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Do You Wonder Where Your Claim Is?
See the pile of paper on the desk in the picture above?
Your claim is at the bottom of the pile and she's going on vacation...
after she collects her performance bonus.
Your claim is at the bottom of the pile and she's going on vacation...
after she collects her performance bonus.
This is the bottom line: If you file a claim today, it won't be properly adjudicated in 125 days. The VAWatchdog advises veterans to plan on a 2 year wait for the denial letter. The appeal will then take another 2 years. The backlog won't be resolved in 2015. It isn't likely that your claim will be either.
Each week your Department of Veterans Affairs publishes the Monday Morning Workload Report (MMWR). The MMWR is in a complex speadsheet and sometimes it's difficult to read.
My mailbox overflows with the question, "How long does it take for my claim to be done?" Most veterans who are new to the VA naively believe that the VA will have a look at their claim, see that the claim is well grounded and soon award the appropriate benefit. After all, weren't we given the assurance that if something bad happened to us the VA would help?
Why do we have to resort to anger and calls to Congressional representatives? As I read the article here "Veterans’ wait for benefits is lengthy" it comes to my mind that there are any number of problems with the picture presented.
The report says that the Vietnam veterans doctors attribute his condition to agent orange exposure. It appears he has a VSO representative. If that's accurate, why then was it necessary to contact his Congressman? “Once they understood the situation, the VA was very responsive,” said Lee Martin, the veterans’ caseworker for Austria’s office. No surprises there. If a veteran can get the attention of a Congressional representative VA is often very responsive. Why can't VA be equally responsive without the press covering the story or a Congressional inquiry? Isn't that what VA is supposed to do? While this Congressman helped this veteran to receive his desperately needed benefits, what's happening to the veterans who don't have a responsive, aggressive Congressional representative?
The backlog is happening and it's worse by the day. (Data is from the VA MMWR site)
The simple chart above illustrates what
happened in 2011. The year started with an inventory of 775,552 pending
claims. By year end that number had crept upwards to 878,830. In January
2011 there were 331,299 (42.7%) of those claims that were delayed over
125 days. By year end that had risen to a whopping 556,597 (63.3%) of
claims that were long past any reasonable date for processing. There
were 20% more claims that were overdue by the end of 2011...hardly a
record to brag about.
The Veterans Benefits Administration (VBA) uses the term "Pending Over 125 Days" or similarly deceptive terms when discussing the backlog. In reality, that number is representative of the least amount of days that claims are overdue. VBA doesn't want to talk about how they arrive at that figure nor is it ever discussed how many claims are past due by 250 days or 500 days. The 125 number doesn't seem unreasonable if that's all it takes to have the average claim processed. That's a little less than 5 months.
The Veterans Benefits Administration (VBA) uses the term "Pending Over 125 Days" or similarly deceptive terms when discussing the backlog. In reality, that number is representative of the least amount of days that claims are overdue. VBA doesn't want to talk about how they arrive at that figure nor is it ever discussed how many claims are past due by 250 days or 500 days. The 125 number doesn't seem unreasonable if that's all it takes to have the average claim processed. That's a little less than 5 months.
It's The Backlog!
The single most important issue that every veteran talks about at VA is the time it takes to get a claim resolved. The backlog is the signature event that defines the VA. No matter the successes, today's VA is known for the infamous "Delay, deny, until I die" phrase that's been around as long as any Vietnam vet has been alive. Every year we hear how the backlog will get better next year.
Shinseki: VA on Track to Break Claims Backlog
WASHINGTON, April 2, 2012 – Veterans Affairs Secretary Eric K. Shinseki says VA is on track toward meeting one of the top priorities he set on arrival at the department three years ago: breaking the back of the disability claims backlog.
VAWatchdog hasn't forgotten how it feels to have a claim delayed first for months and then for years.
The fix, according to your VA, is computers. Everything will be better if we throw money and computers at it.
"VA spent the last two years creating an automated tool to make claims determinations faster and more accurate, he said. “Our intent is to have no claim over 125 days,” Shinseki told American Forces Press Service. “And every claims decision that we put out the door [will be] at a 98-percent quality mark.” Toward that end, VA has been testing the new Veterans Benefit Management System..."
Your VA seems to have forgotten a simple rule..."Computers have enabled people to make more mistakes faster than almost any invention in history, with the possible exception of tequila and hand guns”
The backlog has a single cause. It isn't what your VA would like you to believe, that veterans are just filing too many claims, it's that the error rate of initial adjudications at the VA Regional Office approaches the 70% mark. That means that 7 of every 10 claims filed will require an appeal. To appeal adds work and wastes your tax dollars. Although VA does a poor job of measuring the error rate, the fact that most appeals are handily won at the DRO or BVA is proof enough.
In January of 2011 the claims pending over 125 days represented 39.4% of the total inventory of all claims. In April of 2012 claims pending over 125 days represent 65.9% of all claims.
If VA doesn't address the problem by striking at the root cause, we'll soon see an overall inventory of pending claims in excess of 7 figures...we will pass the 1,000,000 number...and it won't be long before the claims pending over 125 days catches up.
To do it right the first time is the only reasonable goal. If other federal agencies can do it, why not VA?
Why are there so few veterans who tell us of their claim being correctly processed in 5 months? Why is the backlog so large and steadily growing?
It isn't difficult to understand if you give some thought to the process. Much like any business, the VBA has a task to accomplish. To correctly adjudicate a claim for benefits is their most important job. This isn't much different than building a car. Raw materials (the data about the claim or the materials for a car) come in one door of the building and the data is worked on to be turned into a decision. The decision exits the building and goes to the veteran.
However, the VBA gets it wrong so often that the finished product (those flawed decisions) must be returned for reworking. The rework is often done by the same people who didn't get the job done in the first place.
Returning to the analogy of building a car, try to imagine an auto manufacturer who delivered 70% of their products to customers and the customers discovered that it didn't run, the electronics didn't work and there were no windows in place. Since there's a warranty in effect, every one of those customers would immediately return the vehicle and demand that it be repaired or replaced.
That's precisely what's happening at your VBA. The backlog grows as the system is overwhelmed with appeals. My personal estimate is that 70% of all initial decisions are flawed to the point that they must be appealed. I could be wrong. The VBA doesn't accurately measure how many are returned for appeal, how many veterans give up and never appeal nor how many die waiting for the decision.
If I'm wrong and it isn't 70% but "only" 40% of the first level decisions are deeply flawed, is that acceptable? How about 30%? Your VBA accepts those numbers every day and seems to believe that it's OK to make the errors that are just a routine part of doing business.
VBA continues to blame the veteran for the problem. They say there are too many of us and we're filing too many claims. The VBA attitude seems to be that if there weren't so many pesky and demanding veterans knocking on their doors, they could get some work done.
Veterans are smarter than we're given credit for. Since 2007 we've gained the right to use lawyers to help us with appeals. More and more of us have found our voice and we aren't allowing the VBA to provide shoddy work. We're demanding that they get it right even if it takes years.
And it will take years. The 2012 calendar isn't looking very good. The Iraq war is over. The military is downsizing. Estimates hover at 100,000 new veterans will be hitting the streets soon. Unlike previous generations, they have the Internet and an endless stream of information about How To File A Claim. They're filing claims at record rates. The new veterans have no fear of retaining lawyers to assist them to wring out every benefit they earned. The new veterans won't accept the typical VBA decision letter with its errors.
Until the VBA corrects the problem at its roots, the backlog will grow. Unless VBA responds to the cry of "Get It Right The First Time", the Board of Veterans Appeals and the Court of Appeals for Veterans Claims may as well plan to beef up their staff and work some overtime.
The delay in processing the simplest claims is ugly now and it's likely to get a lot uglier in the months ahead.
The Backlog
The Department of Veterans Affairs (DVA or VA) recently announced that it would begin to transition to a paperless, computerized system that will "break the backlog" by 2015. The backlog is the common phrase used when we address the number of benefits claims that languish at the Veterans Benefits Administration (VBA), the sub-division of the federal DVA that is responsible for the adjudication of claims. The backlog is mostly made up of claims for disability benefits. The VA measures the backlog in terms of "over 125 days" but doesn't speak to just how far beyond the 125 day mark the majority of these backlogged claims are.
The announcement of how the VA will become computerized and solve the problem has been taken up as great news by the mainstream press and government publications. The institutional memory of these organizations is brief. They don't recall how many times they've published similar headlines.
The backlog will not be resolved by an assault of technology. Veterans are already encouraged to submit claims on-line and all the necessary forms are posted in numerous web sites, including the massive VA site. VA doesn't have a good record of using technology.
The backlog will only resolve when the VBA begins to advocate for the veteran and not serve the VA. The VA typically blames the veteran for the massive amount of work waiting for VA employees. In nearly every press statement there will be a reference to how many veterans are filing claims. The message is clear...if it weren't for all those pesky veterans, VA could get some work done.
In today's VBA a veterans application for a service connected benefit is viewed as illegitimate from the beginning of the distinctly adversarial process. The burden of proof rests squarely on the shoulders of the veteran. Without reams of evidence the veteran will be denied the benefit. This denial occurs in approximately 70% of all initial applications. The denial is then overturned in the great majority of those that are appealed. The high rate of awards upon appeal is the best indicator of all that the problem that creates the backlog is at the ground level...within the fortress-like, heavily guarded walls of the VBA.
Before journalists and government officials applaud this latest announcement, they should study history. You, and the popular press, are being spoon-fed your tasty pablum by a marketing machine that is the envy of any business.
"Those who cannot remember the past are condemned to repeat it"
08/31/2010 Shinseki: VA Backlog Will Be Broken This Year
10/14/2009 Backlogs continue to frustrate progress at VA
09/24/2009 Quality Over Quantity Important in Reducing Veterans` Claims Backlog
07/12/2009 Veterans Affairs Faces Surge of Disability Claims
05/04/2007 Veterans Affairs backlog, bonuses stir anger
03/13/2007 New idea offered for easing VA claims backlog
05/23/2007 Veteran-Claim Court Faces Highest Caseload in Its History
03/27/2002 VA Making Progress On Backlog Of Claims
05/28/2002 VA Slashing Backlog
06/20/2001 VA Benefits Claims System Flawed
10/03/2001 VA Claims Processing Task Force
Backlog For Veterans Claims Mounting
2010 "Shinseki: Backlog will end this year"
2010 Shinseki vows to reduce VA's claims backlog
Congressman Rich Calls on VA Secretary to Reduce Backlog at St Petersburg VA Regional Office
(WASHINGTON,
D.C.) – While assisting a constituent with a case involving the VA,
Rep. Rich Nugent (FL-05) learned of an over eight hundred person backlog
at the St. Petersburg VA Regional Office. In response, he sent the
following letters to the House Veterans Affairs Committee and the Secretary of the VA:
Secretary Shinseki
Department of Veterans Affairs
810 Vermont Ave, NW
Washington, DC 20420
Dear Secretary Shinseki,
I write today to bring to your attention a problem that I recently learned about at the St. Petersburg VA Regional Office (VARO). While working a case on behalf of one of my constituents, a member of my staff spoke with the Legal Administrative Specialist at the St. Petersburg VARO and was informed that their Fiduciary team has over 800 appointments waiting to be scheduled. Additionally, the Field Examiner who is currently assigned to my constituent has a number of cases older than his, which is already over 77 days old.
While I understand these fiduciary cases require a thorough vetting process, an 800 person backlog is unacceptable. While these people waiting to be interviewed by the Field Examiner are still able to receive their monthly benefits, I am concerned about those individuals, like my constituent, who are suffering extreme financial distress while waiting for the retroactive payments they are due.
While I will be working with my colleagues who are serving on the Veterans' Affairs Committee to improve the efficiency of the fiduciary approval process, in the meantime, I would like your commitment to work with the St. Petersburg VARO to cut down this unacceptable backlog of cases. I thank you for your work on behalf of our nation’s proud veterans, and I look forward to your response by December 23, 2011.
Sincerely,
Rich Nugent
Member of Congress
The Backlog
12/12/2011 Pending Inventory St. Petersburg VA Regional Office (Source)
Compensation Claims Pending 47,455
Claims Pending over 125 days 28,906
% pending over 125 days 60.9%
12/12/2011 Pending Inventory Nationwide
Compensation & Pension Entitlement 878,574
Pending over 125 days 551,047
% pending over 125 days 62.7%
Can IRIS help you determine how long it will take to process your claim? NO!
Why Not IRIS?
I often recommend that IRIS and the VA toll free number be avoided. The VA OIG Report of 05/13/2010
seems to agree when it comments that, "we concluded that any one call
placed by a unique caller had a 49 percent chance of reaching
an agent and getting the correct information."
This means that even the VA agrees that your IRIS inquiry will be answered correctly less than 1/2 the time.
The
veteran who sent the communication thread below to me has made plenty
of strategic errors. He has done his future financial planning betting
that he'll receive a windfall of VA disability money and that will solve
his problems. He's also thinking that if he yells for HELP that someone
will speed up his disability benefit process just for him.
The Department of Veterans Affairs is not a financial institution. The adjudication of your claim for disability benefits will not consider your financial circumstances. You may be very wealthy or very poor and that will not enter into the decision. Your claim will be decided on the merit of the claim itself and nothing else.
Most claims are denied. It is common that even well grounded and perfected claims are routinely denied and must be appealed. Many advocates believe that 70% or more of initial decisions at Regional Offices are denied without proper cause. They must then be appealed.
Veterans must plan their finances as if they will never receive any VA disability benefit money.
Having said that, this veterans frustration and anger is understandable. The system is failing us. The backlog is growing daily. Erroneously denied claims that require appeal and are ultimately awarded also are increasing.
How to correct this? Do it right the first time and do it swiftly. This requires that the veteran and the veterans representative present a legitimate claim that is properly perfected to the VBA. Once that's done, there is no excuse for the VBA to fumble that ball for more than 90 calendar days.
If the claim is to be denied, get on with it. If not, make the award and allow the veteran to receive what he or she earned through their honorable service.
It isn't that difficult a concept. Although I don't know anything about the claim presented below, I see claims every day that are easy to understand and award. They never are awarded as they should be and thus, we have a backlog.
It's time to implement the promised change in the number one problem at our VA. 2012 should be the year that there is no backlog of stalled and wrongly decided claims.
And...don't bother with IRIS. It's not there to help you.
Jim Strickland
The Department of Veterans Affairs is not a financial institution. The adjudication of your claim for disability benefits will not consider your financial circumstances. You may be very wealthy or very poor and that will not enter into the decision. Your claim will be decided on the merit of the claim itself and nothing else.
Most claims are denied. It is common that even well grounded and perfected claims are routinely denied and must be appealed. Many advocates believe that 70% or more of initial decisions at Regional Offices are denied without proper cause. They must then be appealed.
Veterans must plan their finances as if they will never receive any VA disability benefit money.
Having said that, this veterans frustration and anger is understandable. The system is failing us. The backlog is growing daily. Erroneously denied claims that require appeal and are ultimately awarded also are increasing.
How to correct this? Do it right the first time and do it swiftly. This requires that the veteran and the veterans representative present a legitimate claim that is properly perfected to the VBA. Once that's done, there is no excuse for the VBA to fumble that ball for more than 90 calendar days.
If the claim is to be denied, get on with it. If not, make the award and allow the veteran to receive what he or she earned through their honorable service.
It isn't that difficult a concept. Although I don't know anything about the claim presented below, I see claims every day that are easy to understand and award. They never are awarded as they should be and thus, we have a backlog.
It's time to implement the promised change in the number one problem at our VA. 2012 should be the year that there is no backlog of stalled and wrongly decided claims.
And...don't bother with IRIS. It's not there to help you.
Jim Strickland
~~~~~~~~~~~~~~~~~~~
From: Dept of Veterans Affairs
To: **************@**************.net
Sent: Wednesday, October xx, 2011 1:00 PM
Subject: [Inquiry: ********************]
Recently you requested assistance from VA. Below is a summary of your request and our response.
If you wish to reopen this issue, you may do so within the next 21 days.
Please do not re-enter your name, file number, social security number or
other personal information you have already provided to us in this
Inquiry. Please just enter your question or comments.
Thank you for allowing us to be of service to you.
To update this inquiry, please perform the following steps:
1. Click the Reply button, just as you would click Reply to respond to a regular email.
2. Go down to the brackets on this message. There is a space (a blank
line) BETWEEN those brackets.Please type your update in that space/blank
line. The space will expand as you type.
3. When you have added your update in between those brackets, click the Send button to transmit the updated message to VA.
[===> Please enter your reply below this line <===]
I
was in the decision phase, I was told it may take 37-40 days and then
notification; that was on AUG 24th this year - now it is day 96 of the
37-40 day period.
So
while I was sitting in my apt. alone on Thanksgiving eating tomato soup
and cheese sandwiches I began to wonder what was going on. I was told
from an earlier call my case had gone to UTAH? "Yes it went to Utah it
needed some work done on it." "What does that mean what kind of work?"
APRIL
2012 will be TWO YEARS since filing a claim. I am nearing eviction (14
day notice), I managed to hold off the Electric bill for a 3rd month
($138 so far), and because I am forced to get cash advances ($200 each
month with a bank fee of $16) and actually live on $350 month: minus
rent ($152) food ($50) and other costs as well.
I got long hair because I cant afford a haircut nor shave regularly, no more car or anything. I have used EVERY avenue to survive to this point, every dept, agency, etc. - THIS IS IT! I have no other resources or options and I am 80% likely to be homeless with nothing in a few more weeks.
I got long hair because I cant afford a haircut nor shave regularly, no more car or anything. I have used EVERY avenue to survive to this point, every dept, agency, etc. - THIS IS IT! I have no other resources or options and I am 80% likely to be homeless with nothing in a few more weeks.
H E L P!
Response via Email Via Email (Department of Veterans Affairs) 10/xx/2011 05:38 PM
Dear Mr. ***************:
This is in response to your inquiry to the Department of Veterans Affairs (VA) dated September xx, 2011.
We
apologize for the delay in responding to your inquiry. We are currently
experiencing a large volume of inquiries and are working as quickly as
possible to respond to each in a timely manner.
We
received your claim on April 13, 2010, for multiple contentions. Your
claim is currently awaiting a decision by our rating activity. A rating
specialist will review it to make sure we have everything we need. If we
determine additional information is needed, we will contact you. If we
have everything we need, we will prepare a decision on your claim.
The Decision Phase is completed on most claims on average in 37 days.
Your
claim’s Decision Phase began August 24, 2011. The length of time it
takes to complete the Decision Phase depends on several factors, such as
the type of claim filed, the number of disabilities you claimed, and
VA’s pending workload. A claim may take longer in this phase based on
the specifics of your claim.
There is one additional phase: Notification Phase.
We
are currently processing a large volume of claims, and we are doing our
best to process these as quickly as possible. We generally process
claims in the order received. We appreciate your continued patience.
Thank
you for contacting us. If you have questions or need additional help
with the information in our reply, please respond to this message or see
our other contact information below.
Sincerely yours,
xxxxxxxxxxxx xxxxxxxxxxxxxxxx
************************
IRIS Response Center
~~~~~~~~~~~~~~~~~~~
.
The Backlog Do You Believe That Your VA Has Any Interest In Properly Adjudicating Your Claim?
Why does The Congress seem so shocked and awed that "VA" is synonymous with "SNAFU"?
Va Fighting Losing Battle Against Backlog May 2005
Senator Barack Obama; "veterans deserve better than long waits and uncertainty"
VA Claims Backlog Is Stacking Up Quickly May 2005
Obama Targets Backlog Of Veterans' Claims August 2009
"The VA says it's receiving about 13 percent more claims today than it did a year ago." In almost every press release VA makes the point that we vets are filing too many claims. The backlog is your fault.
Lawsuit says VA mishandled claims July 2007
Obama pledges to listen to VA employees August 2009
Action memo on VA December 2008
Hidden, Lost, and Unopened Benefits Letters at the VA March 2009
Veterans Dept. Nears Dubious Milestone June 2009
"Since early 2007, the VA has hired 4,200 claims processors and with that has seen improvements in the number of claims it's processing. It's also working to modernize its system." June 2009
VA opposes bill to let veterans hire lawyers June 2006
VA facing lawsuit over claim delays Appeals often take years, veterans say November 2008
Quality Over Quantity Important in Reducing Veterans` Claims Backlog September 2009
"...we (The American Legion) applaud the energetic and conscientious efforts the VA is making to address the claims backlog problem."
Disabled Veterans Battle For Benefits March 2009
Veterans’ Programs Overwhelmed, Panel Is Told March 2007
Judge warns of disability appeal backlog May 2007
We've talked about the problems at VA for many, many years. Now what do we do? April 2012
Let's hold some more meetings! Senate Veterans Affairs Committee
And even some more meetings! House Veterans Affairs Committee
"If you had to identify, in one word, the reason why the human race has not achieved, and never will achieve, its full potential, that word would be 'meetings.'"
Dave Barry
