How VA Games Their Claims System:
"We have to draw the line somewhere." (VA VHA official quoted by AP)
VA's Veterans Benefits Administration and Veterans Health Administration skillfully developed their own solution to a mutual problem long ago.With hospital appointment lines long, budgets constrained, staff overburdened, and a too-visible claims delay backlog...lightbulbs went off over the heads of staffers from these separate but related functions of the VA.
(note below: advantages favor VA, disadvantages favor veterans)
A. The VA Delayed Claims Solution: Deny claims (as often as possible for whatever reason comes to mind (legal or not) but not right away...wait out as long as possible until the time stamp on the claim starts getting visibility for being too long delayed,) then deny the claim.
• Advantage: many vets give up at this point or die off.
• Advantage: VA continues to deny all medical care and benefits for a year or more, with great savings and shorter appointment lists
• Disadvantage: some vets will appeal to the Board of Veterans Appeals (VBA)
B. The VA VBA Appeals Delay Solution: Delay for several years, with perhaps three-four years since claim submitted. Then remand to start all over again, deny to force appeal to CAVC or in a few cases, approve.
• Advantage: more years with medical care denied, vets give up, survivors don't know how to proceed, vets die off (VA term:vet deaths = "advantageous wastage"
• Advantage: process looks fair, although designed to prevent rather than approve claims
• Advantage: even if claim is approved for total righteousness, BVA decisions set no precedent so an identical claim five minutes later can be decided totally differently
• Advantage: Few vets have resources to hire representation; most VSOs are less skillful than attorneys
• Disadvantage: denying precedent wastes VA resources as identical cases eat up time, when precedent could instead be cited for denying more claims coming into BVA
C. The VA Court of Appeals for Veterans Claims Delay Solution (CAVC): Additional several years to be heard, often remanded back to rating office for minor details,
• Advangage: many more vets give up or die off; even their survivors start dying off
• Advantage: VA continues to deny all medical care and benefits for several more years, with fantastic savings and shorter appointment lists and forcing vets onto Medicare, Medicaid.
• Advantage: CAVC decisions are not precedent-setting except by three-judge decisions
• Advantage: surviving vets after these years generally focus more on health than legal conflicts, either giving up, becoming less competent, or conflicted with other commanding health issues
• Disadvantage: none. Few vets have resources for representation, plus mandatory fees help discourage representation but for the odd pro bono
• Disadvantage: precedent rules requiring three-judges means identical cases often have to keep being heard, wasting Court time but assisting VA in preventing all care to the affected veterans (remember...prevention of care is the priority. Prevent, Prevent until they die. Refusing medical care helps the vets die off faster, saving both money and appointment list scrutiny.)
Veterans Solution: The immediate help for veterans would be a claims process providing immediate overall review to identify "more likely than not" appropriate disability claims and permit those veterans access to VA medical care on a tentative basis. With or without compensation, but at least medical care to survive.
Those claims continue into a "fast track" system of evaluation to be resolved and terminate VA care if appropriate 30 days after denial, with a scheme to either buy into a private plan or an alternate, lower priority VA program. Approved claims join the ranks of approved claims in the normal manner.
VA Solution: Obviously, none of the above. Find more ways to delay. Redefine various obligations for care to further exclude veterans from eligibility. Tell Congress things are working well except for the odd, delusional veterans who whine on about things when they should keep their damn mouths shut!