The VA’s Secret Claims

Is the VA sweeping the vast majority of its claims under the rug while proclaiming progress?

National Journal
Jordain Carney
June 26, 2014, 4 p.m.

The long-stand­ing slog with­in the Vet­er­ans Af­fairs De­part­ment to cut down its moun­tain of dis­ab­il­ity claims has been well doc­u­mented.

Or has it?

The VA loves to talk about how it’s on track to reach its goal next year of com­plet­ing all dis­ab­il­ity com­pens­a­tion and pen­sion claims with­in 125 days — keep­ing them off the dreaded “back­logged” list. Fre­quently over­looked? The oth­er two-thirds of VA claims — or more than 1 mil­lion re­quests — aren’t sub­ject to the de­part­ment’s 125-days, 98-per­cent ac­cur­acy goal.

“The VA does a good job in con­vin­cing law­makers and the pub­lic and the me­dia that the only claims that every­body should be fo­cused on should be dis­ab­il­ity claims,” said Ger­ald Man­ar, na­tion­al vet­er­ans ser­vice deputy dir­ect­or at the Vet­er­ans of For­eign Wars and a former 30-year VA em­ploy­ee. “… It’s disin­genu­ous of VA lead­ers to claim that they’ve made pro­gress, but there’s still all this oth­er work out there.”

What are these oth­er claims clog­ging up the VA’s sys­tem?

They run the gamut from aim­ing to change the amount of dis­ab­il­ity pay a vet­er­an re­ceives to ap­peal­ing pre­vi­ous de­cisions by the de­part­ment. They also in­clude re­sponses to con­gres­sion­al in­quir­ies. So while the num­ber of pending VA dis­ab­il­ity claims has shrunk in re­cent years, the num­ber of over­all claims has mush­roomed to roughly 1.64 mil­lion. That’s com­pared with 941,666 in late 2009.

Here is a break­down of the main claims the VA is wrest­ling with un­der the radar.

Award Ad­just­ments For those of you who don’t spend your free time dig­ging around the VA’s web­site or aren’t flu­ent in VA-speak, an award ad­just­ment is, well, ex­actly what it sounds like. Vet­er­ans or their fam­ily mem­bers can try to change the amount awar­ded to them or their fam­ily mem­bers for a vari­ety of reas­ons. The VA can also re­quest a change.

For ex­ample, a vet­er­an could want to re­in­state a child’s de­pend­ent status, so the child can re­ceive pay­ments from the VA. Or the de­part­ment could try to de­crease pen­sion pay for vet­er­ans whose in­come ex­ceeds a cer­tain threshold.

The VA needs to tackle 471,418 of these award ad­just­ments, which are di­vided between com­pens­a­tion and pen­sion pay­ments. And al­though these out­stand­ing claims aren’t in­cluded in the VA’s drive to cut the back­log, nearly 70 per­cent of them have been pending for 125 days or more.

Ap­peals These make up the second largest group of the VA’s oth­er claims. There are 279,055 pending ap­peals, which is more than the VA’s in­fam­ous num­ber of back­logged dis­ab­il­ity claims. Vet­er­ans’ ad­voc­ates are split on what is be­hind a re­cent in­crease in ap­peals. Some be­lieve that in the race to clear the claims that are of­fi­cially “back­logged,” more vet­er­ans are forced to ap­peal VA de­cisions that were rushed or in­ac­cur­ate. Oth­ers say that as the num­ber of claims that are pro­cessed in­creases, it makes sense to see a cor­rel­at­ing in­crease in ap­peals.

Either way, the ap­peals pro­cess can leave a vet­er­an in claims limbo for an ad­di­tion­al two and a half years.

The Oth­ers Think of it as the kit­chen draw­er where you stick the odds and ends — ran­dom takeout menus, those hol­i­day cook­ie cut­ters that you nev­er used, a broken can open­er you should prob­ably just throw away. Ex­cept when it comes to these oth­er claims, the VA has a lot of them — 327,602 to be ex­act, a ma­jor­ity of which are tied to com­pens­a­tion.

These claims can in­clude Free­dom of In­form­a­tion Act re­quests, cost-of-liv­ing ad­just­ments, and even cor­res­pond­ence with law­makers. They also in­clude in­tern­al qual­ity re­views — an in-house at­tempt to catch ser­i­ous mis­takes.

A minor­ity of these claims — slightly more than 30,000 — are tied to pen­sions, which fol­lows a lar­ger trend in which pen­sion claims make up a re­l­at­ively small amount of the VA’s total claims work­load.

And while ac­know­ledging that the VA has made pro­gress on its dis­ab­il­ity com­pens­a­tion and pen­sion claims, Man­ar said, “The prob­lem is that they’ve done it to the ex­clu­sion of much of the rest of the work­load, and, as a con­sequence, there are even more glar­ing prob­lems.”

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