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]

Oh, and to be honest my experience with VSO's and other reps has been... poor at best. I know there are good ones, and some good ones post here and at VBN, but my experience has been less than ideal. There are good raters... I HAVE met some of those personally. There are good VSO's I assume, but I just havent personally met one. Our state reps are... ok, but the wont do anything but a basic claim... no NODS appeals, nothing. They do seem to file basic claims well though, and I am on a first name basis with them.

As far as DAV goes, I reccomend that a veteran NOT use them, AmVets as well. they may do great things at the national level, but their veteran representation (IN MY OPINION) leaves much... way much to be desired. I have said this before.. the DAV and the VA are colocated in most instances, and I personally believe that they are too "close" to each other both physically and philisophically... big word.

It just my opinion though.. so anyone can say I am right or wrong... I wont take offense.

I have a great deal of respect for Vike... sometimes his advise comes across as.. well anti-veteran, but thats NOT his fault its EXACTLY what the VA would say. Its VITAL that we know stuff like that, and his opinions are priceless just because of that. I want to KNOW what the VA would think, and how they would respond, and if he tells me that, then I cannot take offense, its what I need to know. Sometimes frankly the truth hurts, or offends, because the VA is the way it is... hes not making personal comments in my opinion hes just saying what the VA would and will do, and the fact is the VA is so screwed up that sometimes its just plain crazy... but I'm not going to blame him for the system.

You do MANY things on a much higher level than me Berta, and I have said that I both admire and respect you for that. I cannot work that way, its too... long term for me. I work better when I have a forseeable goal with some immediate (12-18 months on average) results... what you are doing takes YEARS... and I just dont work that way.