Complex Va Rules Delay Claims?

[Loose Cannon]

This is an interesting article. This happened to me and it delayed my claim about a month. Overall, I think this is "minor" when you think about all the other delay tactics and other reasons why VA claims take so long...Check it out:

http://www.airforcetimes.com/news/2011/11/military-complex-va-rules-may-delay-claims-111611w/

LC

[carlie]

I do understand that the conditions must be related to active duty and I have no problem with this.

ALL THE DOC's have to do is put whether at least a portion of the condition, is as likely as not . . .

[Veldrina]

while yes, VA is retarded when it comes to ll the red tape & the way things must be worded thanks to the courts, i must pipe in here. I am sick & tired of having exams sent out for one thing or another & the doctors ignoring & even canceling some exams, not using the template, not giving X-rays or Deluca or Range of Motion, GAF scores, etc., not giving an opinion after we expressly asked for one, etc. And the worst part is, we can't hold them accountable! VA benefits dept,. has no authority over VA hospitals...all we can do is bombard them with email requests or the "insufficient Exam" request...which supposedly counts against them but I have yet to see them quail in fear of our threats to do so. So claims get delayed every day because of their carelessness or unwillingness to comply. And I say this because they are GIVEN the templates to follow, especially now where we've come up with something called a DBQ (disability benefits questionairre) where all they have to do is check things off....and they STILL don't do it completely! I can't tell you how many times it happens. Just don't think they're all innocent in this.

[Pete53]

Good point about C&P exam I was surprised that my C&P exam looked only at me the day I saw the Doc and ignored what the RO said that she wanted.

To overcome this problem I hired my own Doc and got an IMO. Its my opinion that unless you were diagnosed during your service you are going to need an IMO.

[Loose Cannon]

while yes, VA is retarded when it comes to ll the red tape & the way things must be worded thanks to the courts, i must pipe in here. I am sick & tired of having exams sent out for one thing or another & the doctors ignoring & even canceling some exams, not using the template, not giving X-rays or Deluca or Range of Motion, GAF scores, etc., not giving an opinion after we expressly asked for one, etc. And the worst part is, we can't hold them accountable! VA benefits dept,. has no authority over VA hospitals...all we can do is bombard them with email requests or the "insufficient Exam" request...which supposedly counts against them but I have yet to see them quail in fear of our threats to do so. So claims get delayed every day because of their carelessness or unwillingness to comply. And I say this because they are GIVEN the templates to follow, especially now where we've come up with something called a DBQ (disability benefits questionairre) where all they have to do is check things off....and they STILL don't do it completely! I can't tell you how many times it happens. Just don't think they're all innocent in this.

Interesting stuff...Here's what I would do to solve THAT problem if I were "king for a day":

All contracted providers (let's use QTC as an example) MUST comply with ALL elements/details of a C&P exam as requested by the VA before they get paid a nickle. They're habit of spitting out half-ass reports with missing information will continue unless someone holds them accountable. Hit 'em in their pocketbook and maybe things will improve. If not, fire them and find another contractor to do the exams properly. In our current system, it's the veterans who suffer. I could go on forever on this subject but I'm sure everyone out there has their own story and can relate... Life goes on so I won't be holding my breath for changes any time soon. Again, JMHO.

LC

[Notorious Kelly]

Great to see your 2 cents worth, Veldrina!

Raters can't work with incomplete information.

I'm guessing the government rates/regulations don't attract the Best & Brightest in the medical field so that could add to the problem.

[Berta]

I would reword the title of this topic to "Complex Claims delay VA Rules."

Veldrina-it is always great to have your take on claims issues!

And I sure agree with what you said here,as a claimant who had to fight over poor Posthumous incomplete or medically inaccurate C & P exam results.

Then again some claims are so complex maybe it is difficult for VA to even determine what types of C & P exams are appropriate.

I have said here over the years to tell the VA stuff like they are ten years old.

What I mean sounds sarcastic but I found that a claim has to be worded and spelled out carefully from the git go and even evidence submitted needs a 21-4138 or cover letter showing why the evidence is probative to the claim.

Many of us get so caught up in our claims that we forget we need to simplify much of what we submit.

No sense in long personal renditions or extemporaneous stuff - trying to keep it simple and as focused as possible sure can help.

I should talk Veldrina-I certainly have added lots of paper to the VA stack over the years for my claims. Ha Ha.

Still it was all probative in some way to my claims.I had what my former reps always considered as complex issues but the awards always matched what the original issue was for and I maintained my focus throughout those ordeals trying to simplify the issues as much as I could.

Documented medical evidence is EVERYTHING so that always was my main focus.