Va Timeline Policy....

[veteran7796]

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?

[veteran7796]

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.

[TiredCoastie]

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 August 28, 2014 by TiredCoastie

[rootbeer22]

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 August 28, 2014 by rootbeer22

[veteran7796]

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.

[rootbeer22]

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 August 28, 2014 by rootbeer22

[veteran7796]

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 August 28, 2014 by veteran7796