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MikeS

Virtual Va

Question

Hi all:

My current claim status on e-benefits shows: "Outpatient treatment records from VAMC added to Virtual VA".

What does that mean?

Also, my claim status shows that the VARO request for a C&P was made on 12/1/2011 and received on 12/15/2011. I never had a C&P although I received a letter from the VARO advising me that a request had been made from them on 12/1/2011. And, I was never scheduled for one either.

What happened to my C&P?

My claim status is: Preparation for Decision.

Any thoughts?

Thanks,

Mike S.

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Outpatient in virtual Va is just gathering of evidence. Nothing to worry about just a new Va policy. As for the exam it might have been a doctors opinion needed without the veteran. Was a previous exam ordered? It might have been insufficient or conflicting evidence or not enough information. This means they got all your information from you and just need doctors input

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Hello Mike S.

I was once a Veterans Service Representative (or VSR) once upon a time, but I left the VA because... well.....let's just say management has no idea how to treat their employees. I've often thought that it is as bad working for the VA as it is trying to file a claim with the organization. But I still have friends that work there and they keep me up to date on the new things happening (or supposedly going to happen in the future). Anyway....on to your question/comment.

E-benefits just recently updated their system. Now you have something like 8 steps in the claims development cycle, where as under the old e-benefits system, you only had 4. When you (the veteran/claimant) tell VA that you received treatment at a VA Hospital or Outpatient Clinic, by law, VA has to obtain those records, or keep trying until they get a negative response (such as they were somehow lost or are unavailable). A few years ago, we (VSRs) had to actually print out all records from the VA treatment center(s) noting your condition(s). That sounds easy for one or two conditions with a few years of treatment. However, we have a lot veterans who use nothing but the VA for their healthcare needs and would have 20 or more conditions treated at VA and claimed for VA compensation claims. As you can imagine, that creates a lot of paperwork. Some days, I would sit and do nothing else but print medical records from our electronic system.

Now the VA is trying to move into the paperless era, even though the organization really isn't prepared to do so. So what they have to do now is copy your treatment records from one electronic system and paste it into a document into another electronic system (i.e. Virtual VA). I think that sometime in the future, Virtual VA will be the virtual claim for all veterans as you can electronically store service records, DD214s, Rating Decisions, and treatment records all on one database, but don't take my word on that just yet. It's is still in the beta process.

As for your C&P exam situation, that depends. I agree with T8r that a medical opinion may have been needed, but it also could have been something scheduled in error. If you recently had a VA exam (within the past few months), the VSR may have forgotten to send the c-file, or the exam itself may have been inadequate to make a rating decision off of. VA doctors get paid for C&P exams whether they're right or wrong, however, they get paid on a hourly basis. If they are only paid for two hours to give you a VA Exam and your exam starts to go over, they don't get paid for that extra time,which is why sometimes they will rush the exam to finish on time. Also, they don't get paid when veterans fail to show up to a scheduled C&P appointment, which is why they ask that you please be on time. I wouldn't worry about it though. VA will notify you if you need to make it to another exam.

The benefit to your claim status being in the stage of "Preparation for Decision" is that it should be in a Rater's hands relatively soon, as I have heard word that all VA Regional Offices are scrabbling to find claims to make a decision on and meet monthly quotas. The bad news is that you are just stuck waiting because it is unknown how long that will exactly take. It may take less than 5 days or it may take more than 30. E-benefits will not provide you with this information because the system doesn't know. It can give you a national average waiting time, but that may not be the average for your particular state's Regional Office. My advice to you would be that if it takes over 30 days and your claim hasn't moved to the next phase of "Pending Decision Approval", try and contact your Power of Attorney (POA) to find out why your state's Regional Office has not made a decision yet, and if that doesn't work, use an IRIS inquiry at www.iris.va.gov and click on the link "Ask a Question" and submit you question concerning your claim status there. You are supposed to receive an answer from the VA within 5 business days of submitting an IRIS request and best of all, it's in writing. It may even help to move your case into a rater's hands the day VA receives your inquiry. When your claim moves to the "Preparation for Notification" phase, that will even better news to you because the VA has made a decision on your claim and is getting ready to mail it to you. It should only take 3.5 days to get the decision from a rater to a VSR to type of the notification letter and mail the decision to you because if it takes longer, then the station can be written up for holding on to your decision to long. Hope this helps...

WorkAHolic

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WorkAHolic:

Thanks for giving me a better idea about how e-benefits works.

The C&P that was supposed to be scheduled, then cancelled, was for housebound benefits.

The problem is that I was denied housebound benefits last year. Then, the C&P was with a nurse who complained to me that the VA C&P for housebound for veterans with 100% PTSD was inadequate because 99% of the exam focuses on aid and assistance for our brothers and sisters who "physically" are restricted to their homes.

I had asked the VARO to reconsider their decision due to an error on the part of a VA doc who put into the record that he had made an error.

If I don't receive a decision by this March, I will have to file an NOD because March is when my year to appeal runs out.

In my humble opinion, veterans with 100% T&P PTSD who file a claim for housebound benefits should be evaluated in a different way than those hurt brothers and sisters whose limitations are more physical than emotional/mental.

Your input is greatly appreciated.

Mike S.

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I do not have ebenefits to search status of my claim. I am online with Fast Track. They tell me that updates on it are posted by the RO handling my case which is Portland, OR. 2/28/2012 my case finally moved from Decision to Notification Phase. Needless to say, I was excited assuming that a decision had been made. (It is a presumptive IHD case under AO) I called the 800 to verify that I had reason for this excitement last week. They told me that a letter was generated and I should be receiving it in approximately 5 days from the 2/28 date. When no letter arrived (no money in the bank) I took another stab at this and called the 800 number. This time I was told that this is NOT the case. He tells me to expect a minimum of 70 days (depending on workload and priority cases) to hear anything. He also said that he could NOT see where a letter has been generated. Popped my excitement "high!"

But, I noticed in your posting that once the case goes to notification they are under time constraints to process this letter. Maybe I am reading wishful thinking into your posting and that is likely. Are there steps in the Notification process that I do not understand? My claim for IHD is my main claim and I thought that was all I was claiming but I believe that because I have had a bypass, heart attack and other related conditions that there are additional claims on this main claim of IHD. Fast Track also has a 800 number, they tell me that they are done with their portion, it has been forwarded to Portland for review and decision. I watched it (on the Fast Track site) move from the Development Phase to Decision and then finally to the Notification Phase.

My personal frustration with the 800 number is all the conflicting information I have received. The lines can often be too busy to get through and that is not a concern, I can understand the demand. But, when one operator tells you one thing and another one disputes it, it is frustrating to say the least! I have sent an inquiry through IRIS, I have had better response through them. Hoping they will clear up this last piece of confusion for me.

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The VA says that they have time constraints but I have not seen any evidence that supports that they follow them.

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