"A judge is reviewing your appeal" "Decision soon"

[PostMan1988]

Update: Closed August 15th

Wondering if anyone else has seen this before and if the timeline was about right?

 

Edited August 17, 2019 by PostMan1988

[Fat]

That's a good point HUCAST 21. 

Ultimately manpower and definitive guidelines for claim adjudication will help.

I know some will say the M-21 manuel provides that guideline, but I mean even more simple.

Inservice incident, current diagnosis, and medical literature or opinion by specialty doctor about relationship of two.

The first part is quite simple. You do or you dont have the information.

The hardest part is current diagnosis or sickness. Has to be by verifiable medical means.

Last, opinion from specialty doctor on causation and relationship.  The opinion from a doctor in that field of concentration should carry huge weight.

Just my opinion..............

 

 

[Scottish_Knight]

20 hours ago, Hucast21 said:

The problem is with BVA appeals, about 37% of appeals are issued grants. This means too many initial claims were denied, which should not have happened in the first place.

From my experience, the VBA has claims adjudicated as fast as possible but dumping it on the BVA appeals process to do the heavy lifting. Thus, creating a huge backlog.

 

This is basically what I was on about.  I honestly don't feel the VA do an in-house-senior-leadership review before the initial decision is made. 

This may be a bad analogy considering the current matters.... but when I was a CID agent...   when an agent is working an investigation....once every 7-10 working days, the agent's team chief (TC) would review the case file.  One a month, the special agent-in-charge (SAC) would review it.  This would continue through the life cycle of the investigation.  When it was time to close (solved or unsolved), the case agent would type the final report, the TC would review said report (most like changes would be made) and then it would go to the SAC for final review and eventually signing off.  CID got this from the FBI.  Can't say if NCIS and AFOSI do the same.  This ensured thoroughness. 

Difficult to compare an MCIO to the VA.  A CID special agent might have 20-25 investigations at any given time.  How many claims do one VA claims rep have at a time?  Dunno.  A criminal investigation need be done quickly and thoroughly.  Does the VA have time constraints?  Again, dunno.  But a tiered review process, at least when the final decision is made, might prove beneficial and reduce the number of appeals being made.

In regards to the claims process, the VA is about as transparent as an iron curtain.  I feel that if every veteran or spouse (like Berta) who's had to go through the appeals process only to have the BVA or CVA award in favour of the vet, wrote a letter to their congressman detailing the facts and circumstances, it would get the attention it needs.

Out of curiosity, where did you get the 37% figure?  I was trying to find one for my first post in this thread and pulled 40% out of my arse.  Not a bad guess. 

@Fat, aye the M21-1 is a guideline, and to some degree so is 38 CFR and USC.  What I want are the in-house SOPs and directives.  Those would be a goldmine!

Edited June 23, 2021 by Scottish_Knight

[Hucast21]

4 hours ago, Scottish_Knight said:

This is basically what I was on about.  I honestly don't feel the VA do an in-house-senior-leadership review before the initial decision is made. 

This may be a bad analogy considering the current matters.... but when I was a CID agent...   when an agent is working an investigation....once every 7-10 working days, the agent's team chief (TC) would review the case file.  One a month, the special agent-in-charge (SAC) would review it.  This would continue through the life cycle of the investigation.  When it was time to close (solved or unsolved), the case agent would type the final report, the TC would review said report (most like changes would be made) and then it would go to the SAC for final review and eventually signing off.  CID got this from the FBI.  Can't say if NCIS and AFOSI do the same.  This ensured thoroughness. 

Difficult to compare an MCIO to the VA.  A CID special agent might have 20-25 investigations at any given time.  How many claims do one VA claims rep have at a time?  Dunno.  A criminal investigation need be done quickly and thoroughly.  Does the VA have time constraints?  Again, dunno.  But a tiered review process, at least when the final decision is made, might prove beneficial and reduce the number of appeals being made.

In regards to the claims process, the VA is about as transparent as an iron curtain.  I feel that if every veteran or spouse (like Berta) who's had to go through the appeals process only to have the BVA or CVA award in favour of the vet, wrote a letter to their congressman detailing the facts and circumstances, it would get the attention it needs.

Out of curiosity, where did you get the 37% figure?  I was trying to find one for my first post in this thread and pulled 40% out of my arse.  Not a bad guess. 

@Fat, aye the M21-1 is a guideline, and to some degree so is 38 CFR and USC.  What I want are the in-house SOPs and directives.  Those would be a goldmine!

“According to the latest data, the VA made 85,451 Board Legacy Decisions and 17,202 Board AMA decisions in 2020.

Of the Board Legacy Decisions:

33.8% claims were allowed

40.6% percent of them were remanded (sent back for reconsideration)

20.3% were denied

Of the cases decided by a Board AMA:

37% were allowed

28.2% were remanded

27.6% were denied”

https://disabilitydenials.com/blog/va-disability-appeal-success-rate/