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New Civilian Doctor Claim Form

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Carl the Engineer


Just got my VFW magazine. Article on new form that civilian doctors fill out and then the VA will not need to send you to a VA doctor. To speed up the claims process. Hmmmmmm....



Can't see how this could get FUBARed???

“There is no hook my friend. There's only what we do.”  Doc Holiday 

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Page 10

Issues Up Front

Tim Dyhouse

VA Wants to ‘Break the Back of the Backlog’

VA hopes new computer technology, better business practices and greater employee accountability are the keys to reducing its claims backlog.

The goal is simple, yet monumental in its scope: VA wants to eliminate all pending compensation and pension claims by 2015. By then, VA Secretary Eric Shinseki wants all claims processed within 125 days at a 98% accuracy rate.

As of Jan. 22, 2011, VA’s claims backlog, which it defines as cases waiting more than 125 days for a decision, was 324,843, nearly twice as many as a year earlier.Total pending compensation and pensions claims were at 773,673, a 58% increase from the same point in 2010.

If burial and education claims, as well as appeals, are figured in, the total swells to nearly 1.5 million.

The backlog results in average waiting times ranging from 180 days for new claims to be adjudicated up to four years for appeals. In addition, VA’s inspector general notes that the department’s claim decision error rate ranged from 25% to 38% last year.

“Asking a veteran to wait half of a year or more for a rating decision that could have a one-in-three chance or more of being incorrect is absolutely unacceptable,” VFW Commander-in- Chief Richard Eubank said.

Currently, VA accepts about 100,000 new claims per month and anticipates a 60% increase in claims over the next five years. By the end of 2010,VA had received about 200,000 new Agent Orange-related claims after adding three new illnesses to a list of service-connected conditions in March 2010. After VA streamlined the claims process for vets with PTSD last July, it was receiving some 14,000 related claims each month by the end of 2010.

New Technology Being Tested

So,with an even larger backlog looming, how does VA plan to meet its 2015 goal?

At a media roundtable VA hosted in December in Washington, D.C., VA Chief of Staff John Gingrich told attendees that VA will use technology developed by IBM—in use since November to process Agent Orange-related claims— to attack the backlog.

The new technology streamlines and automates the evaluation and rating process. For example, it uses online medical exam forms from private physicians that eliminate the need for veterans to be examined in VA hospitals.

In late January 2011, the new chairwoman of the Senate VA Committee Sen. Patty Murray (D-Wash.) Said her main priority will be to address VA’s claims process.Her goal, she said, is to create an electronic claims-management system to reduce the backlog.

Last year, VA rolled out its “Claims Transformation Plan,” which vows to “break the back of the backlog” while improving the quality and timeliness of its claims decision.

VA states that the plan has “more than three dozen initiatives” addressing three focus areas: creating a culture of accountability and advocacy among its employees, re-engineering its business processes and deploying leading-edge technology.

Jim Wear, assistant director for veterans benefits policy in VFW’s National Veterans Service, says VFW is encouraged by recent VA initiatives to reduce the backlog, such as:

• “Quick Pay,” where complete claims are processed upon receipt.

• “Express Lane,” where less complex claims are given priority processing.

• “Fast Track,” which VA is testing on claims for the three new Agent Orangerelated conditions where processors use an automated paperless system.

VA also plans to roll out its Veterans Benefits Management System—which uses VA’s new computer system to manage the flow of paperwork, electronic forms and correspondence—nationwide in 2012. It was tested at the Baltimore VA regional office in May 2010 and is currently being tested at the Providence, R.I.,VA regional office.

In 2010, VA hired some 3,500 more claims adjudicators—for a total of some 15,000—to fight the backlog. It also shortened application forms for new claims. Moreover, it created new, easierto- process application forms for veterans seeking increased benefits and those who take advantage of the new fully developed claim program.VA says this is “the fastest means to receive a claims decision.”

"Don't give up. Don't ever give up." Jimmy V

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  • HadIt.com Elder

The VA has itself to blame for a lot of this. Seems like it would be mich easier for the VA to follow its mandate and help Veterans with their claims,

By keeping Veterans in the dark and waiting for Veteran to ask it takes a lot more time and a lot more claims.

If VA would grant SMC when they know that its there that would be a big step.

How many here with SMC did not have to ask for it after a claim where the VA later granted it.

Veterans deserve real choice for their health care.

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The VA forms regarding a civilian doctor's report for any vet with a new AO presumptive and civilian medical care for it have certainly helped many AO claims go faster and the need for VA C & P is eliminated unless needed for rating purposes.

For example VA has stated (in the CRA report I believe)they they expect most IHD AO vets will get a 60% IHD SC rating based on METs and/or ECHO.

With the METS and/or ECHO and the new IHD form filled out by their civilian cardio doc, those claims should be easy to award fast.

These forms are short and to the point. They are at the AO forum here.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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  • Content Curator/HadIt.com Elder

Wonder when the form will be available for other conditions...

"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat

Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.


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  • HadIt.com Elder

If you wonder why the VA does not spend more time doing outreach I think it is to save money. Many elderly in nursing homes may be eligible for A&A. I have yet to hear about VA doing aggressive outreach to them or their guardians for such purpose. My elder care lawyer did this form my Aunt. I actually did all the leg work. On my mother they stalled until she died. For my grandmother they said since her husband had served before WWI they did not have records to prove he was a vet. Of course, I think they lied or were too lazy to look.

Every vet in the USA should be called or mailed something to help determine if they are eligible for benefits. As far as SMC, ha,ha I had to file for mine as a CUE. I never would have gotten it.

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