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Va Timeline Policy....


veteran7796

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Good Morning,

I recently had the pleasure of speaking to a long term (13 year employee) VA rater on a personal level who is outside of my RO in another state. The rater seemed to be appalled at how my RO in Waco has handled both my claim and many other claims in this region.

The rater informed me it is written verbatim in VA policy that once a rating decision has been made and granted, the VA has exactly 5 working days to "promulgate" the claim, finalize it and pay the veteran.

Has anyone else heard this?

I ask because both my VSO and this rater looked at my info and said my claim is already rated, it just needs to finalize. The thing is, they rated my claim and granted it over a month ago...and it's just sitting there. The rater said it could be done "today" if they wanted and there is no excuse after a decision has been made and approved for it to sit for another month...let alone another week.

However, my VSO who works at the RO in Waco just told me although my claim is rated, I should expect another 60 days before they can process it.

I told the rater what my VSO said and the rater said that was absolutely absurd and that the VSO should have already reviewed it in (VBMS?), sent it back and have it processed right away. No excuse.

Any thoughts?

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  • Content Curator/HadIt.com Elder

I can tell you that after my last claim was approved, postprocessing was so fast that it would make your head spin.

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there is a backlog that Sec. SHinseki had been fighting & now the new guy AND Allison Hickey are battling. Claims are "supposed" to have a turnaround time of a business week but it doesnt always happen. VSOs may not have gotten the hang of reviewing things in VBMS but that's no reason for a hang-up...at least in NY our instructions were they get a week to review & if not, onwards.

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Exactly where does your claim stand within the VARO? Has the decision been signed as approved by however many decision makers are required to sign it? If a rating decision has been crafted but not finally approved, that might be your hold up. Sounds like it's stuck in someone's inbox waiting for approval from what you've been told.

Don't be too surprised if your claim's decision bouncing back and forth several times between the rater and whatever approving official(s) is/are involved before they come to a final conclusion and decision.

If the claim has been approved, signed, and is waiting for distribution, that can occassionally take a while. Sometimes it's really fast. My last couple of claims, though, required some amount of time to make it's way through the mailing system inside the VARO -- Christmas holidays really slowed things down -- or somehow just plain hung up -- an IRIS inquiry email freed up the large white envelope with a later date stamp on the letter than eBenefits showed the claim closed. But if your VSO says 60 days until a formal decision, then it's probably not stuck in the mail room waiting for Labor Day to pass.

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Veteran7796:

The good news is that either way, you are getting closer which is good. I wish you all the best of luck and hope that you get eveything that you deserve soon. Frankly, I'm not a very patient person myself and the whole disability application process requires a lot of patience so I'm learning to adjust. I'd like to hear more directly from rating officials like you have to learn what they are going thru as well and what their challenges are to finish our applications and ratings. I'm sure that they are very good folks working hard to take care of us but with a tremendous workload? I did hear that VBA is working to make it a smoother transition from the rating to actual payment so at least they are trying. I try to think about the other side of the equation and it can't be easy for them as well? But, very soon, you are probably going to see a singificant sum in your bank account and you'll be able to celebrate..good luck..

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According to my VSO and the rater I spoke to, the database shows the increase from 0-10% and the effective date back to 5-31-2011 is already "rated" and "granted" as they put it. The rater seems to think my VSO is the one not doing their job in getting it pushed through. I have to agree considering that the rater I spoke to is under the firm impression that if my claim were at thier RO, based on what they see in the database, it could and would be completed by the end of the day. I guess it is waiting on a single signature to get it all done since it was a CUE. But, again, from what the rater told me, it could be done today.

So, Im perplexed. All in all, it just upsets me more that they deliberately put it into a false status on e-bennies to justify putting it off. Why am I in Prep For Decision when a decision has already been made a month ago? I mean the claim made it all the way to Prep for Notification then got pushed back to ROE and now is Prep for Decision. Based on the raters mindset I should be in Prep for Notification...if not COMPLETE.

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rootbeer22,

I get what you are saying and I understand the red tape that has to be sifted through. However, this is a claim for an increase on a single contention I KNEW they messed up on. My initial claim fell into the group last year where they tried to eradicate the backlog. It took them well over 2 years to do my initial claim!! In the process, they made a lot of mistakes. All said and done, because I had to pay back my separation pay, I didnt start receiving a check until last month...LOL!! So, IF the VA hadnt made the CUE, I would have actually started getting paid $683.00 a month over a year ago which really would have helped my financial situation.

The other things to consider are that this increase was a Fully Developed Claim AND a financial hardship AND it was a CUE made by the VA. In addition, they left me with no ammunition to start an appeal because they STILL have never responded to my FOIA/Privacy Act Request from a year ago which would have helped me in my appeal process. Instead, my FOIA Request still sits in CLAIM RECEIVED well over a year past my 1 year appeal deadline.

It's just frustration that they screwed it up bad from day one and when I tried to appeal, they left me in the dark and now drag their feet on the increase too.

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Im also hoping that I get lucky like others have and a deposit just shows up in my account before e-bennies gets updated or the BBE shows up in the mail. However, from my experience with Waco, my e-bennies updates have been dead on. I knew my claim was completed and what my % was in E-benefits before the BBE showed up in the mail.

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Hey 7796, it seems like what I thought was correct. There is a rating decision drafted but it has not yet been approved for whatever reason. I'm surprised that anyone would tell you what the draft decision says because it could change either way. Some VAROs are faster than others. At our local one that services our geographic area, the situation can be much like what you're experiencing. For my last claim, they farmed it out to a different RO to get the decision through. eBenefits showed that it went out there on a Monday and was finalized before Friday...after several drafts of a decision based on the status changing sometimes multiple times a day. The rater you spoke with may have been from a VARO more like the one that finalized my last decision (of course, there is a NOD in on that one but I can't argue with the speed at which a decision was produced!).

Could your VSO push it through? Sure, they could try to turn up the heat. They aren't likely to do that on your behalf, though, IMHO. There are only so many "silver bullets" in their six-shooter and those only get used on very special occasions. At best, they'll send an email to a rating supervisor and express the need to move it through - or will tell you they did and who knows if that's really true. I'm not saying that your situation isn't important or even desperate...but that the VSO isn't necessarily one to rock the boat. They have to work with those same people day after day - and going to war over one vet might, in their view, damage their ability to advocate for every vet. Unfortunately, that means that many or most VSOs don't advocate very well.

Take a look at the Monday Morning Workload Reports sometime:

http://benefits.va.gov/REPORTS/detailed_claims_data.asp

These statistical workload reports show (supposedly) how many claims each RO has at the end of the past week/first thing Monday morning. Some have fewer and seem to move claims faster (that's faster relative to others...not necessarily what any of us would call "fast") based on the percentage that are "overdue" as well as the new pages that have the average processing time for each RO. Some are overwhelmed and move at glacial speed.

All I'm trying to do here is explain a probable "why" you haven't seen a claim decision yet. I can only imagine how I would have been 3 1/2 years ago desperately waiting for my initial claim to process - so I could feed my family - if someone from a different RO would have told me that at their RO, I'd be done already. You're doing an awesome job keeping your cool.

Now if you are in severe financial difficulty - defined by very specific criteria - your claim ought to be able to be moved now. If they're blowing that off, IMO, you need to get after your VSO. If your VSO can't or won't fix it, fire them and get another...or do it yourself.

God bless and hang in there!

Edited by TiredCoastie (see edit history)
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Veteran7796:

I agree that it is taking way too long...espcially for a single contention? I know that the VBA is using more fast track "lanes' now to expedite the smaller and simpler claims. Theorectically, your VSO is supposed to help "unscrew" this type of issue but I've learned from my own experince that all VSO's are not created equally in terms of skills. I'd probably do another IRIS Inquiry to at least show that you your pushing the issue up...even if it's uphill. I lack much patience myself but I know the average VBA worker is doing a very good job and this is one where some intevention from higher ups should occur? So, this seems to be something that needs to be risen to the rating supervisory level. My gut feeling that if it got to the right level, it would be resolved fairly quickly. Also, I was a Federal FOIA Officer for many years and your FOIA is required to be answered with 20 business unless there are very rare and special circumstances? You should have received a letter from the FOIA Officer when you first submitted your FOIA giving you your rights and options? I'd call/contact/send a letter to the FOIA Officer advising him/her that the response is late and requesting a status update immediately? This is clearly stuck in the system somewhere...Good luck on this...

Edited by rootbeer22 (see edit history)
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Update: But nothing in terms of movement.

My VSO said my FOIA Claim was never processed because my records were "transferred". At any rate, the non-response from the VA on my FOIA really left me completely unable to do a solid appeal for my claim. I was actually going to appeal both my neck and PTSD, but my PTSD they denied service connection for, which, according to the rater at the other RO, is also a CUE based on their opinion. Given I am a Spec Ops combat veteran, with campaign medals and badges for OIF/OEF and many other missions and still was denied and the VA diagnosed me with anxiety/panic disorders which was "at least as likely as not" caused by my service...but that's another story.

So, I simply filed for an increase on my neck right before the 1 year deadline to ensure I got back pay to the initial effective date since my FOIA was and still is completely ignored. Had my FOIA been processed, I probably could have filed a more detailed appeal for both contentions.

Lastly, IRIS finally wrote me back with a detailed response. The inquiry stated that YES, a decision HAS been made on my claim as of July 28th and its waiting processing. This phase normally takes about 16 days (as you can see we are at 30 days as of now, LOL!!). It also said that there is a backlog on FDC claims in Waco and then another backlog on finalizing claims already rated!! So, in other words, the backlog has a backlog. Go figure.

So, I sit and wait. I just wish I could screw up as much as the VA does and still not get reprimanded or demoted at my job.

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Veteran7796:

So, who has possession of your records now? They are right, if the records are not in their possession they certainly can't release them? But, they had an obligation to refer your FOIA to wherever or whomever your records where transferd to. You should appeal the FOIA on the basis that they did not refer the FOIA to the proper authority and the FOIA is late and way outside ot the statutory time limits under the FOIA. They still need to locate your records and provide you a copy as you requested originally. You can also do a Congressional or letter to your congress-person and that will probably help with the FOIA to get it expedited. Good luck...

Edited by rootbeer22 (see edit history)
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Well, I am appealing my PTSD on the grounds that my FOIA request wasnt processed at all, thus, leaving me with the inability to properly appeal. As for my records, my VSO didnt or couldnt specify. But, the VA NEVER contacted me to tell me how to get them, where they were or why my claim wasnt processed. It still sits in CLAIM RECEIVED a year later. It's been 3 1/2 years total and the whole process has been a complete mess.

But, in terms of my claim for increase on my neck, my patience is thin because things are so bad. I actually got my 30% regular pay this morning in my checking account and used it to turn both my electric and gas back on (so Im broke again). My electric has been shut off 3 times in the past 90 days and each time they charge me more for a deposit and of course reconnection fees. I just cant catch up and the backpay would catch me up, eliminate two bills AND increase my monthly income to keep my head above water. I'd be back in regular form very quickly.

As I said, Im a single father with 3 boys and no child support and I make about $600 a week after taxes. Not bad money, but certainly not great and very hard to feed 3 teen boys on that. I filed for financial hardship and my VSO submitted it, but it has done nothing to expedite the process.

Edited by veteran7796 (see edit history)
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rootbeer22,

I get what you are saying and I understand the red tape that has to be sifted through. However, this is a claim for an increase on a single contention I KNEW they messed up on. My initial claim fell into the group last year where they tried to eradicate the backlog. It took them well over 2 years to do my initial claim!! In the process, they made a lot of mistakes. All said and done, because I had to pay back my separation pay, I didnt start receiving a check until last month...LOL!! So, IF the VA hadnt made the CUE, I would have actually started getting paid $683.00 a month over a year ago which really would have helped my financial situation.

The other things to consider are that this increase was a Fully Developed Claim AND a financial hardship AND it was a CUE made by the VA. In addition, they left me with no ammunition to start an appeal because they STILL have never responded to my FOIA/Privacy Act Request from a year ago which would have helped me in my appeal process. Instead, my FOIA Request still sits in CLAIM RECEIVED well over a year past my 1 year appeal deadline.

It's just frustration that they screwed it up bad from day one and when I tried to appeal, they left me in the dark and now drag their feet on the increase too.

You post there was a CUE.

What was the CUE ?

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According to my VSO and the rater I spoke to, the database shows the increase from 0-10% and the effective date back to 5-31-2011 is already "rated" and "granted" as they put it. The rater seems to think my VSO is the one not doing their job in getting it pushed through.

This "rater" your referring to is questionable to me because once a rating decision has

been made - a VSO has absolutely nothing to do with promulgating the decision.

Certain procedure still has to be followed after a rating decision has been made and, it

does not involve any further input from any VSO.

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carlie,

I definitely understand that. Yet, it was explained to me that the VSO is supposed to review and concur the decision within a set amount of time and apparently records show that did not happen. Now, as Veldrina explained, her instructions were they had a week and if the VSO didnt review, they moved on. Perhaps Waco doesnt follow that policy or just hasnt checked up on it.

At any rate, the IRIS response I got pretty much confirmed what the VSO and rater I spoke to said and that is a decision has been made on my claim. They just have a backlog of claims that are complete and just need processed.

Could you provide any further insight on what the actual "promulgation" phase consists of?

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carlie,

I definitely understand that. Yet, it was explained to me that the VSO is supposed to review and concur the decision within a set amount of time and apparently records show that did not happen. Now, as Veldrina explained, her instructions were they had a week and if the VSO didnt review, they moved on. Perhaps Waco doesnt follow that policy or just hasnt checked up on it.

At any rate, the IRIS response I got pretty much confirmed what the VSO and rater I spoke to said and that is a decision has been made on my claim. They just have a backlog of claims that are complete and just need processed.

Could you provide any further insight on what the actual "promulgation" phase consists of?

One thing I'm going to share with you - - -

It will be healthiest for you to know that timelines and the VBA process

do not belong in the same sentence.

Just keep going on with your life and it will happen as it happens.

Things are actually moving along fairly quickly for you, from what you have

posted so far.

Promulgate = total process completion of the rating decision .

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Carlie,

Thanks for the replies. I know timelines vary no doubt. But, if policy is in effect, why is the VA not held accountable for violating that policy by weeks, months or years? Ive been trying to get approved for my neck for 3 and a half years now and come to find out, the delay is a CUE made by the VA.

I also understand others have had it worse while others fare better. But, there needs to be more transparency from the VA to the veteran in terms of their claim and where it stands. If the VA is saying average times for a FDC claim are 125 days for a specific RO, yet the real #'s reflect 12 months to 2 years then you have a great disparity and someone is cooking the books to make it look good. My initial claim took over 2 years for 1 contention to get approved and they messed it up so bad it is just laughable.

I respect and value your input and you certainly know much more about the VA process than I do. I just dont see why policy is in effect if it is broken 95% of the time. LOL!! Might as well do away with it and get real..."our goal is 125 days for claims, however, 90% of our claims take exceedingly longer than that and most are not complete within 18 months". At least I could respect that honesty. LOL!!

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Carlie,

Thanks for the replies. I know timelines vary no doubt. But, if policy is in effect, why is the VA not held accountable for violating that policy by weeks, months or years? Ive been trying to get approved for my neck for 3 and a half years now and come to find out, the delay is a CUE made by the VA.

Policy is not the same as laws and regs, all policy means is the way they would like something to be done.

Policy is broken all the time - or is not applicable all the time, everywhere.

It is a Policy that a certain hotel does not accept animals - but in real life, let someone show up with a bonafide service animal,

the no animal Policy goes out the door.

Policy is that if an officer catches me speeding - I get a ticket - yet I only get a warning - Policy again, just went out the door.

I'm sure you understand that Policy is not a law or reg carved in stone.

Again I ask, whatexactly is it, what law or reg was broken by VBA that you feel is a CUE ?

I also understand others have had it worse while others fare better. But, there needs to be more transparency from the VA to the veteran in terms of their claim and where it stands. If the VA is saying average times for a FDC claim are 125 days for a specific RO, yet the real #'s reflect 12 months to 2 years then you have a great disparity and someone is cooking the books to make it look good. My initial claim took over 2 years for 1 contention to get approved and they messed it up so bad it is just laughable.

I respect and value your input and you certainly know much more about the VA process than I do. I just dont see why policy is in effect if it is broken 95% of the time. LOL!! Might as well do away with it and get real..."our goal is 125 days for claims, however, 90% of our claims take exceedingly longer than that and most are not complete within 18 months". At least I could respect that honesty. LOL!!

Yes, it is widely known that the claims process sux and is not what it should be - but this is certainly nothing new

it began in the 60's, if not sooner.

IMO - everything that is decided quickly, denied or lowballed through FDC or provisional, will just add to the ALREADY

BACKLOGGED status of appeals and more cooking the books, done by the higher level VBA employees (G-13) or higher,

in my opinion.

BTW - I'd really like to hear about your CUE.

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Carlie,

The rater I spoke to and my VSO both said the notes on the acct reflect that my inital rating for my neck should have been rated atl10%. Paraphrase: "Due to a Clear and Unmistakable Error the rating for neck injury is increased from 0 to 10% due to range of motion was limited to x amount of degrees during C&P examination....new rating is effective to 5/31/2011.

In addition, the rater said they absolutely have 5 working days to promulgate the rating once a decision has been made or they are in violation of policy. As a current federal employee I know that if I were to fail to get certification before a contract expires I would absolutely get paperwork or a day on the street without pay.

My mother has worked for the VA for over 30 years (unfortunately not in the compensation arena) and she gives me a very real scenario of what occurs. Its unfortunate.

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Carlie,

In addition, the rater said they absolutely have 5 working days to promulgate the rating once a decision has been made or they are in violation of policy.

Oh goodness - I laughed so hard reading the above that I almost wet my britches : - )

Heck, many times it takes 5 days to get something from the mailroom to the decision maker.

Policy is violated on a regular basis without repercussion - remember we get paid no interest

on our money - which by some Policy's ( not VBA's) is a violation under our property rights.

Procedural errors are made frequently without repercussion, etc . . .

I sure hope you get your money in the timeframe quoted - if you do, you might want to also

purchase a lottery ticket on that lucky day.

Me personally, I don't drink the kool-aid.

Also, thanks for the CUE info - looks like the VBA caught a CUE on it's own - did they ?

jmho

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