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Veterans Affairs wants to be an advocate, not an enemy

An agency overhaul aims to eliminate a huge backlog of disability claims by 2015 and move to an electronic data system.

May 31, 2010|By David Zucchino, Los Angeles Times

John Lamie survived six roadside bombings in Iraq, only to have the Department of Veterans Affairs refuse to accept three months' worth of medical tests he underwent for jaw and shoulder wounds — tests performed by VA-approved doctors at VA facilities.

Casey Elder, who says she suffers migraines and memory loss from a roadside bomb in Iraq, has been told by the VA that the bombing did not cause those problems — despite a VA doctor's diagnosis that she suffered a traumatic brain injury.

After Clay Hunt was shot through the wrist by a sniper in Iraq, the VA misplaced his disability paperwork for four months. Then he was required to visit a series of doctors to verify the extent of his wounds.

Many veterans wounded in Iraq and Afghanistan are being buffeted by a VA disability system clogged by delays, lost paperwork, redundant exams, denials of claims and inconsistent diagnoses. Some describe an absurd situation in which they are required to prove that their conditions are serious enough for higher payments, yet are forced to wait months for decisions.

"You fight for your country, then come home and have to fight against your own country for the benefits you were promised," said Hunt, 28, who served in Iraq and Afghanistan as a Marine Corps sniper.

It took Hunt, who lives in Brentwood, 10 months to receive VA disability payments for his injuries after the agency misplaced his paperwork.

The VA, which still relies on a mostly paper-based system for disability claims, is overwhelmed by a flood of wounded veterans from the long Afghan and Iraq wars. That's in addition to the Vietnam War, Korean War and even World War II veterans.

Some veterans wait up to six months to get their initial VA medical appointment. The typical veteran of the Iraq or Afghanistan wars waits 110 days for a disability claim to be processed, with a few waiting up to a year. For all veterans, the average wait is 161 days.

The VA says a ruling on an appeal of a disability rating takes more than 600 days on average. The Iraq and Afghanistan Veterans of America, or IAVA, an advocacy group, says the average delay is 776 days.

Up to 17% of veterans' disability ratings are incorrect, the VA says. Thousands of dollars in disability payments hinge on the ratings, which are determined by the VA. The agency says it hopes to eventually cut the error rate to 2%.

With the VA deluged with 90,000 new claims a month, the backlog has reached 175,000. The VA defines a backlogged case as one that takes more than 125 days to process.

"It makes veterans feel like they're fighting VA paperwork instead of the enemy," said Paul Rieckhoff, an Iraq veteran and executive director of IAVA, which has praised the quality of VA medical care but has criticized the claims process.

VA officials concede that many veterans face delays, mistakes and bureaucratic logjams. But they say they are instituting reforms that are making the system more efficient and equitable.

"We absolutely agree it takes too long to process a claim, and we absolutely have to do a better job," said Michael Walcoff, the VA's acting undersecretary for benefits.

Walcoff acknowledges that veterans have "a lot of negative feelings" toward the VA.

"A lot of veterans don't trust the VA because of the hoops we make them jump through" for some claims, he said. "We'll do whatever it takes to fix this system."

By 2012, the agency plans to move away from paper-based claims to an electronic data system. The VA has provided some veterans with advocates to guide them through what Walcoff concedes can be "a confusing, difficult process."

Another reform has allowed service members at many bases to file for VA disability payments before they leave active duty — giving them a head start on the claims process.

This spring, the VA expects to ease requirements for proving post-traumatic stress disorder, the signature wound of the Iraq and Afghanistan wars. Veterans will have to show only that the totality of circumstances during their service caused PTSD. Currently, they must prove that a specific "stressor" incident caused the disorder.

But a huge backlog remains. VA Secretary Eric K. Shinseki, who has promised to eliminate the backlog by 2015, called it "one area in which we did not progress as I would have wanted."

In a speech to the Veterans of Foreign Wars in March, Shinseki promised "to change the culture inside VA to one of advocacy for veterans."

The Obama administration has proposed a 27% increase in the VA's budget for next year. The agency has hired 4,200 employees since 2007 to tackle the backlog and has increased overtime.

For 27,000 veterans in a pilot program, the average wait for benefits — after they finish the disability evaluation process — was reduced to one month, from six to eight months. Another pilot program puts VA employee advocates at 27 military bases, assisting nearly half of the veterans seeking disability benefits.

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