Restructuring The Dva: Part Two

[allan]

<H2 class=date-header>Monday, February 09, 2009</H2><H3 class=post-title><A href="http://vnvets.blogspot.com/2009/02/restructuring-dva-part-two.html">Restructuring the DVA: Part Two </H3>

News reports indicate Congress is being asked to fund an increase of 55,000 new employees for the DVA. Some will go to staff new Rural Health Centers and others will go into the Claims Process system.

We think that without a viable training program, this is merely throwing good money after bad. It grows government where it is not necessary, adding to the bureaucracy.

Instead, we believe a wholesale change in the training and personnel administration of employees of the DVA is what is called for.

Here is what we propose:

NVLSP Involvement

We would like to see the National Veterans Legal Services Program [NVLSP], an organization that already trains people in the DVA Claims system, in conjunction with input from the DVA and the various Veterans Service Organizations, develop a classroom training program for employees of the DVA and Veterans Service Officers from the Veterans Service Organizations [American Legion, VFW, AMVETS, DAV, Veterans of Modern Warfare, FRA, V V A, and so on.] This warrants a grant from Congress to fund the NVLSP's effort and a warrant from the same authorizing legislation that allows the NVLSP to be the final arbiter in any issues raised by either the DVA or the VSOs.

The NVLSP would also be responsible for training the training staff comprised of DVA Instructors, and Veterans Service Officers from the various Veterans Service Organizations. Trainers would be licensed and would participate in training classes as instructors in various regional locations across the Country. Expenses for the VSOs would be funded by their Veterans Service Organizations, but wages for training classes will be paid from the DVA Budget. The classes where trainers are trained will lead to Trainer's Licenses. The training of VSOs and DVA Claim Processors will result in Professional Licensure, required to serve in either capacity. Refresher training shall be required every five years in order to renew the license.

The Program

The training program puts the Veterans Service Officers into the same classrooms at the same time as the Claims Processing Personnel from the DVA are trained. That way, every claim processor, and every VSO is on the same page when handling claims. Further, some portion of each training class will be required by all administrative staff. The Secretary and the Undersecretaries and Assistant Secretaries should also be required to complete the same training course as the VSOs and the Claims processors in order that all shall know what is required of the Veterans to complete a valid claim for benefits. The medical staff personnel employed in any medical or administrative capacity shall be required to attend the classes so they may also see what the Veteran must go through before they even get to the Doctors and Nurses, and medical administrative staff. Finally, legal staff should also participate in the training program to see first hand the fruits of their labors. Finally, attorneys and paralegals that work with Veterans Claims and as Veterans Advocates may take the training also, and should be licensed as well. Their expenses incidental to the training should be at their own expense, including the cost of the training, as they earn money from what they do.

The Details

The course will be covered over a two week period, with classes lasting 6 hours each day, with a half our break at mid-morning and again at mid-afternoon, and an hour for lunch. The last hour of every day is spent in review exams, review and Q&A sessions. The classroom work ends at the end of a full day of review and preparation for the final exam on the second Tuesday. The final exam is on Friday. The Practical Exam, where test claims are filed by the instructors, to be processed by the students on Wednesday and Thursday.

Successful completion of the course is required for licensure. Failure will result in the individual waiting until a review course is available, a 7 day, shortened version with the last five days the same as the full course. A second failure will result in termination from the VSO program for VSOs, or from Claims Processing positions for DVA Claims processors. The DVA may provide alternate employment for those refused licensure, but at no time may that employee ever become a part of the claims process system at any level.

The Kelley Principle

The indomitable Charles Kelley of the website 2nd Battalion, 94th Artillery, is a strong and dedicated advocate for change in the DVA. He emphasizes, among other things, a standardization of ratings, and a common sense/logical approach to claims. If, he posits, a claimant has a head injury and the claim processor approves the claim for 50%, then identical cases of head injuries should automatically be approved for 50%, and after that, if any varations are warranted, a deeper examination of the claim may be in order. I like to call this system of establishing case precedents, the "Kelley Principle".

This, in its simplicity is a major key to reducing any backlog in claims processing. We have embraced his concept from the start, and see it applied here as part of the training.

We believe the claims process should go through a number of steps.

Step One:

Examine the claim for eligibility based on military record and search for possible service connection.

<LI>Step Two:

Validate Service Connection and select the portion of a claim liable to generate the highest rating. Apply the

"Kelley Principle"

to DVA System records of precedents and if applicable, assign a temporary rating and approve the claim, so payments begin and medical coverage is authorized in the shortest time possible.

<LI>Step Three:

Examine and validate the claim for variations in the initial rating based on current examinations by DVA Medical Staff, adjust accordingly. Increase the rating of the claim based on other and/or secondary conditions as precedents warrant, again checking the DVA System for

"Kelley Principle"

precedents. Adjust the rating accordingly and approve or deny as the claim warrants.

All of the above subject to review by supervisory staff at each level. Each step is handled by an increasingly senior claim's processor.

Advancement of these licensed personnel shall be based not just on seniority, but an acceptable level of claim reversals on appeal, or by supervisory personnel, and a satisfactory claim completion rate.

It is highly recommended that all claim personnel be Veterans of the United States Military.

Positive Results 2

We think the adoption of this policy, should Congress embrace it, is a common sense no-brainer. It effectively addresses the regional variations in claim ratings and denials, and provides a clear structure to the claims process. It additionally places everyone in the claim process system except the Veteran into a standardized system that would provide the same results for identical claims at any Regional Office in the Country. It would simplify the claims process, and eliminate the backlog. It would be an efficient method of serving the Veterans of this Nation.

VNVets

http://vnvets.blogspot.com/2009/02/restruc...a-part-two.html

[john999]

The best way to restructure the DVA is with a bulldozer.

[mike/3/8/cav]

<H2 class=date-header>Monday, February 09, 2009</H2><H3 class=post-title><A href="http://vnvets.blogspot.com/2009/02/restructuring-dva-part-two.html">Restructuring the DVA: Part Two </H3>

News reports indicate Congress is being asked to fund an increase of 55,000 new employees for the DVA. Some will go to staff new Rural Health Centers and others will go into the Claims Process system.

We think that without a viable training program, this is merely throwing good money after bad. It grows government where it is not necessary, adding to the bureaucracy.

Instead, we believe a wholesale change in the training and personnel administration of employees of the DVA is what is called for.

Here is what we propose:

How about the KISS principle?

NVLSP Involvement

We would like to see the National Veterans Legal Services Program [NVLSP], an organization that already trains people in the DVA Claims system, in conjunction with input from the DVA and the various Veterans Service Organizations, develop a classroom training program for employees of the DVA and Veterans Service Officers from the Veterans Service Organizations [American Legion, VFW, AMVETS, DAV, Veterans of Modern Warfare, FRA, V V A, and so on.] This warrants a grant from Congress to fund the NVLSP's effort and a warrant from the same authorizing legislation that allows the NVLSP to be the final arbiter in any issues raised by either the DVA or the VSOs.

The NVLSP would also be responsible for training the training staff comprised of DVA Instructors, and Veterans Service Officers from the various Veterans Service Organizations. Trainers would be licensed and would participate in training classes as instructors in various regional locations across the Country. Expenses for the VSOs would be funded by their Veterans Service Organizations, but wages for training classes will be paid from the DVA Budget. The classes where trainers are trained will lead to Trainer's Licenses. The training of VSOs and DVA Claim Processors will result in Professional Licensure, required to serve in either capacity. Refresher training shall be required every five years in order to renew the license.

The Program

The training program puts the Veterans Service Officers into the same classrooms at the same time as the Claims Processing Personnel from the DVA are trained. That way, every claim processor, and every VSO is on the same page when handling claims. Further, some portion of each training class will be required by all administrative staff. The Secretary and the Undersecretaries and Assistant Secretaries should also be required to complete the same training course as the VSOs and the Claims processors in order that all shall know what is required of the Veterans to complete a valid claim for benefits. The medical staff personnel employed in any medical or administrative capacity shall be required to attend the classes so they may also see what the Veteran must go through before they even get to the Doctors and Nurses, and medical administrative staff. Finally, legal staff should also participate in the training program to see first hand the fruits of their labors. Finally, attorneys and paralegals that work with Veterans Claims and as Veterans Advocates may take the training also, and should be licensed as well. Their expenses incidental to the training should be at their own expense, including the cost of the training, as they earn money from what they do.

The Details

The course will be covered over a two week period, with classes lasting 6 hours each day, with a half our break at mid-morning and again at mid-afternoon, and an hour for lunch. The last hour of every day is spent in review exams, review and Q&A sessions. The classroom work ends at the end of a full day of review and preparation for the final exam on the second Tuesday. The final exam is on Friday. The Practical Exam, where test claims are filed by the instructors, to be processed by the students on Wednesday and Thursday.

Successful completion of the course is required for licensure. Failure will result in the individual waiting until a review course is available, a 7 day, shortened version with the last five days the same as the full course. A second failure will result in termination from the VSO program for VSOs, or from Claims Processing positions for DVA Claims processors. The DVA may provide alternate employment for those refused licensure, but at no time may that employee ever become a part of the claims process system at any level.

The Kelley Principle

The indomitable Charles Kelley of the website 2nd Battalion, 94th Artillery, is a strong and dedicated advocate for change in the DVA. He emphasizes, among other things, a standardization of ratings, and a common sense/logical approach to claims. If, he posits, a claimant has a head injury and the claim processor approves the claim for 50%, then identical cases of head injuries should automatically be approved for 50%, and after that, if any varations are warranted, a deeper examination of the claim may be in order. I like to call this system of establishing case precedents, the "Kelley Principle".

This, in its simplicity is a major key to reducing any backlog in claims processing. We have embraced his concept from the start, and see it applied here as part of the training.

We believe the claims process should go through a number of steps.

Step One:

Examine the claim for eligibility based on military record and search for possible service connection.

<LI>Step Two:

Validate Service Connection and select the portion of a claim liable to generate the highest rating. Apply the

"Kelley Principle"

to DVA System records of precedents and if applicable, assign a temporary rating and approve the claim, so payments begin and medical coverage is authorized in the shortest time possible.

<LI>Step Three:

Examine and validate the claim for variations in the initial rating based on current examinations by DVA Medical Staff, adjust accordingly. Increase the rating of the claim based on other and/or secondary conditions as precedents warrant, again checking the DVA System for

"Kelley Principle"

precedents. Adjust the rating accordingly and approve or deny as the claim warrants.

All of the above subject to review by supervisory staff at each level. Each step is handled by an increasingly senior claim's processor.

Advancement of these licensed personnel shall be based not just on seniority, but an acceptable level of claim reversals on appeal, or by supervisory personnel, and a satisfactory claim completion rate.

It is highly recommended that all claim personnel be Veterans of the United States Military.

Positive Results 2

We think the adoption of this policy, should Congress embrace it, is a common sense no-brainer. It effectively addresses the regional variations in claim ratings and denials, and provides a clear structure to the claims process. It additionally places everyone in the claim process system except the Veteran into a standardized system that would provide the same results for identical claims at any Regional Office in the Country. It would simplify the claims process, and eliminate the backlog. It would be an efficient method of serving the Veterans of this Nation.

VNVets

http://vnvets.blogspot.com/2009/02/restruc...a-part-two.html

[mike/3/8/cav]

I think they are going to put everyone on a rice diet.

I really would'nt mind the rice diet, we eat that all the time. But I would like rural care. We are very remote and any kind of help from VA in that regard I could handle. However I do like some kinda meat with my rice.

[allan]

I think since rural clinics & hospitals are strugling to exist in todays economy. That isuing health insurance cards to Vets so they can go to any local existing facility for treatment, would cut costs of operating VA drastically.

I also think we would get better care. Much of VA health care funding is tied up into the facility & staffing. In turn, VA staff do whatever they can to cut the budget. Delay that test, MRI, diagnoses, treatment. Whatever it takes to keep the funding.

Pain management is a good example. They know Oxycodone(CR) has far less side effects, but insist on Morphine with a take it or leave it attitude because it's cheap. Theres no vet like a heavilly sadated vet that can't function enough to complain.

The private sector tends to function on the hipocractic oath of relieving pain. VA will skip doses or delay sending them 2 to 4 weeks sometimes, just to save money. Meantime the vet is not only suffering from lack of pain control, but thrown into sudden medication withdral symptoms.

Multiply a vet experiencing delayed medications around the country, and you've saved a geat deal of VA funding at the suffering of Vets.

Private sector facilities DO NOT get away with the same things VAMC's do.