OIG: VA fails to have appropriate staff address Vets appeals.

[broncovet]

Its explained here:

What this means:  There is a good chance if you recently completed an appeal, it was done by people who lacked the experience/expertise to do it.  

Who pays for this?  Vets do, in long delays.  

[Vync]

This goes in line with the question I posted recently about the AMA appeals process. I realized the hearing process changed where one ALJ does the hearing and another makes the decision. Makes me wonder which one of these might be the less qualified. Based on the OIG report, it sounds like the decision maker. The ALJ who headed up the hearing didn't do much other than verify my identity, swear me in, and verify the purpose of my appeal. Turns out they were unable to answer any questions pertaining to the content of my appeal, but did give me an opportunity to make a statement. Of course, I pointed out everything again. However, 20+ years ago I had a fantastic back and forth conversation with a travelling BVA judge who had a very thorough grasp of my original appeal. He genuinely seemed to care that my appeal was addressed in a fair and accurate manner. Nothing quite like getting all claims denied because treatment records were silent for all conditions, but then I learned that the treatment record portion of my claims file consisted of an empty folder. Good thing I was able to provide a complete second copy of that and things started turning out better, although not perfect hence the current BVA CUE/appeal of the initial findings. I just wonder if I will have an opportunity to have an actual hearing with the ALJ who will make the decision. If not, then it makes me wonder why they even have an option for hearings if they are not a truly interactive discussion of the facts, laws, and regs...

Learning that the MST issues were not handled properly is definitely quite alarming. I helped a vet a while back who claimed MST just as the VA was beginning to take those claims more seriously. They denied the MST/PTSD claim, but just gave them a 10% rating for adjustment disorder. Makes me wonder if they decoded for the adjustment issue because it was diagnosed, but the MST was less provable. Also wonder if their decision maker might have been less qualified, too...

[brokensoldier244th]

I honestly can't speak to that (if they went for the sure thing with Adj Disd), it would totally be speculation. I do see a lot of "adj disorder" tossed around in STRs, though,  along with things like 'immaturity syndrome" and other made up BS and it seems to frequent those claims where the incident was not reported but the veteran was dealing as best as they could. I understand completely why most are not reported, just like bum knees, minor (later major) head injuries, or whatever. We've all done it...er....not done it, because we didn't want to put up with our peers or cadre for the next X days giving us shit about it. One thing that has happened in the last few years (10 or so) is the recognition of WHAT can be an indicator of a latent stressor and what behavioral cues can indicate that all is not well in the state of Denmark. The recognition of these seemingly unrelated behaviors and deviations from the norm, when put into context with times and dates, can reveal enough to at least get an examination requested even when a black and white glossy photo with circles and arrows and writing on the back is not available.

Younger or more experienced counselors/doctors/examiners can contextualize these markers enough to opine that SOMETHING happened even though there may not be a named assailant or crystallized details- all they have to hit is ALALAN. Do some probably get through on the barest of circumstantial evidence? I have no doubt- but I don't examine them, and I don't do the decision, I just find all the crumbs and put them together in as clear a narrative as I can with pointers to various places in their military and post-military history. The raters make the decisions based on what the examiner says and what is in the records that I research. They aren't psych doctors and they don't Dx- there are some times when there is so little to go on that the examiner can't make a Dx either, and all PTSD examiners for MST are all Psychs or Psy D's (practicing psychologists minus the academia part that makes a PhD). Those suck because after the hours I spend 1. I didn't 'win', and 2. I know that 'something' happened.

Problem is that a good chunk of these particular OIG claims that I look at are 15-20-30 years old, and many have been gone through more than once, even appeals, and even under a prior OIG review (there was another one of these big reviews in 2018-2019. I do find a lot of mistakes there- but this was when any VSR of any length of time could develop these claims, too. Some of that inexperience is a VSR that should have known enough to say "slow your roll....I'm not comfortable taking these..." and didn't, or they were voluntold. Ive also found reports from military psychs that literally say things like "shouldn't have been x,y,z...." "should have known better than to have......." etc, moralizing from the bench, as it were. These entries in STRS are usually more of a product of their time, so my looking at them with a more modern perspective often finds deficiencies there, too. I love those- doing my 2 cents to shoot down a doctor's opinion, even if it WAS 30 yrs ago. 

Edited March 23, 2023 by brokensoldier244th

[Rattler]

On 3/23/2023 at 5:56 PM, brokensoldier244th said:

"black and white glossy photo with circles and arrows and writing on the back is not available."

Alice's restaurant? (You know "you can get anything you want at Alice's restaurant.")  Maybe we should play the song over and over until the others get it. 

I suspect that my MST kind of got caught up in some of that stuff 2017 - 2018 pre AMA until I made enough stilk till it got dent to the right group.

Vync I have a habit of attaching everything to my BVA appeals so there is no excuse that the info is not there. I had a telehealth hearing in maybe 2 -3 Mo. (I was advanced on the docket because of skin cancer at the time) Over the years I think I have 3 or 4 copies of my military records including some of the ordinals that they don't have.

[brokensoldier244th]

What are you in for? …..Littering……

[Rattler]

27 minutes ago, brokensoldier244th said:

What are you in for? …..Littering……

I knew you would get it. No room 604 I was on the bench with mother rappers and father stabber's.

Alice's Restaurant 

https://youtu.be/m57gzA2JCcM

 

 

[Vync]

@brokensoldier244th When I took Introduction to Psychology in college, which relied on an earlier version of the DSM, one of the things they focused on was interim diagnosis like adjustment d/o instead or going straight for PTSD. If the symptoms continue, even with treatment by psychotropic meds, they would not change the diagnosis until certain criteria and/or durations are met. That's probably why you are noticing this having had occurred with much older claims. 

@Rattler I do the same thing with my appeals. I have been burned repeatedly since the very first claim I sent. They claim something is not there, but I make certain that it is, plus I spoon-feed it right to them. All they need to do is take a moment or two to simply verify. I also was surprised to find that the VA repeatedly has said that they could not find something in my service treatment records. I pop open my physical folder and there it is. I also open the c-file copy they sent me 10+ years ago and usually find it there, too. But when I look at the PDF containing my c-file I got a couple of years ago, I find it is either completely missing or some redaction element is covering up the text on an older handwritten document. Or, I can find it in all of those places and the VA still says they cannot find it. It never fails to amaze me...