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A Rating Question

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OSC

Question

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

60 Nephropathy w/Hypertension

60 PN Upper Left

40 PN Lower Left

40 PN Lower Right

30 IHD

20 DMII

20 PAD Lower Left

20 PAD Lower Right

10 PN Upper Right

10 Scar L/R Carotid

10 Scar Abdomen

0 Hypertension

0 Surg Rt Ring Finger

100% P&T plus SMC (K-1)

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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.

Star review has been around quite a while now - I don't think it has lessened errors

or appeals.

JMHO

Carlie passed away in November 2015 she is missed.

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No star review does not lesson reviews or appeals, but it is used as a training tool. the reviews tells us how frequently certain ERRORS occur and what needs to happen to prevent them in the future. There is a constant turnover of people at the VA. People quit, retire, get fired, all the time. There are always people to be trained and there are always people who can't do the job and it does take a while to weed them out. It is the way it is, especially when the Government system applies the Peter's principle when promoting emloyees.

The Government is not good at running a Corporation such as a large private corp for profit, you won't get an argument from me on that. But you will get an argument when you say the employees don't care about Veterans. I work in an RO where 6 out of ten employees are themselves Veterans. Many of whom are disabled themselves. They care but they also care about themselves and their families too.

I watched last year as the VA tried to contract out some of the development process to civilian workers. They liked the work and they felt they could deliver the product, but we found out real fast, they could not do the job, and in fact, most of what they did had to be re-done as it did not meet the legal requirements for claims processing.

I know it's not a good system, but the past two years, VA CO has implemeted ideas that VA employees came up with to help the system. One of the biggest was the DBQ for all physicians and the acceptance of private physicians who fill these out to be accepted as though the VA examiner did it. It is a huge plus for Veterans and has helped in the Veterans getting fair exams and quicker processing of claims.

If people here on Hadit have ideas or legitimate suggestions to improve the system I am will to submit any legitimate idea on their behalf. I don't carry any weight but I would be willing to submit ideas to the Director or through the Corporate channels.

There are positve changes taking place and once the backlog is reduced I think you will see things getting better and better.

Appeals is a different subject and I do not know what it will take to break the dam on that backlog.

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My spouse had surgery yesterday, and I am home taking care of the post-op stuff and driving due to medication issues.

I hope you and your spouse are both doing good.

Thanks for the informational posts, from an insiders view.

Carlie passed away in November 2015 she is missed.

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Carlie, Thank you, we are doing well, for today.

I do want to give real information to the Hadit members on how it really works at the VA. We all have ideas on how things should work, but sometimes it's nice to know what is really happening where the claims are actually being processed. There are times when knowing things are messed up is better than wondering if things are messed up. :) IMO

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The Government is not good at running a Corporation such as a large private corp for profit, you won't get an argument from me on that. But you will get an argument when you say the employees don't care about Veterans. I work in an RO where 6 out of ten employees are themselves Veterans. Many of whom are disabled themselves. They care but they also care about themselves and their families too.

Hope your wife is recovering well.

This is no surprise to me. Practically every VA employee I've ever interacted with really wanted to do the best by the veteran. Just like being in Service, seems like the VA has a lot of good people doing their best under the circumstances. There is a lot of agnst out there regarding how fast those good people, like yourself, get to do their best. The whole situation just seems like a mess for everyone. Hang in there and thanks for all you do.

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