ACE Eliminates Need for Some In-Person Disability Exams

[pacmanx1]

ACE Eliminates Need for Some In-Person Disability Exams

As part of VA’s transformation efforts, we are implementing people, process and technology initiatives to improve benefits delivery to Veterans – with the goal of improving accuracy and timeliness.

We recently launched a new initiative called Acceptable Clinical Evidence (ACE). This is a joint venture between the Veterans Benefits Administration (VBA) and Veterans Health Administration (VHA).  ACE was developed and piloted at VBA’s St. Paul Regional Office and the Minneapolis VA Health Care System. During the pilot, ACE helped reduce the time to complete a Veteran’s Disability Benefits Questionnaire (DBQ) from a national average of 25 days down to just eight days; that’s a time saving of more than two weeks.

ACE gives VHA the option to review a Veteran’s existing medical records instead of performing an in-person or telehealth examination to complete a DBQ, expediting the disability ratings process by eliminating the wait time to schedule and conduct an in-person exam. DBQs are medical examination forms used to capture essential information for evaluating disability compensation or pension claims.

When a Veteran seeks compensation benefits, VA personnel review the claim to determine if additional medical information is necessary to render a disability rating.  If a medical evaluation or opinion is needed, VBA submits a request initiating VHA to schedule an exam for rating purposes. Under the new process, VHA can complete a DBQ without a medical exam if a Veteran’s existing medical records contain sufficient evidence.

ACE is one example of an improvement to VA’s processes that will help us meet our goal to eliminate the claims backlog and provide more timely benefits to our Veterans, their families and survivors. To learn more about our transformation initiatives, visit our Transformation website.

https://www.blogs.va.gov/VAntage/9048/ace-eliminates-need-for-some-in-person-disability-exams/

OK I can see where this could help veterans but my thought is, VA personnel review the claim to determine if additional medical information is necessary to render a disability rating bothers me.  Instead of decreasing the backlog this could increase the backlog even greater. Since VA has removed the public DBQs and now putting VA employees in the position to approve or deny a veteran's claims seem more like stacking the deck against the veteran. I am trying to rap my head around this but it seems to me to be simply saying that the local VARO employees will determine if a veteran gets a C & P exam.  Before most C & P exams were somewhat automatic when a veteran files a claim. I say somewhat automatic because a veteran would have to show some kind of link for a medical opinion but now the VARO can say not related and no C & P exam and claim is denied. The article does not say VA personnel level who reviews the veterans claim just that it would be reviewed. Any insight thoughts?

[brokensoldier244th]

Local varo vsr’s have always determined if you get an exam or not, based on caluza. They weren’t automatic just because you filed a claim. Vsr’s have always had the ability to send directly to ratings. 

Edited May 3, 2020 by brokensoldier244th

[broncovet]

This doesnt seem to be anything new.  If the Veterans medical evidence contains what was needed, no c and p exam was ordered.  The VA has always had discretion on whether or not to order a c and p exam, regardless if the claimant  was ultimately  denied or awarded, based on the evidence in the file.   

Frankly it sounds to me like someone "sold" still another Acronym to VA, with another new "program" that does little or nothing.  VA loves to have a list of "programs" they can cite when things go amuck at VA, and they can say stuff like:   

Quote

"Yes, we are also concerned about the delays for Veterans benefits.  And we are working on that now, as we speak.  We have instituted a new procedure called "ACE" designed to deliver benefits faster.  Now, what VA needs is more money from congress to implement that plan."  

By giving the pig "3 seperate coats of lipstick" its assumed she will be beautiful.  The VA system is largely broken and "more lipstick" does not change the pig into a beautiful woman.  Instead of just grabbing the pig and putting on lipstick, someone came up with the idea that we need to give the lipstick an acronym to make it sounds like it really does something.  VA executives get paid for thinking up stuff like this.  

Instead, my opinion is "no VA executives should get paid" until every last Veteran is paid, first.  The VA executives would then make sure that Veterans got paid so they could get paid.  As long as the VA executives get paid, while Veterans wait in a long line, nothing really happens, except that about 22 Veterans per day take their own life.  Source: https://www.washingtonpost.com/news/fact-checker/wp/2015/02/04/the-missing-context-behind-a-widely-cited-statistic-that-there-are-22-veteran-suicides-a-day/

Edited May 3, 2020 by broncovet

[brokensoldier244th]

There are directives to send anything that doesn’t specifically require an exam ( no recent exam, for example, or a first exam, or specialist) to ACE. It’s being enforced as a performance ratable item for vsr’s. You can see what’s ACE exception in M21 Starting at III.iv.iii.A.4.b

Edited May 3, 2020 by brokensoldier244th

[GBArmy]

I believe Broken is correct: it isn't a new thing. The VA has the option of skipping the C&P under certain situations,  I had one 1 1/2 years ago for a suppl. exam. It is a small sample, because I only had the experience of one ACE exam, but I wasn't impressed. They missed the critical evidence just like the did on the original denial. Just rubber stamped it. For me, it was a waste of time.

[Vync]

That is exactly why I recommend reviewing your VA treatment/progress notes after they are posted.

About 10 years ago, I checked my notes and found I met the criteria for a higher rating. I requested an increase based on the evidence present in my VA records. I had a couple of them that were approved without the need for a C&P.

Of course, if the higher rating requires special criteria, testing, or details not present in the treatment notes, the VA may still send you to an exam.

[GBArmy]

Just an additional comment on an ACE exam. I had an exam postponed at at LHI because of the caronavirus. So they have a portal you can check to see if you were rescheduled, etc. I checked yesterday and sure enough, I am scheduled for next Friday. In Indianapolis! That's like 1000 miles or something! So I call their "Peggy" and get a rep and ask him if I get mileage for this or what? He looks it up and says, oh, that's an ACE exam. You don't have to go there. I suggested they might want to modify their web page for ACE exams. Thought it was funny. He did say that I would not likely have to do anything, like receive a phone call. But I think he realized he isn't supposed to say that because later he retracted it. I never received a call on my only other ACE exam 1 1/2 years ago. I believe they can call if their is something minor missing in your record, but the very nature of an ACE is ALL the evidence is supposed to already available to the examiner to make a decision.