Va Press Release On Claims Today

[Berta]

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Office of Public and Intergovernmental Affairs

VA to Expedite Claims Decisions for Veterans Who Have Waited a Year or More

April 19, 2013

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WASHINGTON – The Department of Veterans Affairs announced today it is implementing an initiative to expedite compensation claims decisions for Veterans who have waited one year or longer. Effective today, VA claims raters will make provisional decisions on the oldest claims in inventory, which will allow Veterans to begin collecting compensation benefits more quickly, if eligible. Veterans will be able to submit additional evidence for consideration a full year after the provisional rating, before VA issues a final decision.

“Too many Veterans wait too long for a decision, and this has never been acceptable,” said VA Secretary Eric Shinseki. “That is why we are implementing an aggressive plan to eliminate the backlog in 2015. This initiative is the right thing to do now for Veterans who have waited the longest.”

Provisional decisions will be based on all evidence provided to date by the Veteran or obtained on their behalf by VA. If a VA medical examination is needed to decide the claim, it will be ordered and expedited.

“Issuing provisional decisions not only provides Veterans with applicable benefits much more quickly, but also gives them an additional one-year safety net to submit further evidence should it become available. Our door will remain open and if a Veteran has additional evidence, their case will be fast tracked,” said Allison Hickey, Undersecretary for Benefits.

If any increase is determined to be warranted based on the additional evidence received, benefits will be retroactive to the date the claim was initially filed. The initiative protects the Veteran’s right to appeal the decision. If no further evidence is received within that year, VBA will inform the Veteran that their rating is final and provide information on the standard appeals process, which can be found at http://www.bva.va.gov/

Throughout this initiative, VA will continue to prioritize claims for homeless Veterans and those claiming financial hardship, the terminally ill, former Prisoners of War, Medal of Honor recipients, and Veterans filing Fully Developed Claims. More information about filing Fully Developed Claims is available at: http://www.benefits.va.gov/transformation/fastclaims/

Claims for Wounded Warriors separating from the military for medical reasons will continue to be handled separately and on a priority basis with the Department of Defense through the Integrated Disability Evaluation System (IDES). Wounded Warriors separating through IDES currently receive VA compensation benefits in an average of 61 days following their separation from service.

As a result of this initiative, metrics used to track benefits claims will experience significant fluctuations. The focus on processing the oldest claims will cause the overall measure of the average length of time to complete a claim - currently 286 days - to skew, rising significantly in the near term because of the number of old claims that will be completed. Over time, as the backlog of oldest claims is cleared and more of the incoming claims are processed electronically through VA’s new paperless processing system, VA’s average time to complete claims will significantly improve. In addition, the average days pending metric - or the average age of a claim in the inventory - will decrease, since the oldest claims will no longer be part of the inventory.

While compensation claims are pending, eligible Veterans are able to receive healthcare and other benefits from VA. Veterans who have served in recent conflicts are eligible for 5 years of free healthcare from VA. Currently, over 55% of returning Iraq and Afghanistan Veterans are using VA health care, a rate of utilization greater than previous generations of Veterans.

Veterans can learn more about disability benefits on the joint Department of Defense—VA web portal eBenefits at: https://www.ebenefits.va.gov/ebenefits-portal/ebenefits.portal.

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[JT24usn]

Any people this effects. Watch for lowball and prepare for increase if granted. Picture a little Dutch boy with his finger in a leaking levee. Just a little patch for bigger problem. Good heads up Berta.

Explains all the extra files landing here.

Edited April 19, 2013 by T8r

[71M10]

Sure sounds like the "provisional approval" based on evidence received to date....if a VA examination is needed it will be scheduled and expedited, is going to double the work load. To save time we are going to work these cases twice! Wouldn't a better solution be to actually reveiw and decide claims in a non-adversarial-paternalistic environment and give the veteran the benefit of the doubt?

If management wrote up employees that requested unnecessary C&P exams!

How about following the CFR and rules in M21-1MR. Example, when M21-1MR states long standing hypertension will cause cardiovascular disease - award the cardiomegaly claim without issuing a denial only to grant it on a DRO review with no new evidence.

I could go on and on.

At least they are trying something different, but I don't see how they are going to save time by working things twice.

Edited April 19, 2013 by 71M10

[JT24usn]

Sure sounds like the "provisional approval" based on evidence received to date....if a VA examination is needed it will be scheduled and expedited, is going to double the work load. To save time we are going to work these cases twice! Wouldn't a better solution be to actually reveiw and decide claims in a non-adversarial-paternalistic environment and give the veteran the benefit of the doubt?

If management wrote up employees that requested unnecessary C&P exams!

How about following the CFR and rules in M21-1MR. Example, when M21-1MR states long standing hypertension will cause cardiovascular disease - award the cardiomegaly claim without issuing a denial only to grant it on a DRO review with no new evidence.

I could go on and on.

At least they are trying something different, but I don't see how they are going to save time by working things twice.

Save time no, but get rid of old claims in backlog yes. Meaning provisional will end claim and when claim comes in for reconsideration new claim date. Flop side is with provisional if granted on reconsideration effective date should go back to original claim. Jmho

[Chuck75]

Another idea that sounds good in the media. I cannot help but wonder how this can work, since other cases get higher priority.

Perhaps the VA intends to work the older cases and hope that they can deny, and get them "off the books"

[rdawg]

immediate denial of all pending claims.

[broncovet]

Berta

Thanks for posting this.

The VA has cried, "Wolf" one too many times, and this is still another. First, Shinseki was to eliminate the backlog by 2010, and now, that has been pushed back to 2015. I have no idea why it took 5 years for Shinseki to figure out the oldest claims deserve to be handled before the newer ones. It seems like a second grader should be able to figure that one out in 20 minutes.

I am not holding my breath for this to work anytime soon. For example, I have a dependents claim started in Oct. 2011...and I am not expecting that claim over a year old to be done any time soon.