VA Hits Important Benchmark, but Problem Far from Solved

The Department of Veterans Affairs (VA) took a step forward toward alleviating the backlog of disability claims, but that problem is still far from solved.

For the first time since February 2011, the number of backlogged disability claims dropped below the 350,000 mark. That’s a decrease of more than 250,000 cases in the past year, a pace that officials believe they can maintain to bring the backlog to zero by 2015.

Still, 350,000 veterans remain in what has been a rather long waiting line for the past several years. The backlog number is based on the number of claims pending for more than 125 days.

VA Undersecretary of Benefits Allison Hickey said that new technology, the new paperless claims system, better training of claims workers, and improved communication systems have all contributed to the decrease. In addition, the Undersecretary acknowledged that mandatory overtime for claims processors over the last two years has been a critical tool for shrinking the backlog, but constant overtime is not a sustainable business model.

Although there is much work to be done, this is certainly welcome news. The backlog number is also at its lowest mark since before claims tied to new presumptive illnesses from Agent Orange exposure overwhelmed the benefits system.

The move to make those presumptive illnesses eligible for VA benefits in 2010 was popular among veteran advocacy groups, but it also led to a dramatic slowdown in the completion of disability claims as tens of thousands of new cases poured into the claims processing system.

The VA’s ability to deal with claims quickly and reliably came into question, and the Department received stricter scrutiny from Capitol Hill. Now, almost four years later, it seems as though the VA has achieved some progress toward shrinking the backlog for veterans.

To read more on this issue, read the Army Times recent report: http://www.armytimes.com/interactive/article/20140331/BENEFITS04/303310043

So Nothing Got Done This Year

Jim Fausone

Veterans Disability Lawyer

When you look at 2013 there was no shortage of issues of interest to veterans.  VA operations were often in the news from the backlog on disability claims, the quality of health care or the troubled electronic medical record system.  The Stars and Stripes report that no major veteran initiatives made it out of Congress this year.  The one noteworthy black spot on that do nothing record is a budget proposal to remove COLA from retiree pay for those under 62 years old.  So when the politicians are pandering to veterans, as they do every election year, keep this year of zero accomplishments in mind before promising your vote.

http://www.stripes.com/news/veterans/veterans-disappointed-in-lack-of-legislation-for-2013-1.257487

Former VA Secretary Calls for VA Disability Benefits Reform

According to former VA Secretary Anthony J. Principi, the VA backlog of disability claims is in large part due to the more recent policy decisions and laws have burdened the system. 
 

Principi argued that current eligibility requirements are far more liberal than, as President Lincoln once charged, "To care for him who shall have borne the battle and for his widow and his orphan." He said that the 50,000 veterans wounded in Iraq and Afghanistan who have filed for disability claims are not the reason the system is clogged, but that the system was already overwhelmed by veterans who were filing claims from long-ago service.  

"While every benefits system may face the occasional questionable filing, the focus of the VA disability benefits system needs to support the servicemen and servicewomen who need those benefits to which they are entitled," commented veterans disability attorney James Fausone.

Principi called for the restoration of the "integrity" of the Veterans Administration claims system in a keynote address this June at forum on the VA. The forum, co-hosted by Concerned Veterans for America The Weekly Standard magazine, featured Principi's keynote, where he stated that Congress, vet service organizations and the VA must address the expansion of disability pay eligibility. Principi has called for a "rebalancing" of priorities or the VA system will be at risk, he said. His remarks were in sharp contrast to other speakers, who urged the VA to work more efficiently and faster on the backlog of disability claims still pending.

More than one million claims are filed each year; an estimated 80 percent of these are filed from veterans who served prior to 2001, Principi said. A vet who served a single day in Vietnam can file for medical conditions typically seen in aging men, Principi said, such as prostate cancer, lung cancer, Parkinson's disease, and Type II diabetes.

It has been 40 years since the end of the Vietnam War, and 37 percent of VA claims have been filed by Vietnam vets, twice as many as those filed by recently discharged vet, according to Principi. And, says Principi, as much as 11 percent of claims, 100,000 or more, have been filed by veterans who never saw conflict. Vietnam-era vet claims increased, posited Principi, due to assumptions that "ailments of aging" such as some heart diseases and Type II diabetes, were added to the list the VA accepted as caused by exposure to Agent Orange.

The VA paid out $26.6 billion in 2005 in disability compensation. By the end of 2013, it will pay out more than $60 billion.

Source
http://www.military.com/benefits/2013/07/03/principi-eligibility-explosion-behind-va-backlog.html?comp=1198882887570&rank=6

Provisional Rating Approach

Jim Fausone
Veteran Disability Attorney

VA has been under tremendous criticism for the backlog of claims that it has which is approaching 1,000,000 this year.  Congress has been holding hearings on how to clear up the backlog.  Heads may actually roll at VA over this embarrassment.

So VA has to resolve the new claims being filed and the old claims waiting around.  VA has been thinking about how to handle recent filings so they don’t become part of the backlog.  VA plans on computerization to assist on the new claims.  We have heard stories of a software program that will scan applications and use artificial intelligence to make the rating. Call me skeptical that rating by buzz word is a better approach.

On the backlog, VA is proposing to have raters review the oldest claims first and issue a provisional rating based on the file.  VA would not have a complete file or send out questions or send the veteran to an exam.  The VA Fact Sheet on this provisional rating states that the veteran will have up to one year to submit additional evidence to change the provisional decision.  The provisional rating can also be appealed.   Ok, I am still skeptical that this will work.  It should help some people who have good records, but other files are not developed sufficiently for a fair rating.  Time will tell if this approach cuts the backlog.

http://news.msn.com/us/vas-plan-to-reduce-backlog-met-with-skepticism#tscptme

 

Large State – Long Wait

Jim Fausone
Veteran Disability Lawyer

 

While the official U.S. policy is to support disabled veterans with medical care, financial support and retraining, the support they receive has been found to be less than timely. Veterans located in Northern California, for example, wait, on average, more than nine months for war-related disability claims filed with their regional VA office. Meanwhile, vets who live in Nebraska or North Dakota receive their benefits sooner than those who live in Atlanta, Chicago or New York. Geographic inequity has been found to be rampant in lower-populated areas, according to a report by The Bay Citizen and the Center for Investigative Reporting. 

"Everyone agrees that we need to do a better job supporting our veterans when they return home," says veterans disability lawyer James Fausone. "It's no surprise that the entire system is painfully overloaded, but knowing that doesn’t help get disability support into the hands of our vets."

On average, the Office of Veterans Affairs takes more than eight months to process a claim, and despite claims of improved processes, a new $300 million computer system, and more than 3,000 claims processors hired in the past two years, that time is only increasing: The Bay Citizen reports it takes 50 percent longer to have a claim processed in 2012 than in 2011.  The new computer system has been placed in only four VA offices; claims are still on paper, in files and must be handed from office to office and onto a claims representative's desk to be processed. Meanwhile, veterans in both New York and North Texas are waiting, on average more than 12 months. An appeal filed on a denied claim, the report states, can take as long as three-and-one-half years for resolution.

While the VA has publicly pledged to process all backlogged claims by 2015, the number of vets waiting is only growing. As of the end of this July, there were more than 907,000 claims, with 832,000 individuals waiting on disability or survivor benefits, and thousands waiting on pension or GI Bill education benefits. The agency reports that new claims filed annually have increased by 48 percent, though the number of new claims representatives has increased by only 5 percent.

The Bay Citizen has posted an online interactive map to help vets find out the wait times in store for them, based on their location. The map information updates weekly and can be accessed at http://www.baycitizen.org/veterans/interactive/map-disabled-vets-stuck-backlog-limbo.