27 January 2016

VA Secretary Proposes Overhaul of Claims Appeals Process for Senate Consideration. "Fails Veterans," He Insists.

(note: my own claim submitted in 2011, denied in 2012, appealed immediately, is coming up on its third year waiting for the VA regional office to forward it for appeals, after which the Board of Veterans Appeals takes about another six months to process. If successful(?) in my appeal, the claim is returned to the regional office to begin the process all over again in hopes for a more positive outcome. The process described by Secretary McDonald is truly designed to wait out veterans remaining days..."delay, deny until they die" is how the Vietnam Veterans of America describe it.

It might not be clear to non-veterans that all the while a claim sits awaiting an initial decision and then the appeal, VA refuses all medical care and other benefits. In my case, these last five years with cancer, heart disease and other problems would have had me dead and off the VA's queue by now if I'd not had other medical care available. The longer VA delays a decision, the more money it saves.)

“Decades worth of law and policy layered upon each other have become cumbersome and clunky,” McDonald said in a statement to House lawmakers and the press. “Most importantly, it is now so antiquated that it no longer serves veterans well as many find it confusing and are frustrated by the endless process and the associated length of time it can take to get an answer.”
The Cabinet secretary he needs both legislation and resourcing to “put in place a simplified appeals process” to handle the cases in a matter of months, instead of years.
McDonald’s call echoed comments he made to the Senate Veterans' Affairs Committee on Jan. 21 during a hearing on department reforms. He said that with lawmakers’ help, officials could reduce the processing time for appeals cases to less than a year by 2020, much quicker than the current three-year average wait for decisions.
VA officials have worked in recent years to clear the backlog of first-time benefits applications after intense public criticism about the waits facing veterans seeking disability payouts.IOver the last three years, the number of cases pending for four months or more has dropped from more than 612,000 to fewer than 80,000 this week. But officials missed their publicly stated goal of reaching zero by the end of 2015.
At the same time, the number of appeals — cases where veterans believe claims processors have misunderstood the severity of their injuries and shortchanged their benefits payouts — has risen by more than one-third, to 440,000 cases.
VA officials have blamed the rise on the growing number of veterans filing benefits claims, noting the percent of cases heading to appeals has held steady at around 12 percent in recent years.
They also note that administrative moves alone to certify and transfer appeals usually take more than two years.
Veterans also have the option of adding new illnesses and disabilities as the appeals process drags on, giving them the opportunity to receive larger payouts but also lengthening the wait on decisions.
McDonald called the current wait times for veterans in the process “unacceptable.”
The VA secretary says he wants a new appeals process “with the timely and fair appeals decisions veterans deserve, and adequate resourcing.”
House lawmakers have begun work on legislation to reform the appeals process. A bill sponsored by Rep. Beto O’Rourke, D-Texas, would create a “fully developed appeals” process, limiting introduction of new evidence and arguments but guaranteeing quicker processing time and decisions.
Mirror legislation is expected to be introduced in the Senate in coming days. The proposal could become the basis of the type of reform McDonald wants, and has support from key lawmakers from both political parties.
But Senate Veterans' Affairs Committee Chairman Johnny Isakson, R-Ga., last week warned that getting an overhaul plan through Congress in an election year  “will take significant legislative willpower, but it's not impossible.”
McDonald said plans are underway to move on upgraded mail systems and digitized records that will speed the process some. Staff is undergoing retraining to better handle those cases.
“But (those steps) will not be enough,” he said. “We must also look critically at the many steps in the current complex appeals process used by VA and by veterans and their advocates to design a process that better serves veterans.”

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