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SPECIAL SERIES - UNDERSTANDING THE VA CLAIMS PROCESS -

PART 2 of 3 - HOW THE STATE IS THERE TO HELP -- Veterans'

Advocate Jim Strickland - "Before you can get help...you'll have to

sort out who is who. You may need a scorecard for this exercise."

Veterans' Advocate Jim Strickland provides regular columns for VA Watchdog dot Org.

If you would like to contact Jim about his columns, you can email him here...

The archive of Jim's articles is here...

To find an answer to a specific VA benefits question, use the VA Watchdog search engine... click here...

-------------------------

Part 1 of this series is here...
http://www.vawatchdog.org/08/nf08/nfAPR08/nf040208-1.htm

Part 3 of this series is here...
http://www.vawatchdog.org/08/nf08/nfAPR08/nf040408-1.htm 

by Jim Strickland

Understanding The VA Disability Benefits Claim; The Process

Part 2 of 3 – How The State Government Is There To Help You

“Any change is resisted because bureaucrats have a vested interest in the chaos in which they exist.” Richard M. Nixon



I opened my email this morning to read a note from a reader in Ohio telling me, “For too long our Veterans have not received proper services at County Veterans Offices and VARO in Cleveland. We are pushing for more oversight, more services, more accountability.”

The veteran who wrote to me provided this link to an article referring to the situation in his state;
http://www.progressohio.org/page/community/post/brianrothenberg/C3Lk 

As one of the “Rust Belt” states, Ohio has been hard hit economically in recent years. The Department of Veterans Affairs (DVA) estimates about one million veterans live in Ohio and DVA spends some $2.7 billion per year to provide benefits there. The Veterans Health Administration (VHA) operates medical centers in Cincinnati, Cleveland, Chillicothe and Dayton. The DVA informs us that, "In 2006, the Cleveland Regional Office processed 18,007 disability compensation claims, including 5,179 veterans applying for the first time and 12,828 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments." http://www1.va.gov/opa/fact/statesum/ohss.asp 

What was it that drove Brian Rothenberg, Executive Director of Progress Ohio, to write that Ohio, "ranks 43rd in use of available services and 50th in the amount of disability pay." Mr. Rothenberg goes on to tell us of a report that said Ohio, "was at the bottom of the barrel in terms of the number of VA claims filed, the quality or completeness of the claims filed and the amount of money generated by approved claims."

I started at Mr. Rothenberg's informative blog and attempted to sort out what happens when an Ohio veteran files a disability claim to be adjudicated at the Cleveland VARO. As in many states, to file a disability compensation claim at the Cleveland VARO requires the veteran to enter a world of convoluted and vague reporting structures where nobody can be held accountable for any piece of the puzzle.

Keep in mind that although Ohio is our focus today, most of what you're reading applies to every other state.

The state of Ohio, through the Governor’s Office of Veteran’s Services, maintains 88 County Veterans Services offices that are often the first contact for the veteran in need of services. These county offices have varying levels of funding...the dollars going to those programs depend on the economic strength of their county. In a less populous and poorer county, the veteran may be challenged to find the office fully staffed and ready for business.

When a veteran files a claim at a county office with a CVSO , the claim is then passed into a system of representatives from various Veterans (or National) Service Organizations. On the surface, the process in Ohio appears simple enough. The veteran files a claim with a county office, the CVSO at that office completes paperwork, verifies eligibility and so on. The veteran then chooses the Veterans Service Organization that he or she wishes to have as their representative to the DVA/VBA. That's the representative who will hold the veteran's Power of Attorney (POA).

Suddenly, it all gets a little murkier.

Remember...the CVSO is a county function, funded by the respective county. The county's CVSO is only responsible for the completion of the initial paperwork. The National Service Organization is funded by generous monies from the state...rent free housing is provided by the DVA/VBA at the VARO and they catch the veteran's file to present it to the VBA.

Before you can get help with your claim, in Ohio at least, you'll have to sort out who is who. You may need a scorecard for this exercise.

Is the representative you're speaking with a County Veterans Service Officer (CVSO), a Veterans Service Organization's (VSO's) (sometimes called 'National Service Organizations') Veterans Service Officer (VSO) or a National Service Officer (NSO)?

What qualifications does each one have and what are the average outcomes if you select (x), (y) or (z) to advocate for you? Should you go to the local VFW Hall seeking help or call a County Veterans Office? The VVA? How about The American Legion? Who will work best for you?

The CVSO, the veterans first contact, isn't in the loop for an award or denial letter nor do they have access into various phases of the DVA/VBA adjudication process.

The local CVSO is often well trained and able to develop a completed claim ready for adjudication but then, in Ohio, they're required to hand off to a stranger. When the veteran chooses his VSO/NSO advocate at the VARO, he does so from the laundry list of available organizations with no knowledge of which one is best equipped to advocate for him. The CVSO can't make any recommendations...the vet is on his own here.

Once the CVSO completed claims are submitted to the respective NSO’s in their rent free offices at the VARO, the chosen VSO/NSO looks over the claims and then forwards them on to the VARO triage department for adjudication. At that stage a VBA employee, usually a DVA/VBA Veterans Service Representative (VSR), will begin the actual processing of the claim by date stamping its arrival, checking it for completeness and so on.

(At this stage the benefits application has been checked 3 times. Why then does Rothenberg report, “Ohio was at the bottom of the barrel in terms of...the quality or completeness of the claims filed”?)

According to Rothenberg, "it becomes clear that a veteran is at the mercy of the resources of the County in which they live and the efficiency of the veterans organization they choose to track and advocate their claims. There appears to be little if no accountability on the process for follow through."

Legislation has been introduced that could make improvements to the Ohio system according to Rothenberg. However, the direction of the state leadership doesn't appear to have veterans at the center of their concerns.

"State Sen. Bob Spada rushed to the table with S.B. 289 which made no recommendations to fix the VA claims processing system but did recommend that 'the several veterans’ organizations' should get more support", says Mr. Rothenberg.

Among the recommendations made by State Senator Spada: "Maintaining a cordial relationship with both the VA and several veterans’ organizations." Nothing in there is directed to the veteran, the concern is more “support” (read; state tax money) for the Veterans Service Organizations to enhance their “cordial relationship”.

Practical solutions like monitoring the outcomes of claims filed on behalf of veterans in Ohio aren't of any particular concern to the state. There's no push to quantify the number of claims filed, starting at the county VSO and continuing through the VSO/NSO level. Senator Spada didn't see a need to measure the completeness and accuracy of claims nor the average time to resolve claims in Ohio. So long as there is a “cordial relationship” with the DVA and others, everything else will somehow work itself out.

That there isn't any love lost between the different agencies in Ohio is quickly apparent. The most obvious competition is for state dollars. Mr. Rothenberg's article shows us that;

In 2006, Ohio spent over $1.5 million dollars spread among the:

• American Legion, $302,328
• Am Vets, $287,919
• Veterans of Foreign Wars, $246,615
• Disabled American Veterans, $216,308
• Vietnam Veterans of America,$185,954
• Marine Corp League,$115,972
• Catholic War Veterans,$57,900
• Meritorious Order of the Purple Heart, $56,377
• Army Navy Union, $55,012
• Jewish War Veterans $29,715
• American Ex P.O.W., $25,030

There exists a not-so-subtle competition between those National Organizations for the available dollars. By virtue of being the best funded, who is able to recruit the most new lifetime memberships to keep the local post open for bingo on Friday nights?

I've had the good fortune to communicate with Ray Strischek. Ray is a Member of the Athens County Veterans Service Commission and he's supporting about positive change in the pending Ohio Senate Bill 289. Ray tells me that if properly executed, Ohio Senate Bill 289 is a good opportunity to make meaningful change and to streamline the process that veterans are subjected to in Ohio every day.

What the bill doesn't address seems more important than what it does. The bill misses the very important point that even though a CVSO is required to be trained and certified (quite possibly the most stringent and best training in the country), there's no mechanism provided to monitor, measure or track productivity at the county or any other level.

If a veteran chooses the wrong Veterans Service Organization to represent him (one that isn't represented at the VARO offices), the claim may not be sent to the VARO but to some other off-campus locale until a National VSO of the chosen organization has had the time to review it and then forward it to the VARO.

Ray tells me that there is, “No state oversight. Ohio (through GOVA) has no oversight at all over the service officers who work at the VA Regional Office...These service officers make no report to GOVA and very often take the county level service officer out of the loop and deal directly with the veteran applicant even though the veteran applicant is most likely to call the county service officer to demand updates on his/her pending VA Claim.”

I've tried to sort out just who is responsible for the application for benefits if the veteran has questions (“Why is it taking so long???”) 6 months after that application was filed. Should the veteran contact the CVSO he first sat down with? Is it more appropriate to talk with the NSO of whatever organization he elected early on? Maybe he should just call the VARO? In Ohio, there aren't any concrete answers.

Ray is working with his colleague Dave Jenkinson to interject some oversight into any legislative change. Ray and Dave tell me that SB 289 should require ODVA:

a) to set standards of claim development and productivity for the county level service officers
b) require the county level service officers to report claims sent to VARO to ODVA.
c) require that county level service officers remain in the loop regardless of POA designation.
d) require VA Regional service officers to report receipt of claims received from the county to ODVA.
e) require VA Regional service officers to report approvals, denials, remands, appeals of VA Claims to ODVA.
f) required ODVA to hire a service officer to monitor the work of the service officers at the VA Regional Office.

To my mind, that would seem a reasonable and necessary addition to this legislation. I don't understand how any leader believes his business is running well if he isn't in the habit of tracking details and measuring past and present performance to set benchmarks for the future.

If a businessman runs a company manufacturing widgets, to be successful, he must know about the outcomes of his processes. At the end of the day he needs to track the number of widgets that come off the production line, how many widgets need to be reworked, how well each employee is performing in his or her job and how those widgets benefit the customer who receives them.

As it was presented to me, SB 289 is concerned with the high roller players in the bureaucracy, not the ultimate recipient of the process; the veteran.

Personally, I don't much care if the agencies involved have “a cordial relationship with both the VA and several veterans’ organizations”. Thinking it over, I'd prefer that those relationships weren't cozy. One organization competing with another to deliver cost effective services to more veterans faster than ever before would seem a good thing.

Today, the only thing that appears to be accurately measured and accounted for is which National Veterans Service Organization can reap the lion's share of that $1.5 million in state tax money. Providing a high quality service to veterans isn't measured, which group catches the big bucks is.

If you're the veteran caught in this mashup of disjointed state services, what your state's leaders are debating for the future is the least of your immediate worries. Your only concern is where is your claim and who can help you?

I hear from a number of VA Insiders and other officials in Ohio. For obvious reasons, they'll remain anonymous. The numbers I use here are taken from inside the offices where these folks work.

The situation at the VARO in Ohio isn't all that different than other states...the statistics aren't very good but there are no bragging rights when everyone is failing.

The Cleveland RO has a backlog of about 13,000 claims with some 35% of those being over 180 days old. The Compensation and Pension examination situation is terrible with almost 7000 requested exams waiting over 180 days. Ohio remains “50th in the amount of disability pay" received by the veterans who live there.

It's apparent that for all the work done before the claim arrives at the Cleveland VARO, it isn't very well put together on arrival. It's at this juncture, that initial application, that many claims fail.

If we accept that in 2006 at the Cleveland VARO some 5,179 veterans applied for the first time and 12,828 cases were reopened claims, it's obvious that those 12,828 reopened claims were more likely than not an appeal to correct errors from earlier claims. This is an alarm that tells us when those claims arrived at the desk of the DVA/VBA Veterans Claims Representative, they were neither complete nor were they well prepared for adjudication by a rater.

This points directly to a significant failure of the current system prior to any work done by DVA. That a file must travel through multiple steps and delays is bad enough. That there is no way for the state to track the process and hold any group or individual accountable for the failures to pass DVA muster boggles the mind.

If you're a regular VAWatchdog reader, you know that you could have completed the benefits application form yourself, added in any evidence that is asked for, signed it and using certified mail, your claim would have gone directly to the VARO and the DVA VSR.

Earlier we heard that a DAV VSO told a young soldier, “You WILL need help to properly fill out your VA claim.”

In Ohio that begs the question; “Why?”

When we know the failure rate of claims prepared by the Ohio system, what possible advantage is there to using it?

The Commander of the DAV told us that filing a disability compensation claim at VBA is a, “largely administrative claims process, which is designed to be open, informal and helpful to veterans.”

In Ohio, if a veteran files his claim directly with the VARO, he or she will know who is responsible. There won't be unnecessary stops for intermediaries to look over when they get the time and the application won't be shuffled into a file drawer and kept there for weeks, months or years.

Most importantly, you'll know that the person in charge of your claim really cares about what happens to it and is accountable at any hour of any day.

Next up...how to find that outstanding VSO.

PART THREE TOMORROW.....

-------------------------

posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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