ptsd Runaround -delay Or Just Sluffing It Off?

[Guest jangrin]

Berta,

I moved this topic to a new post so we didn't hi-jack Jim's PTSD post....

Also, I took some snipets of your post and pasted it here.

Berta stated, This is another thing I dont understand Jangrin-

In the beginning of 2006 my AO claim went through numerous hands at the VARO-

from January to July- appeals team, predetermination team, in and out of rating board, Dro to coach, back to adjudication, 3 authorizations on three different days- supervisor ,coach, and then rating again- and then to my POA----at one point in March an 800 vet rep who always seems on the ball told me it looked like I would have a decision in days-he said the 3 signatures showed it had not been denied.But then more action took place for 4 more months-

How can -in some cases- a claim isn't stagnant but is getting some sort of attention as it goes from person to person- yet the evidence still remains unread?

The only way this can happen is if the VA employees are passing this claim from desk to desk and from department to department just to avoid having to work on the claim. This could be intentional or it could be because it is percieved to be a difficult case on no-one wants to tackle it.

When the claim came back they immediately appeared to start working on it again-appeals team, rating, coach, regional counsel, rating, RC, rating board, appeals team- sameo sameo-

The case finally got farmed out but then was immediately back on the road again going from desk to desk.???

In all this time I supplied more evidence and now have 3 IMOs to support the AO claim yet have no idea whether any of it has actually been read yet. By Feb it will be 4 years since they got this claim.

Still no one has read or rated or done anything of substance with this claim. ummm?

Berta,

Four (4) years is a very long time time to wait for a determination on a claim. I can't help but think the problem here is not the "meat" or "substance" of your claim. I am sure you have provided ample evidense to support every aspect of this claim in order for a rightful determination to be made.

I believe that there is a problem with "sorting through some cases". Either the cases are too complex for the adjustor, who is over loaded with claims and he doesn't have time to sort through the evidense or,

the files are full of too many very old records and the adjustors don't want to work the file sorting through the SMRs for service connection, or the file is percieved as being just toooo difficult.

The idea of having a file float from office to office so it is percieved as being worked on, with an ocasional computer notation, does not seem too far fetched to me. With everyone hopeing like crazy someone else will finally work that darn claim.

There is no penalty to these people, employees, adjusters, raters, file clerks, government benefit job types ,

for not doing their job. This file is perceived as being too complex and too difficult to rate with too many secondarys for the claims people to sort out. It is far easier to shuffle the file.

If you remember back a few years, I'm not sure if you would have heard about this or not. But the same thing happened in the California court system. There were somany filed law suits that would never be brought to court, because the people involved just kept postphoning the trial date, or asking the court to put off discovery, or for a bunch of different reasons. The cases just never got through the system and it was clogging up the whole legal system in the state.

What happened is the state filed some new admistration laws for the court system and we ended up with what was called FAST TRACT. This made the court cases move through the system whether the attorneys were ready or not. By implementing Fast Tract, the court calenders started to clear out and there were openings for scheduling trials and criminals were once again being prosecuted and trials began proceeding through the courts.

I believe that is the problem with your claim and many others. There are so many difficult cases that they are clogging up the system. The claims people are afraid to try and work the file, or it's easier to bury the file on a desk than to work it, or move it around so it looks like it is being worked. Ask any lawyer how they build a case or work a file. Someone is ultimately responsible for maintaining the file and logging the information so the file can be prepared for trial or settlement.

It seems that there are a lot of people in the file but no one who is ultimately responsible to answer for the condition of the information or the status of its readiness to proceed for rating.

THERE NEEDS TO BE EITHER A PENALTY FOR NOT PROCESSING THE CLAIMS WITHIN A SPECIFIC TIME PERIOD OR THERE NEEDS TO BE AN IMPLEMENTATION OF FAST TRACT TO START MOVING THESE CLAIMS THROUGH THE SYSTEM

I think your claim is too difficult and the people are afraid to rate it. They keep hopeing someone else will work your file. There has got to be some way to make the VA work the claim?

Is there anything that we are missing??? Any laws or regulation with time limits??? I have never heard of a system that does not have time limitations for making decisions.

Jangrin

Edited November 30, 2006 by jangrin

[carlie]

I think it's like half the shit in America now, no one wants to be responsible enough to REALLY do their job, what ever it may be doing from flipping burgers to taking care of kids or the elderly, auto mechanics, people employed in retail, most just plain don't give a rats ass anymore. When are we goinig to believe and realize that anywhere you turn employees feel like --

YOU DON'T LIKE YOU'R HAMBURGER ! !

WELL THAT'S JUST FINE -- DON'T FRIGGIN COME BACK AND BOTHER ME ANYMORE

BECAUSE VERY SOON ANOTHER FOOL WILL COME THRU THAT DOOR TO BUY MY HAMBURGER EVEN THOUGH THEY ALREADY KNOW IT JUST PLAIN AIN'T WORTH A SHIT ! ! ! ! ! THEY KEEP COMING THRU THAT DOOR IN HOPES IT MIGHT JUST TASTE A LITTLE BETTER THIS TIME -- IN HOPES THEIR LETTUCE WON'T BE A SLIVER

OF WET - SOGGY - YUCK that they crumple in their napkin -- IN HOPES THAT WHEN THEY LOOK UNDER THEIR BUN A BIG HARD KNOT ISN'T IN THE MIDDLE OF THEIR TOMATO.

Well guess what ---- not a damned thing getting better here on the old homefront.

I feel like many, many veterans were dedicated, loyal ass employees whether in the military or the private sector ---- some how Uncle Sam did get it through to the ones of us that had not already gotten it -- take some pride in yourself and some pride in what you do. I feel this is also why vets with good, honorable and documented claims have this dark spot in their lives, like they've been slapped in the face every time they get a lowball, denial or have to NOD and appeal.

No longer are there consequences for screwing up.

Man, it felt good to get that out !

carlie

[Guest jangrin]

well well ,

I think we have figured it out. The VA likes to promote from within. So I believe what has happened is over the years the VA has promoted until everyone has actually been promoted to their own level of incompetency.

Thus, when a claim file comes to the employees department or desk they have no idea what to do with it, so they then take the file, place it on a shelf. Then they wait. They wait until the person that use to have that job comes by to visit and see how the old department is doing without them.

When the old guy pops his head in the door the new guy asks the old guy what he should do with the file. The old guy tells him to send it over to the other office. The file is moved to another office.

Unfortunately,it is then put on another shelf. This happens over and over because the VA has promoted from within and everyone is promoted to thier own level of incompetency, no one knows what to do and all files are shelved until the old guy can come by and tell the new guy how to do his job.

VA strickly adheres to the Peter Principle. Which has obviously been dutifully applied, because they can't seem to get a claim rated and cannot tell the veteran what is happening and all the files seem to go everywhere but no work is reportedly done.

There you have it folks, don't blame the VA, blame it on the Peter principle.

[john999]

Carlie

The very best and most loyal are all dead and rotting in the ground. The ones here are the ones who somehow escaped and keep on living even if they have had all their wits and humanity scared out of them. People in war can tell you this or that, but mostly they were just scared to death if they were human.

I don't wish that on anyone.

[Brandy]

Carlie,

YOU SAID IT!!!! I guess I was raised in the old school ways. Respect your elders, do a good job, try to do your best and you know what? It works, respect others, take pride in what you do, no matter what it is.

It absolutely amazes me how terrible customer service in all areas of businesses today. It could be retail, medical facilities, insurance, fast food, or the VA reps, the customer service is lousy. When you hear the person on the other end of the phone sigh, like you are bothering them, what does that tell you as the customer! They apparently have better things to do than talk to their customers. Their business customers that they are in business for HOPEFULLY TO MAKE MONEY? Who, knows... I refuse to talk with someone like this or I will have a few choice words for them, one or the other!

The school systems today are teaching our kids in history classes about other countries, for example the arab culture. But they have not taught them about the attack on pearl harber. What is going on with our school systems today?

Your absolutely right, "No longer are there consequences for screwing up". I can't tell you how many times in the last several years I've said "What happened to good customer service?". And this applies to the VA system as well.

I think it's like half the shit in America now, no one wants to be responsible enough to REALLY do their job, what ever it may be doing from flipping burgers to taking care of kids or the elderly, auto mechanics, people employed in retail, most just plain don't give a rats ass anymore. When are we goinig to believe and realize that anywhere you turn employees feel like --

YOU DON'T LIKE YOU'R HAMBURGER ! !

WELL THAT'S JUST FINE -- DON'T FRIGGIN COME BACK AND BOTHER ME ANYMORE

BECAUSE VERY SOON ANOTHER FOOL WILL COME THRU THAT DOOR TO BUY MY HAMBURGER EVEN THOUGH THEY ALREADY KNOW IT JUST PLAIN AIN'T WORTH A SHIT ! ! ! ! ! THEY KEEP COMING THRU THAT DOOR IN HOPES IT MIGHT JUST TASTE A LITTLE BETTER THIS TIME -- IN HOPES THEIR LETTUCE WON'T BE A SLIVER

OF WET - SOGGY - YUCK that they crumple in their napkin -- IN HOPES THAT WHEN THEY LOOK UNDER THEIR BUN A BIG HARD KNOT ISN'T IN THE MIDDLE OF THEIR TOMATO.

Well guess what ---- not a damned thing getting better here on the old homefront.

I feel like many, many veterans were dedicated, loyal ass employees whether in the military or the private sector ---- some how Uncle Sam did get it through to the ones of us that had not already gotten it -- take some pride in yourself and some pride in what you do. I feel this is also why vets with good, honorable and documented claims have this dark spot in their lives, like they've been slapped in the face every time they get a lowball, denial or have to NOD and appeal.

No longer are there consequences for screwing up.

Man, it felt good to get that out !

carlie

[Berta]

An interesting take on it all-----

I think some of the raters and DROs are actually petrified of making decisions.

Jangrin -you stated something (forget where) that I need to disagree with.

BUT your point is important-

You stated that my claim was probably a very complex issue and this is why it is taking so long.

My POAs have said this too but they have no copy whatsoever of my initial AO claim and about a year of other documents and my CUE claims are missing from my POA files and they cannot explain that. Neither can I.

It is not a complex claim at all-

When I first emailed Dr. Bash I explained the AO claim and the evidence in 4-5 sentences.

He immediately emailed me "sounds good!" and told me where to send the records.

Five days after his receipt of all the records he called me and said he went over everything and had already prepared an IMO that agreed with my claim.

It is not complex at all.

The veteran's files do involve 5 volumes of medical records and I also supported the claim with medical evidence from my husband's VA records and other documents from General Counsel.

Even though they ignored my submissions,the initial IMO I got from a VA doctor and the two IMos from Bash

support the claim and reference the exact med recs and documents they need (which I sent to them anyhow.)

I have believed that the VA has consistently and deliberately ignored my IMOs.This is a violation of VA case law and I sent them the regs that support this fact.

I also sued them for property damage and talked to Regional Counsel about this FTCA claim.

The IMOs were sent to the BVA and then remanded back to the VARO with the claim.

However I am dealing with another situation too-

Maybe the RO had never seen my IMOs at all-up to that point-

When I asked my vet rep at the RO level to check to see they were in my file, he called me and said they were-in 2005-

But that is when they seem to have disappeared.Subsequent submissions of the IMOs were also ignored.

The VA has until February 28th to acknowledge their receipt of and their proper attention to my IMOs -

as probative evidence under 38 CFR that they must consider-otherwise I will take them to the federal court for restitution.

However what if the vet rep took them out of the c file and never put them back.

A VA statement shows that they never had any IMOs to consider at all.Even after he said he had presented them to the DRO.

The VA doctor didnt have them even though the vet rep said she would get them too.

My point is- we can knock our selves out by sending them undebatable medical evidence from the med recs, as well as even sending them the regs they are to follow. We can send them internet prints, OGC pres ops, and CAVC decisions and prepare a claim that should succeed.

But a good IMO can do all that for us because it is the word of a professional-and overcomes their ability to say we are not competent enough to render a medical opinion.

An IMO makes their job easier. A good one can render a denial based on a C & P as defective.

These IMO doctors carefully assess everything far beyond the 10-15 minutes of a C & P exam.

The criteria for good IMOs -as I read BVA decisions- is applied to VA doctors too-as far as a rationale for their opinion.

My claim is not complex at all. BUT It involves a challenge to VA under the Nehmer Court Order.

My vet rep at the RO knows this facet of the claim extremely well as we discussed it.

I think he discussed this with the DRO instead of giving her my IMOs.

Ron Abrams (NVLSP) knows this too-they won Nehmer and never had a challenge to Nehmer like my claim.

Last email I had from Ron-he said to tell him of any denials I have gotten-

he has no idea of the IMOs I have submitted.

I have had relationship with NVLSP since 1991.But I want to get the award first and then contact him as to Nehmer.

As this claim stands now they owe me offset refund, some educational Chap 35 retro,funeral bills and REPS-

and that is all I expected when I filed the claim in 2003-

But Nehmer means- 12 more years of DIC,too-per NVLSP.

The biggest problem with my claim is how they will handle the Nehmer Court Order.

Men and women dont forget- the VA tried to snooker millions from retro due to AO veterans and NVLSP went into the ROs and got them their money.

Millions- think about it-

ROs had the entire Court order and the Stipulation agreement under Nehmer and still they violated the tenets of established VA case law.

Thousands of those AO veterans had vet orgs and SOs who stood by and watched this occur-or simply were too stupid to advise these veterans to challenge the retro awards.

I am beginning to think that most veterans should get an IMO as soon as they file their claim.

The IG has clearly shown that VA employees do not take the time to render good decisions.

I have evidence from VA that only one single statement I made as to med entries in support of my claim was ever considered in over 3 1/2 years and they interpreted the entries wrong-per MediLexicon- the same reference for med symbols that VA uses.

It was my initial statement in my Feb 2003 claim.

If I had sent them an IMO right off the bat with the claim-it could have saved time and a lot of work.

Sorry for this long post-

when my claim is resolved I intend to get a copy of the c file from 2005 to present and I bet that-again-I will be quite surprised to see what actually is in there.

The BVA focuses on IMOs, when they are probative, as they go beyond what a claimant can prepare.

Edited December 1, 2006 by Berta

[Guest jangrin]

Berta, I know these are alot of questions. Please if you could when you have free time, I know it will help me but it may also help some of the others hanging out heretrying to learn about the claims process. Thanks your swell. No really I think it will help.

How much time lapsed between the time you won you 1151 case with substantial award and the time you file the AO case which I believe you said is substantial retro?

Initally, was it the same SO for both claims?

ALso I know you wouldn't probably know, but could it have been assigned the the same claims adjuster that handled the 1151?

The CUE claims, are they part of the AO case or the 1151?

You switched to a new SO, has he stated whether or not he has read or even seen any of your (3) IMO's?

The destruction of property case, is that the case they have until February 28th, to do something about?

Has the councel for the VA contacted you at all?

Does the SO know about the law suit for destruction of property?

Hove you done a request of records for the AO case only- under the FOIA recently?

When you started recieving DIC, was that awarded under the 1151-AO-or totally seperate?

Could you explain Nehmer and how it affects this case.?