16 March 2013

Recent Improvements in VA Disability Claims

Some very sensible changes were made during the first quarter of 2013 regarding VA disability claims. Goal: faster, easier and fewer errors. Might work!

1. VA practitioners are now permitted to complete Disability Benefit Questionnaires for issues they treat, removing the previous prohibition on their input to the claims process. These DEBs can be pricey to have private physicians complete and often, the VA practitioner has greater in-depth familiarity with both the veteran and the service-connected issue. Good move, VA! DBQs greatly speed up the claims process because everything relevant to a particular issue (there are 71 different DBQs) is documented for the C&P reviewer to work with.

2. C&P Exam no longer needed for some disabled vets     

In a modest change that could end up helping up to 40 percent of disability claimants, the Veterans Affairs Department is eliminating the need for an in-person medical examination if there is enough evidence of a service-connected disability in a veteran’s files or available over the phone.

The concept, tested in a 15-month pilot project, not only helped VA process claims more quickly, but it also eliminated the need for veterans to make another trip for a medical exam, which can take a month or longer to schedule.

The streamlined process will not be used in every case, VA officials said. Those most likely to benefit are veterans who have already been treated, either at VA or by private physicians, and have test results in their files providing key information. A good example, VA officials said, would be a veteran with hearing loss who has received hearing aids.

The process calls for a medical professional to screen files to decide if there is sufficient information to provide clinical evidence of a disability. In some cases, information in the file can be supplemented by a telephone interview, officials said.

In a pilot program, 38 percent of disability claims were eligible for what VA is calling Acceptable Clinical Evidence, or ACE, processing. Processing time was cut by two-thirds to an average of just eight days, down from 25, VA officials said.

VA-wide expansion of the program began in October as part of a larger five-year plan to find new ways to process claims and eliminate a growing backlog. On average, it takes VA 265 days to process a disability claim. VA’
s goal is to process all claims within 125 days by 2015. with.

3. The Joint Services Records Research Center will be providing much more accurate information in their responses to VA inquires regarding C-123 issues, thanks to initiatives undertaken by the Center's director and his VA liaison, Mr. Jim Stempsel.

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