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.