Thousands wait months for word on benefits

June 27, 2009 - Houston is at the heart of a growing national crisis involving the backlog of claims at the Department of Veterans Affairs that’s approaching a record 1 million, including thousands of returning service members injured in Iraq or Afghanistan.

Nearly 18,000 veterans are waiting for the Houston VA Regional Office to process their applications for disability benefits, according to the most recent data released by the VA. What’s even more troubling for some veteran advocates is the fact that 26 percent of those claims in Houston have been pending for more than half a year, compared to 21 percent nationwide.

Total claims in Houston, including nondisability compensations and pensions, add up to almost 24,000, with 24 percent pending over six months. That percentage, too, is higher than the national average.

Houston also currently has 11,389 claims in appeal, more than anywhere else in the country.

Houston Among ‘Worst’ in U.S.

Overwhelmed, the Houston VA Regional Office has outsourced some of its claims processing to VA facilities elsewhere in Texas and other states.

“The situation at VA’s Houston office is among the worst in America — more than 20,000 veterans are waiting for a claim decision from VA, and more than one in four veterans already waited more than six months for an answer from VA,” said Paul Sullivan, executive director of Veterans for Common Sense, a national advocacy group. “Our veterans and their families deserve better.”

A Houston VA Regional Office spokeswoman said the number of claims received by the facility have increased by 26 percent since last year, a trend that represents more than twice the national average of 12 percent.

“While the total workload pending has grown in light of this, improvements have been made with regard to processing timeliness,” Valerie Martinez said in a statement.

In addition to outsourcing, she said, the Houston VA Regional Office has been authorized to hire 105 employees to improve efficiency.

The average wait to complete a disability claim in Houston is about 192 days, an improvement over last year’s average of 222 days.

The VA Waiting Game

Tomball native Richard Jimenez is all too familiar with the VA’s waiting game. Every time the 27-year-old Marine veteran gets a VA form letter in the mail, he barely glances at it before tossing it in the trash.

The letters all say the same thing: That the appeal of his disability claim rating for injuries he suffered during two tours in Iraq and Afghanistan is still being processed. He’s been told to expect a two- to five-year wait.

“It perplexes me that people could get welfare in a much smaller time frame,” he said.

Jimenez first applied for disability benefits three years ago after being diagnosed with post-traumatic stress disorder, constant ringing in his ears, arthritis in both knees, hearing loss, traumatic brain injury and pain caused by a bone fragment in his back.

He meticulously filled out the VA’s 23-page application and waited eight months for his claim to be processed. The appeal he filed to challenge his disability rating — which determines his level of benefits — has been pending since April of last year.

“To me it’s not even about the money,” Jimenez said. “It’s principle more than anything. I volunteered to join the military. I didn’t even know what disability was at the time, so I never expected anything, but if they do offer I think they should follow through on it.”

Veterans advocates say the complex claims process takes far too long, especially for seriously wounded veterans, some of whom face financial hardship or possible homelessness while they await disability checks.

“They’re dependent right now for the VA to make the quickest decision possible, and a lot of them are paying their bills off of credit cards or going into debt,” said John Roberts, national service director for Wounded Warrior Project, a nonprofit that assists injured Iraq and Afghanistan veterans.

Jump in VA Claims

Roberts worked as a supervisor in the disability claims division at the Houston VA Regional Office before leaving to take a job with Wounded Warrior Project in 2007.

He traces Houston’s problems to poor leadership and a staff shortage, compounded by a flood of new claims.

Nationwide, the total number of VA claims has increased from 638,648 this time last year to 723,152, as of June 20. The number of appeals went from 173,682 to 195,194.

[VCS Note: The national total of 723,152 claims and 195,194 appeals equals 918,346 veterans waiting for an answer from VA.]

At a congressional hearing in Washington last week, VA Deputy Undersecretary for Benefits Michael Walcoff said it is incorrect to designate all these claims as a backlog because the total number “includes all claims received, whether pending for just a few hours or as long as six months.”

Roberts said that’s semantics. “Every number still represents a veteran waiting for a decision,” he said.

He attributes the bump in claims to troops returning from Iraq and Afghanistan with severe injuries and mental health problems, as well as legislation that made it easier for Vietnam veterans exposed to Agent Orange to qualify for disability payments.

“All that took place, and it kind of put Houston in a hole they haven’t been able to dig themselves out of,” he said.

Stress on Employees, Too

Right now, the Houston VA Regional Office doesn’t have enough low-level mail sorters and filing clerks or senior officials trained to process and review claims, Roberts said. “It’s a large volume of paperwork, and they basically don’t have the manpower to handle that,” he said. “It causes a lot of stress not only on the veteran but a lot of times on the VA employees themselves.“

Jimenez, for one, isn’t waiting around for a check to arrive in the mail. He’s studying biology at the University of Houston. Scheduled to graduate in 2011, he jokes he could earn his bachelor’s before the VA finishes with his appeal. For now, he has a part-time job at a car dealership to make ends meet.

“It’s been tough, but like I said, I survived two wars. I can survive the civilian world,” Jimenez said. “Just work a lot of overtime and learn to budget well.”