Bogus Claims Clogging The System?

[Hoppy]

The question of VA backlog and bogus claims jamming the system has come up once again. The VA through its procedures actually invites bogus or more accurately described as "poorly thought out" claims. Correct me if I am wrong or if anything has changed recently. The last time I went into an RO there was a flier on the wall telling people that if they feel they have a claim to just fill out the claim form and the VA will do the rest. This flier explained the duty to assist as being the VA's motivation to process the claim.

The veteran then goes to a service rep. sitting at a desk and tells him he wants to file a claim. This rep has a mind of his own and interacts with the veteran. The rep can decide to file a claim or become argumentative because he feels the claim is a waste of time (this happens for a fact. It has happened to me both ways. I have encountered argumentative reps and reps who just rubber stamped my request and sent it along.) In the event the rep decides to start a claim either because the veterans story sounds plausible or because somebody told him to start all claims requested by the veteran and the rep decides to go along with the program and thus the claim is started.

VA procedures then required that the veteran provide the RO with the names and addresses of treating physicians and release authorizations for the records. Additionally, the RO acquires and reads the SMR. If the adjudicator thought that their might be a connection then a C&P can be scheduled. If he thought the claim was a waste of time then he can deny the claim as not being plausible or without any possibility of being able to be developed due to lack of medical support.

The VA must feel a little paternal to go to all the trouble to read the SMR's and or doctors reports just because they have a duty to assist. The VA should accept the claim form and set the claim date. However, they should add a step in the process. The VA could save a lot of time by requiring the veteran to obtain and have the rating schedule, SMR and the personnel file in his possession prior to the VA obtaining and reading them on their own. This would give the veteran and his representative (should he have one) a chance to look at the claim more objectively and then decide whether or not they want to continue. Then the veteran could file a statement that he has obtained the SMR, rating schedule and desires to continue with the claim.

In one of my claims the VA went to all the trouble to obtain and read my entire SMR for a condition that they thought I was not even treated for in the military. What a waste of time. Had they had me read the SMR and I found out that I filed a claim for something I was not even treated for in the military I would have dropped the claim. Had they told me to obtain and read my SMR I would have noticed that the military doctors called the same symptoms by a different name than the post service doctors and diagnostic term I used when I filed my claim. This little problem delayed my claim by three years and caused the RO to waste their time typing up a denial that was based on inaccurate information. The denial was eventually overturned.

Edited March 16, 2007 by Hoppy

[Josephine]

Same here for me. I thought that the VA was my best friend upon filing in 1978 and when I filed again in 2002, I also believed everything that the counselors told me.

Now, I am fighting my claim the correct way. I could have saved myself many years had we had the internet and the help of others to make it through the system.

Josephine

[Vike17]

Josephine,

After going back through the forum and re-rerading your post, in particular your remand you posted, and Patrick428 and my responses, It appears the VA has handled your claim correctly. As a matter of fact, it looks like they are trying every avenue to assist you and to ultimately grant your claim. So much for the "adversarial process."

One of the reasons why your claim has probably been denied is the two 5-6 year periods after your discharge where there is lapse in treatment, which most likley does not show a nexus (probably due to the numerous different diagnosis and so forth) to your military service of 11 months. Due to the conflicting diagnosis that have occurred, there in now a difference of opinion between doctors, which the VA seems to be trying to resolve.

I'm not going to discuss this any further with you as I have already stated "why" your claim is at the point it is and "why" the VA has, up to this point, decided what it did. Go back and re-read Patrick428 and my responses to your questions which are currently on pages 55 through 59 of this board. The VA regional office and the VAMC's for that matter haven't screwed your claim up. There simply isn't the needed evidence in your C-file to grant the benefits you've claimed. The bottom line is you're probably missing the nexus between your current diagnosis and the symptoms you had while in the service, and until you produce the needed "connection," the Va must continue to deny your claim. Just because you think the VA system has done you wrong, doesn't mean this is actually the case. The "other side of the story" seems to indicate otherwise.

Pete,

"I did not mean that the VA is Bogus I think that the backlog of claims is bogus. Certainly in 16 years the VA would have figured out a way to get the backlog to a manageable amount that they could handle Veterans claims in a reasonable amount of time?"

The VA has pretty much figured it out, they have repeatedly stated to Congress they are under funded and need more personnell to chip a way atthe back log. Congress continues to under fund them year after year. So who's basically at fault? I would venture to guess it's the Congress, not VA.

Vike 17

[Josephine]

Vike,

As you said you have no more to say. I thank you for your research. I will corect you on my 11 months of service. Not true. I was in the navy for 15 months. Also I was discharged June 1964 and started medication in 1967. I did not have the years of lapse as you quote.

The two psychaitrist may state that I have, but with my private medical records to read, this is an untrue statement on their part.

Please use your knowledge, for those who need your expertise.

Josephine

[Vike17]

Josephine,

I said I wasn't going to discuss this anymore; however, it apears that there is some informstion that isn't correct which was stated in your remand versus what has been posted here and I'd like to clarify those differences.

Could you re-post the link to you remand at the BVA. You edited out of your past post on page 56.

Vike 17

[carlie]

It's getting time here, for a few people to take a deep breath before the post something they will later wish they hadn't.

We ALL NEED TO UNDERSTAND -- VIKE is not the VA -- He comes here extending an open hand,

his words are not meant as weapons to attack anyone with. Take some time, just click on his name and read through his postings, you will clearly see that he presents to us, how the va

adjudication process works and/or why claims are denied. If we can understand why our claim's are denied - and what is required to get them granted -- what more help could we ask of him?

Vike did not make up the rules and regs - Vike DOES know how the rules and regs are to be implemented. We all need to remember that as simple as one little rule can APPEAR to be --

when you look at that same little rule from totally a legal standpoint - NO EMOTION INVOLVED --

many times you will understand that one little rule, in a totally different way.

I hope we start remembering that old saying, "Don't shoot the messenger". Just because the answer you get, is not what you wanted to hear, does not have to be a negative. Take the answer and find a way to make it work to your advantage, learn from it instead of getting defensive or nasty.

jmho,

carlie

[jbasser]

Folks, anytime there is money involved there is always the temptation for some to cheat. I Feel that there are some claims out there that are not waranted. Those claims are few. I dont think they are backlogging the system. The problem with the system is Mass confusion the hands of the VA Raters, VSO'S and sometimes the Veterans themselves.

It is a plesant atmosphere when I see people with the experience on this board who actually know what it takes to win their VA claims. A few people are so advanced with their knowledge that I read their posts very carefully so that I may learn something New.

I welcome VA employees or former employees on this board as I am a former employee.

Those folks can show us the way if we listen. If not for their advice it would be like going bear hunting with a BB Gun?

John