VA: Disability Claim Appeals Process Broken

The VA acknowledged recently that its claims appeal process is broken and they are working to address the issues involved. Currently, many thousands of veterans are waiting more than 5 years for their claims to be settled. From 2012 to 2015, pending appeals cases increased by 35%, to more than 450,000 today. Of those, more than 80,000 veterans have been waiting longer than 5 years and 5,000 veterans have been waiting for more than 10 years for their cases to be settled.
 
Steps currently being taken include updating the computer and IT systems used to process claims appeals, streamlining the appeals process by making it possible for veterans to submit additional information without triggering another set of reviews, hiring additional personnel, and digitizing archived inactive claims records to allow for quicker processing times.
 
A year ago, the VA launched Caseflow Certification, a web-app which verifies whether the required documentation needed for an appeals claim is present and automatically identifies if new information is added, reducing errors and delays caused by manual claims processing.
 
Earlier this year, the Veterans Benefit Administration began collecting archived claims records from regional repositories east of the Mississippi and digitizing them to be uploaded into the Veterans Benefits Management System. Previously, the VBA only digitized an archived claim records if the veteran or family members submitted new disability or Dependency Indemnity Compensation claims. When these claims were submitted, the records had to be located and retrieved, boxed up and shipped to the office handling the claim. This added several days to the claims process. By digitizing archived inactive claims records and uploading them into one system, this information will be instantly available to claims processors anywhere in the country. The VBA expects to complete this work by the end of 2018.
 
The VA pledges to continue its efforts to improve the appeals claims process for veterans. Because of the fact that many of its procedures and policies are mandated by Congress, the VA has reached out to both the House and Senate for help in passing legislation that will make it possible for the VA to make significant changes to the process. In recent months, several bills have been introduced in both houses of Congress to address these issues. Hopefully, legislators will recognize the urgency of acting quickly to help our veterans get the benefits they deserve.

6 Comments

  • I appealed a simple effective date determination in late 2016. Automatic response said claim will take a minimum of 377 days. Only excuse was volume of claims. Why are there such a large volume of claims unless decisions were poorly made. How can I argue my claim with the same group that makes a high volume of bad decisions?

  • The main issue is that they are cleaning up from years of improperly processing claims (not necessarily making bad decision). In reality, many appeals are submitted just because the veteran doesn't like the result, not because the VA made a mistake. I'm definitely not going to defend the VA for the many times they do make mistakes and the years of bad claims management that definitely needs to be fixed. Hopefully these changes will finally enable them to fix this process and make correct decisions quickly and effectively so all veterans receive the benefits they deserve.

  • Hi Sean –

    Here are a few references for you:

    S.1024 – Veterans Appeals Improvement and Modernization Act of 2017
    https://www.congress.gov/bill/115th-congress/senate-bill/1024

    S.712 – Department of Veterans Affairs Appeals Modernization Act of 2017
    https://www.congress.gov/bill/115th-congress/senate-bill/712

    H.R.457 – VA Appeals Modernization Act of 2017
    https://www.congress.gov/bill/115th-congress/house-bill/457

    Government Accountability Office report:
    https://www.gao.gov/products/GAO-17-234

    Caseflow Certification information:
    http://www.blogs.va.gov/VAntage/27107/new-tool-launches-improve-benefits-claim-appeals-process-va/

  • There is no excuse for the backlog being anything other than part of the VA's Ponzi Scheme – they scream to congress for more money to fix the backlog, Congress gives them millions, everyone gets bonuses, and the Veterans get screwed as the backlog continues to grow.
    My own personal case, over 7 years old, is a clear example of where equipose has been exceeded clearly, yet the BVA continues to Remand it for the VA to correct their claims to impede due process!
    The backlog is a tool used by AFGE to get more money, if they fix it the gravy train stops! It's not rocket science, we have too many people making money off of veterans suffering!

  • amen brother. I been waiting six years and I feel the same way. the process has been slowed to a craw to delay rightful claims. they could hire and train more judges and move the process along but they wont. just like they need more doctors and nursed but instead of getting what we need they hire more middle management and make more management positions instead of getting what the vets need. lots of good people at the va but they need help not some new boss looking over their shoulder.

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