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Interesting Email


Berta

Question

Article published Dec 17, 2006,

http://www.news-record.com/apps/pbcs.dll/a...ID=200661216004

From: DALE PETERS

Sent: Sunday, December 17, 2006 2:04 PM

To: colonel-dan@sbcglobal.net

Inconsistency skews vets' disability pay

By Lex Alexander

Staff Writer

David Best of Fayetteville developed knee pain while serving in the Army in

Korea during the Vietnam War.

That pain turned out to be a symptom of osteoarthritis in his hip. But the

Department of Veterans Affairs has denied Best's disability claim, saying he

had suffered no knee injury while in service and knee X-rays taken then were

negative.

But the doctor who found Best's arthritis several years ago took one look at

his hip X-rays and told him, "Wow, they should have found this 25 years

ago."

"The VA is obligated to choose the diagnostic code that will yield the

highest disability rating," says Best's attorney, Craig Kabatchnick of

Greensboro, who defended the department against disability claims in the

early 1990s. "In fact, the VA is doing the opposite: They're finding ways to

give the lowest rating possible. They're finding excuses to do it. That's a

tactic we used to use."

Best's case illustrates a long-standing problem with the department's

disability system: Inconsistent or inaccurate disability ratings threaten

the financial and medical security of the nation's veterans. The issue

particularly concerns North Carolina because more service members are

discharged here than in almost any other state.

The department's disability rating system has remained essentially the same

since World War II, despite rapid change in everything from the labor market

to prosthetic limbs.

But the problem is magnified by inconsistency and inaccuracy despite

congressional investigators' repeated recommendations for improvements.

As a result, not only could veterans be denied money to which they're

entitled, they also could be pushed farther back in line for VA-supplied

health care. That's because disability ratings determine eligibility and

priority for many treatments.

At the other extreme, the inconsistencies leave the department vulnerable to

fraud.

The problems are so bad that in January 2003 the Government Accountability

Office, the investigative arm of Congress, designated the department's

disability compensation and pension program as "high risk." That designation

identifies programs either vulnerable to waste, fraud, abuse and

mismanagement or facing major problems with their economy, efficiency or

effectiveness.

The department has not responded to e-mailed questions about the disability

program.

Says Kabatchnick, "It's a real mess."

The ratings system for disabilities, in place with only minor changes since

1945, aims to compensate for the average impairment of earning capacity in

civil occupations caused by an injury or disorder.

It is based on the nature and extent of a veteran's physical injuries or

dysfunctions, or how well or poorly the veteran functions with a mental

disorder. The rating scale runs in increments of 10 from 0 (no disability)

to 100 (totally impaired or disabled). The rating translates into monthly

disability payments of between $115 and $2,471 - more if a veteran supports

a spouse or children.

The static and subjective nature of the system has drawn criticism for

decades, but the most significant alarm might have been sounded in 1997 by

the nonprofit National Academy of Public Administration. That group called

on the department to set consistency standards and to test how well

standards were being met, either through its quality-review process or by

sending identical test cases to regional offices for rating.

But in August 2002, the GAO noted that the VA still wasn't grappling with

the differences among regional offices or inconsistent decisions on

particular types of disability ratings. It recommended that the department

begin doing so. The VA said it would; however, the GAO noted, it "did not

describe how it will measure consistency and evaluate progress in reducing

any inconsistencies it may find."

The VA has resisted other recommendations from the GAO, as noted in the

January 2003 "high-risk" report. There, the GAO again called on the VA to

update its disability ratings. But Anthony J. Principi, then secretary of

veterans affairs, refused, saying the existing standards were "equitable."

The VA also has struggled with rating accuracy, which is assessed through

reviewing randomly selected cases.

Kabatchnick, the attorney, said certain types of errors are common, and most

work to the detriment of veterans.

For example, a VA employee may require a veteran's case to meet all criteria

for a particular disability rating, even though the rating schedule requires

him to meet only one.

"A vet with asthma can get a lower rating because he uses an inhaler, even

though all that does is relieve the symptoms," Kabatchnick said.

The VA also frequently will assign lower disability ratings based on

criteria that aren't part of the official rating system, he said.

"The VA takes the liberty to deny rating increases on the grounds that the

vet has not taken medicine for his condition or hasn't been hospitalized

recently for his disabilities," Kabatchnick said. "These criteria aren't

part of the rating schedule."

Beginning in fiscal 2002, the VA focused its assessment of quality on

whether benefits were correctly granted or denied, rather than on technical

issues that might not affect a ruling on benefits. Despite that more lenient

standard, the department's accuracy rate fell from 89 percent to 81 percent.

The inconsistencies in rating gained national attention in December 2004,

when the Chicago Sun-Times published VA data showing that the average annual

payment per disabled veteran varied from $6,710 in Ohio to $10,851 in New

Mexico.

The report came just weeks after the GAO had recommended that the VA use

computerized records to identify inconsistencies in disability ratings and

identify medical conditions most likely to result in those variations.

In October 2005, the GAO told Congress that the VA had taken neither action.

And there is no record in subsequent GAO or inspector-general reports that

those changes have been made.

Contact Lex Alexander at 373-7088 or lalexander@news-record.com

News & Record . 200 East Market Street . Greensboro NC 27401

[Non-text portions of this message have been removed]

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Berta, this is great info. I have a question? My depression and anxiety claim was granted and made part of the PTSD claim. I raised a claim for panic disorder with agoraphobia that was denied. I was wondering if instead of anxiety they should off use panic disorder with agoraphobia as part of the PTSD. Panic dosorder with agoraphobia was part of at least 7 of my 8 C/P. I`m wondering if this is a correct assumption. I just notice that in my rating decision the VA worded depression and anxiety attacks as part of PTSD.

Hope vets pay attention to the way raters write their evaluations, they could find lots of errors. Rigo

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Dear Fellow Veterans & Friends

I hear many people say the VA does not conspire to delay or deny claims, There are to many people who would have to be in on it. Well if the ratings are low balled across the board. How much more easy is it to dney claims, On Fox 28 2 days ago is showed those people injuried working cleaning it up spend years with the same old silly games us veterans go through. Its hot just in the VA a consperciy to deny benifits but through out the insurance inducstry red tape and criminal acts to keep folks from benifits.

The book insult and injury about civilan insurance industry criminal acts that were taken to court and a lady got million dollar verdict for what she went through. Many of you read your denial letters and you will see the same illegal tactics iin your denials for which that lady got paid millons for. I made a posting here on the book months ago. I think you can find it under insult and injury.

Veterans should understand with the overwhelming evidence agianst the VA they are breaking the law and the posting on VSO's misconduct. Veterans should know the VA and VSO program is there to work aggainst them and it may take years for you to get through there slick talk to find out just how they screwed you.

Terry Higgins

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  • HadIt.com Elder
Dear Fellow Veterans & Friends

I hear many people say the VA does not conspire to delay or deny claims, There are to many people who would have to be in on it. Well if the ratings are low balled across the board. How much more easy is it to dney claims, On Fox 28 2 days ago is showed those people injuried working cleaning it up spend years with the same old silly games us veterans go through. Its hot just in the VA a consperciy to deny benifits but through out the insurance inducstry red tape and criminal acts to keep folks from benifits.

The book insult and injury about civilan insurance industry criminal acts that were taken to court and a lady got million dollar verdict for what she went through. Many of you read your denial letters and you will see the same illegal tactics iin your denials for which that lady got paid millons for. I made a posting here on the book months ago. I think you can find it under insult and injury.

Veterans should understand with the overwhelming evidence agianst the VA they are breaking the law and the posting on VSO's misconduct. Veterans should know the VA and VSO program is there to work aggainst them and it may take years for you to get through there slick talk to find out just how they screwed you.

Terry Higgins

I have read that book, Terry, thanks to you. It is excellent! You can see how the VA, SSDI, and Insurance companies work. Delay, delay, delay and then deny, deny, deny.

pr

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I have read that book, Terry, thanks to you. It is excellent! You can see how the VA, SSDI, and Insurance companies work. Delay, delay, delay and then deny, deny, deny.

pr

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