Backlog?

[88 mike]

I also wanted to know why ismy current claim is taking so long? My last two claims were processed and out the door and in my hands in less than six months combined. This one on the other hand has been177 days and counting. The 1 800 # could not give me a straight answer on this matter. I read in another post that it takes longer when you have a retro payment that is over a certain amount. Can this be the case?

[carlie]

I also wanted to know why ismy current claim is taking so long? My last two claims were processed and out the door and in my hands in less than six months combined. This one on the other hand has been177 days and counting.

The 1 800 # could not give me a straight answer on this matter.

I read in another post that it takes longer when you have a retro payment that is over a certain amount. Can this be the case?

You are probably thinking about additional signatures needed after 25K retro or more.

Sure it could be a case.

[broncovet]

Mike

Actually, the special procedures apply to awards of $250,000 or 8 years or more retro. They have been changed, however, because of a fairly recent court case that said this was illegal. Refer to this fast letter:

IMHO, however, this is pretty much a moot point, because most "lower level" rating specialists are rarely, if ever going to award huge retros, and will likely simply deny it if pushed. They are afraid to. Instead, they just deny them and let the BVA or DRO sort it out. I mean think about it. If you were just on the job a couple months, and you get a claim that involves say a third or half million dollars. What do you do? Approve it and get yelled at, or deny it and nothing will be said? They have a name for this among government employees: Its called "passing the buck". Pretty much nobody wants their signature on a decision of lots of money except for the most experienced and qualified DRO's and senior level raters.

Carlie may be right, tho, as I seem to also recall reading that even claims with 25k retro require multiple signatures. It sounds like their are 3 tiers: Those with Retro 0-25k (anyone can sign them), those with 25-250k, (requiring two signatures), and those over 250k which requires it to be sent to VACO in Washington DC for BIG BIG shot approval.

Edited December 22, 2010 by broncovet

[broncovet]

I would like to add that this is precisely why people complain of a "culture of denial" at the VA. It seems very interesting that a rater with practically no experience can deny claims by the dozens..this does not cost the VA any money. However, to get a big retro APPROVED, it requires big shot approval. It looks to me a denial should be given the same considerations as a quarter million award. Here is one reason.

The VA put this "safeguard" in place, so that rating specialists cant commit fraud by awarding his brother in law a half million in benefits then split it with him. It seems to me to be one of the good intentions gone wrong. IMHO this fraud can still go on....the rating specialist simply awards an amount "just under" the wire. In other words if the VA checks and double checks retros over 250k, then why not award your brother in law 235k instead and then award his neighbor another 235k, and skip the accountability breezing through? This checks and balances wont prevent fraud, it will just make it easier for them to commit fraud.

The problem is to the deserving Veteran. He finally gets his claim where its about to be approved, and it has to be gone over with a fine tooth comb by all the bigshots...searching for a reason to deny it after all.

I can see that claims need to be audited, that is, checked by others for accuracy. But why only large retros? Should not denials also be audited to ensure their accuracy?

The only way to scientifically or fairly determine accuracy would be to audit every tenth claim, whether its a quarter million retro or a denial.

[Seabee14]

Sir,

All awards over $25K require a third signature. This is in the manual M21-1, Part 5, Chapter 9.01. Some stations may require larger awards, say over $250K, be reviewed by the Director at that station.

The Fast Letter 07-19 your refer to was rescinded on 8/14/2008.

Any retro amount is not determined until the end of the process, when the award is finalized. I have on good authority that this would not cause undo delay in a claim, other than the time it would take for the third person to review it. Each claim is a new experience, regardless of what the issues are.

The third signature refers to (1) the VSR that prepares the award, (2) the authorizer that reviews it, and (3) a supervisor that does a second review. At least at the station I am familiar with. And at that point it is not a matter of changing the rating, it is making sure the amount is correct and nothing was missed.

Also, RVSR's are in a probationary status for an amount of time, depending on station policy. I know of one station that requires a second review on all ratings for up to two years after training is completed. And reviews are done after that for quality purposes. Does that mean that errors will still get through? Most anything is possible. I have it on good authority that the VA calls in files for reviews on claims, and if an error is found it is returned to the RO for corrective action.

I am not trying to start anything with you, sir, but to clarify. I am a veteran and I hope I can help clear the air.

[Pete53]

Seabee:

Thank you for your post and your courtesy. It is appreciated and most informative. I hope that you have many more posts here and thank you for taking the time to help Veterans.

It is Hadit's policy that personal attacks on Members is forbidden. However if a Member disagrees with another Member it is to the benefit to discuss the issue using the Socratic method. Present the facts back up with citations of laws and regulations and if it is an opinion state it as your opinion.This can lead to a better understanding of issues that confront members every day. After all the purpose of Hadit is to help Veterans and their families deal with the VA.

I have been here a long time and have my share of corrections made by Members and I appreciate it.

For the Members the first paragraph was for Seabee and the rest for all of us.