when reviewing?

  3. Flagwaver says:

    Yes, it will cut the number of back logs. However, the number of twenty-star generals and space shuttle door gunners will be laughing off their arses because they will be getting free money from the government.

    However, those of us who need the money to live will be receiving pennies and having to jump through hoops to get what we need to survive and to pay our bills (medical and otherwise).

    So, I agree with everyone else. However, it is not a bandaid on a sucking chest wound. It is a cork in a spewing asshole.

  4. Nik says:

    @3

    Common sense? C’mon, this is the US Gubbermint we’re talking about here. Them’s fighting words.

  5. PintoNag says:

    It sounds like a white-wash to me. Vets are going to be hurt.

  6. Ex-PH2 says:

    @6 Oh, yes, and it could have been avoided, too.

  7. TSO says:

    Welcome Rob! /wave

    Rob is a great dude. So give him a good welcome.

  8. MSGRetired says:

    I have been waiting for 16 months now, I do not want a temp rating. Mine is probably taking so long as we had to explain to them what Tricare Prime Remote means. Yes I had civilian doctors while on active duty .. Holy Shit, that was a concept they just couldn’t seem to understand. I was also injured in Iraq but I don’t have a Purple Heart, that’s because the Enemy did not cause my injuries. Do you know how many people have tried to submit paperwork for me to get a PH WTF people. Listen to whats being said and is documented and STOP trying to read shit into things .. Sorry for the Rant !!

  9. Phydux says:

    I am in the appeal process now (and have been for 18 Months) I just received another request for information on Friday. I have been going through the 38 page request for information they sent. This comes after losing my paperwork, messing up my records, losing more paperwork, sending me someone else’s paperwork, me starting an IG inspection and having to go through two more physical exams. My feeling is they are hoping to get me to quit and keep the rating I have of 30% (despite being in a wheelchair). They have also never provided a wheelchair and I had to buy my own after TRICARE paid 36 dollars for one which does not work well. I have been referred to their prosthesis department, but they will not call back, I think it is because they would then have to acknowledge that fact I am in a wheelchair based on a combat injury. I have now been put on disability from work because I am too much of a liability based upon my physical injuries.

    This is the process these underrated Veterans have to look forward to, substandard care based on substandard evaluations. Then being treated poorly by the appeals process in hopes they will give up and accept the rating they have been given.

  10. Cacti35 says:

    The claims process became more of a log jam when Ischemic Heart Disease was added to the Agent Orange group along with some other new diseases. Add to that the large amount of claims from the GWOT and it really ground to a slow crawl.

    When I filed my AO claim in 2003, it took 4 months to be approved and after my cancer treatments lasting through 2005 the final rating came 90 days later. When my brother in law filed a radiation exposure claim that occurred in back in 1954 he is still waiting for the final part of the claim now going on 3 years. I understand how people are frustrated. It took 18 months to get the VA to include my dependant who turned 18 and was still in high school. A simple thing that should have been a couple of keystrokes on a computer. I hope it gets better but I frankly will remain skeptical.

  11. Joe Williams says:

    Twenty years to get my 40% rating raised. My injuries had become so bad that I could no longer work. The VA’s catch 22 is that if you are working then there is no need to raise your rating.

  12. TwoFiveZulu says:

    After a couple of “events” with the VA in the 80′s I learned one key thing. Never ever deal with the VA for Anything. Never. Ever.

  13. Flagwaver says:

    #9, “I was also injured in Iraq but I don’t have a Purple Heart, that’s because the Enemy did not cause my injuries.”

    I’m going through this, too. I am a former National Guardsman and they tried telling me that my injury was a non-duty related injury in the beginning. You know, civilians always get concussive damage to their internals. And don’t even get me started on my PTSD, anxiety, and depression…

Leave a Reply

Your email address will not be published. Required fields are marked *