The Decision Review Officer and You: Be Afraid, Be Very Afraid

Decision Review Officer(Also known as my “that’s f-ed up” blog post.)

Last week I had a hellish Decision Review Officer hearing. This hearing told me what the DRO is actually looking for when vets are trying to get benefits. And this post is all about telling you what the DRO secretly wants and what the Government tells us about the Decision Review Officer.

As you read this, ask yourself this question, “Are felons in prison treated with more or less dignity than our nation’s veterans?” The VA seems to assume our nation’s heros are also it’s biggest liars.

I’m still very salty about this but thought writing while pissed would work.

The Magic Words – Not Quite Abra-ca-dabra

Last week I had a disturbing revelation during my Informal Decision Review Officer hearing. DRO’s use behavioral psychology to decide their claims when they meet you in the flesh. This should scare you because it is totally subjective. Subjective tends to be bad when it comes to the VA or any application of law.

For years, I’ve held that Voc Rehab and the VA use secret “decision rules” in deciding who gets what. When it comes to the Decision Review Officer process, it is also probably true. Now, I’m going to reveal the magic words you need to look for during your hearing.

“I do not care about the money. I just want the VA to make a decision on my claim based on the law.” Seems straight forward and, well, what is supposed to happen, right? Don’t hold your breath.

My Decision Review Officer Experience

This happened to me last week after a 30 minute argument. The DRO refused to address my claim, like the actual words in my claim, other than telling me I needed yet a 4th exam on the same thing. That’s it. 18 months of waiting boiled down to, “We need another exam.” When I asked for the regulations mandating this, he was set of.

I flatly told the guy “no” and requested to record the remainder of the hearing. That’s when the magic happened. After 30 minutes, he finally read my claim in front of me and we settled.

One odd-ball story. The VSO and the DRO gave me this dumb as hell example about why they make it so hard on vets. “Either the VA just gives disability ratings away like a gumball machine or they make the process hard.” To me, this is where my meeting was fucked. “No, why don’t you guys make decisions based on the law!” However, we all know the VA only likes the law when it allows them to keep your money for a little while longer after denying you access to benefits.

Another friend of mine, an ex officer, had the same experience last week regarding tinnitus. The DRO told him she didn’t believe him and was antagonistic until he also said the magic words, “I don’t care about the money, I care about getting diagnosed.”

You’re take away? Just come back to the law, no more, no less.

Some Government Facts About Decision Review Officers

The DRO wants you to convince him during the hearing that you are sincere. This is laughable to me because he already has a fully developed claim with documentation. In court, sincerity only matters when weighing evidence. However, if someone has a broken leg or brain scarring, it is what it is and the attitude of the victim doesn’t matter.

Things to know about Decision Review Officers according to the Government Accountability Office in their report “Clearer Information for Veterans and Additional Performance Measures Could Improve Appeal Process:”

  • DRO’s lack a formalized, national training process
  • There is no appropriate metric for performance
  • Veterans are not given enough information to know what’s going on

I especially like the last one, but they are all pathetic in their own way. First, if I’m paying a lot of people over $100k every year, I sure hope to hell they can write well. Second, it’s not surprising the VA has no metric for performance. Third, the formalized training process is interesting because it may expose employees to liability for a §1983 lawsuit and the VA to further liability.

We may skin that cat if they don’t shape up. That kind of suit holds the official liable for their own actions. Many VA employees operate with a perception that they are immune even when they violate your constitutional rights. However, the 9th Circuit recently held that the current VA approach to TBI and PTSD victims violates the Constitution. Maybe we’ll see who’s right over the next few years.

Your takeaways: Further Advice on Decision Review Officer Process

First, record the meeting if it’s legal to do so. The VA has NO POLICY on recording. I called the VA Office of General Counsel, here. If you live in a single party state, you may not need to ask permission to record. However, be sure to check with an attorney before you record without permission.

Second, be prepared for a fight. Have your documents ready. The DRO may or may not have read your claim. They will likely tell you they need a new exam if the initial exams are a year old or older. This is fucked because the delay has everything to do with the VA taking their sweet ass time to process your claim. Be ready for it. You can say no.

Third, your Veteran Service Officer may be working with the Decision Review Officer behind the scene to come to an amicable resolution. This may or may not be in your best interests. They can play “Good Cop, Bad Cop.” This is fucked. It’s fucked because it implies veterans did something wrong. No, just give us our damn benefits.

Fourth, be ready for your VSO or the DRO to present you with a settlement on the spot. Be ready to understand how a settlement would impact your disability rating. Again, if your Veteran Service Officer is working with the DRO to close your claim, the VSO may not have your best interests in mind.

In the future, I am going to do research into Decision Rules. There is something suspicious going on, and it’s time for it to end. Help us get to the bottom of this. Take this quick survey if you’ve had a hearing like this. It’s our Decision Review Officer Survey.

Voc Rehab Survival Guide Benjamin Krause is an award winning investigative reporter, Veterans Benefits Law attorney, and disabled veteran of the US Air Force, where he served in its Special Operations Command. He attended Northwestern University and  the University of Minnesota Law School using VA Vocational Rehabilitation.

While in law school, Benjamin won his decade-long fight for full disability benefits and now helps others do the same with this website and his guide, the Voc Rehab Survival Guide for Veterans. Since its first publication in 2011, the guide has helped the veteran community receive millions in untapped benefits through the VA Chapter 31 Vocational Rehabilitation & Employment program. 

Connect with Benjamin on  Google+,  Twitter,  Facebook and LinkedIn.

Comments

  1. carmine zinno says

    Im waiting on dro to look at my appeal from may of 2013. The dav told me to submit a nod and ask for a dro, after a year they said i made a mistake and should have gone a different route. When i call the 800 number the rep said i did the right thing and the previous appeal was never looked at. I asked where the decision came from the year before and they said the va is still working on my original claim!
    At this point im totally confused!!.ive asked for someone to call,me and explain it clearly and ndver got a call!!

  2. charles jenkins says

    this article is very good one for multitude of info from different perspectives. I thought that my experience with the DRO was a unique experience, I see things a little clearer now. Boy would like to share my nightmare with your viewers.

  3. Isaiah says

    Hello to all I was a medic in the army and later on worked for the VA for 3 years on the medical side of the house. I read the comments and article about the DRO and as much as I dislike VBA I believe you have not given them enough credit. Richard hit it on the head that the DRO is simply an authority that has the power to overturn decisions on a veterans behalf. I had an in person hearing and it was relieving to see that the individual in fron tof me let me tell my story. The VA has laws that govern making determinations on claims before we all start bashing them try educating yourself about what they look for. The information is out there for public use. Key words on this site are schedule of ratings.
    http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title38/38cfr4_main_02.tpl
    The VA needs 3 things to determine service connection…1) an event that happened during service (proved with medical record or other servcice members that witnessed it) 2) a current diagnosed disability and the 3rd thing which is probably the most important a NEXUS or link between the current diagnoses and the in service incident or condition. Don’t think everything is black and white there is a grey area… you could have sprained your ankle in service got out and now have limited motion and have it diagonosed doesn’t mean they will see it as oh that is definitely because of that incident. I found a website a couple weeks ago that provided more information to me than 3 NSO ever have. It was written by a fellow disabled veteran. You can type your own NEXUS letter and go over it with your doctor and they will either agree or disagree and attempt to twirk it but you have to work with the provider because it is their opinion that is on the line. I have had 2 of my doctors so far sign and it is now sitting with the DRO and I now know I will have a favorable decision because it provided what they needed. All reasonable doubt is in favor of a veteran that is under chapter 3 adjudication. Educate yourself and stop waiting for handouts because if the VA bends over backwards for every veteran which in my opinion they should but lets be realistic there wouldn’t be enough benefits to go around.
    http://www.veteranscorner.org/thenexusletter.htm
    Check out the links provided and get the needed information to the DRO or you won’t see any change regardless.

    • Tony says

      Negative,
      I was a patient advocate with the VHA for 2 years and a program aide for 3 years VBA, I also served for 9 years in the military spanning Desert Storm and the Operation Enduring Freedom. While there are “policies” in place, the VA on any given day is a bureaucracy and fords the ability to simply over look them when it works in their interest. 90 percent of the time the VBA simply hopes the veteran gives up and the VSO more often is just happy to be involved. But lets pretend that the stars align and things are as you say they are, you went as far to list the CFRs websites, and once again while they exist in theory, they are IGNORED in practice. Secondly, the author Ben Krause, is literally recounting the events of his own experience with the DRO office, it’s also a very common story, so is everyone making it up?
      While you may believe a veteran should have to prove his injury, others favor the requirement of the VA to prove it. That is apart of its mission and if the VA is going to shrouds itself as defenders of veterans honor and purveyors of their trust then secret waiting list and hiding behind confused looks is a horrible example of it’s sincerity.
      http://www.fiercehealthcare.com/story/va-scandal-healthcare-execs-may-face-criminal-charges/2014-06-10

      While in reality we know the VA has dropped the ball many, many, many, many times, where are the consequences? That leads us to the last contention. In recent weeks several inconsistencies on how the VA reports their numbers have come up somewhat “skewed”, getting help from the VA is dangerous waiting game, one I rather chance with seeking out privately. If I choose to pay the extra price and get a physician’s opinion that isn’t anchored on a revenue source, I will go with the non bias diagnosis any day of the week. http://www.usatoday.com/story/news/politics/2014/06/11/senate-passes-veterans-bill/10330951/

      Thanks for really putting your best foot forward as a VA employee to explain how great the VA is working for you.
      Tony

  4. richard says

    This is the most inaccurate article about the Veterans Benefits Administration that I have ever read. I would like to know which regional office has handled your claim. A DRO simply reviews the decision that was previously rated and appealed by the claimant. A decision that is based on LAW. The advantage of a DRO, is that he can change the decision based on a liberal interpretation of the law. Seems to me like your DRO experiences have more to do with assholes than their actual title of DRO. I personally worked for 5 DRO’s for over 2 years. I watched them everyday go above and beyond to try to find a legal way to change the decisions in a favorable way, while staying within the limits of the law. Sorry you had a bad experience with the VBA, but dont go writing about a bunch of shit when you dont know what you’re talking about.

  5. Kilroy says

    After retiring from the “military” (*I’m still “iffy” the VA will see me posting things – sorry) I worked at the VA until April of 2011 as a Veteran’s Service Rep. (VSR) for 2 years until I quit in frustration. I was a Sr.NCO with > 22 years of honorable service and an Undergraduate degree (with honors), I was looking to make a difference – to HELP fellow veterans; then the scales fell from my eyes. “Holy SHIT” I thought, “This place is all F-d up !” I mean, “I” was a veteran and they treated “me” like crap – AND I WORKED THERE ! But you have to know a few things. First, the people they hire are mostly gleaned right from colleges. Don’t get me wrong, some work hard, but oddly the DVA really doesn’t go out of its way to hire veterans – people who actually KNOW more than just governmental regulations. Secondly, there are some BAD regional offices (Houston, Denver) and GOOD regional offices (St. Paul) – so WHERE a veteran files a claim – geographically – makes a difference between approval & denial. Lastly, there are some raters & DRO’s who make LEGAL decisions in a subjective fashion every day – some rate harder than others…that doesn’t seem fair to me – how about you? All I can say is this, I left in frustration after making GS-10. I was disgusted by the attitudes and neopatism. Many of these “kids” walk around wringing their hands while reciting the mantra “we’re serving veterans.” Horseshit ! The claims process is much harder and more complicated than it needs to be; most veterans just give up and go away – guess what ? THE DVA DOES NOT CARE ! If you throw in the towel, the DVA will not call you and ask if you need help. Veterans get confusing form letters and little else. I FIRMLY believe a civilian company could streamline the process and do much better – actually SERVE VETERANS better than this cobbled-together mostrosity known as the VA ! Did you know that in the DVA, they have several different software systems that a VSR uses on a daily basis that CAN’T communicate with each other – imagine Volvo, IBM, Best Buy or Apple having that problem ! The “training” provided is complete eyewash ! NOTHING but power points (PPT) and handouts which do less to train VSR’s, Raters, and DRO’s and MORE to satisfy required training in a cover your ass mentality. Trust me IT’S NOT TRAINING ! And in conclusion, “ASPEN” counts MORE than the veteran EVER will. In this tough economy, people want to keep their jobs. The DVA uses “ASPEN” (a computer program) to track their employees daily workload. If you are a GS-10 you are required to generate “x” ASPEN points every day – or you can get into some hot water and eventually get fired or forced out. Now, instead of providing the veteran with quality work and empathy, the employee chases ASPEN POINTS all day. For instance, a veteran with follow-up work, let’s say making a SECOND request to a civilian hospital for records, on his/her C-file gets the DVA employee ZERO points ! However, sending the C-file to the rating board (marked “RTR” or ready to rate) gets the employee 1 point. In conclusion I say this – USE the law (38 CFR & M21-1MR) to support your case and NEVER EVER give up – you raised your right hand, swore an oath and you served ! One, four, 20 years, it doesn’t matter, you served (Less than 2% of the U.S. population does). If you were shot (combat or training) , fell down an open ship-hatch, had Agent Orange splashed on you in the RVN, inhaled toxic fumes from a witches brew of burning garbage in Iraq, or got bitten by a pit-viper in the Horn of Africa, IT’S ALL THE SAME – you deserve treatment & compensation, NOT a stonewall legal jargon and brush-offs. Congress will bend over for banks, big business, OTHER countries, Fannie & Freddie, but “we veterans?” Nope, we get to chase our tails for benefits. Good Luck and keep at it.

  6. NIKO says

    I was thrown from a duce and a half (2 1/2 ton troop transport truck)to the road… the rear tandum (4 wheels) went over my lower body from the waist down. The injuries were as follows…..
    Broken Pelvis in two places…. Ruptured Bladder….Ruptured Eurthia…. Neurological Damage to Both Legs…… Vascular Damage to Both Legs… Chronic, Severe, Post Traumatic Stress Disorder. I was evaluated by the VA in Newark New Jersey in 1968, and the award was 10% ($23a month)
    After years of fighting with the VA and letters to two Presidents I was awarded a combined disability of 90% which is reduced by their formular to 70% but still give me the difference in Unemployability to get me to the 100% , Total & Permanent, and that was in 1995….so much for a speedy dicision.
    I now have a temporary denture since they pulled my teeth and waiting for over a year for the permanent one. This temp is cracked….two tront teeth are chipped and the relining that they did has washed out and I have to use glue to hold them in my mouth……… “SPEEDY VA DENTAL CLINIC” I’m 65 and have to worry about getting bills paid?? FUCK the VA and the LEGISLATURE that runs it.

  7. Marshall Crippen says

    Raul,
    Did you serve on the independence cv-62 from the time frame of 1/77 to 2/79?

    If so interested to hear about you case.

    Email me back if you are he.

    Thanks

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