Wrongly-denied claims add to backlog at Veterans’ Administration
by Martin Schram
Columnist
March 27, 2013 11:21 PM | 2482 views | 4 4 comments | 8 8 recommendations | email to a friend | print
MEMO TO: President Barack Obama and Secretary of Veterans Affairs Eric Shinseki

RE: A Veterans Affairs Department’s backlog battle you haven’t begun to fight

Four years after you both famously declared war on the VA’s unconscionable backlog of military veterans waiting for benefits they earned fighting our wars, there is one backlog battle you haven’t begun to fight.

It’s a battle against the VA’s enemy within. The VA’s own first-deciders are unintentionally undermining the VA’s backlog war.

Mistakes and flawed rulings by the VA’s often-inexperienced claims adjudicators are adding to the VA’s huge backlog they were supposed to be reducing. Consider this shocking statistic: The latest annual report of the U.S. Court of Appeals of Veterans Claims shows that in the 2012 fiscal year, the appeals court upheld only a quarter of the VA’s denials.

The independent court found at least some problems with most of the denials of veterans’ claims by the VA’s initial adjudicators, or by the VA’s Board of Appeals. (The board is the first stop for veterans who want to appeal denials handed down by the VA’s claims adjudicator.)

The independent Court of Appeals of Veterans Claims remanded back into the VA Department’s system some 60 percent of the cases that veterans had appealed. And those cases became, once again, a part of the VA’s infamous growing claims backlog. Sometimes, the cases went back to the VA’s Board of Veterans Appeals; other cases went back to the VA’s original adjudicator. Then the whole process began anew.

Here’s what this means for veterans: After being forced to wait months and even years, they must begin another long-wait process.

Here’s what it means for the VA claims-case backlog: It is being increased, not decreased, by often-inexperienced VA adjudicators who too often fail to get it right the first time.

By the end of March, 1 million veterans will be waiting for claims to be processed, according to VA statistics. Right now, everyone seems to be focused on the fact that the VA hasn’t finished computerizing its records. But even when the VA catches up with the computer age, expected in 2015, you both will find that your backlog is being undermined by bureaucratic snafus.

There is nothing wrong with the process in theory. When veterans’ claims are rejected, they can file an appeal. The appeal works its way through the system to the VA’s Board of Veterans Appeals. Sometimes the board sends the case back to the adjudicator for new consideration; sometimes the board agrees with the initial denial.

Then the veteran can take the case outside the VA, to the independent Court of Appeals of Veterans Claims. That court concluded that a mere 24 percent of appeals were rightly denied by VA adjudicators and the board.

Clearly, the VA system would be much more efficient if its first adjudicators got it right the first time. Or if at least the board of appeals got it right the first time, after the adjudicators didn’t.

Mr. President and Gen. Shinseki, why do you still tolerate a VA claims-adjudication system that works so poorly?

After all, those problems are nothing new. I highlighted a number of them in my 2008 book, “Vets Under Siege.” I reported and reviewed dozens of outrageous decisions in which VA adjudicators denied or delayed claims that veterans had clearly earned. Why does it happen?

I came up with two explanations that remain valid and unresolved today:

• The Development of an Adversarial VA Mindset. While the VA has thousands of excellent workers, a mindset has spread among some in the VA. Some who decide veterans’ claims see themselves as adversaries, certainly not advocates. They become preoccupied with detecting and blocking veterans’ false claims, not helping veterans get all the benefits they earned by serving America.

• The Rise of Unwise VA Incentives. Bonuses have been awarded to VA personnel for saving the government money, not primarily for helping veterans get their deserved benefits.

That’s why I have long urged a departmental name change that is far more than just cosmetic.

Call it the Department of Veterans Advocacy, Mr. President. It is a way to fix the VA’s collective mindset and affix the correct sense of mission for all who work there.

As an added benefit, one retired four-star Army general will finally have a title that reflects his career-long sense of self: Secretary of Veterans Advocacy Shinseki.

Martin Schram writes political analysis for Scripps Howard News Service.
Comments
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A VA employee
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May 10, 2013
While I understand the frustration, I feel your explanations are incorrect. Most VA employees WANT to grant benefits. I have heard a mantra around here for the raters are "grant if you can, deny if you must." The reason why there are so many errors? Things change ALL the time and it is hard for us, even those that have been here for years, to keep up. Then we have constantly changing "priorities." All the while we have stresses of making daily production numbers in order to keep our job, so some of us may rush through things. I personally try not to worry so much about the production part because I want to do the best job I can do for each veteran, but even sometimes I get caught up and try to move things along quickly, by the insane workload they dump on each employee because there is a lot of work, it's not usually easy to work each case, and it'd be nice to have more employees to help out. I believe the system is flawed and wish there was a way to make things easier - for the employees AND the veterans, because it can be confusing to the veterans how the claims process works! Now, this is coming from my perspective, as someone who processes the development side and the award processing/notification letter side; I don't rate cases. But I know everyone is overwhelmed and it stinks when you have dozens of files in your cubicle and you're not allowed to help those veterans because they're not as "priority" in management's eyes compared to other work. And I won't even get into the training we have... suffice to say, don't blame the employees because most of us really care about the veterans and try to do it right.
Jim Stoll
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March 28, 2013
The only part of Martin Schramm's article is the part where he writes about "The VA's own first deciders are UNINTENTIONALLY undermining the VA's backlog war". Another statement in his article: "Bonuses have been paid to VA personell for saving the government money" is proof positive that there is nothing but an adversarial relationship between veterans and the VA. The problem is simply that those who govern our nation truly believe that any money paid out on veterans claims is money that they cannot use for their own benefit, either to increase their own wealth of to pay out to others to get themselves re-elected to their positions of power. This is not a new phenominum. It has been going on for as long as I can remember and I am a Veteran of Korea. There is an old saying among veterans that I know from my war. It goes "There are only two ways for a man or a woman to come back from one of our politicians' wars: "Either in good health or in a flag draped box". I have found that politicians believe that only politicians deserve any monitary benefits or special treatment after they have served their country. It's a sad, sad commentary on the mindset of those who govern today.
Realpoet2
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April 18, 2013
It is indeed a shame when it has taken over 7 years for your claim to be approved and while it still have people in the VA system that are too lazy to read the records and when you try to get answers about your own case, it seems they push your file back even futher because you have questions. I have been a victim of information incorrectly placed in my claim and it is still going into the 8 1/2 year now to get my claim benefits finalized and corrected in accordance to VA regulations. I only wish that the VA would rid themselves of the people who do not perform their jobs correctly.
David Davis
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May 08, 2013
We must ask ourselves why the leaders of this great nation who use their email, many MS Office products, Advanced modelling and predictive software products have chosen to allow the Veterans Admin to squander billions of dollars in antiquated paper methodologies to continue operating this way year end and year out. Would you want these same people in charge of the next conflict? Should we continue to bring knives to gun fights? These leaders need to be replaced and congress needs to retire. If Americans keep relying on Advisory rather than Action committees we are doomed to another 40 years of VA trial and error concepts. Put progressive thinking and actionable people in charge. When you have a donkey leading the way it will take forever on flat land to get there. We need INTELLIGENCE and INTEGRITY in these leadership positions not mundane followers
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