Preparation For Notification

[usdart]

Just checked Ebennies and it moved again! Prep for Notification is the next to last step so here we go!

Excited? yes

Nervous? very

Relieved? not yet!

[WhyMista]

I'm wondering that as well.

[Valhalla0321]

Pending Decision Approval.....ugh!!! nail biter.. what could it be , i hope not a big fat 0

[rootbeer22]

usdart:

How long has it taken to get to this point and how many contentions did you file for? I'd just like to get a sense of what is currently happeing with claims now. Right now, there's a big push to get claims done for FY 15 and reduce the backlog whihc is dropping very quickly right now? Frankly, there's been a huge drop over the last 3-4 months in the claims backlog according to the VBA Monday Workload Reports. Overall, it makes me wonder if there are going to be any problems with accuracy or a significant increase in Denials, NODs, Deferements or Appeals as a result? I know if someone wants to get something off of their desk, then there's a lot of ways to do it....including processing claims properly and moving workload to other regional offices to do the claims.

[TiredCoastie]

usdart:

How long has it taken to get to this point and how many contentions did you file for? I'd just like to get a sense of what is currently happeing with claims now. Right now, there's a big push to get claims done for FY 15 and reduce the backlog whihc is dropping very quickly right now? Frankly, there's been a huge drop over the last 3-4 months in the claims backlog according to the VBA Monday Workload Reports. Overall, it makes me wonder if there are going to be any problems with accuracy or a significant increase in Denials, NODs, Deferements or Appeals as a result? I know if someone wants to get something off of their desk, then there's a lot of ways to do it....including processing claims properly and moving workload to other regional offices to do the claims.

Great point, Rootbeer. I've been watching the same thing, particulary over the last six weeks. Two things seem to be happening. Claim numbers seem like they are dropping very fast. Looking at the published average number of days to process a claim by RO, seems like 250 days is one of the longer averages with many claiming much faster average times to a decision. Sure beats the year plus many of us have suffered through. But if you look at the published accuracy numbers in the MMWRs, they aren't that great.

The MMWRs are only part of the story. Here's an example showing that you're right that accuracy is taking a hit as a result of moving too fast. I submitted a NOD then a Form-9 on a couple of decisions. Instead of moving the appeal off to the BVA, a DRO at the RO reversed decisions and granted me seemingly everything I asked for. However, he did it very quickly and used an analogous rating rather than picking the right diagnosis out of 38 CFR part 4 even though I highlighted exactly what my doctor's had said in the Form 9. Then the raters who processed the decision didn't pick up that they owed me 100% for 6 months, probably because of the analogous decision, although they got residuals rating right. My guess is that my contentions had sufficient merit so the fastest thing to do was get me off the books rather than have my easy win be one more claim clogging the appeals system. But because the DRO's decision didn't result in 100% for 6 months, then there's yet another decision that needs to be fixed. It sounds like other vets are having similar experiences.

Like I wrote before - it's like a kid who cleans his room by stashing all his toys in his closet. Sure, it looks great at first glance, but mom better wear a hard hat to open the closet door!

We like to complain that it takes too long to get a decision out of the VA. However, there is a cost to getting a decision too quickly. At some point, I'd like the "right" decision.

Edited April 10, 2015 by TiredCoastie

[rootbeer22]

TiredCoastie:

Agreed, I think we share the same analysis and interestingly, the pressure is going to build right up to the end of the FY15 to ensure the claims the backlog numbers are where leadership wants them to be. Overall, the stats for RO accuracy have been in a steady uptrend but the newer numbers could be different now? OIG results sometimes show a different picture but they look at a wider area as they inspect. Currently, I know that my claim is in a critical stage and although I would like it done expeditiously, I don't want to spend years in NOD, deferals or appeals to rush it? Overall, electronic processing and VBMS should be at the point where Raters are now starting to become more proficient which may be making an impact now? Frankly, there was a great deal of money spent on the VBMS (about 700 million so far) so I'm sure leadership wants to/needs to see the dividends of using such a system by the end of FY15? I think we are at the point where congress is going to press the issue more this year on the backlog because of previous promises made and money allocated by leadership? Also, if you go back and look at media articles on the backlog, OIG Investiagtions and statements by senior leadership, 2015 is when the backlog was supposed to be reduced significantly and that is what appears to be happening now? As I said before, my primary personal concern is that I have a lot of handwritten SMRs in my claim and at least for me, it's a major part of my evidence. I just hope in the "rush" to get the backlog down that it is not overlooked with my claim? Anyway, based upon what is going on now with this "push", my claim is going to be decided much quicker than the 15 then later 37 months that was projected last December? It's one thing to have a contention defered but another to be denided because of the push to "getter done" faster? What I don't know is it more work for a rater to approve, defer or deny a claim? I asked that question because, I used to manage and approve overtime for large numbers of people on big maintenance projects where folks were under great time-pressure. Anyway, at some point and depending upon the timelines and conditions, mental mistakes start happening which affect the quality of the work. The second issue that the workforce gets tired and mentally fatigued and morale suffers a bit. Then on the the 3rd Stage, I call it the "path of least resistance". That's were they employees still try to meet the minimum acceptable standards but start using or finding the easiest method to reroute or move the work to the next person or stage in the process? I think that that path of "least resistance" will show up when claims are going into the final review over the next few months. But for instance, if approvals, deferals, or denials are the easiest to do, then that's going to be the "bill payer" of the push and what we will see more of? But whatever, it turns out to be, "No One" will want to slow down the "progress" of getting the backlog down for FY15? My hope is that we see claims being approved and not defered or denied in this period? In contrast, if it's easier to deny or defer claims to improve the stats, then my fear is that that will happen? The VBA acutally has process improvement and crossfunctional teams that are designed to catch this sort of trend. It will be very interesting to see if there is a significant up-tick in NODs and/or Appeals that directly coorelates with the improved claims backlog numbers? Anyway, at some time in the Fall there's probably going to be a big press conference to announce that the FY 15 Claims Backlog Goals were/are being met? However, I believe if the NODs and Appeals show a sharp rise during the same time period that Congress and the media may jump all over it? That said, my sincere hope is the backlog drops dramatically and that there's no statistical increase in NOD's, Deferals and Appeals, then everyone who is invovled with processing disability claims will be "heroes" and vets will get their just due? From what I've been able to find in the research for my article is that the average employee involved with the rating process is hardworking and very dedicated. But like all employees, they have to be given the proper resources, time and conditons to do their job right - the first time. Either way, the stats are starting to become more clear now and the trend should become self-evident by at least mid-summer or so.

[TiredCoastie]

I think you're dead on with your concerns, Rootbeer. Personally, I think there is political pressure to approve more claims now than before. Otherwise, why would the RO pull my appeal back from the brink and grant me on both contentions? But that's just my gut and not based on anything solid. And you're looking for the right answer with your claim decisions, and I have seen that yet after five years.

It didn't look like they would make the FY15 deadline of "elminating" the so-called backlog and, without more claims cleared faster, it still doesn't look to me like they'll make the September 30th deadline. But they turned up the tempo right after Christmas so it seems and started really driving things down. Quick check looks like there are between 32 and 38 weeks remaining depending on when you think they pushed the throttles forward, and there are 25 1/2 weeks until the end of the FY. VBA needs to reduce the overdue stacks by an average of about 7,393 per week to make it from last Monday's report. They've made the overall number of claims on hand and overdue about the same as they were when Nehmer hit, so the VA will have enough of an impact to declare victory and back off the overtime $$$ burn even if they don't make it to zero overdue claims.

All I can tell you is that not one of my claim decisions that have been made, starting in 2011, have been 100% right. The only thing that was right was a CUE that the RO called on itself when presented with an effective date blunder. So if you do as well as me, your effort to get it right will continue for quite a while, no matter how fast or careful the RO is when your decision is made.

They say all change in government is incremental. Guess you could also say that about getting our disabilties rated correctly...incremental improvements heading toward the right answer.