VA Audit: Over 40,000 Veterans Appeals Ignored

From Ben Krause VCS AD for Advocacy and founder of disabledveterans.org

 

VA Regional Offices are ignoring 18.5 percent of veterans’ appeals on average, according to a recent audit. The Veterans Affairs Office of Inspector General (OIG) found that ignoring claims causes a processing delay of 444 days.

Let’s hope the VA notices your appeal. In “Audit of VA Regional Offices’ Appeals Management Processes” report, auditors found that one veteran’s claim had been ignored for over 1,500 days.

As of the date of the audit, 246,000 disability appeals were on file. If the 18.5 percent average holds across the entire VA, another 45,000 appeals claims are not on record despite the VA having the appeal on file.

To assess appeals processing, the Veterans Affairs OIG created a sample of VA regional offices across the US. These offices served as the “average” regional offices. The auditors then handed the different offices 783 potential NOD’s. VA adjudicators failed to identify 145 of these as potential appeals.

Here is how the process works. A veteran files an appeal because they disagree with a decision by the VA. In this form, it is considered a Notice of Disagreement (NOD). Once a review of the claim is completed, if the reviewer does not agree with the veteran, a Statement of the Case is created by the VA. If the veterans still disagrees, they appeal and VA then certifies the appeal to the Board of Appeals.

For the Notice of Disagreement portion, the VA has set a target of 125 days to complete the review. The VA has also set a 180-day target for the certification process.

In 2010, VA took an average of 656 days to fully process an appeal. This audit does not provide the average for 2011, but one unidentified regional office averages 1,219 days.

The audit of the Veterans Benefits Administration also revealed de novo review appeals are decided more quickly. A de novo review means the Decision Review Officer will look at the existing evidence and make a new determination. It is like looking at a claim with new, more experienced eyes.

The Veterans Affairs OIG released the results of their audit into disability claims appeals earlier this week. The Veterans Affairs OIG audit was intended to seek out the root of delays relating to veterans’ appeals.

On a high level, it revealed that regional offices are focusing primarily on new claims and not appeals. This means, if the claims adjudicator gets it wrong the first time, the veteran has a very long wait to get the appeal decided in less than one year. If the VA fails to notice the appeal, that veteran will have another 1 year and 4 months to wait before VA even begins to adjudicate the appeal.

This audit evaluated eight regional offices throughout the country. The Veterans Affairs OIG specifically selected regional offices that would serve as an average across the VA.

The regional offices audited were: Boston, Lincoln, Los Angeles, Milwaukee, Montgomery, New York, Philadelphia, and Salt Lake City.

 

DisabledVeterans.org Survey Critique

This survey does a great job exposing some of the issues veterans are experiencing. It tells us that a de novo review is a quicker solution. It also tells us that the VA is failing to even notice almost 20 percent of veterans appeal.

The survey fails to identify the regional offices and their performance. It gives us a list of which regional offices were audited. It does not tell use the performance of each. Instead, the Veterans Affairs OIG craftily assigns numbers to each. It does not tell us which regional office is assigned to what number.

It further fails to give us a firm averages. How long does it take to process an NOD? How long does it take to process the appeals certification? We do not know.

http://www.va.gov/oig/pubs/VAOIG-10-03166-75.pdf

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3 Responses to VA Audit: Over 40,000 Veterans Appeals Ignored

  1. Edward Scott Hanson says:

    Discharged I was offered $27,000 lump sum and then informed that if I took it that I would be treated at the VA as if I was never been in the service. After serving one-month, one-week, and 4-days shy of having thirty-years in, I told them “HELL NO! I DID NOT WANT THE LUMP SUM!”
    I was discharged on Friday and applied for benefits on Monday; it took twenty-three months total to receive my benefits. When I applied for my disability in 10/2006, I had been under VA care from 11/2004 via Community Based Health Care Organization (CBHCO). I was told by one employee “unofficially” that it was because I was in the National Guard, and not in the “real Army.” I ended with 100% disability.
    Because, most of my service was in the National Guard I have to wait until I am sixty or older to start receiving my retirement. Then I have to apply for it, as of discharge date it will be not for another eight-years, or when I want to start it. I was not able to return to my civilian employer because I was an over-the-road truck driver, and my injuries, and medications prevented me from keeping my CDL. I was unemployable, unable to get credit. I had to utilize my savings, emergency savings (6-month living expense), and my 401k completely depleting my 401k
    As you can see the twenty-three month delay really put us in a bind, my lovely bride and I nearly filed bankruptcy, and moved onto the street.
    Sometimes I feel the VA still has two levels of care: level one for those who were active; level two for those who were in the Reserves and National Guard.

  2. Anthony Payne says:

    Edward, I disagree with your assessment of what branch of service matters. In my case, I am a Marine; I was discharged in 1991 after Desert Shield/Storm. My injuries included Traumatic Brain Injuries (TBI), because of the effects of my injuries, I was unable to communicate effective enough to assist VA staff in adjudicating my claim. My claim was opened and closed from 1991 through 2009 with new finding, unmistakeable errors, and reconsiderations. In April 2009 a DRO discovered that the VA never administered a TBI C & P exam. After the exam was administered it was discovered that I have suffered from several related and undiagnosed conditions. My new appeal began then and I am still waiting for my appeal to be certified. I have been given multiple exudes why it is being delayed but I have not gotten my file certified for BVA nor have they issued me a supplemental statement of the case. I have requested that my Senator look into my case. I think the IG conveniently overlooked my case.

  3. raymond gumbleton says:

    is there anyway to find out not just the staus of youre of youre appeal,but whereis my folder?