Veterans Appeals Process Disastrously Flawed – deliberately!

WASHINGTON — The average time for a denied claim to work its way through the actual goal of postponing claims as long as possible is worsening.

A cumbersome Department of Veterans Affairs appeals process shot up to more than 900 days last year, double the department’s public long-term target, but perfectly in line with VA's actual goal of as much delay as possible.

Much of the backlog in appeals developed from VA's push to reduce claims backlogs. It proved so simple to process claims by denying them, rather than evaluating them. Most denied veterans don't bother appealing, so VA achieves savings there, and claims which required any thoughtful evaluation were more easily "tossed upstairs" by denial for eventual appeal, again achieving VA goals in reducing its claims backlog while simultaneously avoiding any awards. 

From a VA rater's perspective, any time spent evaluating a claim is wasted time, much better spent denying that claim to make time to move on to the next claim to be denied. And certainly, if any error is made it is far, far better made against the veteran's claim, rather than in favor of it. That would be absolutely unacceptable to VA, the very worst of employee errors.

While there might not be official encouragement to make errors against veterans' claims,

there must be particularly severe employee reprimands for any errors favoring a veteran's claim. The former is okay, the latter is a career-ender.

A careful perspective of VA claims backlogs should more realistically consider the combination of claims and BVA appeals and its growth over time. Further, a separate tracking of claims resolved not by award, but by the death of the veteran while waiting should be made public.

This purposeful delay awards Veterans Health Administration tremendous savings by preventing expensive medical care needed by already-ill veterans. The longer the delay in awards, or in appeals, the more money saved by VA.

And there's alway's VA's hoped-for best solution, death of the veteran before any award at all. More frequently, VA is able to engineer BVA claims into a remand situation, the better to stall even longer. 

While backdated checks for eventual decisions might someday arrive in a veteran's mailbox, VA does not refund the cost of medical care the veteran covering him/herself over the years spent begging to be admitted into a VA hospital. Veterans realize that the BVA process, designed to bring justice to veterans' claims, actually is used to postpone those claims and prevent VA health care for otherwise eligible disabled veterans.

After hovering between 500 and 750 days for the past decade, what the VA refers to as its “appeals resolution time” hit 923 days in fiscal 2013. That was a 37 percent jump in one year, from 675 in fiscal 2012, according to a review of the department’s annual performance report.

The department’s long-term goal is to get that figure to 400 days, although the trend over the past decade has been in the other direction.

Asked about the slowdown during a conference call to discuss the VA’s appeals system, the department said it has been reviewing the measure to see if it’s the most meaningful one to convey to veterans how long the appeals process might take. The department also said it was continuing to look for ways to make the process more efficient.

Laura Eskenazi, the official who oversees the department’s Board of Veterans’ Appeals, cautioned that the long processing “time is not at all indicative of inactivity.” She said the many layers built into the system prompt many of the delays.

The VA organized a conference call Thursday with reporters to explain its complicated, multi-layered appeals delay process, which begins when a veteran’s claim for disability benefits is denied in full or in part.

Disability benefits are awarded to veterans who suffer physical or mental injuries during their military service. They range from $131 a month to $2,858 a month for a single veteran.

The VA has been engaged in a very public battle to reduce its overall backlog – the number of claims awaiting an initial decision. By 2015, the department wants to get the backlog to zero. That would ensure that no claim is pending for more than 125 days. That’s the elusive goal receiving the most attention from Congress, the administration and veterans groups.

Veterans who appeal their decisions go into a separate system designed to extend those waits far longer.

That appeals system has evolved in layers since it was adopted after World War I. It allows veterans, survivors or their representatives to trigger a fresh review of the entire appeal at any time by submitting new evidence or information, the VA said. The Board of Veterans’ Appeals can grant, deny or – most commonly – remand the case to one of the VA’s regional offices for additional review and planned delays.

According to the most recent VA performance report, published in December, the VA’s “strategic target” – essentially a long-term goal – for total appeals resolution time is 400 days; its short-term goal is 650 days. The unofficial goal...as long as possible without Congressional backlash. 

Three years now and with any luck, VA hopes for four years or even longer. That's a six to seven year delay, insuring fewer vets survive to someday be allowed into VA hospital wards to seek care.

BVA hasn’t hit its publicized goal  650 target in the last five years, although it got close in 2010, when the average appeals time was 656 days, records show. Then concerned that the process wasn't slowing claims appropriately, leadership stepped in to extend delays closer to actual objectives of at least three, and hopefully four, years before awards or remands.

Advocates said that the VA’s intense focus on reducing its backlog could help explain the jump in appeals processing times.

“As the VA has pushed to end the backlog, there’s been a diversion of resources from the appeals system to tackling the backlog,"  reported one veterans' advocate. As legislative attention was drawn to the delays in the disability claims process, VA achieved much of its goal in delaying claims by shifting them into the appeals process for long waits and remands, rather than decisions. 

This process is wholly controlled by VA and the delays involved work completely to its benefit, never the veteran's. 

Only when years of a veteran's efforts are exhausted lost in the VA claims labyrinth can actual justice be received from jurors on the Court of Appeals for Veterans Claims. There, independent judges apply laws and delivers fair treatment, finally free of the VA's political agenda.

Read more here: http://www.mcclatchydc.com/2014/02/27/219665/vas-time-to-resolve-disability.html#storylink=cpy