Pages: Lists of Fundamental Documents

08 April 2014

Partial Solution to VA Claims Backlog Proposed

Here's an idea: Legislation, or Presidential Directive, forcing VA to pay for whatever medical care a veteran has between the period of diagnosis of a service-connected illness, and the final VA approval of a claim.

The VA's present claims process is carefully designed to prevent providing medical care and other benefits for as long as possible, stalling any claim approval or, even better, denying the claim altogether. Delay=VA savings!

We can change that, for the better! Tell the veteran to simply save his receipts and compel the VA to reimburse medical expenses once the veteran's claim is approved. Faced with no longer being able to force the veteran's medical expenses onto the vet's shoulders and faced with having to pay the bill anyway, VA will speed the process up to get the veteran into the VA facilities where services can be provided (or denied) less expensively.

Presently, VA's tremendous reward is by preventing costly medical care for veterans who've presented serious illnesses such as ALS, soft tissue sarcoma, heart disease and other ailments. Vets submit their disability claims but faced with such serious health challenges also seek immediate medical care through whatever health care system available to them: Medicaid, Tricare, private insurance, charity. Or they might be forced to postpone vital care altogether. VA saves money by stalling their claim and forcing years of medical care elsewhere...anywhere but the VA at the VA's expense.

Works for the VA! By postponing action on veterans' claims, VA skips those initial surgeries, rehab, prosthetics, all the expensive stuff.

A few years later, once the claim floats through the process, VA can then deny the application as they'd planned all along, keeping VA hospital doors locked to the vet while the Board of Veterans Appeals process cranks along. That cancer or ALS patient thus is somebody else's financial burden. Even when perfectly correct claims are denied, veteran loses, VA wins, because the only justice awaiting the veteran after years of struggle is the catch-up check for monthly disability...pennies compared to the cost of medical care which the VA refused to provide and for which, if the veteran is treated outside the VA, there is no recovery at all. Total veteran loss.

This can change, and via a very simple process. Place before the Secretary of Veterans Affairs the inevitable medical bill, if paid to outside providers, or the cost of less expensive VA medical care, and the VA will see the immediate financial requirement to process claims on a near-immediate basis.

Take away the immense financial incentive for VA to delay, delay, delay approval of veterans' claims, and the incentive to deny perfectly valid claims to stall them in BVA queques, both saving VA budget by refusing VA medical care throughout the claims process.

Take away the very reason, that most-powerful objective built in VA's claims delay schemes and VA will discover ways for the millions invested in their new claims process to actually work.

Might this motivate VA to quickly deny perfectly valid claims? Absolutely...they'd see that as an objective immediately. To counter this, we would need an outside review process capable of a rapid..one or two weeks...review of any application for disability rejected by the VA, and that outside review process must have some motivator for VA accuracy...perhaps, awarding improperly denied veterans' claims double whatever correction is ordered. If a legitimate claim is improperly denied by VA and the veteran's interim medical expenses total $100,000, the outside review process should be able to award double the recovery. This removes any VA incentive to scam the system by blocking claims, and encourages very rapid approval of proper disability applications.

Who knows: it might work!

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