VA Claims Backlog

Posted: May 31, 2012 in Uncategorized

Mike Grabski, 32, left the Marine Corps in 2006. The burly veteran, who played defensive end on the College of San Mateo football team before joining the military, would sometimes wake up in the middle of the night at home in San Bruno and grab his girlfriend, putting both hands around her neck. “I had no ill will toward her,” Mr. Rodriguez, 28, said in an interview, “but while I was asleep I felt like I was still back there, and I acted it out.” He said he slept with a .40-caliber Glock pistol under his pillow and drank a bottle of whiskey every night to help him forget the war and fall asleep. In December 2006, he filed a claim with the Department of Veterans Affairs, arguing that he deserved a monthly disability check and priority mental health care from the agency because of post-traumatic stress disorder. More than five years later, he is still waiting for a final determination on his case. Rodriguez is one of 870,000 veterans nationwide who are waiting for a decision on a disability claim from the V.A. The waiting list has more than doubled since President Obama took office, despite the appropriation of more than $300 million for a new computer system and the hiring of thousands of claims professionals nationwide.
The problem is particularly acute in the Bay Area, where, according to figures provided by the V.A., returning soldiers wait an average of 313 days for a decision. Eighty percent must wait at least 125 days. Of the nearly 60 V.A. offices around the country, the Oakland office at 1301 Clay Street, Rm. 1400 North is the slowest. “The place is filled with paper, piles of it, everywhere,” said Representative Jackie Speier, a Democrat from San Mateo who toured the Oakland office last month as part of a meeting with the agency’s regional director on behalf of a group of constituents with claims dating as far back as six years. According to Speier, the backlog in Oakland has grown so severe that all new claims are immediately sent to V.A. offices in Lincoln, Neb., and Muskogee, Okla., where the backlog is less serious. “It is an epidemic of delay,” Speier said. “I did not exactly leave invigorated.” The Bay Citizen was denied a request to tour and photograph the department’s Oakland office and interview its director, Douglas Bragg. Mr. Bragg was unavailable for comment, according to Jessica Arifianto, an agency spokeswoman, but she released a statement from the office. “We are continuously working to improve our timeliness and performance in our service to our veterans,” it said, citing “ongoing efforts” to improve the quality and timeliness of ratings decisions, including hiring additional staff members, using simpler forms and forming quality control teams. The statement said the office was “taking steps” to meet a goal set by Eric Shinseki, the secretary of Veterans Affairs, to process all disability claims in fewer than 125 days with 98 percent accuracy by 2015.
On a tour of a V.A. facility in New Hampshire on 10 APR, Mr. Shineski said that, nationally, he expected waiting times to be cut in half over the next year as the new strategies are implemented. So far, however, there is little evidence of progress. According to government records, the number of V.A. disability claims, and the resulting backlog, has grown every year since Mr. Obama took office. While the agency has modestly increased the number of claims processed each year, the number of new claims filed has increased by 48 percent over the last four years as a flood of Iraq and Afghanistan veterans return home and file disability claims seeking compensation for wounds suffered in the line of duty (677,000 as of October 2011). At the same time, 231,000 Vietnam veterans have filed fresh disability claims related to diseases that the government only recently acknowledged stemmed from the spraying of the toxic defoliant Agent Orange.
“They build a technology infrastructure but haven’t pulled the trigger,” said Tom Tarantino, a former Army captain who works as a deputy policy director for Iraq and Afghanistan Veterans of America. “So all the extra money and full-time employees have done is prevent the problem from going way into the red. If they hadn’t been doing what they were doing, it would be a total disaster.” Meanwhile, hundreds of thousands of veterans wait. “The V.A. is this monster paperwork machine,” said Mike Grabski, 32, an Army veteran of the war in Afghanistan who has been waiting since December 2009 for his disability paperwork to go through. Grabski, who lives in Napa, is unemployed and suffers from post-traumatic stress disorder. In 2007, Grabski’s friend, Staff Sgt. Larry Rougle, was killed by Taliban fighters. “Seeing your best friend full of holes is not fun,” he said. Grabski said that in addition to post-traumatic stress disorder, he sustained a mild traumatic brain injury, shoulder and knee injuries and hearing loss related to bomb blasts during his tours as a paratrooper in Iraq and Afghanistan. He also suffers from asthma, which he said worsened as a result of his service. “It’s been a constant heartache,” Mr. Grabski said of the disability claims process. “The money would be nice, but it’s not about the money. It’s about the care. I’ve got issues that need attending to.”
For Rodriguez, the Marine Corps veteran from San Bruno, the money is important. He filed his initial disability claim for post-traumatic stress disorder in December 2006 and received a 30 percent rating from the V.A. 403 days later, in January 2008. Rodriguez said the rating, which entitles him to $389 a month in disability payments, is not generous enough to allow him to take off from work to attend counseling and group therapy sessions that the V.A. offers during business hours. He said he wants the department to give him a 70 percent disability rating, which
would entitle him to $1,272 in compensation monthly. In an interview, Rodriguez said he still experiences frequent flashbacks and intrusive feelings of guilt and grief, prompted by his experiences conducting house-to-house searches during his deployment in Iraq in 2004, as well as by a stint in New Orleans, where he deployed to collect bodies after Hurricane Katrina. “If they upgraded my claim, I would be able to go to group therapy every day,” Mr. Rodriguez said, “and I hope I would get better.” In handing down its initial 30 percent rating in 2008, the agency did not dispute Mr. Rodriguez’s description of his condition, but wrote that “to assign a greater evaluation, there must be reduced reliability and productivity.” Michael Blecker, the executive director of Swords to Plowshares, a nonprofit veterans services organization that is helping Mr. Rodriguez with his appeal, said disability is not only about the ability to work. “It’s about somebody’s quality of life and making them whole from what they lost in the war,” he said. [Source: New York Times Aaron Glantz article 14 Apr 2012 ++]


The Veterans Affairs Department faces a "staggering" backlog of 897,566 disability claims with more than 65 percent pending for more than 125 days, a problem compounded by an error rate of 16 percent, representatives of veterans' services organizations told lawmakers on the House Veterans Affairs Committee on 18 APR. The department has seen a 48 percent increase in claims since 2008. Officials expect the backlog will grow to 1.2 million claims this year and another 50,000 will accrue in 2013 as veterans of the Afghanistan and Iraq wars flood the system, Veterans Affairs Secretary Eric Shinseki told the Senate Veterans Affairs Committee in March. He vowed to process all claims in fewer than 125 days with a 98 percent accuracy standard by 2015. Veterans' services organizations testimony included:
 Jeffrey Hall, assistant national legislative director for Disabled American Veterans, an advocacy group, told House lawmakers that "while the elimination of the backlog will be a welcome milestone, we must remember that eliminating the backlog is not necessarily the same goal as reforming the claims processing system, nor does it guarantee that veterans are better served."
 James Wear, assistant director for veterans benefits policy for the group Veterans of Foreign Wars, testified that the high error rate and the poor quality of VA's rating decisions, which determine the financial benefits veterans receive, are a serious problem. "Quality of decision-making is problematic . . . The national average [error rate] has remained nearly stationary at 16 percent for months," Wear said, adding the Veterans Benefits Administration's Baltimore regional office has the worst claims error rate in the country — 29 percent, which is a slight improvement over its error rate of 33 percent just a few months ago.
 Randall Fisher, the American Legion's service officer for Kentucky, told lawmakers that in order to improve the claims process, VA must make training a priority and hire more veterans whose experience would prove beneficial. Hall said due to budget constraints, VA has cut back on training, conducting it locally rather than using its national training academy. "We have concerns that this change was made strictly for short-term financial considerations rather than to achieve the long-term goal of reforming the claims processing system," he said.
Rep. Bob Filner, D-Calif., the ranking member on the committee, said, "There's no shortcut of getting around the basics — of having well-trained employees who are empowered with the right tools and the right systems to get the job done right the first time." Shinseki promised earlier this month that VA will roll out its paperless Veterans Benefit Management System to 16 regional offices by September, with installation in all 56 regional offices in 2013. Hall said he was concerned budget constraints could impede the national rollout of VBMS, and urged the committee to provide full funding for the system. VA requested $92.3 million for VBMS in 2013, and spent a total of $343.6 million on the system in 2011 and 2012. Even as it moves to a paperless claims system, Hall said VA still will face older paper claims and it has yet to determine when or how those would be converted to digital files. A majority of claims processed each year are for reopened or appealed claims, which can remain active for decades. "Until all legacy claims are converted to digital data files, VBA could be forced to continue paper processing for decades," Hall said.
Paul Sullivan, managing director for public affairs and veteran outreach at Bergmann & Moore LLC, a law firm based in Bethesda, Md., said veterans service organizations or lawyers representing veterans cannot gain access to VBMS, something he urged the committee to change. On 16 APR, VA announced plans to streamline and speed up disability claims processing by segmenting claims so those that can be more easily rated can be moved quickly through the system; more complex claims would be handled by more experienced and skilled employees. Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, said VA's track record of making changes to its claims processing system has been "substandard." He added that VA needs to ensure that the much touted VBMS system is set up correctly and used efficiently. [Source: Bob Brewin article 19 Apr 2012 ++]


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