Honorable Eric Shinseki
1722 I Street N.W. CSS
Washington DC 20421
Dear General Shinseki,
I have been involved with a VA
disability claims since I retired from the Air Force in 1990. I would
like to make some observations on how the clams process can be
streamlined from a veteran's perspective.
- The C-file is bogging the entire
system down. After prevailing in a BVA appeal, my claim was split
between the AMC and Bay Pines VARO. While the AMC spent a year
working on my claims, the Bay Pines VARO was unable to work on their
part of the claim until my C-file was returned from Washington.
Since the C-file has not been turned into electronic records, the
single paper C-file can add years to the claim process.
- The VA needs an integrated
database. When My Disabled American Veteran (DAV) representative
looks at my claims status, he has to go into 5 different electronic
systems. If I call different organizations in Washington or at Bay
Pines about my claims, I get different very different answers from
the VA representative on my claims' status.
- Both VA and veteran
representatives frequently move and this creates an institutional
knowledge gap. I am on my fifth DAV service officer and my third Bay
Pines VARO claims officer in the past year. Transfers need to
be slowed down to improve service and to maintain institutional
knowledge.
- The Board of Veteran Appeals (BVA) should be given the authority to raise a disability rating to the next higher level. Using 7903 as an example:
7903 Hypothyroidism
Cold intolerance, muscular weakness, cardiovascular involvement, mental disturbance (dementia, slowing of thought, depression), bradycardia (less than 60 beats per minute), and sleepiness--100%
Muscular weakness, mental disturbance, and weight gain--60%
Fatigability, constipation, and mental sluggishness--30%
Fatigability, or; continuous medication required for control--10%
Cold intolerance, muscular weakness, cardiovascular involvement, mental disturbance (dementia, slowing of thought, depression), bradycardia (less than 60 beats per minute), and sleepiness--100%
Muscular weakness, mental disturbance, and weight gain--60%
Fatigability, constipation, and mental sluggishness--30%
Fatigability, or; continuous medication required for control--10%
For example if a veteran has been rated
10 per cent disabled for 7903, Hypothyroidism and the BVA believes
the rating is too low, The BVA should have the authority to raise it
to the next level that is 30 per cent in the 7903 example.
The BVA
could offer the veteran the next higher rating or the option to
remand the appeal for a rating higher than the 30 per cent level . Many
veterans would accept the next higher rating. This would avoid
another year or more of paperwork that a remand at this time
requires. This could reduced the remand load on both he AMC and the
VAROs.
The AMC and VAROS are ignoring
Appeals Court guidance on disability ratings. Symptoms
listed in the rating criteria are simply examples
of the type and degree of the symptoms, or their effects, that would
justify a particular rating; analysis should not be limited solely
to whether the claimant has the symptoms of all of the examples of
a particular rating level.
- These examples are not rating criteria
and the VA Appeals Court has repeatedly stated the Veteran does not
have to meet all of the examples to be rated at a particular rating
level. In fact, the higher levels are inclusive of the lower levels
(Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002) and DIANNE C.
TATUM, APPELLANT).
This suggests the AMC and VAROS are
starting at the bottom of the 38 CFR, Part C rating examples and
then moving from the bottom of the scale upwards and ignoring the
higher level indicators of a condition as well as the medical
evidence that the veteran is providing (see UNITED
STATES COURT OF APPEALS FOR VETERANS CLAIMS NO . 07-2728.This is an institutional problem that is allowing the VA to low ball veteran's claims.
If the VA wants
to be a true advocate for the veteran, the claims officers should
start at the 100 per cent level to see if the higher level indicators
exist. If not, the rater should move to the next lower level.
In the
hypothyroidism example, the rating officer would move from the 100
per cent level to the 60 per cent level. The rating process would be
more equitable if this process were used and the number of appeals
would be reduced in the VA.
It is my express hope that these observations will be useful to the
VA. It is clear during the Bush administration that the VA system is
broken and I know that you and President Obama are working hard to
improve the Veterans Administration.
Sincerely,
The Major, USAF (ret)
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