Segmented Lanes: a New Process for Claims

Working at one of the Big Six Veteran Service Organizations taught me a few things about VA. First, the regional offices that process compensation claims are not equal, some are more consistent. But the most important thing I learned during my three years representing Veterans who filed appeals to the Board of Veterans Appeals is this: NO CLAIM IS THE SAME. I learned while some claims may appear similar, little variances in each make all the difference.

The Veterans Benefits Administration’s Transformation Plan is change of giant proportions. We’ve tested and measured more than 40 initiatives that are in some phase of implementation. Each initiative falls into one of three categories: people, process, or technology. It’s not enough to change only our processes, update technology, or only change the way we train our employees. VBA Transformation must take place across all three fronts.

Segmented Lanes is one of our new processes that we have implemented at 16 regional offices. The rest of our regional offices get Segmented Lanes throughout 2013. When you file a claim or send evidence to support your claim, our Intake Processing Centers sort it into one of three Segmented Lanes: Express, Core, or Special Operations. This allows VBA to identify at the earliest possible point any Veteran who requires expedited handling, such as a Veteran experiencing financial hardship, a homeless Veteran, a Veteran over the age of 75 or a Veteran who has a terminal illness.

For the rest of us, Segmented Lanes helps get our claims processed faster, in the hands of the right processor, increases accuracy and standardizes the process across all regional offices. This means that the process at the New Orleans Regional Office is the exact same process at the Salt Lake City Regional Office.

The lanes break down like this:

  • Express Lane: claims that have one or two contentions, or fully developed claims (an example would be if a Veteran files for an increase in compensation for a back issue and is also seeking to have her left hip condition service connected)
  • Core Lane: claims that have three or more contentions, or any claim that does not meet the criteria for Express or Special Operations.
  • Special Operations: All claims that require special handling because of their nature (examples are Post Traumatic Stress Disorder associated with Military Sexual Trauma, former Prisoners of War, Traumatic Brain Injury).

Each lane has dedicated claims processors whose skills and expertise match the lane to which they are assigned. This is how VA will process claims more quickly and more accurately. While no claim is the same, certain aspects of processing are alike, so if you work similar claims the process naturally speeds up and quality increases. When I worked at the Board, I often worked several claims in a row for disorders that resulted from a Military Sexual Trauma because some of the same regulations applied to those claims (like rating criteria), even though the claims themselves varied dramatically. Not having to refer to different parts of the regulations saved time, but I also became really good at claims resulting from MST. If I worked at a regional office today, I would probably be in the Special Operations lane.

Another way the lanes are ensuring speed and quality is through our Fully Developed Claims program. FDCs are claims where the Veteran certifies at the time they submit the claim that he or she has provided all evidence. That certification allows VA to move forward without waiting the mandatory waiting period for the Veteran to submit evidence. Veterans can file an informal claim stating they intend to file a claim for benefits using FDC to preserve an effective date and allow them time to collect evidence. We have assigned these claims to the Express lane, allowing FDC claims to be determined in an average of 100 days.

Veteran Service Organizations are available to help Veterans, their families and survivors file claims using both the traditional process and the Fully Developed Claims process. They provide this service regardless of whether you are a member. Let them help you.

Segmented Lanes is just one part of our Transformation and as such and it alone will not eliminate the backlog. But collectively, the initiatives will give VA the ability to process all claims within 125 days at 98 percent quality in 2015.

Cat Trombley is a communications specialist with the Veterans Benefits Administration. Prior to working for VA, she was an assistant director with one of the Veteran Service Organizations and represented Veterans before the Board of Veteran Appeals. She is also an Air Force Veteran.

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229 Comments to “Segmented Lanes: a New Process for Claims”

  1. Joseph Anthony Liello says:

    My claim went in June it was complete , I am 77 years old about when can I expect a answer ? Please.

    • Spencer says:

      I would not expect a response for a few months if not longer. I put my last claim in November of 2010 and am still waiting.

      • Jbeav says:

        you NEED to follow up! That is WAY too long. I hope that you have at least had your C&P exam sometime in the middle

        • Mike says:

          I turned my claim in January (12) and still waiting. My daughter’s father-in-law was able to pay cash for a new truck with his claim as it took over 2 years.

          • deanna says:

            you all need to write to John Mccain. i did this for my ex husband and he was approved for benefits 3 weeks after we got the letter from Mccain that he was looking into the case.
            good luck.

            ps …
            never settle for the first answer of disibility % they give you. they will only give you the min. and try to give you less than that

          • Mark says:

            Deanna- you’re incorrect- ratings are not arbitrarily made up. Ratings are established under 38USC Part 4- available on the Internet for your perusal. Raters do not “give you the min. and try to give you less than that”… If your knee only has a certain range of motion, then the law in Part 4 is applied to that range of motion. If your knee is within standard range of motion limits, the claim will be denied. No mystery here. As for applying again as you suggest, only do it if you meet a higher rating standard. If you read your rating thoroughly, you’ll see that the narrative includes the criteria for a higher disability rating for every condition you claimed. Opening claims that aren’t going to be approved only clogs a system already crushed by numbers.

      • Jerry Cox says:

        Folks… you need to look into the va representation at Allsup.com. I have used them for my ssid and they are great at customer service and are your legal representatives. They stand up for you and wont allow the DVA to push you around as I have put up with for years.Yep, you have to pay them a percentage but what do you have to lose; just dealing with this unconcerned DAV group… Try them. tell them an old Nam vet by the name of Jerry Cox recommended them.

        • spouse of a veteran says:

          Jerry, I agree with you. Let the Legal System handle this. Im done trying to be patient. There is way to much run around and lieing going on but when i went to Allsup.com website it says for social security dissability, not VA dis. It looks to me like they handle more SSD. We arent having any problems at all with SSI, just the VA?? Did they help you with you VA dis or just your ssi dis??

      • GREGORYA.ROBERTSON says:

        I,HAVE BEEN DIGANOSE WITH (PTSD) SINCE 2004-2005, SERVE ON BOARD THE (USS KAWISHAWI AO-146) DURING OPERATION EAGLE PULL & FREQUENT WIND. HAD A COLLISION OUT AT SEA WITH THE (USS HANDCOCK CVN-19) DURING THIS MISSION RESCUE 400PLUS VEITNAMEES PEOPLE. SEEN SOME DIE AND THE CREW ON BOARD THE (USS KAWISHAWI 146) WE ALL COULD HAVE LOST OUR LIFE FOR THIS GREAT COUNTRY. I’VE YET TOO BE RATE OR ARE HAVE A C&P EXAM. ALSO BEEN GETTING THE RUN AROUND FROM THE REGIONAL OFFICE HERE IN NEW ORLEANS LA. IN 2009 I DECIDED TO REQUEST FOR A BVA HEARING. AFTER TWO YEARS OF WAITING AN NO HEARING, DECIDED TOO SEND CLAIM BACK TO REGIONAL OFFICE BACK HERE IN NEW ORLEANS, LA. STILL WAITING!
        PLEASE! HELP ME.

        THANKS!
        GREGORY A. ROBERTSON
        (VFW MEMBER POST-5852 LUTCHER,LA.)

        • Bill Prevatt says:

          My suggestion is that you get in touch with one of the organizations, DAV or VFW. I would go with the first one; DAV and they can give you the assistance you are needing. Keep up the fight! DO NOT GIVE UP!!

        • Wanda Brooks says:

          I suppose I was lucky to get a decision from the VA inn New Orleans in 8 months then. Unfortunately, it was the wrong decision. I can barely walk ten feet without being in serious pain and they are proposing to decrease my disability because my condition has gotten “better.” Most days I can hardly get off the toilet, let alone walk any real distance, and my condition has gotten better.
          I only asked for increased compensation for one of my knees because the VA only did a MRI on the left. Now I am requesting increased compensation for both knees.
          I had a feeling this would happen because I did a Congressional on them. I think the decision was made purely out of spite. If I could prove it, I’d file a lawsuit.
          Their standard answer at the New Orleans VA is that they don’t have enough staff to process claims in a timely manner. The answer to that dilemma is quite easy. Hire more staff or consider training personnel at the local VAMCs process claims. There has got to be a more efficient manner to handle claims.

          • spouse of a veteran says:

            Wanda sorry to hear that your health is so bad. The reason yours was done in 8mths is because your absolutely correct they alway give you a low rating the first round, so it shows a claim was processed ,knowing that your going to file a increase, disagreement or appeal etc. Then here comes the years of waiting and frustration. Join the rest of the veterans in the same long and unjustifiable lane.

    • keith says:

      Sorry but i’m not new to the appeals merry go round. I have an active appeal on going at this time. It has been On Going for 16 years. Good luck every one. I have had to go outside the VA for treatment even though I am rated at 100% SC for 14 years.

      • Bill Prevatt says:

        I too have gone outside of the VA for treatment, but the medical evidence that I have presented wasn’t good enough for the VA. My appeal has been on going for 13 yrs 10 months.

    • Peter Conway says:

      09/30/2009 Local VA Office Decision RO
      01/06/2010 Notice of Disagreement (NOD) RO
      01/12/2010 Appeal Pending BVA

      And until recently I was homeless….but you know that
      And I lost everything…..but you know that
      And I have to choose between shelter and food….but you know that
      And as a result of my injuries, I live on social security disability….but you know that too!
      But still I wait….
      this program doesn’t address the problem, it just screws over other claims that are waiting to be heard. Put down the smoke and mirrors and provide the benefits we earned.

    • david m suchevich says:

      Hard to say my claim has been at the review board for two plus years.

  2. Louis Schneider says:

    This is great, but happens to the over 500k claims that are pending today. Many of the complaints today are because the present operations have not worked the cases and there is over a three year wait for adjudication. My case is pending from late 2009 and still they come back to me after telling me that the case was in the rating board, and asked for a QTC exam… after I submitted records from the VAMC Audie Murphy…. the VA doctors, The VA xrays, ultrasound performed by a Doctor of the VA… Everything submitted is from the VA Medical yet they ask for QTC.

    So how is this going to help the older claims?

    Thanks, Lou

    • Thank you for your comment Lou. One transformation initiative that will affect current claims is the re-deployment of 1,200 claims experts to target and tackle the most complex claims in the backlog (claims pending more than 125 days). These experts will complete 100,000 of the backlogged claims by the end of 2012. Our transition from paper to electronic records will also improve the way you access benefits and claims information (including online through eBenefits).

      • Paul says:

        Just as many Vets, I pray that these new approaches actually work. Though over the years with numerous plans to solve the constantly growing backlogs of claims, and things just getting worse I can’t help but recall one of Aesop’s Fables, The Boy Who Cried Wolf.

        Please prove me wrong.

    • Catherine Trombley says:

      Lou,

      First, thank you for your service. We have implemented several measures at every RO to help speed up the process and improve quality as part of the Transformation. (see the post by Richard Allen Smith on our new employee training). But the truth is our Transformation is a multi year process and means we won’t be able to meet our goal of completing claims in 125 days with 98% quality until 2015. This is a major overhaul of the system so we can better serve you. Maybe it won’t affect your current claim, but it will certainly affect any future claims you file. (as we age disabilities typically get worse).

      As for the QTC exam, I don’t have access to your file. But based off your comment and my best guess, I think your probably submitted a lot of medical evidence but no nexus opinion. In order to get service connection, you need three things — (1) a current disability, (2) something that occurred in service that could have caused that disability and (3) a medical opinion that connects the two — the nexus opinion. Your claim may have made it to the rating board and it was determined you needed an opinion.The QRTs aim to catch that BEFORE it goes to the rating board.

      • PJ Allen says:

        Catherine: can you tell me if a veteran is 100% disabled and 100% unemployable is there any sense in going for increased percentages on secondary or even the primary disabiltiy as they continue to occur.. We know there isn’t any more additional compensation but our rep said that we should continue to apply because sometimes something might get better and percentages taken away….can that be done for a permanent disability ??? I think our rep is misinformed and it seems to us that this is something that could backlog the system also if vets are continuing to file for increases when they are already at a certain level , in fear of somehow losing what they have recieved ??

        • spouse of a veteran says:

          PJ, our rep. said once you are at 100% perminent unemployable they cant take anything away from you. and the reason for that is in almost all cases when you get award perminent I/U. that means those medical issues will never perminently ever get better.(example your leggs could be bad one year and the next alittle better, then the next worse again, well they cant spend all ther time changing %’s, so thats why its perminent because they know there will never come a time when its better on a constant basis. Now i could be wrong, but i dont think so. Lets see what Catherine has to respond . Im sure her answer will be more accurate.

          • Catherine Trombley says:

            PJ and Spouse,
            Technically VA can reduce an evaluation; however it usually needs overwhelming evidence to do so. VA must notify you proposing reduction and you have time to submit evidence stating why they should not reduce you. It’s rare, but I have seen it. However, if you have an evaluation greater than 0 percent for more than 20 years, VA cannot reduce you unless there is clear fraud.

            Therefore, it may not be worth it to file for increase claims. (My thoughts were always to let VA propose than to ask for increases once a Veteran is at 100 percent). However, I always advised my clients to file for secondary conditions. Some conditions may entitle you to Special Monthly Compensation. Also, if a Veteran dies of a service connected disability, the Veterans spouse is entitled to Dependency and Indemnity Compensation (DIC). A spouse can always argue that a condition should have been service connected, but it’s usually easier (and less time consuming) if the condition was service connected at the time of the Veteran’s death. … I guess I always looked at it as estate planning, or taking care of your spouse. I can’t see your file, but it seems your rep is advising you wisely.
            Thanks for serving!

        • John says:

          If you are already rated unemployable permanent and total you are playing with fire if you go for an increase you have the same benefits as someone rated 100% scheduler.Anytime you ask for an increase the first thing they will do is try and find a reason to take that rating away.DO NOT DO IT do not listen to that rep who told you to keep trying to get a higher rating, it aint his but on the line its yours.The Rep who told you to do that should not be representing Veterans.You will not get more money anyway unless you have a SMC addition to your rating.

          • spouse of a veteran says:

            John, What does SMC addition stand for?? Thanks

          • Bill Prevatt says:

            SMC = Special Monthly Compensation

          • PJ Allen says:

            why would someone be entitled to SMC ?? my husband was 90% with 100 % unemployable but he applied for an increase, and it was granted and now he is 100% disabled and 100% unemployability….you ae right , same pay, but now spouse should be taken care of and I wouldn’t have been at 90%/100%.

      • PJ Allen says:

        thank you Catherine for your input…you said 20 years….as in my husband’s case, his claim was taken back to the date he showed medical evidence that his diabetes was diagnosed (1998) although we filed only a few years ago..Does that mean his claim would be now 14 years, back to that date his claim acknowledged he was diagnosed, or the date he first filed. Most of my husband’s claim is made up of secondary diseases, i believe his total at this point is around 180% and he has part of his claim still being reviewed for another secondary, and i doubt with his condition anything will ever be better, we struggle everyday to try to maintain his current medical status and we have watched him progressively grow worse over the past few years, I was just wondering because as you can tell on this page, it is quite alot of stress and frustration to deal with . Thank you again for your time!

        • Catherine Trombley says:

          PJ, yes, the clock starts on your effective date, so in your husband’s case the date he showed evidence that allowed the grant. After 10 years of perm and total, the spouse is automatically eligible for DIC. If your husband progresses to the point that he needs a caregiver, he may be eligible for Aid & Attendance.

          • PJ Allen says:

            thank you Catherine, so glad I found your blog..this type of communication and a place to find the answers is SO needed for us veterans and spouses, as you can tell. Most of us don’t seem to be able to get the information from our reps . Thanks again for your time!

        • Catherine Trombley says:

          Hi, Special Monthly Compensation (according to 37 CFR, Section 3.35) is payable for each atatomical loos or loss of use of one hand, one foot, both buttocks, one or more creative organs, blindness of one eye having only light perception, deafness of both ears, having absence of air and bone conduction, complete oraganic aphonia with constant inability to communicate by speech, or in case of a women, loss of 25% or more of tissue from a single breast or both breasts in combination (including loss by mastectomy or partial mastectomy) or following radiation tratment of breast tissue.

          • PJ Allen says:

            thanks Catherine, good to know…my husband has lost his hearing totally in one ear and has lost most of the hearing in his other.He lost his hearing all of the sudden…at first they thought it was stroke related …..this is the only claim for we have pending right now. In the ear he still has hearing, he is losing it slowly over the past few months. The VA doctor stated he believed it is caused from my husband’s vascular condition so I think it will be approved. He also has PVD as a secondary condition approved already and poor circulation could at some point cause an amputation. Thank you for the info, I will file it away.

      • SR Sneed says:

        I had 2 Nexus letters and still nothing. So now what?

    • John says:

      Because the head of QTC used to be the VA secretary they have the contract to do C&P exams, so even though the exam may not be necessary they do it anyway it is a money thing.

  3. David Ames says:

    I wish I could believe this, my claim is 5yrs and 1 month old. I was at the VA today and was told that my file is being work on TODAY. They gave me a print-out of the screen showing it was pull and on a person desk.

    And that it will be done by 9-02-2012, I will wait and see?

  4. My claim (C****), has been processing since September, 2010, and it is for Prostate Cancer, among other things. It should be on a “fast track” because I am going to die from this disease, which has been attributed to my US Army service in Vietnam 1968-1969. It would sure be nice to have some compensation flowing my way, as I suffer the side effects of the disease, and the radiation therapy, and the chemottherapy which is quite disturbing and uncomfortable. This new process is 25 years too late for me, as my first claim for psychiatric disabilty compensation was made in 1976. If there is any way to push my current claim to the decision phase, it will be greatly appreciated.
    Sincerely, Robert Fournier

    • Catherine Trombley says:

      Robert… I cannot say enough about having a Veterans Service Officer to help you with your claims. I know the process and laws and still use one for my claims. VSOs are physically located in the regional offices with our employees so they can make sure you are indeed given a priority status. Next time you call, ask if you have been given a priority status and if not ask them exactly what you need to submit to get priority. Also, talk to a VSO about filing conditions that are secondary to your treatment. If what you say is true, (I assume it is since I don’t have access to claims files anymore) and you should be service connected for prostate cancer, then other conditions caused by that could be service connected as well. Thank you for your service to our country.

    • manny tolentino says:

      I filed my claim for prostate cancer due to agent orange in Dec. 2010. I got my rating decision in June 2012, and they gave me 100% for the first 6 months and was dropped to 40% due to the residual effects…. incontinence and impotent. I was also awarded a monthly special compensation (smc-k) due to loss of function of an organ which is the prostate. If your treatment was not successful and that you still have traced of cancer in your prostate your percentage will remain at 100%. Did you had your C&P exam yet? It should not take that long anymore and you will get a letter from VARO. Sorry to hear about your health. God bless you.

    • Glenette says:

      My father was waiting for his claim to be processed and has since died with his illness now my mother who is also very ill has refiled in her name and is currently awaiting. I myself am waiting for my claim for reevaluation to complete the process and I started it in August of 2011.

      • Catherine Trombley says:

        Glenette,

        I am sorry to hear of your mother’s health. Please contact the RO or your representative and ask for expedited handling due to her health. Claims may be expedited for terminal illness.

        • Deidre Dunwoody says:

          Catherine Trombley: I hand carried in documents last week on my brothers behalf and would like to know how to check on the status for the increase in his pension as his health is not good. I have been fighting with this since 2009 after his major heart attack which left him with a quarter of a heart, diabetes, CHF, CAD, MI, neuropathy, and lung issues from past embolisms.

          Please advise.

  5. Susan Fillippeli says:

    I have been told by several different VA CSRs that claims cannot be expedited for veterans over age 75. This post would seem to indicate otherwise. My 85 year-old father has had his claim in development for 384 days. We sent in additional information and the certification that he has submitted all the evidence he has, but nothing has happened. When I called the Pension hotline yesterday I was told that it was likely to be AT LEAST another 120 days before a decision is made. This is unacceptable. The fact that a claim is already in the system is just telling the veterans that have been in limbo for a year or more that they are screwed.

    • ROLAND says:

      I know if may sound crazy but I asked my congressional representative to look into the matter for me and withing two weeks from the conference call with the VA and the congressional office my claim was finished. Luck or coincidence I don’t care but everyone out please get your congressman’s office involved. It worked for me.

      • charles barton says:

        I did have my Senator look into my claim also. The VA said instead of contacting them I should look at their website for information. Nothing has moved forward. It went back one step after contacting my senator. Coincidence or not? My claim has been in since early 2010 and will probably still be there in 2013.

        • John says:

          Anytime you get a polititian involved in you claim all it does is slow down the progress of your claim even more because your Claim File has to be pulled out of the line in order for them to go over it and give the Congressman/Senator an answer which is the same answer in standard format that they are working on your claim, the file may have been next in line to be rated. That usually causes at least a 45 further delay then your file will hopefully be placed back into the same place in line. Polititians have no power to make your file move any faster in line.

      • Bill Prevatt says:

        As I had posted before, getting our elected officials involved in our claims process is truly a waste of time. If you are persistant with your case then you will get more answers than your elected official will. Speaking from experience. When I say experience, I have gotten my elected officials involved in two states and I ended up with more information than they could ever come up with and I also work/communicate with my attorney’s office on a regular basis. I either call them and/or send them an email. There has been times that I have gotten in the mail from the officials office what I had gotten a week before and it was something that I had already worked on and requested. So yes the statement about our claims file being placed under someone else’s b/c we contacted our elected official is true. The VSRs do it out of spite b/c we are questioning them as too why it takes so long for our claims. I mean we present our evidence, it is exactly what the problem is and is right on point, but b/c it is not worded correctly or that specific VSR doesn’t want to take the time to read the information, they send out a formatted letter by just typing in something that they just pulled out of some manuel, just to waste more of our time.

  6. Sharon says:

    I think this idea of segmented lanes is a great one. I also like the idea of the Special Operations lane. Please, please implement whatever you can as quickly as you can. All Veterans deserve this.

    • Bill Prevatt says:

      I agree with you Sharon about being a ‘great idea.’ One thing that needs to be done though is to stop creating so many different processes, just hire more claims adjusters to do the job right the first time. Nobody should have to wait years for their decision.

  7. Oh, Goody, does this mean I only have to wait another 14 months on top of the 14 I already have?

    • If your claim is over 365days long, please contact your congressman for the state you reside in. If you have an appeal pending then unfortunatly you may have to wait it out, always remember to ask for notice of disagreement before a full outright appeal.

      • Bill Prevatt says:

        Honestly contacting your congressman or your elected representatives will not do a thing for you. There hands are tied. I say that from past experience. I have since moved from Kentucky, where I actually got my congressman involved and to no avale nothing happened that I had already knew. I have moved to NC and since gotten in touch with my congressman here and once again a huge waste of time. See if it doesn’t benefit them, why should they do anything but send out formal letters? Oh yes I have a very bad taste in my mouth with VA and our elected officials. The issue with VA is that they have nobody to answer too. They can take as long as they please on our claims. The elected officials have someone in their office do nothing more than you and I do, so before you go and waste your time, truly think about this reply. It will just make you get even more upset with the process. It is really sad when we as American Veterans trying to get what we are due, seek out assistance from our elected officials and they are not able to do anymore than we do.

        • John says:

          Contacting a Congress person is a complete waste of time, in fact it will slow down your claim even further. The only way to contact VA is by certified letter return receipt requested so if they lose something you have proof you sent it in as requested by VA with the green card attached to the letter or evidence you sent,may cost about $5.00 but is worth it.The only other best way it to go directly to your Regional office or VBA office at your clinic and talk to a live person face to face and keep notes of what was said and copies of what you submitt with VA date stamp.

      • Catherine Trombley says:

        Speaking freedom,
        A veteran files a notice of disagreement when they don’t agree with an RO decision. They have two choices: ask for a decision review officer (DRO) to review the claim or appeal to the Board of Veterans Appeals. If the DRO still does not grant the claim, the claim proceeds to the Board. I believe you meant to say “remember to ask for a decision review officer before a full outright appeal.” I agree with you… A DRO allows two bites at the apple. Thank you for serving our country.

  8. Victor Castro says:

    SharePoint, SharePoint, SharePoint!!!

    VA needs to look to SharePoint solutions in capturing patient data that allow for collaborative shearing globally. Would gladly provide written input upon request, thank you.

    V/r

    Victor Castro
    SharePoint Manager
    HQAMC, G-6 CIO
    Redstone Arsenal, AL

  9. Ginny L says:

    How dors this work with appeals? I have heard there is change here, too, where the appeal will be reviewed again by this new team ?? I have been fighting for my benefits for 23 years. Endometriosis, loss of creative organs, shoulder injury with spontaneous dislocation, migraine with neuro accompaniment, PTSD for military sexual/physical trauma and hearing loss. In 2001, with new evidence, I was denied everything except my shoulder and loss of an ovary due to cysts, not endometriosis. I waited for the BVA, then in 2004, they conveniently lost paperwork and closed my claim.

    In 2010, with new evidence, I opened my claim again. This time, I was awarded for the endometriosis after an MD wrote that there is clear documentation of the symptoms in the military records that are indicative of endometriosis. I was also approved for the migraines since that was all over my records. However, I am in appeal for the rest of it, including a CUE, to be back paid to 2002. Now, I find out that appeals are reviewed at the RO for a decision, then if claim still not accomplished, then off to the BVA. That sounds like even more trash inducing, hurry up and wait; not to mention, condescending treatment of me, and other vets like me!! And the government doesn’t care that I lost my ability to survive in this world!

    • Bill Prevatt says:

      All I can say is “DON’T GIVE UP!!” My appeal has been on going since Nov 1998. So it has been about 2,145 days since I have been waiting on mine. My attorney proved my case but do you think that VA actually did what they were suppose to do? Not a chance. What the VA wants is us Veterans to give up our fight so they can keep that money for themselves. Did you know that VA has nobody to answer to when it comes to our claims? They can take as long as they want to, in hopes of us just throwing in the towel. A friend of the family, it took him 15 years to get what he was entitled too and a member of the family it only took him 20 plus years. My question is why does it take so long to give us what we have proven over and over again? There is only so much evidence that we can provide to VA without giving them our first born. I claimed sleep apnea and VA didn’t even look at my new evidence when it was submitted. My claim has been remanded back to the RO at least 6 times. Hello RO get a clue!! There is a reason that BVA has remanded my claim back to the RO, b/c my attorney have proven my case. BVA can see it, so why can’t the RO see it?

    • John says:

      Try to keep you appeals out of the hands of BVA always go the Decision Review Officer Route at your Regional Office first and any time you send anything to VA does not matter what it is make sure you send it Certified Mail Return receipt requested and attach the green card when it combes back signed to a copy of what you sent.When dealing with BVA expect your appeal to go anywhere from 5 to 15 years because of remands after remands back to your Regional Office.There are some Vietnam era Veterans that have claims at BVA going on over 20 years.

      • spouse of a veteran says:

        John, Why arent these REPS. telling veterans this information about Notice of Disagreement or Decision Review officer route. In my husbands case our rep just said to file an appeal. Why in the world would anyone want to file an appeal if it take years and years to get approved. My husbands could have been over turned with just the additional medical evedence we provided. Now its just siiting there collectioning dust in appeals. Is there away to resubmit this medical evidence to the Decision review?? We would have never filed this appeal had we known about all this. Ours should be a very simple proceedor.

        • Bill Prevatt says:

          Spouse of Veteran, the Veteran Service Representatives (VSRs) are not saying this stuff b/c they want us to file an appeal b/c they think that eventually we will give up b/c it takes so long on an appeal. Nothing is more frustrating then sitting waiting for a decision that you know is easy to make but they the VA wants to just drag it out. Example; my attorney proved my case in court, sent it back to the VA and instead of honoring what was suppose to have been done, the VA just by passed everything and here I sit 165 months later “WAITING.” So you were not told about the process in hopes that you will just give up.

          • spouse of a veteran says:

            Well im not giving up Bill, for what is rightfully owed to my husband. and i have learned to do things for myself now. I am very good at submitting medical/lay evidenace properly. I have learned alot from all these comments/replies. Just wish i could turn make the clock on this but nobody will respond to me. How do i get my claims out of the appeals process. I want to submit it as a FDC claim, so i dont have to wait 2years.

      • Bill Prevatt says:

        I have an attorney’s office representing me and they copy me on everything they send to VA. I think when I actually take the time to place all my VA claims stuff in boxes, I will end up with about 4 or 5 boxes. Just down right pitiful that you have to have so much wasted time. My attorney has all documentation and I stay on top of it all.

        • spouse of a veteran says:

          Catherine, can you tell me if an appeal has already been filed and its still in stage one according to the E Benefits website, which had our rep. told us about this Notice of Dissagreement we could have filed for, i truely believe ours would have already been resolved with the additional medical evidence and lay evidence we submitted along with this one appeal. Can we resubmitt this medical evidence and lay evidence to this Notice of Dissagreement department your talking about? That to me seems like the way most of these claims should be going anyway if they were denied the first time, Not an appeal. I would think an appeal should only be done, if the Notice of Dissagreement was denied. Am i correct in the way im thinking? And is it possible to change it now?

    • Catherine Trombley says:

      Ginny, each regional office has an appeals team to handle appeals. When you file an appeal, the regional office has to produce a statement of the case (SOC). this is a summery of the file and all the evidence that has been considered to that point. You get a copy (to help prepare for the appeal) and a copy goes in your file. So the RO is not reviewing to render another decision, they are required by law to provide you an SOC.

      Now if the Board remands your claim, it goes to the Appeals Management Center they oversee the remand by sending the claim back to the regional office to fulfill the orders of the remand. Once all steps are completed it goes back to the AMC to either grant or continue the denial. If they continue the denial the claim automatically goes back to the Board for review. I know appeals are a lengthy process, but this system is uniquely pro veteran. At every step in the process through the Board, you can add evidence to help prove your claim.

  10. Gregory C. Middleton says:

    Why, then, has my claim been awaiting a decision since May 04, 2012?

  11. thomas says:

    I applaud your dedication to your office and what you write seems like it should work but evidently all of these lines bottleneck at the hold it hold it and hold it some more lane. I have gotten my first rating and have 4 issues that are on deferment, they have already verified that nothing else is needed on my part to provide, But It has been at that status for 7 Months. My audit was back from DFAS since Jan 2012 but it still has not been paid out to me yet. I see the blogs on this website with VA reps getting annoyed with US vets and they say that they are working as fast as they can, well why is it that your offices do not hire more people? There is justification to put in for a term/temp 1 year hire, so that the workload can be reduced? The last combat troops are not slated to come back until the end of 2014, wouldn’t that be a necessary step to take? If there is so much outrage among us Vets about the lack of understanding and care that the VA offices give us I would think that as Americans we should be more willing to help our fellow Americans. Why is it that I see the va reps making comments about what they call “claims we think we are entitled to”? I think that that is a very arrogant comment to come from a VA rep that if they were the one that had the claim they would want a better handling of their claim as well. Just very sad that we didn’t wait when it came to defending this country, why is it that we have to wait for entitlements we are authorized. I can understand someone claiming a limb is gone and not evidence to prove it, but If a Doctor states that a soldier has PTSD, why is it that the VA has to have one of their doctors verify that? Is the doctor not a doctor for a reason? It’s not that the VA doctor is not going to work in the interest of the VA…. No not at all. RIGHT. I just pray that when it comes time for your team to get SSN benefits you’re not given the same treatment.

  12. Antolin L. Garza says:

    1) We sent in papers for Declaration of Status of Dependent for my wife since April 11, 2011. I call and all I get is that all is in process. What is the hold up?
    2) I sent in all my “psychiatrist exam” paper for increase in benefit for panic attacks and depression since some time back. I call and all I get is the same stuff, all is in process.
    All this does not help our situation..Please HELP!

  13. hugh tole says:

    How will the appeal process change? I have waited over 500 days for a correction
    to the rating I received for Ischemic Heart disease. All of the evidence submitted was not considered in the original rating. An error in the nurse’s notes at the VA medical center stating that I use a push mower was the only thing considered. In the appeal the correction was made by the Nurse and the two other medical people that copied her notes instead of taking notes at my hospital visits.

    • Catherine Trombley says:

      Hugh, our providers are now using Disability Benefits Questionnaires for all our exams. This makes the process much more standardized so that typos and errors on the exams are less likely to occur. The Disability Benefits Questionnaires are available to the public so you can give them you any private providers you see. We have also increased our quality reviews so differences between the exam and hospital notes can be spotted at the earliest possible time. Thank you for serving our country.

      • Bill Prevatt says:

        Catherine, when was the Disability Benefits Questionnaires introduced? I have yet to see those questionnaires and where can we get them?

        • Catherine Trombley says:

          http://benefits.va.gov/TRANSFORMATION/disabilityexams/. They were introduced in the Spring.There is also a secton for doctors. If I were you and going to a private doc, I would print the doctor’s section to give to them.

          • Bill Prevatt says:

            Let me just state for the record that I have attempted to use those forms to have my specialist fill them out and he refuses to fill them out b/c he doesn’t deal with disability issues. His office directed me to have my primary care provider to fill them out, but my issue with that is the information is not being provided from the specialist but from the person’s primary care provider and for some that are not familiar with the medical field, their providers are general practice providers when they should have an internal medicine doctor to tend to them. So my question is if the primary care provider fills out the forms will VA accept them as if the specialist filled them out?

  14. Benjamin Montgomery says:

    My claim began in 2006, I have had three C&P exams where even the doctors can’t believe my claim hasn’t been finalized. There is so much documentable evidence for unemployability that my two PCP’s, the VA’s physicians that are supposed to know more about our health than any other physician, have both documented my inability to ever work again. I have slowly moved up 20 to 40 to 60% service-connected disability, yet there is ample evidence for total and permanent. My first appeal went in Sep 2010 and I still have not heard. I hope the new system works faster for the Regional Office in North Little Rock, Arkansas. My life began to end when I could no longer work because it was all I knew. To have to wait this long to have any sort of life that isn’t full of constant and persistent struggle when so much evidence exists in VA and outside medical records and nothing but delayed decisions continue is simply cruel. But like all the other veterans with service-connected disabilities, all I can do is wait and wait and wait. Please, I know you can do better than this. Show us you can. We need it and we deserve it.

  15. Michael says:

    I hear everyone’s frustration, but with the VA just instituting these changes it will take awhile for the bottle necks to open up. There was also a press release about the VA hiring more people to get the claims done, but you also have to realize that NEW employees are going to be reviewing files and that also can slow things down. I am a county veteran service officer and want my vets claims to fly through, but in the Chicago area, it’s a given most claims take 18 – 24 months, period.

  16. Americans we should be more willing to help our fellow Americans. Why is it that I see the va reps making comments about what they call “claims we think we are entitled to”? I think that that is a very arrogant comment to come from a VA rep that if they were the one that had the claim they would want a better handling of their claim as well. Just very sad that we didn’t wait when it came to defending this country, why is it that we have to wait for entitlements we are authorized. I can understand someone claiming a limb is gone and not evidence to prove it, but If a Doctor states that a soldier has PTSD, why is it that the VA has to have one of their doctors verify that? Is the doctor not a doctor for a reason? It’s not that the VA doctor is not going to work in the interest of the VA….What make the VA doctors better then our doctors 9yrs the same doctor what better person to know agout your disiability,I have been to the C.of VAppeal three times, and the laywer that represented me was paid three times a sum of $1.948.00, and i got a big fat REMAIND back to the VBA, were i was told it will be another yr be for we can get back to you. how the hell can you pay a lawyer when then the person they are representing, have file for hardship,can not work because of his or her injury but every one else get paid and they are not waiting (yrs) to be paid, our body are like cars if you do not fix the problem, they cause other problem bigger then the one you have now and that is a fact!!!.
    I Hope VA Stop playing with people life, most are doing more harm then good. the rep tell you the same thing i know trying to help, but they never tell just what they are working on and hepl never come.
    Please i hope this work if not there are a lot of us who need the work need help call us the veterans we will get ridge of the backlog.

  17. ronald goad says:

    I take advantage of every opportunity to comment on the VA disability rating and compensation claims processing procedures. I have been fighting with the VA for 20 years about my disabilities incurred in service. I have taken on their endless legal teams and have only one thing to say about all of it…THEY LIED. and they continue to lie to deny benefits to deserving veterans. Segmented Lanes-Are you serious, The problem isn’t that the claims are processed slowly (however that is unfortunate), the problem is that VA denies more than 98% of all claims. Denied claims are appealed, appeals are appealed, appealed appeals are appealed. etc… Therein lies the problem of case overload. But that is the technique used by VA to string along the VETS. Look, if the VA approved benefits the Government would have to borrow more trillions to pay us. All this really makes me puke!!!

  18. Steve says:

    My issue is claims/regional office not processing benefits/entitlement correctly. If they wouldn’t look to rate everything at 0% before looking closely at how the disability is tied to the veteran life then it wouldn’t be so many appeals. The rating is always 0% and then you must prove once again why you feel you are entitle to benefits at the 10% rating level. I will continue to fight for benefits that I deserve. Once more issue how can 1.2 million vets have a 10% rating for something that is the same as mine but I get a 0% rating. Sounds like staff at the the Regional office are not fair in their decision making and are bias to the facts and give who they want a favorable decision rating that is the real issue not the long waits.

    • Catherine Trombley says:

      Steve, without looking at your claim it is hard to say. But I highly suggest working with a Veterans Service Officer or County Service Officer. The simple fact is all claims are different. My claim is different from my friends’ even though we have some of the same disabilities. Think about your service: everyone has unique experiences even though they may have been stationed at the same place. Claims are the same way — as unique as the people who file them. Therefore, we can’t rate them all the same way.

      38 US Code and Federal Regulations stipulates how we rate each claim. Your symptoms — as evidenced in your claim — have to line up with the criteria for a certain rating. If they don’t we cannot legally increase your rating. If you review the reg, or consult with you power of attorney, like a VSO, and still feel you are entitled to an increased rating, use the Decision Review Officer and/or appeal to the Board of Veterans Affairs. You can always submit new evidence to further support you claim at both stages, (though at the Board you would have to waive review by the RO).

      I know its frustrating when you believe you are entitled to something and don’t receive it, but we hear you and are working to right the process.Thank you for service our country.

      • Bill Prevatt says:

        You know it is one thing to sit there and use the regulation to back your reply up, but there comes a time when that regulation needs to be updated to something more current. You want to use regulation, well how about this. Competent lay evidence: This is usually the Veteran’s report of symptoms that he/she experiences. Lay evidence usually consists of statements from a Veteran, Relatives, Neighbors, Buddies and co-workers. A “lay witness” is a “person called to give testimony who does not possess any expertise in the matters about which he/she testifies.” Generally, lay testimony is limited to opinions which are based on first-hand knowledge or observation. The Veteran is considered competent to report what he/she feels or sees. Assuming the Veteran is not a doctor, he/she would not be considered competent to report that he/she has arthritis of the left knee; however, he/she is competent to report that he/she has pain and swelling of the left knee. So what I am saying is we as Veterans know our bodies better than those of you making decisions on our claims and instead of just seeing how the square will fit into the circle, look outside the box and read what we Veterans have submitted, both medical evidence and lay evidence and see how that fits into the 38 US Code and Federal Regulations.

        • Catherine Trombley says:

          Bill, you are right about lay evidence and I wish more Veterans used it. When I argued claims at the Board many Veterans would not use it and it would make my job as their advocate harder. Lay evidence is considered with medical evidence. But there still needs to be a Code for uniformity. Already you can see the comments on this post where Veterans don’t understand why their buddies with the same condition gets a higher ratings. Can you imagine what that would be like if there was no Code for uniformity? I can sympathize with you because I have felt the same way not only for myself, but for the Vets I represented. But at the end of the day, there are laws that govern this process.If the Code is not specific then it becomes too hard for Veterans to know what they are entitled too and too hard for advocates to advise them.

          • PJ Allen says:

            My husband used lay evidence in his claims, one from me, when he first submitted his claim and later when he applied for an increase after his condition worsened, my sister (his sister in law) sent in her letter (opinion) of what she has been observing also…i don’t know if the lay evidence helped, but my husband hasn’t had much problem getting his claim accepted. I will agree with what was said earlier, it is very important to get into the claim rep’s hands evidence that shows, the disease, how it was caused by the military service, and a medical opinion stating the connection…That is what we did…alot of the piles of paperwork is unneeded…just state the facts i just listed and if you have those, there shouldn’t be a problem…except for waiting the year or two to get it. Good Luck all…

  19. Brady Lewis says:

    I have read each veteran comment’s and have to agree with them. I too have had a claim in Gathering Evidence since March 26, 2012 this claim was sent in June 3, 2011 they gave me the increase’s on the others March 26, 2012 along with adding back my son which at that time was still in high school and I have not been paid the back pay increase or for adding my son back to the Compensation on top of that they deferred my sleep apnea and diabetes. I have done what my fellow veterans have done and called, called, called the reps on the phone cannot tell me what is going on. I directly contacted the Supervisor over Compensation and Pension rating team in Montgomery Alabama asking what the holdup was she told me that she did not know and not to contact her like that again that was not proper protocol. Well I have contact Richard Shelby and Jeff Sessions on the matter and if they can’t take care of I have three lawyers waiting to sue the VA. We all applaud what you and your team is trying to get done, but what about our young veteran’s coming home they will go through the same problems that us older vets have gone through. I fought proudly for this country and would be glad to again if I am able, but those people working our claims, I wonder how they would have felt if we veterans told them and the American people we will work your claim to protect you and give you a decision in 180 days, a year or two to go and defend your right to live, work and prosper. I am more than sure they would be upset like the rest of us. A great man once said “To care for him who shall have borne the battle and for his widow and his orphan” Abraham Lincoln said this in his second inaugural address it will be nice to see it actually come to life when it comes to processing our claims.
    Brady Lewis
    Retired, 1SG
    U.S. ARMY

    • dave knight says:

      I agree with you 100%……as a young private went to SE Asia..who would have known that problems would follow me. I was living in Bama Doctor said you have type 2 we see this alot in old GIs who were in RVN, I went to local VA sent in paper work got turned down after 15 months. Why my claim was not totally reviewed ie VA had not read the Doctor’s findings. I also wrote our elected officials (what a joke). Their staff sorry agreed with the VA. I found a VA officer in Limestone who worked, called the attention of VA to the proper documents in the claim, well after 2 to 3 years that got approved. I think many of us lifers in the service did not report things related to our health for years why (we all know) the chain of command !

    • John says:

      Calling and E-Benefits is usless or even the IRIS system or a Congressman or Senator do not bother contacting VA unless you do it writing Certified Mail Return Receipt Requested and when you get back the green card signed attach it to the letter etc you send them i finally got smart and started to do that 8 years ago and got good results because i put them on notice that i will keep track of my documents and when i sent them in.That way also if you ever have to use a lawyer you have solid proof.I don’t know why veterans have to go to such extremes as to look like thay do not trust VA making them sign for everything should not have to be that way.

  20. Jim McElfresh says:

    I represent vets and had 3 with terminal illnesses succumb to their diseases before the claims were resolved. Despite my pleadings, the family, friends, etc. it was fruitless the veteran died. It would seem to me when envelope after envelope, letter after letter stated TERMINAL CONDITION/ HARDSHIP PLEASE ACT IMMEDIATELY that a red flag would go up.

    I find it inexcusable, irresponsible and deplorable.

  21. wayne schatzle says:

    the whole problem is that the va does not adhere to their own regulations, which I have been showing them for 6 years now, and they will not explain to me how they get around them- they just ignore answering. my claim will wind up in fed court which will take more years. also dont count on any of the vso groups for help.

  22. John says:

    I had a claim/appeal at the Waco VARO that went 11 years and all the issues have still not been resolved thats what i call efficiency, the original claim from 1992 should never have been denied to begin with because of all the solid evidence is in my service medical records. After getting it sucessfully re-opened in 2001 Waco still denied it and it went to appeal BVA finally approved most issues in 2011 but there are still other issues, i am a Vietnam Era Veteran itis not unusual to see Vietnam Veterans with claims/appeals going over 15 – 35 years.I received an expedited appeal waiver of RO office jurisdiction in February to sign and return so they say they have other issues to send to BVA and after 4 request to find out what it is about no one at Waco has got back to me yet it has been 6 months.

  23. LUTHER HARRIS says:

    i put in for up grade and it has been well over a year i got a letter saiding it takes 332 days i think to file a claim it has been longer than that.can you tell me what is the hold up ? i have been to the Dr that they send me to

  24. Nick Swan says:

    Fairness of Veterans Disability Compensation (25 Billion for Vets Compensation or 350 Billion for Illegal Aliens ?) There are 4.1 million Disabled Vets who vote, who would like to know if you really care about us !
    The current VA Disability Compensation payments is ONLY ½ of what the VA should be paying. According to the current VA method of calculation,( which has not been updated since 1945), it takes almost 12 service connected ailments to reach the 100% disability level. Listed below is the compensation table in question which clearly shows the disparity in compensation paid to our Vets. 10% of something with an established 100% value should be 10% not 4.5%. There is a 40% premium for the last 10% of disability. I think the VA, our Congressmen, Senators and everyone running for a public office spouting how they take Care of the Vets should address this issue. Share with all Vets you know, every medium, and every forum. The Net is our friend.

    Explain to the veterans how the current compensation table is fair ?
    2012 Table % without children where 100% = $2769
    Current Table
    10% = $127 or 4.5% of $2769 10%= should be $277
    20% = $251 or 9%
    30% = $389 or 14%
    40% = $560 or 20%
    50% = $797 or 28.8%
    60% = $1009 or 36%
    70% = $1272 or 46%
    80% = $1478 or 53%
    90% = $1661 or 60% (40% premium for the last 10%)
    100% =$2769 If you place this value on 100%, then the values on the descending percentages should be equal to the % of that 100%
    What it takes in ratings to reach 100% based on current rating system.
    Each % is equal to a rated Service Connected Illness
    60%+30+30+30+20+20+20+10+10+10+10+10 (12 Subject ratings)= 95%
    The new compensation rates will range from $127 monthly for a disability rated at 10 percent to $2,769 monthly for 100 percent. The cost of living adjustments (COLAs) also apply to disability and death pension recipients, survivors receiving Dependency and Indemnity Compensation, disabled Veterans receiving automobile and clothing allowances, and other benefits. The full rates are available on the Internet at http://www.vba.va.gov/bln/21/Rates/#BM01.

    • Brady Lewis says:

      I agree this is what Abrham Lincolon set this system up for. I cannot understand why they feel that giving a lower % number matters 50% should be 50%. What the VA does not understand along with those that work these claim and have never servered in the military is that we are not going to give up, they want us too so they do not have to pay anything, but we need to stand strong. What they don’t understand if it where not for us they would not have a job. Thank you so much for your insight in this problem.

      Brady Lewis
      Retired, 1SG
      U.S. ARMY

    • william says:

      Nick Swan,

      I will cut and past this information and pass it on to my wife while we keep wondering if we can pay bills next month.

      • Bill Prevatt says:

        Nick, I am right there with you. I am barely making ends meet and to be honest with you I am sick and tired of living like this. There is always one excuse after another and what would have happened if we made a decision like this on the battel field, oh that is right we probably would have lost. I just can’t understand why this has to be long and drawn out.

  25. C.Zappley says:

    I placed a claim over a year and a half ago to do with my back and secondary injuries and have been in the decision phase for over six months..Whats the hold up Philadelphia.My representing POA just gives me the run around.

    • Bill Prevatt says:

      C. Zappley, your representative isn’t giving you the run around, they are only telling you what they are getting. Even though they are your POA and representing you, VA has no one to answer to so they don’t care about how long it is going to take on your claim. All you can do seriously, is to just forget that you even have a claim in. That way you won’t be expecting anything anytime to soon.

  26. Michael P. Greenhouse says:

    Hmmm..My claim has been pending since May 2002. Yet Im waiting for it to go thru the segmented Lanes. I hope I will not have to wait another 10 years for a answer after 28 years of dedicated service.

    • Catherine Trombley says:

      Michael,

      Have your ever recieved a decision from VA? Or are you in the appeals process?

  27. maurice wyman scott says:

    I agree with most of the posters, but it’s great that they tell us all of these solutions, but in Columbia, SC, they have another problem, one being the c and p doctors, they aren’t veteran friendly, seeming from the nonsense that goes on, they must be on a bonus program as well, just write whatever they wish, regardless of the truth. Just have a C and P during business hours, then wait sometime, and have another one for the same thing, on a Saturday, or after five. The one during business hours, says ” It’s not service connected, but if you have another one during after hours, or on Weekend, that one says, sure is Service connected. If this isn’t corruption what is. About two weeks ago, I finally became IU, I was happy, but not happy with the years they rob from me, you see, the Regional Office admitted they mishandled, lost, or destroyed my service medical records, which was fine, but in claim the original date, they said oh, you didn’t originally sign a electronically submitted claim in 2005, so we can’t go back then. Now that would have been fine if true, but in 2005, I did provide a signed copy. Now in evidence of this lie, the person handling my claim wrote all the C and P’s I needed, yet they never schedule them. As it seems that only records concerning my injuries or complaints got missing, I affirm that whomever handled my claim made damn sure, that all related signatures pages got missing as well, they did the total destruction program to ensure that benefits would never be paid. This isn’t new to the Regional Office, a number of years ago, they were reported in the shredding gate of files, or throwing claims away totally, so why is it surprising today, it never stopped. With the admission of losing or destroying my service medical records, I am going to file my appeal for a original filing date, and unfortunately even with the admission, I am sure that this is years away, but eventually the corruption, because of that admission will come to light, and hopefully justice will be served, but probably not until it reaches a civilian court system. I wonder what’s going to disappear after this, my whole claim folder, huh? How stupid could one be to admit, that they lost something or otherwise discarded it, then blame the veteran for something not being there, wow.

  28. c j says:

    the va dosen’t care.how long you have to wait.it if was up to them ,they would probale wait for you to get mad enough to say the hell with this or just wait for you to die.that seem to be the sad facts. they keep telling us that there hiring new people or training them so that they can help but nothing gets done .there liar’s .your veterans who served our country and kept us safe. you shouldn’t be treated this way.they should show you with the up most respect.that you deserve.in stead they give you the run around.you need and deserve it know not 14 month’s or years later. you bills dont stop ,they keep coming in every month like clock work

    • Bill Prevatt says:

      Thank you CJ for truly agreeing with all of us have been saying for years. You are correct in what you say about the VA wanting us to give up or die. It is a sad day when we have to actually prove ourselves over and over again for something that we did not have when we joined the military. You are also correct when you say the VA doesn’t care. They like to give this dog and pony show to America that they care about us when in fact they are so full of it that it is coming out of their ears. Yeah the hiring of new people, that is truly something that is also a joke. It takes at least 8 weeks to train these new hires so in the meantime there comes more of a backlog once again.

  29. Jeff Perry says:

    I have had my claim in appeals for a total of 5 years and at the board of appeals for over 2 years now with nothing said or any progress. I am a struggling vet financially because I can barely hold down my part-time job working 20 hours a week. Anxiety and Paranoia suck. But anyway will this new process help with the giant backlog of cases already completed? It all sounds nice, but will it work in reality?

    • Catherine Trombley says:

      Jeff, we have tested each Transformation initative to ensure they work. This type of change at VBA has never been done before. I assume you mean appeals be “backlog of cases completed.” Each regional office will have dedicated appeals teams to help expedite the process. Also, if you are struggling financials call the Board and ask for expedited review, or to be advanced on the docket. You usually only need to send in a statement and late bills (eviction notices or foreclosure). If you work with a VSO at the Board contact them for more information. Also try the BVA ombudsman at 1-800-923-8387 Monday-Friday 9:00am-4:30pm (Eastern time zone).

      Thank you for your service.

  30. william says:

    This is the information I see on my e-benefit web page. I have been looking at this same information since November until I decided in March to go and gather my own medical records and send them to my regional office. I sent in all medical information; I could get my hands on. I was told the VBA was able to get my medical records if I was send and treated at any of there VA medical centers; in which I was. After looking at the same information on e-benefit day after day; I went and got my own medical records and sent it to them. The question I have now is why can’t I look at e-benefit one day like today and see that my claim have move to the next phase; to the reviewing of Evidence phase? Every time I look at e-benefit it looks like nothing is happing. Every time I call the 1-800-827-1000 number I receive the same information I see on e-benefit web site.

    Gathering Evidence
    Details of Your Claim
    Claim Received: 10/17/2011
    Claim Type: Compensation
    Estimated Claim Completion Date: 05/24/2012 to 02/19/2013

    What Do We Still Need From You? Your Attention is Needed

    We need evidence showing that the following condition(s) existed from military service to the present time:

    As we consider your claim, you may submit evidence showing that your service-connected
    Date Requested: 11/10/2011
    Due Date: 12/10/2011

    0820 10/27/2011

    Med Evidabce- CBOC 03/13/2011

    VAMC Treatment Records-La Junta, 03/13/2012

    • Jeff Perry says:

      I have put in all of the paperwork with help from my advocate. I have completed 3 C&P exams since my appeal and none of them lasted more than 15 minutes. I have been going to the VA in over 10 years and have been through five different psychiatrists. My current PTSD rating is 50% but because I cannot hold down even a part-time job without medicating myself before going to work, at lunch and during the second half of the day my advocate and myself believe that I should be at a higher level. I am medicated beyond what others are taking and it still helps minimally. I have a therapist that I see every two weeks as well that is paid by the Vet Center. I just wish that they would move a little faster on it and not leave us veterans hanging by a string all stressed out on whether they are going to get help or will they continue to suffer with the nerve wrecking response that it is in progress. I think the added stress for me of losing my psychiatrist who understood the level of my illness and now going to talking with a doctor on a video screen from another facility is also stressing me out. I don’t know if there is a shortage of doctors but it is weird that my doctors at the VA discuss how serious my condition and then I get a 15 minute C&P and they say it is not that bad. I just don’t get that myself. If it is not so bad why am I jacked up on so many antipsychotics and antidepressants. I use the chat line crisis a lot and that helps me out but all of them keep saying that they would recommend me going inpatient to see if they could find a good medicine combination. I cannot do that because I am barely making ends meet as it is.

      • william says:

        Jeff Perry,

        I hear you; I thought my case was an open and close case. I was injured while on duty; received and LOD from my commander and I was escorted to an Army medical center were I was first seen. Later I got awarded a VA doctor so I started see him and he did all of the medical examinations, x-rays and blood work. So, I don’t know what the problem or the delay is. e-benefit states they are gathering evidence but I gave it all to them. I just want to see where someone is looking over all of my medical work, my LOD and my buddies statements.

        • Jeff Perry says:

          Keep fighting them William. I have a good advocate but she is only getting the same response that I am getting that it is still pending at the board of appeals. If you keep up the faith that something good will happen it will one day come to you. I know for myself, the PTSD is making it very difficult to work. I have lost several jobs because of it and quit other jobs because it triggered flashbacks. I am a client in voc rehab now and we are trying to start self-employment because I do not do well with working in the public. I also had the impression that during the C&P that the reviewer was defensive and tried to minimize any problems that I tried to discuss with them. I know that it is a long drawn out process but if you stay on top of it and hopefully in the end you get what you deserve.

          • Jeff Perry says:

            Another thing that really bugged me was that the C&P doctor was very unfriendly the last C&P and all they wanted to talk about was my life pre-military. When I asked him if he needed information of my current state or the treatment I am getting he said they already had all of that information. I later found out that they never did send out for my Therapist information or the doctor I saw before going to the VA for treatment. He kept asking about pre-military drug usage and my school problems. After 15 minutes of that he just said that he had his information and that we were done. It makes me wonder if he even looked at my VA notes from my doctor who I was seeing monthly and had given my wife her direct line number because she was so worried about me. When I look at it I wonder if I should go inpatient because no one is listening otherwise. I hate to go to the hospital and was in the psych unit at a local hospital in 1995 and it was not a good experience.

    • John says:

      E-Benefits is useless their information is usually at least 6 months or longer old it is never up to date.It is just a get the monkey off our backs routine.

      • Jeff Perry says:

        I know what you mean about e-benefits. My stuff is all old and it got me worked up so I called my advocate and she told me it was not accurate.

  31. George says:

    Will my claims for 2 years 3 months be put in the express lane? I submitted 2 claims gout and knees. Also, the VA requested exaim. There was the error in the ratings of my knees and they were to be down graded. That I had to have to or more major bones in my knees infected. In all the claims over the years my knee cap and femur bone have been listed. But the VA exaiminations only showed the knee cap and minor bones which the VA never request the eval of the femur bone as part of the knee exaim. But I am in a posiiton for something they require but never followup on when they did not get the major bones that they require. A phone hearing cleared up the errors on my knee ratings. But will they still evaulate my knee as before when the femur bone is not in their report. But has always been in my claims submitted for my knees?

    • Catherine Trombley says:

      George, to answer your question once a regional office implements segmented lanes, all claims in that RO are sorted into the segmented lanes. As to your specific question about your claim… I really cannot answer that without looking at your claims files. I suggest asking your POA (VSO or CVSO) what their thoughts are since they are privy to the entire file. Thanks for your service.

  32. D mades says:

    REALLY??? I am SOOO excited!! Maybe my claim from September 2007 will be settled by 2017 instead of 2018? YAY!!!!

    AWESOME!!!!

  33. Catherine Trombley says:

    Thomas, this is a new process and has only been implemented at 16 regional offices but we are implementing it at the rest of the regional offices as fast as we can. I don’t have access to claims, but if you were deferred and VA has everything from you, we could be waiting on records, such as Social Security Administration or private medical treatment records. VA is at the mercy of private physicians to send in records and has to wait on SSA to deliver records. Again, I don’t know this to be the case with your claim, but that is typically what it means.

    Transformation is not as simple as hiring new claims processors for a short period. It takes up to two years for a claims processor to become a “journeyman” skill level. The claims process is governed by a series of laws, regulations and precedent court cases – it’s not something that can be learned overnight. So hiring more people would not have the impact we need. Transformation has to include people, process and technology.

    I’m sorry our employees gave you that impression. I can honestly say that everyone I have come across at VA is dedicated and passionate. Many are Veterans themselves and those who are not usually have close relations to Veterans. Often we hear claim processors say they work every claim as if it is their combat buddy, uncle, father, or grandmother. While they may not have phrased it right, what they might have meant to say is that sometimes Veterans file claims that we cannot grant because the law ties our hands. Its one of the most frustrating parts of working claims — sympathizing with the Veteran but not being able to do anything to help. A good example is a Veteran who has had a condition since service, but waits 25 years to ask for service connection. When s/he is granted, s/he asks to receive compensation back to the time he or she left service. By law, we can only grant compensation to the day the claim was filed.

    We relaxed our criteria for rating PTSD so that we no longer have to verify the stressing event (or stressor). However, this means that a VA doc must state that the Veterans PTSD is related to a certain stressor and therefore, PTSD is as likely as not due to service. Because the opinion is a little more complex than a standard opinion, VA makes the determination. However, the VA doctor must address you doctor’s opinion in his or her opinion.

    • Mark Chamberlain says:

      It took how many years to implement this at the first 16 offices? They will not tell you which ones they are because they can clain that the one you are talking about is one of them they have not started the new system at. So time the number of offices by the number of years it took the first 16 and they should be all done by that time. O I forgot there will be a bunch of problems that they can not figure out so add a + 50 for devation.

      • Bill Prevatt says:

        Actually there are 12 RO for the deployment of the transformation initiatives and they are: Huntington, W. Va., Hartford, Conn; Portland, Ore, Houston, Cleveland, Des Moines, Iowa, Boise, Idaho, Phoenix, New Orleans, San Juan Puerto Rico, Atlanta and Newark, N.J. This deployment follows four pilot programs in Indianapolis, Ind., Wichita, Kan; Milwaukee and Fort Harrison, Mont.
        This is per the DAV Magazine for July/August 2012.

    • spouse of a veteran says:

      They have not relaxed anything. My husband is 100% PTSD and that so called C/P examinor got fired for dening so many vets who truely have PTSD. His C/P guy said yes you have PTSD but no stressors. My husband explained the fire fights and told him his best friend died in his arms,leaving him feeling angry and helpless.(he even provided his friends full name) CONT

      • spouse of a veteran says:

        When my husband came home from his C/P exam, he told me from the very beginning that the examinor was very defenseful. I told my husband he should seek out help through the private sector medical profession, so he did. The private MD was so upset that they denied his claim, that he wrote 4pages of stressors and he is currently treating my husband with meds and counseling. The really sad part is he got a honorable discharge for mental problems(personality disorder) That is a lie and the private doctor also agreed with us. .So here we sit, 1 1/2yrs still waiting on the appeal. So i have to disagree with your comment about relaxed.

  34. Catherine Trombley says:

    Ginny, there is an appeals team at each of the regional offices where we have implemented Segmented Lanes. These teams handle appeals exclusively.

    Regional offices do not review the claim once more to issue a decision. Rather, they review the claim to sum up all the evidence thus far and send to you (called a Statement of the Case) a copy also goes in you claims file for the Board to review. Its particularly helpful to your power of attorney, if you have one. It was usually the first thing I read when I worked Veterans claims at the Board.

    Then the claim is certified for appeal and sent to the Board for Veterans Appeals for a decision. If the appeal is remanded to the Appeal Management Center (AMC), the appeals team at your regional office will process the claim in accordance with the Board’s decision and then forward to the Appeals Management Center. The AMC can either grant your claim or continue the denial. If the AMC continues your denial, the claim automatically proceeds back to the Board for final review.

    Thank you for your service

    • Bill Prevatt says:

      My question then Catherine, how many personal are on that appeals team? 1, 2, 3 or 4. How many? If it is true that the segmented lanes will speed this up, than there should be a number of appeals team members making this happen.

      Then my second question to you is ‘why send the claim back to the RO if they do not review the claim? I mean everything has already been summed up in the remand from the BVA, so why send it back to the RO?

      When the BVA reviews the case and see that more development is needed, that goes to show that the RO didn’t do their job, so once again the Veteran is the one that gets strung along. When the AMC gets our claim, what authority or qualifications do these employees have to grant or deny our claim? What is really amazing is that if the AMC continues the denial, that is considered to be adjuicated and the RO gets a bonus. So the more the RO continue our denials, the better it is for the RO. So tell me how does that benefit us Veterans?

      • Catherine Trombley says:

        Bill and Mark,
        Segmented Lanes are currently are at the following regional offices: Wichita, Ft Harrison, Milwaukee, San Juan, Phoenix, Houston, New Orleans, Boise, Des Moines, Hartford, Atlanta, Newark, Huntington, Portland, and Cleveland. Indianapolis was actually the regional office that developed Segmented Lanes, but they have not implemented it yet. The rest of the 56 regional offices will implement Segmented Lanes by the end of 2013. Thank you for your service.

        • william says:

          How funny, my hometown is Atlanta, George; and I lived in Phoenix, Arizona for almost a year, so I guess I just lucked out by moving to the Midwest, How sad! “The rest of the 56 regional offices will implement Segmented Lanes by the end of 2013”; I’ll be glade to pass that bit of information along to all those who are looking for payment from me, by the end of next month.

          • Catherine Trombley says:

            William, if you are expirencing financial hard ship, notify the RO or your rep and ask for expidited processing. Typically you have to show late bills, eviction notice, things like that.

          • william says:

            Catherine,

            Thank you and I will do just that!

      • Catherine Trombley says:

        Bill, the size of the appeals teams depends on the size of the regional office. But to give you an idea, the Atlanta RO has about 25 people assigned to the appeals team. The reason it goes back to the RO is because much of the further development is local, like setting the Vet up with an exam or requesting medical records from local private physicians.

        Appeals are tricky … first off, the veteran can add evidence at any point up until the Court — at the Board you have waive review by the AMC or RO. But every time you add evidence, it changes the facts of the claim. Often the claim the board sees is not the claim that left the RO or AMC. That’s not a bad thing, because it gives you multiple chances to get your claim granted. But it means that the RO or AMC reviewing the claim — or getting credit — is seeing very different facts of the claim each time.

        • Bill Prevatt says:

          You are correct in stating that appeals are tricky, but in my case Catherine the RO “NEVER EVEN LOOKED AT MY EVIDENCE NOR CONSIDERED MY EVIDENCE” per the BVA and now it has been remanded once again to the RO for a process that should never have taken place. In other words the RO should have done their job in the first place. As for the VA setting up more exams when they have current evidence is truly a waste of the VA providers time as well as the Veterans time, not to mention the cost for the same exact exam that was just recently performed and just b/c the evidence isn’t coming from a VA provider, its not good enough. Isn’t a provider (private) considered to educated enough to give their “medical opinion and diagnosis?” Which brings me to the statement about the Disability Questionaire. If we take those documents to our private providers, will VA consider them or will they be tossed to the side like the other evidence we submit from our private providers?

          • Catherine Trombley says:

            Yes, we will consider DBQs, however, the DBQs are meant for increase evaluations. The reason why you see a VA doc for an exam is this: a nexis has a couple of parts — the examiner must look at the claims file, review your military and post-military health records, examine you and then state whether its “as likely as not” (a 50/50) the condition was caused by service. They must state that they reviewed the records and then give a rationale for their opinion. (there are several court cases that set this).

            So if a private provider simply states “His condition is due to service,” as many do, its not enough to meet the legal standard — it leaves too many questions — with what certainty is the provider saying this (50, more than 50?), did s/he review records? Did s/he provide a rationale?

            Here is an example of an opinion that would have been considered good when I worked at the Board. “I have reviewed the Veterans service treatment records and post treatment records. Based on those and an examination, it is as likely as not the Veterans skin cancer is due to his miltiary service since he complexion is fair, much of his service was spent training outside and was prior to the advent of sunscreen.”

            We all know that lack of sunscreen and sun exposure can cause cancer, but a doctor must state a rationale. Also, if a doctor says a codition is due to service, he had to have seen the records. If he did not see military records, he cannot make this opinion.

            DBQs for an increase are different. Since it is already stipulated that your condition was caused by service. All we need is a provider to say to what degree.

  35. Jesus says:

    I had a second lumbar laminectomy back in January 2012 at the VA hospital, I requested temporary 100% in January 2012 and as of July 2012 I have not receive any payment. VA wants to speed up Claims. Here are my two cents. VA Claim system needs to be interface with the VA Hospital System and any Claim for temporary 100% it should be automatic. You don’t need to wait 7 to 12 months to get paid.

  36. Raymond E. Maynard says:

    After 4 1/2 years of claims processing, denials, appeals and whatnot I completed my C&P in Feb 2012. I check with the infamous I.R.I.S. system and get the response that the Appeals Management Center has completed all development actions required by the BVA in its remand and is pending review by a Rating Specialist.

    What exactly does this mean and how long is this going to take.

    • Bill Prevatt says:

      It just means that your file is sitting on someone’s desk in a RO waiting for someone to give it their blessing. Depends on how far down the pile your file is. If its on the bottom of the pile, your looking at probably the end of the year if not sometime in 2013.

    • Catherine Trombley says:

      Raymond,

      It means that the AMC has completed all the steps BVA directed it too in the remand and that your claim is ready for a decision. The AMC will either continue the denial or grant the claim. If it grants the claim, the claim is usually complete. If it continues the denial, the claim is automatically routed back to BVA so it can look at the new evidence that was obtained through the remand. I can’t really give you a time line because there are a lot of variables, but it could be several more months if your claim goes back to the Board.

  37. RICKEY BRASUELL says:

    HOW DO I GET MEDICAL RECORDS FROM GERMANY, FROM MANNHIEM,
    HIEDIELBURG, AND FRANKFORT FROM DATES 72-74?
    SINCERLY
    RICKEY BRASUELL

  38. Luis says:

    How can I apply for this type of job where I can help with the roll-out and the process? I feel I am capable of understanding the process, claims, and help move the process along. I was fortunate enough to have my claims processed in a timely manner and I really feel for those veterans who have been waiting for a long time. I feel there is more we can do but it won’t happen unless the laws are changed a bit to help process claims faster for legitimate claims.

    Sincerely,

    Luis

    • Bill Prevatt says:

      Honestly Luis, you don’t want this job. I did it for a very short time and let me just say, I would much rather work in an ER then do this job. Especially when I would handle a case file the way it should and honestly that is why I am not there anymore. Words can not explain how difficult of a job this is. The training itself is not even up to snuff. It is way different than what you actually do in the RO.

  39. Charles Jackson says:

    I think there are many hands in the pot. Theres a lot of money changing hands and when it comes down to it , no one really cares about a vet. It’s just a way to make a buck.has anyone looked at all the waste that goes on in a office? They loose paper work and it’s still the vets that wait.they just don’t care. Someone needs to look at what is going on. Not working their already.

    • Bill Prevatt says:

      Mr Jackson, you are correct in saying there are too many hands in the pot. Exchanging money, the only exchanging money that is going on is the elected officials and the supervisors. That is correct when you say ‘they don’t really care about a Vet!’ I mean really if you cared about your job, the person whose name is on that file you are working on than you would do whatever possible to process the claim correctly rather than let it sit on a desk and have a chance of loosing the paper work. Here is what I started out with as for my pay grade; GS-996-7 so you tell me they are getting paid enough to do their job correctly plus they get training, so I do not see the problem. All I can say is we need to keep these postings going as long as we possibly can because eventually someone is going to hear us and truly will need to make some changes and I am not talking about the changes that are taking place now. I am talking an overall rehaul of the system.

  40. Ron P. says:

    I filled my claim in June 2011 and am still waiting to hear back from VA. Also, my son returned from Iraq several years ago with several issues and has just lost confidence in the VA system. When seeked counseling they assigned him a Muslim counselor, how’s that for sensativety on the part of the VA. It’s like assigning a Nazi to counsel a Jew, or a VC to counsel a Vietnam Vet.

    • spouse of a veteran says:

      I agree with you Ron. It does make you wonder , where they come up with this good treatment and how they provide the treatment. I can only speak for my husband who is a vietnam vet with PTSD. He has been living with this for many years, trying to just get by in life. Well they deserve more then just getting by. Our private MD doctor has more compasion then his C/P examinor did.. I think the key to all this is are they truely MD’s. My husbands private MD is the most nicest man you could ever meet but he also served in vietnam, so he knows how to handle a vets needs. Alot of vets have built up a wall so to speak, and it takes a special person to take that wall down. I think thats something alot of these VA docs, dont know how to do.

      • RC says:

        I completely understand what your saying about this wall. I have been trying for 25years to bring down my husbands wall.. Im sure its not easy to do, but i will never give up trying. god bless our veterans and families

    • Juan says:

      When we went to Desert Storm we were poison by saudis catering, until today I can’t eat at 7/11 or any store with middle east own, still have flashbacks from iraquis pow from my guard point, I was point at them and today feel like point at them still, believe me I know what your son going tru.

    • Bill Prevatt says:

      Ron, the only thing I can say about your claim, is do not give up! Keep believing that it will get better. That is the only reason I have kept the fight going on for so long for myself is b/c I want to believe that this will eventually get resolved and we will begin to see some improvement. As for your son’s issues and the counselor he has been assigned, I personally would ask to speak with a supervisor about this counselor and explain to them that he is not comfortable with who they assigned to him and request that new counselor be assigned. If that doesn’t happen, I would seek out an attorney that does represent Veterans and the only way they are paid is if the Veteran wins. I have gone that way and even though I am involved in my claim 150%, it still gives me great pleasure to know that she is representing me and fighting for my rights. It does make a difference when there is compassion for those of us that have experienced so much. The bottom line is, tell your son that he truly needs to remember that fight he had in himself when he was over there in Iraq and remember to bring that back into the light and fight for his benefits. That is his God given right and privilege and for the real reason he and so many others have gone to these foreign countries to defend our rights and beliefs.

  41. Robbie says:

    VA has over 1 million claims. So is it safe to say by the end of the year…with all these “whiz bang” programs…all these claims will be processed?

    I think not….Instead of paying these Office Directors and managers these big bonuses for non performance…Secretary Shinseki should start taking some of these managers to “the woodshed”. My claim has been pending for over 3 years, and every time I call..they tell me “its in development”!!

    Mitt Romney needs to be president…just so he can outsource claims processing to India!!

  42. Bill Prevatt says:

    All this talk about Regional Offices has got me thinking. If one RO can process claims in a manner that is truly reasonable time frame, i.e. 60 to 90 days than why can’t the other RO follow in there footsteps? Isn’t the VA suppose to be the exact same way across all Regional Offices? You hear your fellow service members talking about their claim being sent to one RO and then yours goes to another, they have already gotten their decision and your still waiting on yours. What is that all about? The bottom line as I have stated from day one, the VA has nobody to answer to so they do as they darn well please. Forget about the Veterans and their needs. Just as long as they get what they want, that is all that matters. If there is truly any leadership in the VA, than they would be in the fast lane of truly fixing this huge problem; but are they? Nope. Just as long as nobody questions them and there way of doing business, than all is fine and dandy, but if you ask a question that truly fixes a problem then you would be considered not a team player. It all reverts back to my earlier reply about getting our elected officials involved. They have no more power than we do as the Veteran claiming our disability. Until that changes, nothing will truly be done to fix the problems the VA has endured for years. As the days go by, the numbers get larger and more service members are placed into that holding pattern. As those number increase VA is in hopes of us older Veterans will just forget about our claim and let it die where it lands. So in closing I would like to say I am hoping that those individuals that make decisions on our claims truly take heed to what we have posted here on this website/blog. Nothing will be done to change what is supposedly in place, but I do hope that it does improve how claims are processed; not just for me and the others that have posted on here but also for my son, his wife and all the other thousands of service members facing this uphill battle.

  43. Bill Prevatt says:

    Why has my responses been removed? I replied to at least 8 posts yesterday and now all of a sudden they have been removed. So once again, Veterans are being shut down for speaking the truth, as they don’t want the American public to read what is really going on. Whatever happen to my first amendment, “FREEDOM OF SPEECH?” Oh that is right we don’t have anymore rights.

    • Kate Hoit says:

      Hi Bill,

      Your comments haven’t been removed. They are waiting to be approved (we get tons of spam–this way we can prevent spam from taking over the comment section on the blog)–we check and approve comments in the morning and throughout the day. You submitted your comments after the team left for the night. They have all now been approved. Thanks.

  44. Linda says:

    I was told my claim was not accepted because I didn’t have a mountain of paperwork behind it to support the claim. I was originally injured at work, 30 years ago. I went to the ER, was treated, went on quarters and then back to work. So, sorry Mr. Claim Officer, I didn’t keep going back to the ER for that necessary paperwork. My job evaluation would of gone through the toilet and I would of been labeled a malingerer, so I sucked it up… my mistake – but – I’m the lucky one in the family, my Brother in Law died of Agent Orange before his claim was processed – his Wife fought for another seven years trying to get it approved. One Claim Officer refused to speak to her – put you old man on the line – sorry he’s dead…… It’s like if they wear you down – you’ll walk away and they’ll save money instead of doing the right thing and honoring a Veteran for their word alone – no they can’t do it – it would break the bank.

  45. John (Jack) Ridenour says:

    Ihave 2 questions #1. Have claim in for wife that I have been married to for 29 years & had 4 children with. I filed on May 31, 2012 I am finding out that the VA Has hired a company to check on your marriage ????? Just another way to keep all that money that we deserve and earned the hard way. #2 Told by a lot of fellow Nam Vets and Drs. I should file for my trip;e bypass have still not heard about that even though I have been to C & P hearing.

    • Catherine Trombley says:

      Jack,
      We hired a company to help develope our claims, this means getting evidence to support them. If you filed to add your wife and children but did not include a marrage certificate or birth certificates, then our claims developers (whether they work for this company or VA) will follow up with you to get those supporting documents. Once we have them, we can grant the claim. We are moving to make it so you can add dependents through eBenefits, but it is still a couple of months away. May not help you now, but as your children grow, you will have to update the dependecy when they enroll in college and graduate college (or high school if they don’t attend school). When that time rolls around, you should be able to do it through your eBenefits account and get payment within the next month.

      • Tony says:

        Let me understand this. The VA currently offers the ability to add a spouse and dependents on eBenefits because I filed one months ago. So I did as I was asked but now it doesn’t work? I have no problem authenticating my marriage or step-children but I guess we can’t be trusted. Yet another slap in the face.

        By the way, even when you provide all the documentation it sits for over a year. My son’s birthday was wrong and the system showed he turned 18 when he was actually 17. I called, was told to fill out the form and mail a copy of his birth certificate. That was done July 2011. It literaly would have taken one change of a number to fix this issue but instead I get letters saying it’s being worked on. Sounds like one of those jokes – How many VA employees does it take to change a 3 to a 4? The answer so far is NONE!

        One final point – why doesn’t the VA redirect those who work in it’s collections area to process claims? Those workers kick butt. They were able to pull back an over payment in 4 months. Funny how when a vet owes money the VA acts with the quickness but when it’s the other way around there is no sense of urgency.

        Maybe the VA should have to start paying interest on claims that exceed 1 year from receipt of full information for them to make their decision. It would have to have more restrictions than this but there needs to be a penalty for this continued failure of our veterans.

        If all the veterans had worked at the pace of the VA, there would be no need for the VA because this great country would not be free.

  46. Eve says:

    The VBA needs to hurry up and stop all of the politics…while Veterans stand on corners begging for money!!! They take entirely too long to process a claim! If the Social Security Administration can get back to everyone in the Nation that files claims within 5 Months, why does it take the VBA a year, eighteen months, two years or more to process the claims of only the Veterans in the nation…there is something fundamentally wrong; and morally improper with this!

    • spouse of a veteran says:

      I agree 100% with you Eve. I have been saying those exact same words and nobody from the VA responds. And you know why that is dont you…….. because they dont have a honest answer……… Now tell me, they care, Now tell me they’re trying , Now tell me they care about not only the vet but the spouses and families as well, Now tell me its relaxed, Now tell me the truth!!!!…… Thats what i want to hear…..and im sure alot of other veterans as well……How can this be justified..

    • Catherine Trombley says:

      Eve, the difference between filing a SSA claim and a VA claim is this: to get SSA you only need to prove you have a current disability, to get compensation through VA, you need three things: (1) a current diagnosis of a condition, (2) some incident in service that could have caused that condition and (3) a medical nexus (opinion) saying its a 50 percent chance (as likely as not) the condition is caused by service.

      It is governed by a set of complex laws, regulations and precedent court cases. It is not an easy job. I know waiting is frustrating — I am in line too — but two wars, more outreach to Veterans, an aging Veterans population, the economy and adding three conditions to the presumptive list to take care of our Vets exposed to AO have all contributed to the backlog. Its not as simple as hiring, we must Transform our people, process and technology to ensure we eliminate the backlog in 2015.

      • RC says:

        A lot of people have provided all 3 steps u say and it still is taken years to get awarded . So that has nothing to do with this backlog. Take a survey ask these vets if they provided all the above and probaly several times and nothing changes. Va needs to actually look and see vets evedence has been provided the first time they ask for it and no claims move

  47. adam hall says:

    What is amazing, is that the VA has made the process so complex and not transparent. Someone filing for SSI, which is a welfare benefit, can literally call a local office and get immediate, knowledgeable assistance and a specific update on their claim. The Federal Government will go out of the way to ensure the “Duty to Assist” has been fulfilled and order all medical records. If a veteran, who has offered up his life to the country, can call a Service Mega Center, get no info, and be told it would be best to pay for any records and just send them in.
    This is not conjecture, but fact, with experience on both ends of the spectrum of this comment. The VA does not need new processes, they just need to show a little concern and care for the work that they are doing, and provide just a little bit of customer service to the multitude of Disabled Veterans “waiting in line for bad news”.

    • spouse of a veteran says:

      Why is it that no other government program is nearly as complex as this is???? Nor does it takes years and years to receive what they so deserve. Same type of programs and same type of evidence provided, not to mention these people put there life on the line, while families and friends sit and hope they return home safely every single day of there lifes. Makes me cry everytime i read these comments.

  48. Al Nave says:

    I can agree, over the past ten years I have been waiting I have been told by employees at the VA that if I am depressed to get over it, I should have thought about all this before I allowed myself to be injured, we do not oew you a living, if you have a problem go to your regional center and stop calling here. I have notices from the VA that in denying my claim again the person listed as my DAV representative not only completely agreed with the VA but backed every word he said,although I have more medical records countering this than either one apparently understood, I have had the VA and again my appointed DAV rep agree that my injury was not aggravated by my time in service, that I left the day before, the day of or even the month before, even though I submitted copies of all my pay dates from Jan 01, 2002 until my retirement on 01 April 2005, I submitted LES’s, orders, a copy of my Reserve ID showing I retired in 05, I sent a copy of my Certificate of Retirement and they still do not read it or take it in consideration, I have seen the VA and DAV deny me because the claim I am receiving Workmans Comp right now on top of SSDI, that in 1993 I started receivng Workmans Comp and was on full SSDI, the problem here I never filed for, asked, requested or knew about SSDI back in 93, there is also not one singlepiece of paper that says I drew pay from both, my denial and comments to my DAV rep never seems to be read or considered because the same dates, lies and false entries on my denial still occur. Remember Shalinski mandated the VA cut this down, not going to happen, no one should have to wait 10 or 11 years for something they qualify for, when the civilian medical records out weight the IME then that should be the end, I had three IME’s and all three times the VA appointed doctor walked in, asked a few questions, did a range of motion from a distance of 2 feet from me in mid air and walked out, total exam time less than 15 minutes. This is what I know, I have pain so severe I can barley walk, I cannot sit straight or put full weight on my right side, I have to have strong pain medicine to even be able to function and that may be limited, We filed yet again an appeal and have been waiting for our hearing, the lawyer said I should have had my hearing last fall or winter, the VA was hearing 2009 cases, Nov came, dec came and still no hearing, then I was told I have to wait until this fall winter, maybe of these people would do there job right there would not be such a back up, oh and I am on SSDI, I do have an injury that will last me a life time and…

  49. spouse of a veteran says:

    Catherine, i have a question. Why is our rep. telling us once an appeal is approved with will take another 18 to 24months to actually receive a check. Why does it take an additional 2years to receive a check if everything is approved. Thats absolutely crazy. My husband is going to file for SS dissability and they even told us, from beginning to the end it will only take about 6mths to process the whole proceeder, as long as all the medical evidence is provided. It should work the same way with a VA claim

    • Catherine Trombley says:

      I am not sure where this info is coming from. I confirmed with our folks, once an appeal is granted it is processed for payment.

      • spouse of a veteran says:

        Thank you so much for confirming that with us. I dont know where these reps are coming up with all this false and untrue statements. That is what our rep. just told us last week, when we went to see him because my husband had another angio done, so we usually stop by the reps office if he isnt busy, we check the status. I even remember saying to him, why in the world would it take 18-24mths to process a check if its already approved and like i said he responded with backlog and this is a fact. Someone really needs to get with some of these reps. and make sure they are providing accurate info. My husband also has PTSD and since that comment our rep provided, i cant seem to get my husband out of this silent mode he is in. We have been so upset since hearing this news from him. Once again ty for responding this truely might help me to help my husbands state of mind.

  50. spouse of a veteran says:

    Also, we waited 2years for the original denial, and now we are at another 1 1/2 years since our appeal. Nothing has been needed from us since our appeal. They had all the medical eviedence from our private MD. so that is a total of 3 1/2 yrs. and nothing has changed moved forward. Now the rep. is telling us once we get approved, we still have to wait another 2years before a check is issue. How are we suppose to live??? On the air we breath.

    • spouse of a veteran says:

      Catherine, Can you please tell me about how long it truely takes once a appeal is approved and awarded before we would receive a c/p check. 2 more years just seems a bit extreme to me if its been approved and is that even an accurate length of time. I understand you cant provide me with an exact time frame but could you at least tell me if this 2year waiting period is even correct?? A response from you would be greatly appreciated. TY

      • PJ Allen says:

        Spouse: My husband got his check about one month after he got his approval letter, both times..When he first claimed, and the next time when he applied for an increase… I wish we could count our our reps out here that we are assigned, they all have different stories, half don’t know what they are talking about…the sysytem shouldn’t be so darn complicated….Hopefully you will get an answer from Catherine. Good Luck.

        • spouse of a veteran says:

          PJ, ty for the response but how long ago did you guys file, a few years ago it wasnt taken as long. our rep said the reason its taking 18 to 24mths to receive a check due to all the claims etc. This is an appeal, so im no sure if once its approved it has to go somewhere else for checks to be issued but still why 2years. Havent we waited long enough. Catherine also ty for your response above but i could use your help in does it really take 24mths once being approved even if it was in the appeals area????

  51. frustrated & confused says:

    My husband submitted his package to the Regional Office (not in the list of 16 above and 4.5 hours away) in June 2011 with 125 pages of evidence from his service records, PCP, hospitals, personal affidavits etc. We were getting a letter every 3 months saying that the RO was “still working on it, sorry for the delay.” We haven’t received anything from the office since March 2012. He filled out information and has been approved to be treated at our local VA hospital. That took only a month to get approval. He has an appointment in October.

    Since submitting his package he has undergone another lumbar lamenectomy/discoptemy (sp) followed most recently by a second spinal fusion – this time of two disc areas, so now his spine is fused from his S1-L3. The first fusion is included in his claim. We’re afraid to submit the new evidence until we hear from the VA because we think it will toss him back to the bottom of the pile. We’ve been warned – it will take about 483 days average, they will deny everything the first time, they will grant 10% the first appeal (after another 400+ day wait) and may grant more after a second appeal. I wish he had filed when he first got out, but he was sick of dealing with the VA doctors, who at that time told him he was at at least 80% while he was undergoing testing and treatment for Gulf War – which had not been publicly admitted at the time.

    It’s sad to think what these men and women have gone through and given up to be treated so poorly.

    • Catherine Trombley says:

      Frustrated,

      The denial, 10% and then a real evaluation is not true. What typically happens is Vets may get denied and then find the piece of evidence that substantiates the claim and allows us to grant.

      As for more evidence: It depends where you are in the process. If it is still in the development state, you should be ok to add more records. Though it will give a delay, because that evidence must be reviewed and may trigger the need for more development. In the end, I would send it because you want to give the rater all the info so the doc (if you have a VA exam) and opine based on all info and the rater can give you the proper evaluation. The extra time may save you from an appeal.

  52. PJ Allen says:

    Catherine: I wrote you a question up above asking you about whether a veteran should continue to file for increases after they have reached 100%, please could you look for that question above, sorry i wasn’t sure where to put my question to you…I also wanted to ask you if you would have any idea where I could get some information….My son died from Acute Myloid Leukemia,,,,I understand there were studies done that placed a possible connection between AML and Viet Nam Veteran’s children..My son’s father served in Viet Nam and is now 100% service connected….I would just like some answers, nobody ever included my son’s death in any of these studies….My son died in 1997 and i understand studies were done starting in 1999, but nobody ever ask us if my son’s father served in vietnam…no connection was ever made….I would just like some answers, if studies are still being done, i don’t even know who to contact…Is there anything you have ever heard or would you know who i could contact for information? Thank-you for your time.

    • Catherine Trombley says:

      PJ, I am sorry for your loss. As a mother, I cannot even begin to imagine…
      I answered you previous question (my comments have to go through moderation too). As to your question the only condition considered presumed for children of male veterans exposed to AO is spina bifida. You can find more info here http://www.publichealth.va.gov/exposures/agentorange/benefits_children.asp. That said, a presumption list is just that. Other illnesses may have been caused by AO, but you would need a doctor to state that your husband’s exposure caused your son’s illnes. As for studies, I have not seen any, but I suggest looking to NIH.

      • PJ Allen says:

        thank you Catherine: I found the study report at VA.Gov at first , then i googled it and lots of stuff came up about the suspected connection of AML in children and Viet Nam Vets exposed to Agent Orange…I contacted an agency in Washington DC that confirmed for me that they had done a study back then and a couple after that but that presently studies are only done by volunteers…I have to say that angers me, but that is another story…Yes i know the only approved disease in children in Spina Bifida in VietNam mothers ?????? but my husband is 100% with 100% unemployability and he only fathered two children, one a son died at 14 with AML and our daughter and two of her children has a brittle bone condition and there has never been anything like this in our family anywhere….then when i seen that the govenment had suspected the AML and nobody ask us, the studies that said first that there was a link, and then that they weren’t sure , didn’t include ALL the cases and could not have been accurate….I’m not surprised that you aren’t sure about this, no rep i have talked to ever heard of anything……but maybe it is because they never lost a child….Even if a doctor said he suspected that my husband’s disease caused my son’s illness, the VA would dismiss it if it isn’t an approved illness…I guess all i was asking is, who decides what needs to be looked at as being caused by something service related so the government puts it on their approved list…My husband’s doctor did send in a letter saying that my husband had only fathered two children and both had bone disorders and we sent it in with our initial claim but it was never mentioned after that to us , i guess they had no clue either.
        Anyway, thanks again, i know deep in my heart, without a doubt, where my children’s illnesses came from, and i take care of a very very ill husband, and as far as estate planning, i have found it very difficult to find out what i might receive if my husband passes…in fact, our rep acts like he can’t believe i;m asking about it…Agent Orange has totally destroyed my life and the life of my family, it isn’t just the veteran’s life who is effected by it and when they leave us and we are left without a family and struggling to survive, is that fair? Anyway, thanks for listening!

  53. c j says:

    I’am a widow of a vetnaim vet. sorry about the spelling. my wonderfull husband passed away 7 month’s ago. i’m appling for dic. but i’m still getting the run around. why cant they have something out there now that help’s pay the bill’s even for just a little bit.our bills don’t stop coming in.this is so wrong. we had a little saved up . but now the funds are getting low.especial with nothing coming in. would it hurt my chance’s of getting or delaying my dic, if i tried to find a job.

    • Catherine Trombley says:

      No, you can work while receiving DIC. If you are experiencing financial issues, ask the RO to expedite your claim due to hardship. Also, work with a VSO or CVSO, they can be your eyes and ears inside the RO. I am sorry for your loss.

  54. spouse of a veteran says:

    So far there is one hundred comments on this topic and you look at all the other topics and you see 0 or 2. To me, there is one problem and one problem only, things are run very poorly and have been since day one… Now you say there is fast lanes…..There should be ONE lane and One lane only…… Do it right the first time…..Keep them all moving fast…….And honor these veterans and families with what they deserve….. There wouldnt be 980,000 backlog of claims if those would have been done to begin with…..Get a million employees if you have to and resolve this once and for all….This is not right and people see it loud and clear…..

    • PJ Allen says:

      One thing I don’t understand is why some regional offices have things that other regional offices don’t….seems to me ALL the veterans should have access to the same kind of treatment…and another that frustrates me is that thre is NO emergency room care for veterans in all parts of the country….my husband is very ill and if he has an emergency it better be betwwen 8-4 M thru F or we end up having to foot the emergency room bill even though my husband is 100% and it is an emergency, even if the 24 hr nurse on call sends him to the hospital….ALL veterans should have access to 24 hour care and not be afraid to go to the ER because of getting stuck with the bill….and yes we can send in a letter of disagreement, Ha! and wait and wait months and months with no answer….the va knows if they wait long enough, and it turned in on the veterans credit report, maybe they will give up and pay it themself. Sad…Sad… Sad!!!

      • spouse of a veteran says:

        Catherine, can you clarify this, I think if it is a true emergency, they can seek help at the closest ER possible. It doesnt matter if its a va hospitol are not. Example, if your husband is having a heart attack, they wouldnt expect you to drive to a va hospitol. Also if emergency surgery is needed and the VA cant provide it at that time, they will tell you to seek out the surgery in the private sector. That is what our rep has told us. but who knows, they all say something different.

        • PJ Allen says:

          Spouse, in our case it was a blood clot in his leg, the lab proved it, i had pictures that his leg had swelled double with a camera date on the picture, the 24 hr nurse told us to go to the nearest hospital, his pulse was in the low 40′s, his bld pressure was crazy, and his sugar number was thruough the roof, not to mention his bnp number and lot of other labs were elevated, white blood cells messed up.., he required Lovenox shots to dissolve the clot….His vascular is service connected….Yet the va said it wasn’t an emergency ???? we did file a notice of disagreement but when the creditors came after us , we finally had to cave in and start paying….and that disagreement was filed a year ago……than God though he survived it, it’s just i live in constant fear of what to do when it isn’t 8-4 M-F and another emergency occurs… of course his life is of the utmost importance and i will of course get him help but it’s just the stress of it all. Thanks for your help though.

          • PJ Allen says:

            I can’t believe it but today in the mail we got a letter from the va and they have agreed to pay the cat scan done at the ER visit that i spoke of above..the one we had filed a letter of disagreement on a year ago…..so if they paid for the cat scan done that night at the ER, they surely will pay for the ER Room and the ER doctor from that night…It shows that by paying for the cat scan done that night, they admitted they were liable !!!!!!!! Wonder how long it is before i hear about the rest of the bill? There is hope!

      • Catherine Trombley says:

        This is incorrect. According to 38 U.S Code, section 1728, VA may reimburse Veterans for hospital emergency care where the treatment was rendered for: (1) an adjudicated service-connected disability; (2) a non-service connected disability associated with, or aggravated by a service-connected disability; (3) any disability of a Veteran who is 100 percent service connected and (4) any illness, injury or dental emergency of a Veteran enrolled in VA Vocational Rehabilitation and employment.

        That said, here are a few tips should you need to use this: If VA is open, go there. Ensure you doctors at the private ER call the VA and notify them the Veteran is there and that s/he is moved when s/he is stable. If s/he cannot move because VA does not have beds get it in writing.

        So PJ, your Veteran is 100 percent, therefore if there is an emergency and your VA is closed, s/he can go to the ER.

        • PJ Allen says:

          Thank you Catherine for your reply, and i hope it will work out that way, the above past ER visit my husband experienced was indeed an emergency and I had the proof….but the VA denied it saying it wasn’t an emergency, and that is where the fight begins…..the above Code gives me no comfort when i feel the VA will determine that my husband didn’t have emergency because he didn’t have a hrt attack and maybe put on life support etc. although a blood clot is pretty serious stuff. If the VA ever answers my letter of disagreement, and if they still disagree, i know we can go to court…..the problem comes that i have enough stress and it is hard to deal with. Anyway, hopefully in the future, we can get him the care, it’s just who determines how bad an emergency is an emergency. Thanks though for your insight.

          • spouse of a veteran says:

            PJ, when your husband went to the ER, did the hospitol admit him or was this done as a ER out patient proceedor??? If they admitted him , i would say that in its self should be enough evidence to prove it was truely an emergency. Hospitols will not admit you if there isnt something really bad going on. If it wasnt an emergency they would have just treated him and release him. Like for instance my husband went to the ER for a kidney stone, so one would think thats not an Emergency but it was because he wasnt pacing it and in alot of pain, it was lodged up, so they had to admitt him and do surgery the following day to remove it.

      • Catherine Trombley says:

        PJ,

        We have to phase in the implementation systematically. We are completely revolutionizing the way we do things. Change of that magnitude takes time, but more importantly, if we did it all at once, production on claims would fall dramatically. By using a phased-in approach we can measure and adjust, if needed at the remaining ROs. There is a whole Organizational Change Management Plan in place to ensure our employees are prepared for this change.

  55. Chris says:

    I made the mistake of waiting till there was no other option for me, then it was a fight just to have then throw a scrap at me. When I refiled it NO answer or reply have I received except for “it is on their desk.” And do not expect a follow up email when you request information on line.

  56. RC says:

    Ok, i just got of the phone with someone at the VA regional office and i was trying to get the status on my appeal. I called a few months prior to get the status also and the gentleman told me there is a new law passed that all appeals will be done in 339days. He looked up my status and said mine is alittle over that, so I should be hearing something at anytime. Well its been over a month and nobody has called me . So i called again today and the lady said no that is a false statement and there is no proceeders in place to get appeals done in 339days. She told me it takes 3 to 5years for a appeal to be finished. NOW i will not except this. Can someone clarify if this 339days is correct or not. Please a reply would be greatly appreciated. ty

    • Catherine Trombley says:

      RC, I am going to look into this and get back to you. I want to make sure I am giving you accurate information and need to double check. Stay tuned…

      • RC says:

        Thank you Catherine for trying to help me out. I am so confused and upset right now. When that lady on the phone today told me noway and then said 3 to 5years , yet the other man said 339days, common thats a huge difference. Yes i was kind of loud with my response i said someone is lieing and full of crap. She responded with i dont have to hear this good bye. You know with this kind of proceeder going on in the VA there are going to be alot of veterans who are suffering with PTSD worse off due to the lack of information people are providing them. I will stay tuned… Thanks again.

  57. Michael says:

    My claim started in August of 2010. Still no answers. I have tried to call numerious times, and the answers I get is that it is being worked on, and that there is such a big back log. When you say 125 days, I think that is purely fictional, or someone up top stating that is how long the average is without knowing what actualy is going on. The numbers have to be made up. Possibly the numbers reported up the chain are not alltogether accurate. Perhaps the cases are put on hold, thus do not accumulate days.

    My main complaint is that one cannot contact the rating facilities directly. You have to go through the call centers which do not have all the information. They keep the rating centers (Oakland) a secret, and untouchable. I look at E-Benefits almost daily, and there is no updates. The documents that I have sent in do not show up on the web site. How do I know they have received all the documents that I have sent to them? Medical issues are on-going, and things change, especially since my claim was submitted almost two years ago. Do the rating offials routinely check in CPRS for updates?

    DAV is a joke. They do not care one bit about my concerns. You call them, and they will return your call in 3-5 days. Should you be busy, and not able to answer the phone you just missed your chance to speak with someone, and have to start the process all over again.

    I am so frustrated with the VA system. My whole future weighs in the ballance of the decision. I want to go obtain re-training in order to get employed in a job that will not stress my dissabilities. I have applied to a school, and have been accepted for a program. However the program is full time, and I cannot work while going to school. I may not be able to attend the schoool due to not knowing my claim status, or if I can survive without a job. I cannot do that until I know what the outcome of my rating. I fear so much that all the documentation that I have sent in will have not gotten to whom it has to get to, and my rating will not represent this information. I wish I could just call someone in the rating facility and go over all the issues to make sure they have all the documents. One time (over a year ago) when I called the VA call center, they informed me that the rating center was missing my DD214′s. Absolutely nobody initiated a call or a letter to me regarding the missing documents. I know for sure that I sent in all the DD214′s on my initial claim. So, if I had not called the VA call center, my claim would have been drasticly different without this information. Why can’t I…

  58. Roy says:

    Catherine, i have a question you might be able to help me out with.I am currently 90% service connected disabled and its getting almost impossible for me to continue to hold down my job due to all my disabilities and meds that im on. All my symptoms are gettting worse. The doctors are doing everthing they can at this point. My rep said once i cant continue to work he will file unemployability for me. He also said due to all my conditions i have i will qualify. Im confused about why he told me that now since there is enourmous backlog of claims the I/U claims are taking a couple years to process even with all the medical evidence stating you cant work anymore due to your service connected disabilities. I am the only provider in my family. I cant wait 2years for this. I just want to make sure he is giving me accurate information because i would think the VA has all my records since i got the 90%, so the only thing i would have to provide is additional statement from one of my doctors stated im I/U, which all of them said they would provide for me. That seems a really longtime to get something approved. Would it speed up the process by filing a disability increase instead of the I/U which would most likely bring me to the 100% anyway. 2years is a long time to wait.

    • Catherine Trombley says:

      Roy,
      It depends. (I feel like I am saying that a lot, but it really does). The way disability math works is this. Say you have four ratings, a 60%, a 30%, a 30% and a 10%. You start with 60, the highest and work your way to the lowest. 100-60=40 (you can only be 100% disabled). Then take the next highest rating. 30% of 40 is 12. (Add 12 to 60). 60+12=72. 100-72=28. 30% of 28 is 8.4. 72+8.4=80.4. (100-80.4=19.6). 10% of 20 is 2. 80+2=82. We round to the nearest 10, so 82 is an 80 percent.
      If you look at the math, you find that the higher overall evaluation you have, you need a large leap to hit 100 percent.

      If I were you, I would file increased ratings to include consideration for IU. Get the statement from your doctor saying you cannot work (and why, like its a safety hazard). If you run into financial trouble while the claim is pending, make sure you ask for expedited review. Also, if you file this claim, file a fully developed claim (http://benefits.va.gov/transformation/fastclaims/). these claims are getting processed in an average of 100 days because you do all the development (like get a dr. opinion and a medical records) and submit it at the time of your claim. Have your rep help you.

      • Roy says:

        Thank you Catherine for providing me with this information. I will get with my Rep. and show him this information. Hopefully he will know what this new FDC process is because 2 Years and 100 Days is a big difference.

      • Sandra says:

        Hi Catherine, I submitted a Fully Development and my claim is currently at 177 days. My claim packet included; medical opinion (VA Physician). The RO was already had my service records, and my VA records are available electronically. The RO sent me a letter acknowledging my claim was being as a FDC. Whenever I visit the RO, I am told my claim is not a FDC; that is until I show the letter they sent. I recently submitted hardship documentation, yet still I wait.

        I see all of Secretary Shinseki’s media releases regarding speeding up claims, ending veterans homelessness and wonder whom does it apply to? I am trying to prevent my family from being homeless, and get the disability benefits that I feel I rightly deserve as a result of my service. What happens when the the veteran does everything right, yet the VA continues to fail to expedite your claim?

        Thank you,
        Sandra

  59. Juan says:

    I have 2 claims since August/2007 recently went to travel board, now they saying that will be on bva and according to them it will be secure to another pile, I’m out of my savings for my mortgage, hurt on my job but they won’t be responsible because I was injure in the ARMY and the are not responsible, in other word I’m screw and I’ll be on the street thank you, usps and va.

    • Catherine Trombley says:

      Juan,

      The Board will advance your case on the docket for financial hardship. Call your rep and request this or call the Board at 1-800-923-8387 Monday-Friday 9:00am-4:30pm (Eastern time zone) to see what to do. Typically, you need to send in late bills or an eviction notice.

      • Juan says:

        Thank you Catherine, I faxed all paper to my representative and the bva too, I’m in really bad shape. Thank you

  60. Lillian Nybo says:

    I already have a 60% SC and I applied for IU last October 2011. As of today, still no reply and worse yet, every time I call for an update(about once every 2 months) they tell me that there is no open claim for me on file, only to call or email me back later and apologize for “the mix up”. Something is very wrong with this system…… I am seriously considering calling my congressman about this matter, or better yet, making the info public knowledge about how they handle these claims.

    • Roy says:

      Lillian, i was told by our rep. and someone from the VA call center recently that I/U’s are taking 2years to process, no matter what % your ratings currently are. Even if you provide them with documents from doctors stating your disability has gotten worse and unable to work. They say its still going to take 2years to process the i/u claim. I am currently at 90%. I could be wrong but im waiting for Catherine to respond to my comment above. Im sure she has several to respond to but she looks like she is responding ,so just keep looking for her response.

      • Catherine Trombley says:

        Roy, your answer is up top. Lilian, let me get back to you on this. It concerns me that you have been repeatedly told there is no claim in the system.

  61. RC says:

    Catherine, i just want to make sure my above comment didnt get lost in all these comments. You replied that i should STAY TUNED about one person from the VA telling me there is a new law implemented that appeals are taking 339days, then i call yesterday a va lady says noway its taking 3-5years. Thank you

    • Catherine Trombley says:

      RC,

      I remembered. However, no one I spoke to was aware of this law, which was what I thought. Appealing takes several years, they have to work in docket order.

  62. George over says:

    Dear Fellow Veterans

    Thank you for your service,and sacrafice for all.I want to tell you that I have been on the appeals merry go round for a solid ten years now.It has been remanded many time since.Due to a negligent surgeon by the name of John Trader,I am unable to walk.He left three pieces of bark in my left ankle.I did apply last year for SSDI,and only took about 3-4 months.Yes I was awarded the SSDI claim.You call the 800 number,and get about the same thing.A form letter is read to you over the phone.I can never get a straight answer from them.I wish the best for all of you.Please do not give up.Continue the fight we have in all of us.

  63. Selenda Webb says:

    I submitted a claim in June 2010; it was deferred and I was told to expect a reply by July 10, 2012 and all I have is an email stating that they are running behind and thanks for being patient. Wow! if I’m anymore patient I will end up in the hospital on the patient’s list

  64. spouse of a veteran says:

    I agree with you Selenda. My husband is a very sick service connected veteran .. I have also been trying really hard to be patient but I was always the healthy one, but i will say this, ever since we have had to deal with the va disability run around my health has gotten bad.. Man, when they say stress will kill you , i can see now why that is. I have never ever in my entire life and im 55, ever had to deal with this much b/s in my life. I have to somehow, someway continue to stay strong for my husband but im telling you, its getting harder and harder everyday. Ive informed my 20year old son, if something ever happens to your father and me, I wrote down the steps you need to follow/all the records and continue the VA fight for us. That will be when justice is done.

  65. Michael says:

    I am sure Catherine did not realize how much feedback she would receive from this article. I am not sure there is anything at all that can be done. In the begining, I felt this process would not take longer than a year. Boy I was wrong. Now my claim has gone backwards in the process. My fellow Service Members, with so many of us in this process, we surely could have a big group to shout out and be heard by somebody.

  66. adam says:

    Catherine,

    My main question is why does the DAV and representatives have the resources to contact the RO and inquire about the claim, but the Veteran cannot. To me, this seems unfair. Why should the VA create this border between the Veteran and the VA, and force the creation of an entire industry (authorized representatives) to follow these claims. I attemtped to be represented by one of the non-fee based reps, and received a good deal of run-around. Of course, I could hire and attorney, but why should I have to pay someone to follow my claim, and why should someone get paid (non-fee reps) to follow the claims for me. I am able to make a phone call, process paperwork, and interpret congessional law, why can I not call the person handling my claim to request a status, or at least someone in the same building. I know for a fact, that a person filing a claim for Social Security benefits can call the claims examiner directly for a status. Please explain why this disadvantage was created for the Veteran’s.

  67. RC says:

    PJ, it sounds to me that your husbands case should definetly be an emergency since he has numerous medical problems. They have to take extra procautions for all that or at least thats what i would think.

    • PJ Allen says:

      Thank you RC, it difinetly was an emergency as it was life threatening but some battles I have to leave in God’s hands…just life losing our son to AML leukemia, the VA does studies and don’t even count the death of my son..We spent thousands of dollars on his medical care and the va doesn’t even have someone to report such a thing to, and my daughter and two grandkids with brittle bone conditions also need to be counted……..that is all I ask, do a study and Count them!!! I am so sorry you are having so much trouble with your husband’s claims and hopefully you get an answer soon, as I can hear the desperation in your posts.. May God bless each and everyone of our veterans who served for our country and hopefully someday America will make sure that these veterans know that their country cares about them and really makes sure they feel like they COUNT!

  68. Wanda Brooks says:

    The claims process is entirely too long. No disabled veteran chooses to be disabled. I would much rather run and jump with my grandchildren but I can’t because of my knees. No veteran shold have to wait longer than 6 months to get a rating decision. Many of the people we;re talking about went to war for this country.
    I was once told when I called the 800 number that it takes New Orleans office an average of 6 months to longer than other regional offices to process a claim. Why?
    I am currently unemployed and was looking forward to using any additional money I got from increased compensation to tide me over until I got a job. Not gonna happen I see.

  69. david m suchevich says:

    I was told that there were not enough people to handle the claims. I have had my claim in a review status fro 2 and one-half years now with a unknown date for completion. I guess my doctor in Italy in or around 1974 that my ankle will freeze up by the time I am sixty which is only two years from now. Good luck to all.

  70. This is a complete fabricatrion. It insults the intelligence of all veterans. What a pack of lies. I submitted my claim on 5/4/2011. That was over 14 months ago. According to my ebenefits page the estimated completetion date is somewhere between 2/15/2012 and 2/9/2013. Delaying the claim is already factored in. You should be ashamed of yourselves.

  71. LA says:

    I’ve been waiting 12 years for my original claims. The first 4 1/2 years it was denied because the VA couldn’t even find my records, then when I dug them out, all they had to say was that I didn’t have a valid claim, because supposedly, my career field didn’t have any of the situations that I had claimed. Currently my original claim is sitting at the Appeal Board in Wash DC. Since then I filed another claim in September of 2011 for PTSD/MST, and have heard nothing. I’ve been a patient at a VA mental health facility for the last 2 years, and my doctor is the one who prompted me to file for the PTSD/MST, because she sees that I may never be able to hold down a real job. I didn’t choose for this to happen to me, I don’t choose to have severe anxiety attacks, I didn’t choose to be a homebody, and be afraid to go anywhere in public. It seems so unfair that a lot of us Vets chose to help Protect, and Defend our country, but our Country doesn’t help to Protect, and Defend us, when we need it the most.

  72. Bill Prevatt says:

    Now seeing as how VA is developing all these new processes to speed things up, why not look at this scernio. Lets say that a Veteran goes to Duke or UNC for medical treatment for a service connection disability. When the Veteran is seen at one of these facilities, why doesn’t VA have something set up to where they (VA) can access their data base to get the results of that appointment, rather than having to wait for an appointment with the VA that will probably take about 6 months to get in to see a VA doctor? Another one to look at is with the VA so overwhelmed with new claims/new patients why not let these service men and women go to an appointment with an outside provider, rather than wait to be seen by VA in 6 months to a year? It would truly speed the process up of getting new evidence to our files for the local RO to make their decisions. I mean if the Disabilities Questionaires are in place to be given to the outside providers, than why can’t their be something put in place to where us Veterans can be seen outside of VA in a more timely manner than having to wait months at a time to get an appointment to be seen at the VA? There are a few things that would happen. One it would cut down on the time frame a Veteran has to be seen for their disability. Two the Veteran is already paying for the health insurance so he/she can be seen by a private provider, so why spend the money for the Veteran to be seen at the VA when they are able to be seen outside for the same problem? Three the evidence can be submitted to the RO, a decision can be made provided the RO claims processor is doing their job by reviewing all evidence and the decision can be made which in turn if the Veteran does not agree, then he/she can request a DRO to review their file before requesting it to be sent to BVA. I honestly believe that if the segmented lanes are used correctly, there are skilled personal making the decisions by the evidence being submitted than it will cut down on the time. I also believe that if VA gives us the blessing to be seen by our private providers and that information is submitted than it will truly speed up the process as well. For example, lets say that a Veteran needs a sleep study. Instead of having to drive to Durham for that sleep study, why not authorize that Veteran to have a sleep study done close to where he/she lives. One travel pay doesn’t have to be reimbursed, secondly the Veteran doesn’t have to take off work for travel time and then the study, thirdly the Veteran can get in quicker at a local center rather than having to wait 3 or 4…

  73. Catherine,
    Hi, very informative blog. I will be calling the 800 number to see if my claim can be expedited to due financial hardship. (I am permanently disable, with a 50 % retirement from the Army, no one I talk to can figure out the math on that part, either.) I started my claim Jan 2011, before leaving Germany. Should I transfer my claim from Tucson VA to the Phoenix RO? I don’t know when these new procedures will be implemented at the Tucson VA.
    Thank you for your help.

  74. I filed August 2010 and still have not heard a thing. From time to time I get a note telling me they are still working on it.

  75. Semper Fi says:

    Quick question. I have 50% SC form neck and back issues. The VA had 1 contention remaining and that was headaches. I went on to my e benefits and see that it is highlighted in orange with several new contentions that need my attention. Of these contentions 1 has been diagnosided and awarded for. My claim now reads the following.

    Claim type:Admistrative Review – Gathering of eveidence. Has anyone seen this before??

    Thank you,

  76. Roy says:

    Catherine, i am 90% service connected at this time. And i have to under go a bypass surgery for 1 of my service connected dissability. God forbid if something was to happen to me from this surgery, would my wife still be entitled to this DIC if im not at 100% before the operation? Thank you for your help.

  77. EARLY says:

    IAM 100 % and total and uib may been in 2yrs 4mos

  78. PJ Allen says:

    Catherine: I just wanted to say thank you for all the informative information you have provided to us on this blog. You explain things and make them on the most part easy to understand..I’m sure you won’t be keeping this blog up continually but while it is here , it has been a place where i find myself coming back over and over to read others comments and questions and waitng for your reply. I have made notes and copied and pasted information in case i need to use it in the future. I wish the VA would have a place where we felt we could get the answers we all need, i think it would go along way in solving alot of misunderstandings, so if you would pass that tip along , we would appreciate it, and we would like to nominate you to be head of it :-). I know we have our reps etc, out here, but let me tell you, it just isn’t the same and the answers we get are not always something we can take to the bank..Anyway, thanks again for your help! You are good at what you do!

    • concerned says:

      I agree with you PJ and I would like to thank Catherine also. I havent seen any responses being answered in a couple days though. Catherine are you still going to continue to respond to these comments? I know your very busy but just wondering. The net is a great way to communicate because it will help not only the person commenting but alot of times it will effect others who might have similiar issues. I know i have had alot of questions answered by others comments and your replies.I also think it would be great to have a site for veterans to ask questions concerning them.

  79. Jennifer says:

    I have been working on mine since 2008-2009… I was honorably discharged in may of 1993 having a baby in aug 1993, then optic neuritis in oct. 1993. I have since been diagnosed with multiple sclerosis. All of my drs including Neuro and Neuro eye drs have all written letters stating that I had MS as far back as 1993 and that the optic neuritis was my first actual symptom. Well, va’s very own book of rules and regs state that if you have ANY symptOms of MS w/in 7 years of honorable discharge that it is automatic service connected…… Well I wish someone would come down to Montgomery, AL and explain that to them and while they are there explaining that maybe they could explain to them how to handle the paperwork properly!! And more importantly remind them that WE as VETERANS deserve a little respect….And a little politeness and patience would not hurt anyone!! Thanks!

    • Bill Prevatt says:

      Jennifer, I understand your frustration and trust me I feel your pain!! Those that work at the VA RO don’t truly know how to have any respect, politeness or for that matter patience. I can say that also b/c whenever I would call it was like I was bothering that person on the other end of phone; God for bid they work! I am sure that Catherine will get with you, as she is very good at getting to our posts here. The Montgomery AL RO can’t be any worse than the Nashville RO. What is so hard to understand is why can’t every RO be on the same sheet of music and get things done the correct way in the first place, rather than passing the buck all the time? Hang in there Jennifer, my claim/appeal has been going on for the past 165 months. Honestly it should not have been going on this long b/c the BVA pretty much approved it but the Nashville RO just ignored what the BVA’s decision was. That is why I say the Montgomery office can’t be any worse then Nashville.

  80. Sandra says:

    I submitted a Fully Developed Claim on February 6, 2012. The basis of my claim was medically unexplained chronic illnesses and conditions For Desert Storm Veterans. Attached to this claim was a medical opinion from my VA physician. I have been to the Oakland, CA Regional Office a total of 5 times in the last month. Each time I visit the office a discovery is made. Initially my file sat for more than a month waiting to go back to the C&P Dr. after a mental health exam. Both exams were done in the same clinic, hence no reason for the file to be in Oakland Regional. I was told two weeks later when I visited regional again, that the file wouldn’t go back until it came up for review. Once I informed them that I was fed up with this lack progress and intended to start writing letters, my file was forwarded to the clinic the same day and returned in 4 days. I visit regional again a week later to request hardship expediting by submitting an eviction notice, although my file was already marked ‘Expedite’. The VA is advertising the FDC program as adjudicating these claims in ninety days. All of my records, including service records are in there possession. I am currently at 172 days with eBenefits showing my status as, ‘Preparation for Decision’. So, you have two things that should expedite the claim with everything needed to make a decision and yet still no decision. What else can I do? I’m proud that I served my country, yet feel ashamed of the system that was created to care for veterans. I clearly understand the death/suicide rate for veterans with pending claims. This process is enough to drive someone to the brink. To my fellow veterans, DO NOT GIVE UP!!! The DAV has not done anything for me, I have advocated for myself to get to this point.

    • Juan says:

      I’m in the same situation

    • Bill Prevatt says:

      Sandra, I am sorry to hear your issues and I feel your pain and frustration. Our lives are in the hands of people that truly don’t care how this affects our lives. I too am proud that I served my country, like most of us, but the process to get what we truly deserve is truly disheartening and pitiful that we have to go through these loops to prove our cases. I don’t think that the VA knows what “expedite” actually means. Yeah and the VA is stating that they are here to take care of our Veterans. Well you know what I say to that BS. If the VA was here to take care of us, then why has it been 165 months since my claim was submitted and I am still waiting? So needless to say, I feel your pain. I am sure that you have read the posts about contacting your congressman, but whatever you do, don’t even waste your time. Once again they don’t do anything for you. You get more information than what they get. If making a decision is that hard, then get people that are qualified to do the job and get these claims/appeals processed. Stop delaying them for years, it makes NO SENSE!!! Hang in there Sandra! I have to tell myself that daily b/c mine has been on-going for so long.

  81. Sandra says:

    Okay, so I make another visit yesterday to Oakland Regional to submit my marriage & birth certificates, and to check the status of my claim. Since my file is marked ‘Sensitive’ not just anyone can access it, I deal directly with a supervisor. This gets any documentation that I submit added to my file immediately, versus sitting in a pile awaiting a Clerks attention. According to the supervisor, my file is in line waiting to be rated, a process that can take several months. Imagine my astonishment at hearing ‘several months’. Oh, but mine shouldn’t take that long since it’s flagged FDC & hardship is what I’m told. Yet it could be a couple of months before I hear anything. I should just wait for an award letter. To say that I am beyond frustrated is an understatement. I was told that there are thousands of veterans waiting, my response was….I’m here about Sandra. The guy says, “so you’re only advocating for yourself?” My response, “you’re darn right, do I look like a VSO to be doing otherwise?” I pray that the ‘Segmented Lanes’ process works as intended by 2015. Files sit around and every 60 days you get a computer generated letter stating, “we’re still processing your claim”. An employee admitted that the letters are automatically sent, meaning that no one has touched your file per say. Someone in another post commented about employee’s receiving bonuses….yes, they do receive bonuses. One employee was terminated because he denied, denied & denied valid claims to keep his productivity bonuses coming. WE NEED HELP!!!

  82. spouse of a veteran says:

    Can someone please help me out with a question i have please!!! It doesnt appear that Catherine is able to respond to these comments anymore for some reason, but if anyone out there can help me i would greatly appreciate it. How do you get a copy of this SOC(statement of the case)???? Its a summary of the file and all the evidence that has been considered to that point. We have never received a copy of anything from our appeal. And according to Ebenefits, it doesnt appear that all the documents show, so how do we know whats in the file??? Your help would mean alot. THANKS

  83. Sandra says:

    I have been viewing the Monday Morning Workload Report….some of you may find it quite interesting, I sure did. My RO (Oakland) has the worst numbers. I was told by a supervisor at the Oakland RO, that they have the most claims. Upon review of the report I see that what they have the most of, are the most claims pending beyond 125 days.

    I sent an email today to Secretary Shinseki detailing my concerns. Will I get a response, probably not? I just feel he needs to know that all of this talk about adjudicating claims within 120 days is so bogus, at least when it comes to my RO.

    Here’s the link to the reports for 2012
    http://www.vba.va.gov/REPORTS/mmwr/index.asp

  84. spouse of a veteran says:

    William, thank you for your help.

  85. spouse of a veteran says:

    Catherine , you had a guest post dated Aug.1,2012
    TOPIC: GETTING YOUR CLAIM PROCESSED FAVORABLY AND QUICKLY: some helpful hints. I thought there was very good information for veterans trying to submitt there claims in the fastest and most accurate way possible but for some reason your guest post is no longer there. It just dissappeared after you posting it for like 5minutes. Thank god i copied and pasted it , so i can share it with others. I just dont understand why its not on here anymore?????? Some really strange things accure on this site.