High error rate for VA claims frustrates veterans groups

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Subject: High error rate for VA claims frustrates veterans groups

 

High error rate for VA claims frustrates veterans groups
About 15 percent of initial benefits decisions are wrong


By Rick Maze
 Times staff writer
December 19, 2005

 Veterans’ organizations are decrying the fact that the error rate on disability claims remains high even as the backlog of claims continues to grow at the Department of Veterans Affairs. About 15 percent of initial benefits decisions on claims from veterans and survivors include errors, the House Veterans’ Affairs Committee was told Dec. 7, while the backlog of claims has increased to 346,000, almost 8 percent higher than last year.

The average time to process a claim is 120 days, and processing an appeal takes an average of 622 days, the Government Accountability Office said. Ronald Aument, VA’s deputy undersecretary for benefits, said the workload has increased every year since 2000, with 788,298 claims filed in fiscal 2005, a 36 percent increase over that span. “It is expected that these increases will continue over the next five years,” he said.

This complicates VA efforts to reduce errors, but the department is trying. “Given the increase in volume and complexity of the workload, we have remained vigilant about the quality of the claims processing results,” Aument said. Veterans’ service organizations are not satisfied. Quentin Kinderman of the Veterans of Foreign Wars said the VA does not seem to have an overall plan to cut the error rate.“Until it does, and asks for the resources to fix things, little will change for the better,” he said. “For a claims process that profoundly affects the lives of veteran claimants, 15 percent is a very high error rate.”

Staffing and errors
Given the current staffing levels of the Veterans Benefits Administration, which handles claims, Kinderman said the error rate “suggests that every VA decision-maker makes a significant error approximately every other day.” “Veterans and their survivors, after waiting many months or even years for a decision from the VA, may receive a decision that is significantly flawed,” he said. The high error rate is becoming well known and is creating its own problems, said Brian Lawrence of Disabled American Veterans.

“The VA’s reputation for carelessness results in appeals even in cases that are error-free,” he said. “The scuttlebutt among many veterans is that every VA decision should be questioned just to ensure nothing has been overlooked.” That results in an even bigger backlog of claims because VA must process the appeals. Veterans’ advocates say VA is caught in a Catch-22 in which efforts to whittle the backlog of claims by increasing the speed at which decisions are made plays a role in the high error rate.

“Regional office managers are pressing ratings employees to process numbers without ensuring claims decisions are done right the first time,” said Blake Ortner of Paralyzed Veterans of America. Conversely, PVA service officers who help veterans process claims also have encountered VA offices that operate “slower than others,” where decisions are more accurate and more favorable to veterans — but where the backlog is greater.

Years of red tape
Retired Air Force Col. William Jones, a former chief flight surgeon and orthopedic surgeon, told the committee about his 6½-year ordeal with a disability claim based on his 33 years of service, which included combat tours in Vietnam and the 1991 Persian Gulf War. Jones said he has vision, hearing and prostate problems he believes are linked to his service, but he has battled a system “that promoted second-class medical care,” is “programmed to procrastinate” and is “non-caring.” Jones still has not received a decision on his claim.

It recently was kicked back to the regional office in Columbia, S.C., where the claim was originally filed, and Jones said he still is waiting to get word of when it will be considered.J ones said dealing with unqualified doctors and an impersonal ratings evaluation process makes him feel “manipulated by a system of bureaucratic maneuvers.”

“It is impossible to find out what is going on or if they have the correct or most recent data or information,” Jones said, and he implored the committee to “hold this system accountable.” Rep. Steve Buyer, R-Ind., the veterans’ committee chairman, said that if Jones, a doctor who understands medical evaluations, had problems with VA, other people with far less experience with medical matters likely face much greater difficulties.
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Contributed,
YNCS Don Harribine, USN(ret)

Any man or woman who may be asked in this century what they did to make life worthwhile in their lifetime....can respond with a great deal of pride and satisfaction, "I served a career in the United States Navy."