VA Audit: Over 40,000 Veterans Appeals Ignored

26

VA Regional Offices are ignoring 18.5 percent of veterans’ appeals on average, according to a recent audit. The Veterans Affairs Office of Inspector General (OIG) found that ignoring claims causes a processing delay of 444 days.

Let’s hope the VA notices your appeal. In “Audit of VA Regional Offices’ Appeals Management Processes” report, auditors found that one veteran’s claim had been ignored for over 1,500 days.

As of the date of the audit, 246,000 disability appeals were on file. If the 18.5 percent average holds across the entire VA, another 45,000 appeals claims are not on record despite the VA having the appeal on file.

To assess appeals processing, the Veterans Affairs OIG created a sample of VA regional offices across the US. These offices served as the “average” regional offices. The auditors then handed the different offices 783 potential NOD’s. VA adjudicators failed to identify 145 of these as potential appeals.

Here is how the process works. A veteran files an appeal because they disagree with a decision by the VA. In this form, it is considered a Notice of Disagreement (NOD). Once a review of the claim is completed, if the reviewer does not agree with the veteran, a Statement of the Case is created by the VA. If the veterans still disagrees, they appeal and VA then certifies the appeal to the Board of Appeals.

For the Notice of Disagreement portion, the VA has set a target of 125 days to complete the review. The VA has also set a 180-day target for the certification process.

In 2010, VA took an average of 656 days to fully process an appeal. This audit does not provide the average for 2011, but one unidentified regional office averages 1,219 days.

The audit of the Veterans Benefits Administration also revealed de novo review appeals are decided more quickly. A de novo review means the Decision Review Officer will look at the existing evidence and make a new determination. It is like looking at a claim with new, more experienced eyes.

The Veterans Affairs OIG released the results of their audit into disability claims appeals earlier this week. The Veterans Affairs OIG audit was intended to seek out the root of delays relating to veterans’ appeals.

On a high level, it revealed that regional offices are focusing primarily on new claims and not appeals. This means, if the claims adjudicator gets it wrong the first time, the veteran has a very long wait to get the appeal decided in less than one year. If the VA fails to notice the appeal, that veteran will have another 1 year and 4 months to wait before VA even begins to adjudicate the appeal.

This audit evaluated eight regional offices throughout the country. The Veterans Affairs OIG specifically selected regional offices that would serve as an average across the VA.

The regional offices audited were: Boston, Lincoln, Los Angeles, Milwaukee, Montgomery, New York, Philadelphia, and Salt Lake City.

 

DisabledVeterans.org Survey Critique

This survey does a great job exposing some of the issues veterans are experiencing. It tells us that a de novo review is a quicker solution. It also tells us that the VA is failing to even notice almost 20 percent of veterans appeal.

The survey fails to identify the regional offices and their performance. It gives us a list of which regional offices were audited. It does not tell use the performance of each. Instead, the Veterans Affairs OIG craftily assigns numbers to each. It does not tell us which regional office is assigned to what number.

It further fails to give us a firm averages. How long does it take to process an NOD? How long does it take to process the appeals certification? We do not know.

http://www.va.gov/oig/pubs/VAOIG-10-03166-75.pdf

Stay informed on VA news, scandals and benefits. Get our daily newsletter via email.

17343

DisabledVeterans.org

Get our free daily newsletter.

26 COMMENTS

  1. I filed a claim on apr 24 2000 and then again on apr 20th 2007 when the va reopened my claim then filed a NOD on jan 8 2008 Just recieved on june 1 2012 letter from st.petersbug regional office dated may 24 2012 that it will take between 350 to 400 days from the date of the letter may 24 2012 before I can go before the VBA……well jan 8th 2008 to jun 1 2012 is 1641 days i think i have waited long enough already.  I guess this is the VA standard of 125 days

    • I also have been waiting three years on my appeal , got denied without ever seeing a docter the first time around.

      • I was with 5th group, and H Company Airborne Rangers in Vietnam. In contacts, I received 3 rounds of AK through left chest, left arm, and RPG 7 shrapnel in back and leg. Lost my lower left lung lobe. In 2000, a very alert DAV rep. saw my records and documentation, and filed for an increase because a record in 1971 said that I had been “elevated from moderate (20 percent) to moderate severe (40 percent) just for muscle groups 5620 and 5621, 0 percent they said for the most serious, which was my left lung. 10 percent continued for a severed left triceps. My appeals began, and like one poster above, I am now on my third trip to Washington BVA, with 3 remands back to the VA in St. Petersburg, Fl. I have the document which says I was elevated, and it says that it was in May 1971, but they are waiting for me to die. But don’t ever give up, use your training, never quit, never fall out of run, don’t let them beat you by quitting!
        I know that I am not as bad off as a lot of other vets, and this makes me feel awful. There are so many needy vets, so many that have given everything that they have, I just don’t understand the assholes in Washington who send us, in harm’s way, then ignore us.
        Jim

  2. I think the VA is playing the odds. If they put off long enough working the claims of an already screwed up veteran who has to live in extreme poverty and has developed mental problems from their military experience the odds are they will off themselves from the aggravation of dealing with the system in which case CLAIM DENIED. or they will become so desperate they either break the law to survive since they cant hold or get a job or hurt someone else when they go off from the anger they carry with the knowledge they served their country then their country screwed them up and forgot they existed therefore placing you in the category of incarcerated veteran which means NOT ELIGIBLE FOR BENEFITS.Yep the system works just like they designed it to work to pay out the minimum amount of claims.

  3. I am one of the cases from boston that is messed up, served 15mo over seas in Iraq, 3rd ID. FT Stewart,GA. I got Injured and stayed injured in the deployment, the cpt just gave me anti inflamitorys and tramadol to “control my pain” and still stay in the fight, my si joints and lower back and spine up to mid back got messed up and the injury stayed inflamed and i was in pain 24-7 like i am now but my adrenalin was always pumping and it helped conceal the pain, but that is just a bandaid and my lower back and both hips was the first to act up then the lower spine up to mid spine and we are in full battle rattle , over 100lbs of gear ,armor and i carried a 249SAW for my weapon, weighing in at 16lbs. and i had to work the wrecker, a recovery vehicle and i did recovery missions on daily drives outside the wire, 2×3 daily, i have been patiently waiting since oct 28 2008, only 10$ SC for lower back strain they say, i put in a NOD and now got a letter saying its in administrative process. Dont know how long I will have to wait. I have extreme lower back and mid back disc,spine,hips,etc, a long list and now last year been in a wheel chair and have a hospital bed. cant stand and walk for no more than a minute, in severe pain 24-7 and I only get 10% and its not even correct, my back problems started in iraq and stayed bad and only got worse and worse over the years, and i have PTSD 30% , Tinnitus 10% and VA MATH, Its like its not even on record since they dont pay you for it or make your total percent for disability not included, go figure.

  4. As of today, it has been 2047 days which includes 162 days since I saw the judge….I am beyond words at this point!

  5. Over 3 years on my appeal. Initial claim was denied only 3 weeks after I submitted the claim, with no C and P exam. I just received another letter from LA va, stating that they JUST received my claim and the usual turn around is 3 years. Is this 3 more years? Somebody needs to fix this broken system. When I call the hotline, the operator always says that there are just few people working on a lot of claims. I always respond, “Are they being shot at? No? Maybe that is why they are moving so slow.”

  6. I am a hep C vet courtesy of the MUNJI device used by the Army to immunize, I first contacted the VA when I learned I needed a liver transplant and was told the VA didnt recognize Hep C as a service connected injury /illness. That was in early 2000. In May 2000 I had my transplant but spent 3 years after fighting rejection and medication problems, I lost my job, my ability to work, my medical insurance, and my entire lifes savings. I again contacted the VA in 2006 and they sent me the application to file a claim, after returning the paperwork I waited 18 months and heard nothing. I contacted the VA and was told they had never received my medical evaluation and had closed my case file. After some lengthy, heated discussions they reopened my case in 2008. I sent in the medical evaluation and again waited and in 2009 was turned down flat, I sent in my NOD and asked that my case go to a DRO and waited for another 15 months. I tried contacting the DRO several times, I wrote, I called and never heard back. Finally the DRO sent me a letter turning down my claim. I appealed to the VBA and after another 8 months my case was added to the docket. And still I wait, a year ago the VBA sent me a letter stating they were ready to make a decision in my case and since then all I hear from the ombundsman is that my case is still waiting. As a result of my hep C infection I received from the MUNJI imunizations, I have gone through a liver transplant, my kidneys are failing (stage 3), I have diabetes, ischemic heart disease, PAD, and arteriosclerosis. My medication alone cost $1400. monthly before I have any routine test or see any doctors. I am forced to live in exile outside the US and away from family just to get medical care. My rep says hang in there but to be honest I feel sometimes I have nothing left to hang onto.

  7. I think the whole department of veterans affairs should be closed down and put it in the hands of the Chinese that way we know were at war!!!!

  8. I’ve been reading Vets post’s on the net for awhile now. Here’s my story: I sustained a documented Injury, Event or Experience to my back in 1976, while on active duty. Upon my separation in 1977, I went to the local VAMC for a follow-up. After their test, xrays, etc., they could not come to a diagnosis. However the injury & pain was growing worse all the time.

    I had filed my paperwork for comp. and was denied stating that I didn’t have enough medical evidence. Had no insurance to see a REAL doctor. So I lived with it because basically VA was saying the pain was in my head and not in my back. Wrong!!!

    I re-filed in 1980 & 1990 to no avail. Finally got health insurance, and started seeing REAL doctors with REAL answers. Geeez.. come to find out that those test the VA had done that were never followed through with… had/has some important information in it after-all. That is according to today’s Modern testing, i.e. MRI’s, and REAL doctors.

    Then in 2004 that same undiagnosed injury to my back kept me from walking for than 10 feet. Then… zaaap and down to the ground I’d go. The 1st neurosurgeon recommended Immediate surgery. Wow.. that was scary!

    So I reopened my previous claim from 1978, 1980,1990. I have now been in their appeal loop since then. Now.. Finally.. after 30+ years, and new and material evidence, I have a BVA hearing with a Real Person (VLJ) , the man from behind the curtain, coming in 2013.
    Wow! At least that’s what I first thought. However in researching BVA’s history… Only 20% actually Win. 30% are Denied. The remaining 50% go back into the appeal loop with regional.

    What an F N shell game! Not to mention their loss of my paperwork, IME’s, etc.

    So.. hang in there, I have. My only warning to anyone considering joining the service would be… NOT! You become govt. property while you’re in, and just roadside garbage when you’re out! Take Care and good luck to the rest of you.

  9. I’m reading all of these veterans tell their story, having my own story and my own appeal in the long backlog. I feel hopeless and feel like just fucking ending it all now. They don’t give a rats ass about us and we gave our all for them, for a lie at that. I’m so over this. Good Luck my brothers and sisters in getting your claims resolved timely and correctly.

  10. Victor, I served with a guy named Victor, Good People. Not that it has Anything to do with the V.A. Anywho… you’re playing into the VA’s hand. They just want us to go away or die. Fuck em! Keep going! DO NOT Peter out now brudda!! I’ve been at it since 1980 and I think I’m FINALLY gonna break their barrier. I Think!! When you start talking that bullshit about ending it Now.. they win, You lose and I don’t want to hear it. If you want some help or insight, reply back to this and I’ll do the Vulcan Mindmelt with you and let you have what information I’ve learned over these last 33 years while waiting. Until then.. pull up your boot straps, put your big girl panties on, and just smile at em. Hopefully you’ll reply back if you want some help. Talk to you then. Ron

    • Ron all i can say is that i found you coment very inspiring i am OIF vet and have been fighting the va for my benefits since 2010 i got some of my claims approved in june and i am waiting on a DRO since november 2012 i am sure i have a long wait ahead but i wont give up that easy

      Semper Fi

      • Hector, I apreciate your reply man. I’m still waiting since I posted my last response. I don’t care. They’re NOT gonna beat me! That’s one of the things I did learn while on duty… Hurry Up And Wait. Otherwise… anyone else reading these post.. I suggest the same. You all Take Care!

  11. I am a veteran waiting on an appeal. I also work for Social Security, which is incredibly disheartening. Not only are the SSA claims decided, appealed and paid out faster, but they have better service and contact. Even for the SSI portion of disability (which is entirely welfare, paid to people who have never worked significantly), a person has there first decision in 2-4 months, and if denied, an appeal decision in just 2-4 more months. Not to mention the fact that a claimant can call SSA and have their claim process and status explained in great detail, by the person actually making the decision on the claim. A veteran, who has agreed to sacrifice their life to this country if it comes down to it, can generally not even talk to a representative on the phone about their claim, without ridiculous wait times! We should have at the very least, the same rights as welfare recipients.

    • My thoughts on your article Joan, are that you summed our present plight succinctly, as I am now over 2 years/ 2 months and counting for a decision. I called, wrote, and visited the VA Bay Pines, and was told that “that is about the right amount of time for a first time decision…” I said “but this is not my first appeal/NOD, my case has been through the entire process since 2000 3 times and Washington BVA.” She said well you are now listed as a “first time applicant” I tried to find out how that happened, and she said you should be hearing something within a couple of weeks…” That was almost a month ago. I am quite sure there are worse stories out there- that is the sad news, and people that are worse off than you and I who are going through this same ludicrous process, while our government pays foreign terrorist governments billions of $$$$ such as Pakistan (terrorist sponsor government) and Iraq where we had over $100 billion unaccounted for that went to supposedly pay for there power/grid and basic services infrastructure to be put back on line. Wall Street bailouts for white collar criminals who mismanaged funds and got bonuses for doing so, but that is our country, and what we vote for and that is the only chance we have other than the newspapers and news stations to try for change. And now, even those are controlled by those with political agendas, so getting a story printed there by someone who does not have a dog in their fight, is nearly impossible.
      My representative organization is American Legion, and they seem to be about as full of fight as the Pillsbury doughboy. What is needed is an organization which does not kiss the VA’s ass. That totally has the interest of vets with legitimate vetted claims at heart, and will get national news attention showing how those that have been elected ignore, and even work against vets with their votes.This new “organization” would make those records public in the news so that all of us can see who voted how on referendum and laws that would have mandated expedited monies for the massive increase in soldier care brought on by 2 recent wars which never really received an increase in monies beyond what was there trying to lamely keep up with the remaining issues from WWII, Korea, Vietnam, Persian Gulf Wars, and recent wars of Iraq, and Afghanistan.
      I doubt that anyone that would have the heart for this kind of fight, would have the resources/money it would take to stand against all the bureaucrats to be found hiding in their offices behind anonymity of not requiring their records to be made public on critical votes.
      Veterans are tough, and don’t whine, they also are proud and afraid of asking for something for themselves. It serves them well in the service, because they don’t ask for much, and only ask that once in awhile they are treated with some respect. But when they get out, and are discarded, they are reluctant to ask for what they are owed by the government, because they are afraid that they will take something from someone who needs it more than they do. But these rights and their specifics are even mandated in the C.F.R. 38 with specific guidelines defining them right down to each and every malady. Their descriptions of what compensation for it by definition for degree to angle, output, function or lack there of for muscles, limbs, nerves, volume, and even sound, and mental function. You would think that it could be done fairly, but this would require oversight. That is where it all falls down. We have the fox literally in charge of the hen house with the VA. They evaluate initially, then they “interpret”, then they “dispense” based on their findings. Then if we don’t like the outcome, guess who looks at our “appeal/NOD”?
      Sadly, you now know how it all works, and that we probably are at their mercy except for one thing that causes a fair outcome once in awhile- that is resilience. If we don’t quit, and keep coming back time after time with facts, evidence and logic; someone eventually may see the legitimate claim that has been mishandled, and overule all the wrong decisions. Sadly, it might cost him/her their job. No one likes someone who points out all the names that are on a file that has their name on it that was “wrongly intrepreted” and probably gets in the news because of the settlement owed.

  12. After reading how long some of my brothers here have waited, I hate to even complain.. I filed a NOD 18 months ago with the Nashville regional office and have heard absolutely nothing.. I did use IRIS to inquire once, months ago and was told it takes 272 days just for a claims worker to even look at my nod. When I filed the NOD, they said it takes 150 days to get a statement of case. That somehow grew to almost double in a few months. Not looking foreward to the wait some of you have been thru. Also wanted to mention a claims rater who commented on an article in stars and stripes last year. She told the truth, they don’t like us vets very much. They should earn that without us, they would not have a job. In a worse world without us, they would be living in a communist or fascist nation.. The VA is two very different entities. The healt care I find is excellent.. The compensation part is pure crap.. Good luck all..

  13. There are only two ways to control behavior – REWARD and PUNISHMENT. Congress and everyone else has rewarded the bad behavior of the VA Administration in handling veteran benefits claims and appeals by giving them more money, more employees more of everything. STOP GIVING THESE LAZY EMPLOYEES MORE ANYTHING. You are rewarding bad behavior. Start punishing them for their laziness in processing claims and appeals and you will see good behavior. Legislate quotas and deadlines and take away money and employee benefits for anyone not performing up to expected behavior. Psychology 101

  14. I was told by my lawyer that a decision was made on my appeal also that’s what it says on VA web site. my lawyer told me I should hear something in 14 days its going on 2 months still nothing. how long does it take if they already made a decision. my god its been going on since 2010 we have lost our truck have done without. while they sit on there ass and do nothing.

    • i filed 18 months ago and have not been notified in any way since, then on ebenefjts they say a decision was made on 4/19/13 and that a letter was sent to me and my amvet representive. still no letter 41/2 months later. ebenefits also srated my file and records have been returned to another va facility. they have many different ways to lie to us. what ever their tea party republican is telling them to do.

  15. I started my claim in 2006 and now my claim just reached the VLJ last month. No one seems to care or even disturbed at the VA about how long it has taken. I was even discharged from the military for the conditions that I am seeking an increase for. Social Security approved my SSDI Claim in 2 months. I’m not sure whats going on with them, but thank good I have my family to help take care of me. Its so odd that I was injured in the military during desert storm but my family has to take care of me.

  16. Waiting in texas, since 2006, this is what va wants deny,deny,until you die, now va want have to pay,they are pure ass holes, and will go to hell for what they are doing!!!

Comments are closed.