Backlogs and Bureaucracies

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VAHQ "Maybe a radical solution is needed..." This morning I was greeted by yet one more story in the news about a backlog of disability claims and individual stories of claims stretching out two and three years for a decision. Surprise – this story was about the Social Security Disability system not the VA but it sounded so damn similar it was uncanny. Do you suppose the bureaucracy of the federal government simply is incapable of dealing with issues like these no matter how well-intentioned the system or who well-intended the results. If both the SS Disability and VA Disability Compensation systems are so heavily backlogged and bogged down, what solution is there? One thing that struck me from the SS article that I haven’t seen from the VA is the data that were quoted on the numbers of claims that took the various routes through the system. There are five steps in the SS system; 1) initial review, 2) reconsideration, 3) administrative law judge hearing, 4) Social Security appeals council and 5) review by a federal judge. At each stage a claim can be granted, denied or in the later two stages remanded for further review. Any of this sound vaguely familiar to those of us in the veteran community. If the data quoted were correct (small if) and if the data quoted correlate to VA data (larger if, maybe much larger), for every 1000 claims submitted with proper medical documentation and if appeals are pursued following denial, 926 will be eventually granted or remanded for further review. That means only 7.4% will have been denied, 74 out of 1000. I’ve heard Rep. Filner, chair of the House VA committee, suggest that the VA should operate like the IRS, grant claims subject to audit. The problem there is those claims that are denied on audit creating an overpayment but with such a small number, 7.4%, we could almost forgive the overpayment and go on as long as fraud was not involved. I had dismissed Mr. Filner’s idea out of hand but now wonder if there is not genuine merit. Put the bureaucracy to work auditing after the fact instead of trying to decide beforehand. Use some sort of red-flag system like the IRS does and get this thing streamlined? Radical change but if the VA and SS have so much the same problem, maybe a radical solution is needed.
Posted in the burner | 3 comments
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I've actually thought about this quite a lot. It's a tough nut to crack. On the one hand, those numbers indicate that maybe the cost/benefit analysis is not as dire as feared.

My main worry is this. The veterans' community enjoys a much deserved amount of goodwill from the public. I can't tell you the number of people who tell me "If there's anyone deserving benefits from the Government, it's these folk...nobody's done more to earn it." What happens though if a system like this goes through and fraud starts creeping up? What does that do to the goodwill? When do people start questioning whether vets get "too good a deal" from Uncle Sam?

Maybe that doesn't happen. I don't want to imply that vets try to game the system, quite the contrary, I've seen enough of claims to know the vast majority are straight up and legit. I've also seen that there are people who do try to milk it for things that maybe they don't deserve. Even though we hate to admit it, not everyone we served with was above trying to milk the system and get things they didn't deserve.

Is that enough to count against the majority of honorable men and women and deny them a system that would be better suited to helping them? I can't say. I can only say that's the sticking point that makes me wonder.

As I understand it, a veteran is allowed VA disability rating if the veteran incurs a medical condition or aggrevates an existing medical condition while on active-duty in the Armed Forces. Seems rather straight forward to me, but clearly the "burden of proof" is the "sticky wicket" in this process. Where does that "burden of proof" rests - on the veteran or on the Federal government? And what about the "benefit of doubt"?

I seem to recall seeing films of atomic testing in the desert done by the Department of Defense in which the soldiers were placed in foxholes and given protective eyeglasses. They were given instructions not to look directly at the blast. After the explosion, they were instructed to walk around the impact area without any protective clothing against radiation or fallout. So why did it take 50 years for VA to recognize their service-connected exposure to radiation and the cancers associated with that exposure? Duah! I believe the term "medical evidence" wasn't certain that radiation was the direct cause of the cancers or medical conditions.

So the story continued with complaints about exposure to Agent Orange. It only took 30 years to resolve that issue, but there are still Vietnam veterans seeking disability claims for their exposure. Is a matter of a veteran's word versus validation by military documentation? What about veterans who were in places DoD claims we had no troops like Cambodia and Loas -- oops -- too late the cat is out of the bag.

For the life of me, I never could understand how the Federal government could trust veterans with weapons, planes, tanks, and missiles, but can't trust their word as to their medical conditions. Grant the claim, grant access to health care, then validate the cause. Seems more logical than letting the poor GI die waiting for an official diagnosis as to exactly what is killing the veteran.

With Operation Desert Storm veterans, they almost got it right. Some received benefits for undiagnosed medical coditions, but most were told it's all in your head. Some were denied reenlistment because their medical conditions made them fail to meet PT standards. HELLO -- did they meet PT standards before deployment? So you really think their health went to hell when they got back home?

I may not have a PhD or a medical license, but my folks blessed me with common sense. Treating America's heroes as malingerers and deadbeats is hardly the thanks of a grateful nation. To this GI, the "benefit of doubt" began when I completed boot camp and was tenured finally honorably discharged.

Let's face it -- jumping out of airplanes, carrying heavy loads, prolonged visits in hostile territories, getting shots for diseases you can't pronounce, and other uncommon activities -- is hazardous to one's health.

I understand and appreciate your thoughts. Maybe this is not the right way to go. I know that another organization has proposed some changes to the VA claims system. I haven't had time to really evaluate what they are proposing.

It does seem though that both systems (VA and SS) are experiencing something of the same problems or at least they exhibit the same symptom, a large backlog and long waiting times for a decision. That leads me to believe that the similarity in the processes has led to the similarity of the result and that the process needs more than just being tweaked.

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News from the World of Military and Veterans Issues. Iraq and A-Stan in parenthesis reflects that the author is currently deployed to that theater.