Wednesday, August 14, 2013

Why the VA sucks

I posted the initial article on the FB page, "The VA is lying."

The VA approves about 15 per cent of its claims overall. If you appeal to the BVA and prevail, about 30 per cent of VA claims make the cut.

If you appeal the BVA ruling to the USCAVC, about 70 per cent of those filings are overturned.. However, only a small percentage of vets who lose a BVA appeal, go to the USCAVC.

About 15 per cent of VA are fraudulent. This means when the dust clears, about 55 per cent of vets just give up. Perhaps the claim is poorly written or lacks appropriate medical documentation. Most vets just tire of the run-around.

If the VA makes an award, the award comes out of the local VA claims office's (VARO) hide. This is really a conflict of interest and may explain why the VA is so stingy.

About 40-45 percent of claims from Iraq and Afghan vets are being approved. Not bad.

However, if you are Vietnam era vet, it's about 2-4 per cent.

Is this a dual standard for vets? You betcha!
Essentially if 100 vets were to file claims, about 20 would be approved at the the VA Regional Office (VARO) level. If you are an Iraq and Afghan vet, a Purple Heart recipient, paralyzed or paraplegic, your odds improve. 
If you appeal to the Decision Review Officer (DRO) or the Board of Veteran Appeals (BVA), another 20 per cent of those appellants get approved. 
Keep in mind the DRO is bound by it VA Manual, M21-1. It does not consider precedent rulings from the United States Court of Appeals for Veterans' Claims (USCAVC) , the 38 CFR that is the VA directive or 38 USC that is public law.
The BVA will consider USCAVC precedent rulings that require a three panel judge, 38CFR and 38 USC. The BVA is legal administrative proceeding. the BVA will also consider the opinions of private practice physicians in letters and Disability Benefit Questionnaires. 
The VARO will gloss over private practice evidence if it conflicts with the Compensation and Pension (C&P) clinicians findings. Keep in mind that many of the C&P examiners are nurse practitioners and physician assistants. A board certified physician will hold more weight in front of the BVA. 
Make sure your key physicians have conducted record reviews of you military service records. This is important to the BVA.
However, the DRO or BVA base is smaller. Let's says that 50 of the 80 claimants who were rejected appeal. Only 10 would prevail at the DRO or BVA. At this point about 30 per cent of the claims have been approved. However, the BVA may only approve one of your 4 claims and remand the other three back to the VARO for development.
You are now playing remand ping pong with the your other three claims. 
We now have 40 claimants left who didn't make the cut at the DRO or BVA. These appellants can apeal to the USCAVC. If 10 appeal, about seven will prevail. 
These examples are hypothetical and based on limited data the VA has provided on claims. Much of this information was harvested from congressional testimony.
Of the 33 remaining claimants. about half (15) are fraudulent. If you file a fraudulent claim, you will most likely receive a quick reject. You can also be prosecuted.
It behooves the vet to appeal if he/she have a well grounded claim. The writer recently discovered he was very fortunate to prevail in front of the BVA without an attorney. Generally, once you get into appeals, you should probably hire an attorney. 
Refine your claim based on the attorney's advice and bring in new substantial evidence at the DRO and BVA levels, 
Once you appeal to the USCAVC, the claim is locked. You cannot introduce new evidence.
What do these statistics suggest. Appeal, young person, appeal!
Your odds of winning are highest at the USCAVC level, but you better have a solid claim. You cannot introduce new evidence once the BVA hearing is over. 
graphics: courtesy of AskNod blog.
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Robert Campbell said...

Like the left has any compassion for the military or Veterans. Obama has forced 171,000 veterans off of TRICARE with Obamacare.

Eric Elder said...

I am on Tricare prime and was not effected by the change. Indeed, peopel were forced onto Tricare standard. Why?

Because the new TRICARE support contracts were originally drafted in 2007 (during the Bush administration). These contracts were designed to reduce the cost of providing health care to military retirees by constricting Prime service areas.

Try posting something about ACA that isn't half baked next time.