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

[Guest jangrin]

That is basically it- I do get DIC but never saw a check until a few years ago as the offset had been recovered.

Just how does the VA feel they can off set your DIC from the 1151. The rational makes no sense. If a widow (or widower) wins an 1151 claim they are compensated for the VA having malpracticed against their spouse. Thats it they get no other compensation. Nada nothing---unless---the vet is SCd.

Then the VA says well we malpracticed against your spouce so we will compensate you for that, but because you spouse is service connected we are going to take that money away from you until it is off set by the money we are paying you for killing your spouse.

The VA say 1151 and SC are two different things. Unless it means money and then they offset one onother.

My husband deserved much much better than what he got-the second time I studied the med recs for this AO claim I realised just how many times they could have done tests or something to change it all-

The head cardiologist at the Syracuse VA told me he had nothing wrong with his heart and here this jerk had just read the ECHO and could see Rod was in terrible shape.

One of my IMO doctors -the freeby- was the VA doctor who wanted to give him a fingerstick test for diabetes but he was overruled.His IMO is very brief but states very clearly that Rod's glucose was way too high=especially when you consider he had no food for 28 days as his throat was paralysed.

The doctor that did your freeby IMO for you-was he one of the treating physicians when Rod was in the hospital? He may have really been pissed when he was over ruled by the other staff.

They sent him home expecting him to die and no one would find out what they did.And we thought he was going to recover.

I can pinpoint exactly when -in the med recs-they began a cover up-

funny that when I filed the FTCA claim-in 1995 there was a lot I missed then.I found a lot more in 2003.

I named three VA employees in my recent FTCA claim and named them as witnesses to property destruction of my IMOs-

the DRO, the VSM, and the Director of this VARO.

Did you name these people by name or by their position? I have a very strange feeling that when this comes up in February and if it does go to court (?) hearing (?) we are going to start hearing some very loud squealing.

I don't see any of these people taking the fall for someone else. I have a feeling that there has been an actual intentional block by VA people to keep your claims from succeding. I just think there is either the SO/ POA thats nose was out of joint or the claims adjuster who lost the 1151 and is manipulating things behind the scenes. When I am at the SOs they are real buddy buddy with the POAs at the VARO at least over the phone.

The POA at the VARO has access to the file and the VA employees, there all in the same big building. They are all friends. It's kind of like lawyers and the DA and the judges and the bailiff, and the law clerks. They are adversaries in court but in real life they are drinking beer and having lunch together. Something smells really fishy, to me.

They all were sent the IMOs so they are all liable to my way of thinking. However it remains that the IMOs

still should have ended up in the c file anyhow.

I think they will all blame my vet rep.But he could be canned for destroying evidence.

If they blame him and there is any documented basis for that- I can sue the state of New York.

Berta, I don't know where to tell you to stop but I would not stop any of this until you have your claim rated or until you have something in writing. I know its not about money because you recieve your DIC, it is about the VA doing right by your husband. If you let the fish off the hook you'll end up eating worms for supper. JMO

However-the whole point of this new FTCA claim is not for money- I filed it to get the RO to acknowledge my IMOs.

It is basic VA law that they must fully consider probative and competent medical evidence.

PS I just got in the mail- another letter saying "Mrs. Simmons We are still working on your compensation claim blah blah blah"thank you for your patience."

the standard generic VARO thing

I could wall paper my bathroom with all those letters-from over the years-

It would make more sense it they just said the truth -"Mrs Simmons we are still farting around with your compensation claim and we don't have a clue as to how to decide it.Although we do have your IMos and really didnt destroy them, there is no one at the VA medically competent enough to read and understand them.As you well know we dont have many competent doctors. We asked the C & P doctors to read them but of course they know nothing about medicine and usually make something up anyhow in their reports to make sure we deny a lot of claims. However we assure you that your evidence has all been carefully considered- not actually read- just considered-

we considered reading it as it is all stated in very simple terms but we don't know what it says anyhow.Thank you for your patience."

This was actually very well stated. I think maybe at the first opportunity it should be sent to the VA even if anonomously. Less of course your name. Then again leave the name because your already on their s*it list anyway.

Berta, why don't you send the VA councel and the VA claims administrator a letter, and ask for a meeting.

The meeting could be requested because you would like to review the file with those people whom the government have intrusted the responsibility of aiding you in the successful development of your claim.

And you are available to aid and assist if there is a problem. I wonder if it you would even get a response. Of course I might cc: a copy of this attempt to clarify things to some of my favorite people. Maybe you can embarass them into doing their job. You know reverse psychology, like how you get your kids to do something they don't want. Hmmm just a thought

Jangrin

Edited December 2, 2006 by jangrin

[Berta]

Thanks Jangrin -for the suggestions-

I do believe that based on what the 800# says-they are working on all this and have been consistently since the remand.

Remands mean expeditious treatment and they are giving me that- I mean- it moves from desk to desk alot.

I asked the vet rep last week if it was in the PAP yet and he said what's that-

(paper airplane pile)but so far it hasnt' got there.

I just have to patiently await what they will do next. I thought my last claims would never end and suddenly they did . This one will too.

And then I will send a FOIA to the VA for the c file and any other documents they have to try and find out what really happened for these last 3 -almost 4 years. I bet I will be surprised to find out what really went on.

I was shocked at what I found in my c file the last time I got a copy of it.

[Guest jangrin]

Thank you Berta,

I know I learned a bunch today. I hope this was beneficial to more than just me. I would feel selfish about your spending all your time today, posting back and forth to me, but I have a feeling many forum members and visitors learned about the VA from the experiences you took the time to share.

Things sure do get complicated. But I understand alot more about the system and your particular situation, maybe now when you post I will understand more of what is happening, and may be able to offer something constructive to the posts. I Appreciate your time.

Jangrin

[Guest allan]

If the DOD is the decider on how the cash flows for the VA, than arn't we in the same boat as the democrats? They find themsleves at a deadlock on finding funding to provied "NATIONAL SECURITY".

Where do we fit in on the food chain?

Don't know about you Berta, but I aint feelin to expedited these days. I'd say there a stay on paying out anything except just what the DOD needs to spend it on. Since they cant seem to find whats happened to the $$$ earmarked for our troops safety, I doubt we fit on the DOD's list at all.

Someone still has a tight grip on the purse strings, don't they?