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Here Is A Possible Solution To Claim Backlog


SCIDVET

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Dear Veterans,

I had an idea while writing another post. I wrote to Veterans Coalition the suggestions below.

For those of you unaware, SMEAC is a (I think ARMY) method of breaking a problem into parts (such as a wartime objective).

I am no wordsmith, if I were, it would take a third as many words to state my idea. Anyone whom feels they can summarize the concept, please do so, and run with it as you see fit. Semper Fi.

Dear Vet Coalition.

Thanks for being there!

First, let me explain this suggestion in S.M.E.A.C. form:

The Situation is: Vets using up their lifetimes in claim processing, simultaneously clogging the entitlement, compensation, treatment, systems with unnecessary repetitions of appointments. Often, for decades, we pay for our Service Connected disability med treatment, because the VA is so slow or unable to acknowledge its failures in claim processing. By the time we actually receive compensation, the money is worth a third to a tenth what is originally was worth- in 10-25 years. TRUST ME THERE IS MORE TO THIS. Next:

The Mission is: To help right-honorable veterans get what compensation they deserve under law, while the monies still have value, and usefulness. I expect the cost savings will roughly equate to the benefits paid out for the USA.

Execution of the mission: Start a task force that holds sway with the VA rating board, for vets to write to with a short description of what the VA keeps overlooking, and basic evidence to prove it.

Each task force panel will contain one doctor, one disabled veteran receiving VA compensation, one NSO from one of the claim-processing organizations, ie, DAV. They vote on support for the vets claim, a VA representative familiar with claim processing. I believe they should only need to spend 20 minutes on each claim- they can either a: vote for support and grant of claim b: for no opinion of the claim.

It is okay for the VA representative to look from his usual, suspicious, and "If not sure, deny the claim" standpoint. A simple majority rules. Support for the vets claim is passed to the rating board, as if from a higher VA authority, ie, the Secretary. Panel members are sworn to act in accord with the facts, the law, showing no favoritism nor inclination to spare the USA, VA, or military the truth.

In my opinion, the rating board should have no means to deny the claim, but as a disabled vet, losing the meat (Salad days) of my life to claim processing, I cannot speak with detachment on this one point.

Administration: If the vets claim is a: repeatedly denied by VA rating board, BVA, b: Regardless well founded, grounded, and based on fact, and pertinent, THEN the benefit is ordered "Granted" regardless of prior VA decisions to deny IF the task force panel decides so.

Control: This task force will not be permanent, perhaps five years. It will have a sunset clause and a poison pill clause- if the group determines it is creating injustices, it may order itself disassembled panel by panel. The task force should be done catching up the system in five years, and then disbanded. I leave it to you whether any "precedential" aspects are for consideration. Frankly, it seems problematic to me.

The following is a non-SMEAC letter describing the above suggestion, and includes a real-life example of how it would work:

Create a task force whom has sway with the VA rating board. Ask vets to write, in X number words or less, what the VA is missing, overlooking, erring, about, repeatedly, in their disability compensation claims. I suggest a limit of some kind on the evidence also, to help the vet pick and narrow his assertions.

If like me, most vets, over decades of claim processing a single valid issue, want to prove every tiny detail, to corral the VA. This is just unnecessary, and confusing, for vets AND the VA claim system. (This is part of the problem, actually, but another subject)

The objective is to reduce the backlog, and give relief to disabled veterans who have unpopular disabilities, as the law will provide, but the VA is reticent to admit the severity of their error and the injury. Speaking for myself, I dont want to SUE the VA for their grevious errors, I just want the "Someday" to arrive when the sun comes up, and I have finished my VA claim for spinal cord disease and dysfunction. Honestly, the VA claim system ruins mens (and womens) lives, by

twisting people unable to admit weakness into persons having to learn to beg..

Respectfully, sincerely, I HATE WHAT THE VA DOES TO MEN'S SOULS. It's UNSAT.

Example, real, of self:

in 1980, on one page of paper a doctor writes his findings while and after operating, in the military, at Bethesda, he opened my back up, and found extensive scarring (a spinal cord disease called arachnoiditis) even though he errantly operated inches away from the original injury. He wrote: "Appears the wrong level approached" "adhesions" (adhesions is an older term for the more specific "arachnoiditis")

Later, another doctor AGAIN OPERATING IN THE WRONG PLACE sees "Adhesions and scarring" thus supporting this progressive, incurable, spinal cord disease. Seems the VA doesnt like to admit error in order to take advantage of a rare opportunity for the truth to be revealed...

A bit like not wanting to admit a doctor accidently cutting me with a scalpel was how I discovered I was a hemopheliac. (making up an example)

If I have a permanent spinal cord disease in 1980, do I have still have a permanent spinal cord disease during the period in question (1986-1993)?

When the VA FINALLY (after over 15 years of claim processing) in 1996 admitted the issue, granted 100 percent TDIU they want me to hop in a time machine and go back for more evidence- BUT THEY HAVENT ACKNOWLEDGED THE EVIDENCE ALREADY SO CLEAR AND ABSOLUTE! The evidence shows a permanent, progressive, spinal cord disease, and VA specialists detail the cause inservice.. but the ADMIN VA fails to make the connection VA DOCTORS make!

So, I would argue to your task force panel:

"If the VA decided I was unemployable in 1986-1993, does the present day VA agree I was unemployable from 1986-1993?"

(See how deliciously clear this argument is? ) (too bad the VA cannot hear it)

I love my country, but realize now, SOMEONE has to fight the system- employees of VA are NOT suited, positioned, or able, to point out the flaws in the system- WE VETERANS MUST ACT.

I once got a speeding ticket, and the cop says "I don't like this part of the job, it seems wrong to me" and I said "Why dont you try to change it?" and the cop says (sober as all hell) "Thats not my job sir, it is YOUR job".

It is the same here, so I write the Vet Coalition with my remedy. Thanks for being there.

Otherwise, I will consider my job completed, if you write back indicating you read this email.

Sincerely,

Mike

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My idea to try to resolve some of the backlog problem is this:

The vet should do all they can to support their claim with medical evidence, right from the git go. Dont wait for them to send you a letter telling you what you need-

Make sure the VA gets it all.

In a NOD- the vet should focus solely on the reasons for denial and ,on the initial page of the NOD state exactly why they legally deserve the benefit and refer them to any evidence they have not considered ( and attach it again too)and then tell the VA they will continue the appeal until the benefits sought have been granted.

No war stories- get it all on the first page if you can.State it strongly and use terms like "probative, irrefutable", and "overwhelming" to describe your evidence and that it fully outweighs the VA's 'expert' assessment and rests well beyond the Benefit of Doubt and then tell them why- ok you can use two pages- my point is-

they are reading claims and NODs so fast- you have to get their attention right away.

Edit it as many times as you need to- to make it as short as possible.

Sometimes my vet orgs send me claimants-

They write a book in email to describe their claim-

That wont do-I dont like to read long renditions-and the VA doesn't have time to-

On a I-9- send them a statement on Page one of the I-9 that they will not want the board to see.

State that you Preserve on appeals all errors that they could make in regards to M21-1. 38 CFR,38 USC etc

as applied to your claim.Stick that under 9 B.

Type out one or two distinct paragraphs and measure them to fit into the I-9 form under # 10-

where it says "Here is why I think that VA decided my case incorrectly":

I had two issues on appeal-(one wasn't even an appeal issue but I fixed that)

Under # 10 Her is why etc- I put

"The Buffalo VARO, by consistently ignoring my irrefutable, undisputable, and probative medical evidence" (which I described very briefly) has continued to deny a claim that rests well with the Doctrine of Reasonable Doubt as the evidence I have submitted fully outweighs the rationale of the VA examiner in statements with SSOC received here on Dec 23, 2005."

On page two I completely knocked down the VA medical opinion and , since the VA doc said the veteran had never exhibited any "red Flags" to show he had diabetes, I attached as page three 34 Red flags documented in VA med recs, EEOC case, SSA records, and VA personnel files as well as prior SSOCs from 1997.

Page four was again the reminder of my 2 IMOS that they had failed to address and a referral to additional evidence I had sent that- on it's face- even without the IMOs which support the claim, they could still have rendered a proper decision.I ended the appeal stating again what I expect a proper resolve to be.

(The other issue was funny- I was thrilled to take the opportunity in a I-9 to point out their errors in that one-it was not an issue on appeal -it was my SMC CUE claim and I briefly explained that too)-

The VARos are overwhelmed and not paying attention unless you make them pay attention.

My Response to the SSOC was so strong that they had considered it as the appeal and were working on it- but I dont trust them- and sent the formal appeal-

then they started really working on it-I expect a decision soon.

I am not going to sit around waiting for anyone to change the miserable claims backlog-

we have to take action ourselves by sending them brief claims fully supported with solid medical evidence and without any extemporaneous stuff about our anger or our frustrations etc. It does not help the claim and they wont take the time to read it all.

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Guest fla_viking

Dear Fellow Veterans & Friends.

I belive the VA should do away with the SSOC. That is such a waiste of time. The VA can get it wrong the first time and leave it at that. They dont need 2 three swipes to mess with the vets. The vets need to go directly to BVA on appeal if denied. there is so much fraud and abuse at the RO level its not worth it.

This will on an individual baisis help your claims get through.

Terry Higgins

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Guest jstacy

Ladies and Gentlemen, I agree the claims process needs to be streamlined. It can be ran more efficient. On a negative aspect, The system is doing just what the VA wants it to do. The delays are Intentional and have always been that way. The errors are also intentional to cause delay to claims. They are hoping for a full ride all the way to the BVA before they actually react unless the Vet has some real hard hittng evidence.

Someone had to implement the idea, design, and write the book on the system. His guidelines were probally simple. Please come up with the most complicated, complex, and adverse system and we will staff it accordingly with the people that best fit our interest.

Its like shooting a BB gun at a Battleship. Wont even scratch the paint.

Edited by jstacy
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  • HadIt.com Elder

The VA will study it and make a big pronouncement about fixing and things will end up the same. I think in the long run the Medicare Part D Prescription Plan may take a lot of pressure off the VA as Veterans who turn 65 will have access to prescription coverage.

What happened to the Tiger Team?

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Guest fla_viking

Dear Fellow Veterans & friends.

Until veterans relizee the VA is delibertly set up this way and the powers to be will not change it. VA claims processing is not set up to determiine who is eligibel and the laws applied to vets. The VA claims process is set up based upon how much the Feds want to awayd and pay disabled vets. Thats why we go crazy when we try to commuincate cleary the facts and law and the VA gives us alice and wonderland rulings. If they do that, at that level they have already determined your not going to win so you might as well move on.

You look at all the fed comp except SSDI. They are all set up to be the same long term bumbling, denying, corrupt claims processing. This is delibert, so they can control how much they spend

Terry Higgins

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Dear Veterans,

I read everyones reply, Thanks.

It is beyond me to explain why I thought the system could change, except its always been a hope of mine that the system is broken, not designed to deceive. I stand by my belief that nobody cares enough about tax money (your and my money) to limit benefits for that reason.. Instead, it seems appearances are the motive for denial. How often in Your and Your case would admitting your claim is valid means admitting a serious, prior failure by the VA?

Also: think of all the money saved if hundreds of thousands of vets stop having to support their claim by going to doctors, administrators, courts, appeals, for decades? It might be a push, expense wise, to grant benefits. Of course, it also would mean laying off.. at least.. thousands of public employees.

Regards, Kudos, to Berta, I see you are still here helping people. Your points are well taken.

To all vets: I have been many months now without any pain killers, or even motrin, or cigarettes, or anything stronger than Pepsi. I wish to share with you all that thinking is easier, though I still am prone to allowing myself an occasional rant, as you can so intimately see. I feel a bit less depressed- for a change.

I mention my avoidance of mind-affecting chemicals, because it is helpful to understand the VA, how it operates, as well as being able to remember phone numbers, laws, citations, etc. Out of all the troubles (and a few shining exceptions: Excellent VA Personnel!) I have NEVER encountered an instance where pain medications were not immediately granted in large quantities. Its a bit ironic that the main reason I decided to quit them was to get a clear enough mind to deal with the VA claim (now almost 25 years old) but in reality, it seems life feels better, despite a lot of extra pain.

Hats off to Hadit, Berta, and all of you. I am sort of regretful for waxing optimistic, but feel sure you will forgive the delusion and the rant.

Semper Fi,

Mike aka SCIDvet

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Mike- your comments are sure not delusional nor are they rants-

you stated the truth of it all---

I used to dream of how the VA could be fixed-twenty years ago- then I said to myself- it cant get worse, it can only get better-yeah right-THAT was a delusion.

For all of the excellent VA employees there are not enough well trained personnel at these regional offices.

And pressure? I know they are under the gun all the time-

I did some very pro active detective work last year when they sent my husband's c file and med recs to the local VAMC for a C & P exam-

I was hoping I could attend that exam-and called the VA to see when the 'appointment" was - he has been dead for 11 years.

Long story- but I found that the "expert" VA doc who rendered an opinion on my claim told a clerk to call the local VA and get a "few" medical records.

This VA doc even stated in the opinion that she had obtained only a "few" and the complete med history, autopsy, etc-sat here (5 volumes) at the local VA for months-

The VARO clerk told the C & P person that they were under great pressure to get my claim done-

I emailed the VA via the query system and got not one but Two hard copy emails back that confirmed the veteran's c file and medical records sat at the local VAMC for months and were not part of the VA IMO doctors opinion.

I used that documented fact to combat the crappy VA IMO.

My vet rep had prior to this, a conference with the DRO and the VSM as to why my 2,000 buck IMO had not even been considered yet-

This VA fishing expedition for a negative opinion backfired because the VA opinion actually contained more positive evidence then negative-even based on a few records.

I had to highlight how positive some of the statements were, in spite of having just a few records.

It proved to me how lackidaisical they have become in VA med opinions.

Years ago I had a big fight with a VA doctor whose opinion in an SSOC I got was horrible.

Then I found out that he had not been given the veteran's autopsy-his opinion would have been completely different-and he admitted to me that the stress he was under for that opinion was awful-

He recently agreed with my present claim -we had a long talk and he understood why I was so mad that day-when he heard the results of that claim-but felt that since I knocked down two of his VA IMOs, they would not accept another from him-

My long point here is that we deal with real people there at VARos but often never know who they are-

yet they can control our claims.

The system is so broken that maybe it will never get fixed-

I feel that only by being proactive with your claims and fully knocking down lousy medical opinions is the only thing a vet can do to succeed.I fully believe that ,not only in my case, that in other claims situations, the VA docs are under pressrue to say what the VA wants them too- if not the VA will manipulate the medical evidence in the SOC to put it in the best light-for the VA.

And in spite of the fact that the VARO ignored my IMOs last year (I think they have certainly read them since) I still believe that a good IMO is becoming the only way to succeed- in many claims these days.

I dont think that is fair- IMOs can be costly-but they are an investment and can support a valid claim.

Edited by Berta
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  • HadIt.com Elder

I think bringing back a universal draft would improve the VA since more people would be exposed to the system and their would be more votes to improve it. The more people that use a system usually means more accountability. When SSA is involved things happen because it affects so many people and so many have a stake in it. Israel has a universal draft and it has not hurt them only helped them as a nation.

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John, I agree with your draft thoughts. Here are the reasons I don't think they will ever go back to it, unless we are being invaded and are too far strung out in other nations. Today's military is all voluntary, many people who are injured feel that it was one of the things that they signed up for, a risk they were taking to improve their lives, or get money to go to college or back to college.

If you look at all the people that have been serviced by the VA I believe most would be either WWII vets, and now that they are passing away in great numbers, the fact that a lot of Vietnam vets are starting to get into the VA for things like the residuals of Agent Orange exposure. If I were drafted for service, I would think it to be a pretty fair thing to do, but if injured or incapacitated in any way, I would be more apt to file a claim against them, since I was basically forced to go in.

I do believe they know this, and is the reason they are offering such big bonuses to get people in and to get them to reenlist. I love the one trick they are using now, in enticing soldiers to reenlist, they are giving soldiers in theatre the chance to go home advanced party as a reward for reenlisting.

They other thing they advertise heavily on is the ability to get training for a later civilian career. Quite honestly that sounded good but the one thing I wanted to do was work for AFARTS. I had a college degree and some experience but it was the depression of '91-'93 and they told me that I wasn't good enough to be a broadcaster, or any other thing to do with writing or producing. So I signed up for Combat Arms just so I could get the money to go back to school and get a masters degree in something I could find work in.

While the training and discipline were excellent, how many times can I call for fire in the civilian world. Of course the other beauty of it, is that after being exposed to the military, and it's ineptness in many parts, there was no way I was going back to school, and have a bunch of people that never served tell me how I should feel and think just to pass. I already learned that in the Army.

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  • HadIt.com Elder

10thFO

I think it is question of equity. Why should the better educated and more affluent part of our society be exempt from serving in the military? I don't know many students going to Ivy League colleges who drop out to join the Marines in Iraq. Why do the guys from the small towns and lower economic areas have to be the ones who give their lives and limbs to protect America if we are at war as Bush keeps repeating? Bush wants to read your email and listen in to your phone calls but he would not think of asking his girls to go into harm's way and drive a Humvee in Iraq. That is the attitude of the upper and middle class in American also. Let some other mother's son bear the burden and get the "We Regret to Inform" letter. The war I see is the war for many contractors to get rich from Iraq and Afghanistan sellling all their junk to the military. If it is good enough for Israel it is good enough for us. Look to what ends the Israelies are going to get back their service member. They are perpared to kill every top member of Hamas to get their man back safe. Do you think our military would do that?

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Hell no we wouldn't. And I agree, my father was considered rich by our small community standards, but actually he was just above poverty for 15 years til his business came to fruition, and he was from a very poor family and did his time in the Corps. He also taught me that I wasn't going to hang out on the river all summer and catch fish and rays. Once I turned 13 I was toting shingles. I agree that that situation is far and between, especially nowadays where people that are on welfare or just making ends meet give their kids everything they want.

As for Bush and his daughters, honestly do you think Clinton would have let Chelsea drive a Humvee through Mogadishu or Bosnia. Yeah I didn't think so either, but that is the difference in today's politicians and leaders, it's all a big business to them, while we the working class still believe that this is a country of equality. Yeah right.

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When you are in the political arena and didn't grow up in a poor or poverty stricken family, how could you understand what it is like, expecially when you are deciding whether to pass or deny a bill which could benefit those people. Those making these decisions eat the best of food everyday, live in a lavish home, wear the best of clothes and basiclally want for nothing, except more money. They refuse to raise the minimum wage, keep raising the price for medicare or do anything else which would benefit the poor or elderly.

I am sickened when I read in one place that something that would benefit the poor or elderly is not passed, but right beside it is an article where something has been passed which will greatly benefit the rich. Not fair, but never has been.

mssoup1

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  • HadIt.com Elder

I was in College when I was drafted and I also served with quite a few men who either drafted or volunteered for draft in 1968. Unfortunately this Iraq War is being fought by the poor.

By the way the largest Veteran Population is now the Vietnam War and Viet Nam Era Veterans. The WWII Veterans are sadly leaving us very quickly.

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  • HadIt.com Elder

Yes, I read the local obituaries and there are always 3-4 WWII vets who have passed away. In ten years most will be gone. I knew some WWI vets when I was younger. I image 99.9% of those guys are gone. I had a doctor who was a WWII vet and we used to swap war stories. The war had been a positive thing for him. He died a few months ago.

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This why I questioned the vet figures on the data theft info-

It didnt add up right-WWII vets are dying every day and so are men and women in Iraq-

It must account maybe for newly enlisted too?

They also mentioned widows of vets- but I didnt get a letter from the VA on it.

I dont think the VA knows how many vets are out there-

Did these figures just mean vets they account for in the VA system?

What about vets that never enroll in it?

How could they be on the data theft rolls?

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  • HadIt.com Elder

They said spouses of vets as well. My wife did not get a letter. I got a letter. I don't think the VA knows or wants to tell us the extent of the breach. They are doing what they always do which is to cover up and hide facts. Plus they need a fall guy, usually the lowest level guy they can find.

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Guest allanopie

[They said spouses of vets as well.

Those of us with children, have to submit their SSA numbers, & copies of their birth certificates when reporting incomes. If it was set up to cross reference account transactions, wouldn't the files contain this Data as well?

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