A Rating Question

[OSC]

After seeing this report, http://www.va.gov/oig/pubs/VAOIG-12-00244-241a.pdf and the horrors within, a question came to mind.

When a file finally reaches the Rating or Decision section, do the raters pick and chose which file they are going to work on or do they just take the next one, no matter how big or what the contentions might be?

OSC

[Philip Rogers]

I believe Harleyman can answer this better. I believe they basically need to follow the order but can do the easier ones first in the daily's schedule. Remember they get paid on product completed, not product completed properly. I believe that often thick files are rubber stamped, rather than really thoroughly read, using the assumption that the previous rater did it properly, thereby sending it to appeal hell and guarantying themselves more work. jmo

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[harleyman]

Posted Yesterday, 11:54 PM

After seeing this report, http://www.va.gov/oig/pubs/VAOIG-12-00244-241a.pdf and the horrors within, a question came to mind.

When a finally reaches the Rating or Decision section, do the raters pick and chose which file they are going to work on or do they just take the next one, no matter how big or what the contentions might be?

Some teams put all pending rating decision on a shelf and they are worked by DOC next oldest.

Some teams assign work to be complleted by "digit" assigment. For example, an RVSR will work all claims ready to rate ending in the digits 76 through 80. In this case the RVSR would decide which claim is worked next. (Be assured the work load management programs monitor if there is a claim that is being avoided.

Some teams have the coach assign the work and you come in everyday and your work is at /on your desk.

The Coach is reponsible to make sure the "stats" look good, As the management analyist reports to the VSCM and the Director if something or a team is failing to work older claims etc. Everyone like to have a variety of work during the month. We all like "quick easy" and we also like complex claims as the points assigned for credit for RVSR/VSR production standards are based on the number of issues in a claim, but also based on the issues correctly processed. A claim with 2 issues and you miss one means your are only 50% correct on that deicision. A claim if 4 issues and you miss one means you are 75% correct. The Corporate standards goal right now is 98% accuracy.

Lane assigments also make a difference on how fast a claim is processed. Lane assigments are based on type of claim and number of issues claimed. Obviously, less issues usually faster completion. More complex cases are handled by the Core team, two issues or less and FDC claims are handled by the Express teams. DMII, IU are handled by core due to the complexity by nature of the claim. Special Ops handles, homeless, FDC, MST,POW, Fast Track (phasing this program out). Non-rating EP team handles all non-rating issues that do not require and award, (there are some exceptions to this).

Hardship claims are handed by the team where the claimed issues would place it, however, these claims are hand carried to the next step in processing so the file doesn't get sent back to files by accident. Congressional are also handled based on the type of claim and how many issues. There is no special handling of the claim, other than the file is pulled and the Congressperson is sent an acknowlegement letter once the file is reviewed. The then file is sent back to the team for the standard processing, unless the review showed the claim should have been processed as a priority claim or something. Otherwise it is SOP as anyother claim.

There are what we within the VA call "HOT" claims, (not an official term). These are claims where the Secretary of VA or an assistant at Corporate or Area Offices, or the RO Director, or VSC Managers, has a direct interest in having the claim processed quickly and efficiently. These files are hand carried by the Coach to another Coach and tracked daily. These types of files do happen from time to time. It is usually a file where the Veteran's condition is termial or there are extreme family problems or they are trying to get the file to BVA quickly, things of that nature.

I would be more than happy to explain "lanes assigments" in more detail if people are interested. -

Edited August 15, 2013 by harleyman

[harleyman]

Phillip said: Remember they on product completed, not product completed properly. I believe that often thick files are rubber stamped, rather than really thoroughly read, using the assumption that the previous rater did it properly, thereby sending it to appeal hell and guarantying themselves more work. jmo

I wish this was so. It certainly would make things better. The VSRs and RVSRs are held accountable for thier work both for production and for quality. We have a Quality Review team that pulls random files throughout the month and they review the work for each claims assistant, VSR, RVSR, DRO. SO not only are they looking at the end result the rating and the awards they are also looking at did the claims asst set this claim up properly, did all issues get addressed, did the VSR get all the information in the file, did they request to much information, did the rater rate everything and was it correctly rated, did the VSR process the award correctly and was notification correct. We have the QR team always looking over our shoulder on any claim we touch and at anytime. We also have reveiws called "star" reviews conducted at the RO by the Corporate Office team reviewing the work of the RO in processing claims.

[TiredCoastie]

Thanks, Harleyman. I'm interested in learning more about lane assignments and would imagine others are as well.

Thanks, too, for taking the time to explain your world of work that impacts so many.

[harleyman]

Your welcome- I will work on a post for you about the Lane assignments etc. But, I wanted to say, you all can see I am here during the daytime posting once in a while. I got to thinking, it might "look" like I am posting on this forum when I should be working claims. I want to let you know that is farthest from what is happening, and I do not post when I am at work. I always post on my private time/ leave time.

My spouse had surgery yesterday, and I am home taking care of the post-op stuff and driving due to medication issues. I have some time during the day to "play" on the computer so I've been visiting Hadit. Just for those who were wondering "what the heck is Harleyman doing on the cumputer".

[OSC]

Thanks harleyman for the quick and very detailed response and NO I did not feel that you were playing on your computer during government work time.

Hope for a quick recovery for your wife.

Thanks again.

OSC