VA’s Claim Process: Behind the Scenes

Yesterday and today, Dr. Tommy Sowers, our new Assistant Secretary of Public and Intergovernmental Affairs, walked the halls of the Chicago Regional Office to see for himself how claims are received, processed, and delivered.

Along the way, he tweeted photos and facts from his visit (you can follow him on Twitter at @sowers). His insight comes at a time when the disability claims backlog is making national news. Today’s New York Times front page story ran down the difficult truths on why it has grown in recent years, for reasons in and out of VA’s control.

Take a moment to check out the process from behind the scenes below, and if you’re looking to file a claim, check out this post that gives some helpful tips on how to make it a first time go. Hopefully some of the tips will be unnecessary soon; by the end of 2013, all 56 regional offices will roll out paperless processing technology to speed up the process and improve accuracy.


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27 Comments to “VA’s Claim Process: Behind the Scenes”

  1. Jonathan Scott Gosselin says:

    I resubmitted my claim for disability for my right shoulder that ive had surgery on by the us navy due to an injury furing oif/oef and spoke to a rep on the phone who said he would setup new appointments to which i still havent received nor can i hold my four year old son in my arms or throw him a ball. Thanks US Navy for NOT taking care of me still. Hurry up and wait.

    • Dale A.Greene Sr says:

      I would like to know how come its such a hassel to any coorpination with the claims section and why it takes so long to get a doctors appointment ? The Lakeland Va clinic is outstandind and they caring and super personnel (Lakeland Florida) and the VA @ tampa is a night mere especially the parking fo disabled Veterans

  2. floyd britten says:

    My claim has been open since April. 2008 for the same three items they are lost in space. I just received a request for more information the first request in over two years. Then on the ebenifits web site they shoq my claim as closed to keep their stats looking good.

  3. James S. says:

    Good info, but not much details on exactly why claims are so slow to process. How can a two year old claim be in the “review of evidence” phase for nearly a year? Are there enough “reviewers” working on the backlog?

  4. Ioan A Kelemen says:

    Dr. Sowers might want to come down to Phoenix VA! OIF vet, I have been waiting for a c&p since Mar 2011!

  5. Denis La Bine says:

    total failure is VA and DOD, 1) they do not communicate WITH ANY OTHER GOVERNMENT AGENCIES, LIKE STATES THAT MADE YOU PERMANENTLY DISABLE FOR YEARS IS NOT EVEN ADDRESSED BY OTHER GOVERNMENT AGENCIES.
    2) was was sent and verified in letter from them, example november last year, now new letter denies having all documents afte voice and fax verification and verified gov letter of service and honarable discharge.
    3) 4th stroke now, this one june 25-2012 @ VA hospital in loma linda, ca. all summaries mailed via my power of attorney american legion. was denied claiming never gotten requested documents, again refiled this week same information.
    4) major problem all my data was burnt in fire that i was told happened years ago.
    5) my wallet dd214 has army number and is hard to view from extreme years of worn out. the only document left that was verified by VA Service Officer .
    6) I have been permanently disssable and living via SSI for yrs here in California.
    7) now have to prove to vA my stroke, diabetes, memory loss and dysphasia from the va documents from hospital sent to them.
    8) i will die or become homeless again with NO HELP from MY Country when I need it most, proves the consistancy from in uniforms to regular civilians is a national epidemic never addressed by any past or current president, or government agency to help americans who are dissable.
    9) i take personal offence from your doing this major discovery so late in life that many vets are gone and you take it to be the assistant person preaching to the vets who allready know, did you bother to speak to the vets? I see nothing here in that door but your personal discovery of a massive failed consistantly paper mountain of terrorsit acts by our failed systems to address so many years in the making will not be addressed or resolved since all data is gone or purposely distroyed by our goverment’s inability to protect documents, such as fire that destroyed 30 millions of us.
    10) now this stroke loss of vision loss of hearing, diabetes and dysphasia leaves me with total strangers to help me move forward in life, but that is diminished as I am single and elderly. In hospital the WW2 vet in my room was 89 yrs old and homeless for 10 yrs. but yet propaganda lives to claim that billions was offered to vets that our government cause these issues with no protections for chemicals deployed in field that killed our soldiers in slow death of time. I expand 800 percent fonts to try to do this typing today, so than you technology for allowing me.
    11) notice above it asks for Mail (will not be published…

    • Darcy says:

      My husband died in 1999. He had a service connected death. My children grew up without a father. Finally in 2011. 11 yrs later they excepted his claim. They still haven’t received all they were entitled. I remarried and received nothing. It was an unacceptable relationship and I only spent 1 year with the second husband before he went to prison for domestic violence? Assault. Thanks for letting him give all and rest in peace knowing his family was taken Care of VA. Thanks for nothing.!!!!

  6. George says:

    This looks like your really doing your job. From my point of view, you’re blown smoke just like all the previous. How’s this go, your SSN says your not a vet, my DD214 says other, we can’t verify, here’s my service #, and my basic training photos. Sorry we lost your records, Oh, here’s the copy I gave you before, yes I was in Vietnam, here’s more pictures. No they don’t count as evidence, would you like to talk to the guys I was with. Later, they sent you all the statements you requested, sorry we didn’t get any, they were sent certified with return reciept, we don’t have them, in fact we don’t have a record of you filing a claim, I made copies, we’ll notify you if we need more info. 33 Yrs later this crap sure gets old. How do I file a grievance against Pam and Amber for lying? I got them on tape. They were warned I was recording, and lied anyway.

  7. Tammey stuck says:

    I’m impressed you are willing to see the process, but keep the rose colored glasses off. You show stacks of documents in which veterans are making their cases (which is what they are forced to do in order to even attempt the battle).
    What is more disheartening are the claims which are very straight forward. My example is getting the VA to recognize my husband, the veteran, is married. We have been married for over 21 years (the entire time he was in the service). The day he retired, VA recognized him as single. We have sent in three times the evidence of marriage/claim for over 3 years and still waiting.
    He is now trying to go to school and I’m concerned the status will not be corrected in time and this will be another 3+ yrs battle we’ll be fighting!
    If you would like further details or can help, pleas feel free to contact a veteran in process directly and you can get more of the “behind the curtains” view.

  8. Victor Whitmore says:

    1973 to 1989 filed and the VA said I did not: Refiled in 1989 and last week they tell me the same thing, no records of me fileing. But theis time I kept all mail; 1: 1974 copy of Doctor records, Records office in 1989 when I refiled, tell me the VA Administration has my medical records, records show the VA requesting the same records many times, Medical records in the navy, show each issue. Last week I called, report from trhe phone call was told, I have no claim filed. I am currently Single, 400% Disabled, I support myself and 2 young kids on below the natioall income level. I have problems with the VA medical profiding medical care for anything. Screwed by the VA, 1973 to now Sept, 2012.

  9. Thanks Tommy Sowers for your support in helping Veterans get the help they need. I personally, have been on a Campaign talking face to face to Congressmen and Senators about the crisis of 18 Veterans committing suicide everyday 24 / 7. It’s nerve racking, but we need to do our part. I am a 100% service connected disabled veteran getting all of the services that I need, because there are Professionals, like you, out there, watching our backs. Yeah, you are on the right track in simplifying Claims, wow.
    The Congressmen and Senators are out until after the election, and hundreds of Vets will be dead before their return. You just can’t quit, who speaks for the dead? We formed a mental health council at Martinsburg WV VAMC to train Patients in peer to peer support. There are training slots and certifications required, but we care about our recovery. Our Hospital has a great Staff for evaluating Veterans for disability compension and other services. I met one Psych.D, who is the smartest Person that I have come across on this Planet. She is firm about qualifying and fair about getting to the point. No names please, she saved my life. A stay in the Psych. Ward can actually get you on track, they adjust your meds, provide you with a safe and quiet place to make a recovery plan. Been there done that a few times and succombed to my mental illness. We have Groups that meet every weekday for outpatients. Well enough of my jabber jawing. Thanks for all of the work you do for Veterans. Fair winds.

  10. Robert J Casaletto says:

    I’m very much disappointed in the system. I left the #1 Hospital in the country to be independent. If I needed to move I didn’t have to go nuts it would follow me by computer at the VA. Firstly as a matter of my divorce settlement I have great health insurance and my X even works for them. I paid $5 per script co pay. The VA is $8. Being on SSI disability it gets pretty costly. Then I start getting these nasty letters on how the VA is going to attach my SS check if I don’t answer their letters about my income and refer to a sum of money I received prior to going to the VA for help and the only year I filed taxes even if I hadn’t paid any. It was from the passing of my Mom. in July 2010 she died at the age of 94 God bless her. So tell me I got a share along with my 3 brothers of the house when it was sold and here comes a government agency who is advertising good karma all over the place and sticking a knife in my back. Why?? As it is I had to spend the money or lose my SSI check. I invested a lot of it into my Chapter 40B low income Condo. I am finding out I can never get the money back. Another Governemtn Agency Burnt me. 1 of my illnesses is ADHD where I am losing my ability to fill out forms. I won’t get into the rest. I just want to be left alone and get my care without threats. If it goes the way it’s going I know who to talk to. I’m trying to be a good soldier though.

  11. Mike Presley says:

    My experience, VA denies claims hoping they will go away. Whether appealed or not appealed, these denied claims are no longer considered in the pending numbers published as back log. Takes some of the heat off of the VA. Vietnam Veterans are still being set aside by the high volume of current returning veteran claims.

  12. Hoot says:

    Thank you for watch in over us. Milwalkee Wi. was no good meaning REG. OFF. Much of my paper work was lost,that I send to them.But I always had copes .went on for yr.s. Many times I wanted end my Life because they sent me back to V.N.71-72 and left me hanging.Thank GOD.I would work for FREE to be like you,so that I could HELP veterans like me not to go though yr.s ago.

    HOOT ;KEEP UP THE GOOD WORK!!!!

  13. James King says:

    “…is not filing fully developed claims I understand,” but I am always amazed that the disabled are supposed to be perfect and file fully developed claims, but the reviewers can make comments that aren’t true, etc., etc., etc. We also can not get assistance that is very qualified to help us 99% of the time. Not complaining. It is just a fact. Like I filed for my heart disease and was so frustrated I didn’t work on it again for almost a year Calcium scans which are over 400 on the framingham scale are a diagnosis from heart disease. I also submitted papers from the UNC heart center, NIH and I am now on my last year or two, my diabetes re rating, the copy of my file, my case reevaluation and any and neither has been done. Also they were mad that after telling them SEVERAL l times I could not do a stress test, that it was medically dangerous for me to do one or any invasive surgical procedure for diagnosis, and that my mom was on life support so I could not go out of town for anything unless I knew what it was and we could discuss it first. I read the OIG said the Roanoke office in VA., was making many rating mistakes at the time they had my file. I still don’t have the copy of my file or the statement of the case.

  14. jav says:

    You said “Farris” was an Arabic speaker…why am I not suprised VARO employees dont speak English? Most of them cant read, either, because they are constantly saying,
    “The record is absent for”….and when we show them, usuually on appeal, they are like..well why did the first decision maker not see this?

  15. Stephen D Cunningham says:

    Iam a TBISx2 with a lot of medical problems because of the TRAMA .I put manny of clames in only to be DENIED and go with out care.I didnot get any care on active duty and Iam not reciving proper care in the VA. I had to suffer in silence in the NAVY because they said they would kill me if i told.

  16. Dennis Pinta says:

    why after seeing three va doctors and they all say i need hernea surgery since middle of Agust and still have not had it. if it needs to be out sourced what is taking so long i think i have been in enough pain with this lets get it done if it was on the out side it would that 1 day. then when your primary care dr wants to see you in 30 days it is 90 days out if you are lucky

  17. Shawn War says:

    At which step in the this process did the Saint Louis Regional office shred my appeal? I have since cleared this up because I kept a record of everything. Saint Louis even violated the Secretaries own directive by denying they even received the appeal. So they had to shown that they were wrong and they still tried to deny. I will never forget this treatment by the VA and it’s regional office.

  18. Thanks! Due to the loss of important mail I have filed through the state rep.. My regional office is in Montgomery Alabama. There is a three day return policy for mail at my current address so what ever mail that I should have recieved went there. According to an IRS print out the claim pay date goes to the date the VA recirved the claim there. This is back in Feb. of 2008. Thanks again. JessieFurr. jessiefurr@gmail.com

  19. Douglas R. Siegel says:

    Why the VA and other Government agencies don’t make it mandatory to hire ex military, wether retired or medically discharged, I don’t know. #1 we have a vested interest towards our military brethren. #2 we have a better sence of urgency. #3 we are cheaper to employ. Because we already have healthcare, we have a pension and are willing to give back to the system. A lot of us work hard and productive hours. We also know how slow the system is. Use us and see the results.

  20. Dan F says:

    I am rated 100% P & T which took 2 years and 3 months from start to final award from a NOD.

    I signed and later fired three different VSOs for, to keep it brief, incompetence. I took on the entire appeal by myself. I visited several veteran sites that help vets with their claims. I read most of CFR 38 and learned the following:

    1) You, or in combination of others, should make statements in support of your claim. Tell the VA when, where and how the injury, incident or illness first presented itself. Also,these statements should tell how the injury/illness has adversely affected your life.

    2) Gather all the evidence you could submit. Get out of system medical records, copy them and send them in with your claim. Give dates of care you received at the VA (if you have been treated at more than one VA, make sure you note that).

    3) Tell your treating practitioners that you are filing a claim for VA disability. Ask him or her if they would write a statement in support of your claim. (Although a Doctor is not under obligation, and it is not against VA regulations, he/she may refuse to help). A statement is especially helpful if you are having unusual side effects from medications, the injury/illness is causing additional impairment or a difficult diagnosis is involved.

    4) If you are using a VSO, understand that no one has more interest in your claim than you. VSOs are like any professional, they are busy, not perfect and some are better than others. Question any claim that goes 120 days without any correspondence or movement. Sign up for eBenefits and keep tabs on the movement through each stage.

    5) Answer all correspondence immediately and keep copies of everything you receive or send to the VA. Hand delivered papers should be date and time stamped and copied back to you or if you mail them, always send them certified mail with a return receipt request.

    These are just a few of the things I learned that if I knew at the get go, would probably have saved months of processing. Good luck to all out there still in the process and never, never give up.

  21. BR says:

    The claims / appeals process is never ending..feel like a boat lost at sea…stuck in the doldrums….cant get an answer from anyone at the VA………my NOD is going on 16months without a peep…whenever u call the 1-800-827-1000 you get the same script over and over..the representative told me that NOD’s take an average of 289 days…I’m at 480..thanks VA !