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

[sixthscents]

I gotta agree with jbasser and carlie....

There are MANY things wrong with the VA... and errors are made at every level which can and do slow the process of individual claims. However I think the BEST thing that can be done is simply to hire and train more raters. Also, more reps to help veterans file their claims PROPERLY, so that errors, or omissions will not cause delays.

This is a multi-faceted issue with both the veterans and the VA sharing a portion of the responsibility for the backlog... I cannot say that there are bogus claims, but I have seen a great many... "tenuous" claims.. let me say. These do add to the workload. I think if veterans were properly counceled as to what they have in their SMR's and helped in filing realistic claims that really do show service connection etc. the system would be greatly improved. Again, more reps to help vets properly file claims...

As far as Vike's comments. I find him to be generally very correct and precise in his statements. I dont think he's a big fan of the system himself, but he does seem very knowlegable about it.

I only get upset when I see patently WRONG advise, and I havent seen that from Vike yet...

[Chuck75]

I'd have to agree. The VA system as it now stands is the major contributor to delay and improper denial.

There is also an issue with what is "probative" and what is not.

There are serious issues with "Agent Orange" related medical problems and secondary issues to them. The VA's decisions can and sometimes do fly in the face of standard medical practice, references, and even statements of cause and effect by the National Health Institute.

The "Ranch Hand" studies are an example of government inspired manipulation of data to get desired results. It turns out that, based upon the data, Diabetes II and various Cardiovascular and arterial problems should be linked together, since with Diabetes, the others follow. Indeed, the first signs of Diabetes may be cardiovascular in nature. This is consistent with the data in the Ranch Hand study. Yet, undoubtedly because of the number of veterans that have cardiovascular problems, The relationship can/will only be acknowledged by the VA after a Diabetes Diagnosis.

I think that the title should read Bogus VA Clogging the System

[Cavman]

Regarding Vike (and there are others) he helped me alot during my claim. He shoots straight and tells it like it is, not what you want to hear. He also put my mind at ease at times when I got really anxious. I also got equal help from Berta. I so appreciate the help from many.

Cavman

[Berta]

I dont use email and would certainly apoligise to Vike on the board if he returns-for whatever it was I said that bothered him-

please pass that on to him if anyone has his email addy-

And of course Sixthsense I fully apologise to you if what I said offended you in any way-the other day-

Actually you are right- it is pointless to gripe here about the VA but I DO belive it helps others know that they are not alone if they too have a frustrating VARO experience-

but again- I have said this before-

from the 1980s when I was a VA volunteer up to to today-

some of the best people I have even met -work for the VA-at every level- in all sorts of jobs-medical,RO,VA lawyers,directors of VAMCs ---but it is the ones who do not do their jobs properly that can cause veterans problems-with their claims and even with their medical care.

My claim was denied by a state rep over 4 years ago-

not the VA-

because of countless errors that I did not even realise had occurred

by that rep and then 2 more reps,I am finally seeing what happened.The VARO did violate numerous regs-and that is one reason my claim was remanded-it only took a brief email to the BVA with a short follow up letter stating exactly why I should have not been sent there-that is not a gripe -that is a fact-

my POA was livid when the claim came back.They still have to deal with their errors dating back to Feb 2003.

The other reason is that my claim was so mishandled by the initial rep that in order to cover up what he did 2 other reps and even their main director developed a scenario of documented lies in order to get me to the BVA and out of their hair for years.

Unfortunately they did not think I would make formal complaint against them with the state of NY.

Yesterday- this is not a gripe about VA-

I called VA and got a 800 #vet rep who I have known for years via 800- one of the ones who really tries to give out what the COVERS screen says-

98 % of the RO 800 reps I get are just great.

and they all know me after 2 decades- too-

she gave me some interesting information-

what she said doesnt matter here- my claim went back to a rater-

however it did indicate to my that when you make a formal complaint to the people who pay your reps-

and document that complaint with lots of specifics-I have a manila file 4 inches high of correspondence to and from my POA-regarding one single question I have asked them for over 2 years-

and they refuse to answer the question.

in this case, by drawing out what the 800 rep said -I know that 6 page complaint I sent to the State of NY Governor got me some action.

I might well find out that- in spite of the legal errors that the VA did make-enough to get me a fast remand-

their position- that I had sent them no evidence that would even raise to Benefit of Doubt-

might well be based on the fact that my vet reps made sure they never would see any of it.

The director of the NYSDVA wrote to me and claimed my IM0s were not "sufficient" to even be considered by the VA.He is not a doctor nor does he have the right to even opine on valid IMOs.He had never seen my IMOs when he said that and the state of NY division of veterans affairs apparently had never heard of Dr. Bash.They never suggest IMOs to their claimants.

And he wrote to me again on NYSDVA letterhead -when I obtained and submitted the third additional IMO -that I could expect the same situation regarding the newer IMO too.(not at all redundant or accumulative to the first)

The VA has never given any medical rationale against them, nor rejected, nor opined on, nor ever even acknowledged these 3 IMOs at all.

The VA in December said they never even received them.

(but they came back with the remand in Sept and they are per the VA- Gone already-again)

I have blamed the VA for losing them only due to past years of having that happen to my evidence-

but I am sure seeing the fact that-

if a POA keeps removing evidence from a C file-before VA even sees it --

the VA has nothing to put on the scale of Benefit of Doubt-in my behalf.

My claim was denied over 4 years ago by NYSDVA -not by the VA.

[Pete53]

Wow Berta that really sucks. My experience with the VA is everything I sent is in my C File and they also refer to IMO's in denial letters.

It sounds to me like your VSO should be hauled up and spanked.

Good Luck on your claim.

[sixthscents]

Berta.. like I said you dont COMPLAIN you give an example...there a huge difference. If I offended you I am sorry and apologize. Like I said, I value your opinion, advise and knowlege and simply am not willing to lose that over this issue. If I say something that offends you tell me to shut up, and I will... period.