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Disability and Memorial Affairs Subcommittee Examines Appeals Process

On Tuesday, June 18, the House Veterans’ Affairs Subcommittee on Disability and Memorial Affairs (DAMA) held a hearing examining systemic problems with the appeals process for the Department of Veterans Affairs (VA) disability benefits. The hearing, entitled “Why Are Veterans Waiting Years on Appeal? A Review of the Post-Decision Process for Appealed Veterans’ Disability Benefits Claims” sought to examine all levels of the process, including witnesses from the lowest to highest level of the appeals process.

Keith Wilson, Director of the embattled Roanoke Regional Office (RO) in Virginia spoke on the first stage of the process, review by a Decision Review Officer (DRO). Laura Eskenazi, Principal Deputy Vice Chairman of the Board of Veterans Appeals (BVA) spoke about the process at the BVA in Washington DC, the next level of the process, where veterans’ claims are reviewed in detail by veterans’ law judges (VLJs). Ronald Burke, Director of the Appeals Management Center (AMC) addressed the process at VA’s DC-based central clearinghouse for claims remanded for additional work. Finally, the Honorable Bruce Kasold, Chief Judge of the U.S. Court of Appeals for Veterans Claims (CAVC) expounded on trends noticed at the Court.

The subcommittee took VA to task for problems with the appeals process. Ranking Member Dina Titus (NV) noted that despite recent claims from Compensation and Pension Director Tom Murphy that VA was “at a ‘tipping point’ to breaking the backlog,” veterans in her home state of Nevada do not feel that they’ve reached a tipping point. With an average time to complete claims at the Reno, NV RO of over 530 days, more than four times VA’s aspirational goal of 125 days to complete, Rep. Titus noted there were still grave concerns about VA being on track, and reiterated requests to VA for benchmarks as to how VA can reach their goal of 125 days to complete claims at 98 percent accuracy.

A common thread running through the hearing was a desire to avoid “robbing Peter to pay Paul” in the haste to process claims now as a part of the two year old claims initiative, only to send a tidal wave of appeals down the road to flood the system as poorly considered, rushed decisions and denials are appealed by veterans. It does no good to “eliminate the backlog” of claims pending more than a year if hasty decisions rife with errors are only going to be appealed to strain the resources of the BVA, AMC, and CAVC.

Judge Kasold spoke of recurring issues faced by the Court, with “over 50 percent of the [average 4,300 cases per year] we see being remanded for further development that was improperly addressed at the lower level.” Ms. Eskenazi of the Board of Appeals noted of more than 44,000 decisions issued by the Board in FY 2012, nearly 30 percent were grants of benefits. That rate skyrockets to 70 percent or more when remands are issued to allow for the correction of mistakes or improper development at the lower level. In both cases, recent claims by VA to be operating at “greater than 80 percent accuracy” are called into question. Much as American Legion testimony has indicated for years, when independent review of VA cases is conducted, the error rates found are far greater than what VA self-reports.

All of which is critically important as VA struggles to “break the back of the backlog.” The recurring and systemic problems of poor development of cases at the Regional Office level contribute to a seemingly endless appeals system which only further delays justice for veterans seeking benefits. While transformational efforts to complete claims in an electronic environment with the new Veterans Benefits Management System (VBMS) may increase the speed of making decisions, if veterans are subjected to an endless cycle of appeals and remands to correct mistakes, then veterans will not have faith that the system is working to their benefit. Any changes VA is making to how they process claims cannot be simple changes of tools from paper to electrons; they must include a fundamental culture shift towards getting the claims right the first time – and to correcting problems when they are found and not simply passing them along through remands to another desk.

 

 

Don Kandlbinder

November 15, 2013 - 4:41pm

I am looking for a representative to help me with an appeal to the VA Hospital system in Indianapolis, Indiana to help me get a powered scooter.

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