VA Disability Benefit denials

[GBArmy]

I wanted to start a new thread because I didn't want to mess up richard 1954's post. Does anyone know for real why the VA Benefit people bend over backwards to deny veteran's claims. I was told a while back by a VSO who should know that they certainly had a quota to disposition claims.; so many a week or a month.I also heard that the managers, but not the lower tier workers, got some kind of bonus for "cost savings."  What are  those"cost savings?"Do they actually get financially rewarded for denying or making lower rated decisions some how? There has to be some actual truth to this kind of thought because of some of the ways these claims get denied. They ignore facts, don't read the evidence we high light for them, apply wrong diagnostic codes, combine separate disabilities, etc.,etc. Anyone got any knowledge of where we can find any facts if it is indeed financial?

[vetquest]

I just think that the raters have quotas to meet and some of them would rather deny claims to meet their quotas.  There seems to be no penalty for having a decision overturned at the BVA.  If there was I believe claims would be researched and completed in a better manner than they are now.  Every job I have ever worked we had quotas to accomplish and if you did not meet your quota or if your work was slipshod and got returned that reflected badly on you.  I think that if such a QA process was implemented at the VA things would go much more smoothly for the vet.

[ewsieczka]

Government employees do get bonuses due to their performance.

[doc25]

I've had a theory for a few years now. And I could be wrong, but it occurred to me that there could be a possibility that once a certain number of claims get granted every FY. That quota initiates denials.

It's just a hunch.

Honestly, it would just be better off to tell us there's only a limited amount of $$$ for compensation & pension. Rather than string veterans along for months, years, and decades with daggum denials. 

[Buck52]

These  c&p examiners are werid  some mention in the c&p things they never ask    and some things they did......I have notice to some times we think the c&p went good and seem to be on the same page with the examiner ect,,ect,,,  and the veterans has a good feeling about the exam  only to get knocked down with a crazy denial  Thats what hurts!

[doc25]

1 hour ago, vetquest said:

I just think that the raters have quotas to meet and some of them would rather deny claims to meet their quotas.  There seems to be no penalty for having a decision overturned at the BVA.  If there was I believe claims would be researched and completed in a better manner than they are now.  Every job I have ever worked we had quotas to accomplish and if you did not meet your quota or if your work was slipshod and got returned that reflected badly on you.  I think that if such a QA process was implemented at the VA things would go much more smoothly for the vet.

We have a rigorous QA process when we clean and sterilize medical instruments at the VA Clinic I work at. We triple clean and triple check everything before we give it a green light. If it's not cleaned or sterilized properly, or there's any doubt, we send it back to be reprocessed all over again. It's people's lives we're dealing with. This is the standard VA-wide.

 

Same should go with the VBA. The benefits are people's lives they're dealing with and it's imperative they get it right. 

[GBArmy]

I pretty much agree with all of you. There obviously can't be any penalty to the raters if denials are overturned at the BVA, or as Vetquest says they would do a better job. It is a lot harder because there is no logic in what they will deny. It sure seems though that  if you do get rejected, you almost always will need an IMO/IME  to win on the rebound. Just using logic isn't necessarily going to work without the expert's medical opinion. So we are forced to spend the extra bucks we shouldn't have to to get a jusr decision.Bad system!