WSJ Says New VA Disability Calculators Too Veteran Friendly
Wall Street Journal, the newspaper of the 1%, criticized the new VA disability calculator speeding up claims. Some VA employees came forward to complain that the new system rates veterans too favorably.
If nothing else, this unwitting story verifies that VA is moving toward a model that likely will utilize artificial intelligence to adjudicate claims. VA recently approved using IBM Watson to data sift through veterans electronic medical records. Now that claims applications are formalized, the jump to using artificial intel software should be easier.
RELATED: IBM Watson To Fix VA Electronic Health Care System
But can you believe Wall Street Journal and certain scrooge VA employees are blowing the whistle on this one?
Current VA employees were cited by the Journal as the primary source of the story. Those employees claim the new software technology results in a very small percentage (2%) of exaggerated claims getting affirmed instead of denied:
Mark Adams, 64 years old, who reviewed disability claims at the Wichita Veterans Affairs Regional Office in Kansas for more than two decades before retiring in 2012, said he conducted an experiment shortly after his office adopted the new software. Selecting a mental-health case at random, he entered into the computer only the vet’s reported symptoms. Less than three minutes later, the program gave him a 70% disability evaluation.
Mr. Adams then deleted the result and started over, this time spending an hour feeding the computer the vet’s reported symptoms and five narrative pieces of evidence from the claims file, including medical treatment records that “did not support the severity of [the patient’s] symptoms.” The computer instantly returned the same 70% rating.
Without the software, Mr. Adams estimates that a human rater would have determined the vet was only 30% disabled.
“Moving checked [symptom] boxes from one place to another,” he said of his work under the new system. “A monkey could do it.”
Wall Street Journal was allowed to manually review one veteran’s claim. That veteran suffered from PTSD:
In one claim reviewed by The Wall Street Journal, a veteran admitted to his VA psychologist that he was capable of working, but preferred to “do nothing but watch TV movies or play video games” and “use marijuana all day every day.”
While these details were described in the examiner’s comments, the computer program—considering only the reported symptoms on the claim—returned a 70% rating for post-traumatic stress disorder. When the rater evaluating the case overrode the program’s recommendation and denied the claim, he received an error call.
VA employees cited by the Journal complained that the new system discourages VA employees from being excessively critical:
Because overrides are flagged and sent directly to the VA’s central office, raters said they have an incentive to follow the program’s recommendation at the risk of attracting complaints. VA officials said overrides are reported to locate defects and identify further training opportunities.
Apparently, 2% of 1.4 million decisions were overridden by rating officials overseeing the process. Somehow, these a-hole employees are unhappy about the newer, faster system and would rather veterans endure the even higher rate of unlawfully negative, slower ratings that victimized disabled veterans in the past.
Do you think these employees Wall Street Journal interviewed should eat cud? I do. Is 2% call for more critical review or a sign that these stiff lipped employees should lighten up?
UPDATE, 5/13/15, 9:57 AM: I filed a FOIA request for any permission granted to the WSJ reporter to access the veteran’s mental health care records for the purpose of the slam piece. Absent permission, I requested copies of any complaint filed regarding the potential HIPAA violation. See WSJ FOIA request from my company, Armo Press, LLC. This website falls under the Armo Press banner.
Timely article , I learned a lot from the specifics , Does anyone know where my company can grab a template form document to fill out ?
05/18/2015
Dear Benjamin Krause,
namnibor 05/13/15:
“These are the SAME CROOKS that ROBBED AMERICA while maintaining a crocodile smile all the way to the bank. What a 100% Svc. Connected Disabled Veteran receives $$$ yearly is akin to what those same 1% would spend on PART of a weekend vacation in the Hamptons or wining and dining their ‘friends in D.C.”…this is so laughable that again, you just cannot make this CRAP UP!!”
“The sane follows the insane, and the insane follows the criminally insane.”—Don Karg years ago.
That is right —you cannot make this CRAP UP!
Wall Street Journal is different now since the Family was told what was going on and then they sold the business a few years back. Who knew how low Journalism was going to get—back in 1988, except those two guys in a machine shop in Torrance, California [Karlheinz Halter is now dead after all the mis-treatments—“the 40 year war”].
America is finding out the “other shoe will be dropping” soon [a few years in between] as the Market hits new records.
namnibor 05/13/15:
“‘A monkey could do it’…that statement in story by a long time VA Claims Examiner almost made me choke on my coffee this morning. Monkeys at least would not require a Union and would be higher intelligence than what we currently have to endure! LOL!”
If the intent is criminal from the start–what part do you not get!
They are committing Genocide. Back in Torrance, CA the Assistant City attorney [Clark/1988/$1 Million] stated to Halter and I, “This office does not investigate Genocide!” I stated to her What the Fuck does that have to do with an Aerospace Crime [1998 Cox Report]?
Was I Stupid——Mentioned that at my workplace a few days ago—-now I have time to write Mr, Krause once again.
Sincerely,
Don Karg
I tried to locate my military medical files and my VA medical files a few years ago. Military records told me that the VA had my military records. I wrote letters requesting them from every VA facility I had visited, NC, TX, AZ, FL, SC and AL. to file a claim. No one had them. A few years later a VA representative called me about a claim I had submitted. I told him that I couldn’t locate my military records. He said wait a minute, within one minute he said we have them do you want a copy? I now have a copy.
The VA sent me a letter for a physical. While the VA doctor was looking at his computer he asked me about every VA facility I had visited over the last 22 years. Funny no one could find them before.
A note about the doctor a saw, he was very good, I will return to see him. I finally received hearing aids from the VA but still trying to get disability for hearing. Thirty years of jet engines was not good. First 2-3 years with no ear protection.
I’m a retired ( January 92 ) CMSGT with over 30 years active duty.
Anything to speed up claims. I have three claims for herbicide exposure that were denied. It is obvious the VA did not even read the claims because the reasons for denial were flat wrong or violated fed regulations. I was at a reunion where 35 percent of the veterans attending have the same problem. Claim delays stretch into years. The VA hopes if they delay long enough, us Vietnam vets will all die off.
im sorry man, we will right this wrong using international veteran power. we have a duty to stop war.
I agree with the Harvard professor who recommended legitimate claims be approved on objective criteria for which the veteran has documented proof. Under her plan, random investigations would be made to dissuade fraud.
On the topic of raters, one of them went through my medical file and denied a condition for which I made no claim, yet seemed of sufficient seriousness that I one day might. I understand this is common. This is the same rater who could not make the distinction between a twin-engine jet aircraft (A-3 Skywarrior) and a Sea King helicopter.
I have found that explaining naval operations and circumstances to anyone at VA is futile; and that claims based on such information are likely to be denied. It is amazing, nevertheless, to read them lying about situations and concepts of which they have no practical nor even academic knowledge.
Good report Ben.
Rating a case only by a veteran’s reported symptoms creates an entire population of veterans who merely need to memorize the rating criteria for 100% to repeat to the examining physician. This destroys the integrity of the adjudication system. In any decision making system corroboration is essential. This is equivalent to a murder defendant merely testifying that he “did not do it” to get a not guilty verdict. The notion that AI should evaluate claims is preposterous and dangerous.
ericman, the thing that is preposterous and dangerous is the raters in the VA disability system. They will deny a claim that is a “slam dunk” guarantee of a rating. I know many vets who have the needed words in print in their medical records and they still get denied. This may not be the best system and it may need some tweaking but this sounds as if it may be a better system. If you have ever had to go through the current system and fight it for five years as I have, then you will know how terrible the current system is and how crooked and unfair it is.
Another VA rater heard from. You only assume some untrustworthy vet will be speaking into a microphone without a doctor present verifying the reported symptoms have a medical basis. I would much rather have a doctor check a box verifying reported symptoms so AI could provide a rating in totality and accounting for all rather than relying on some VA flunky determining one symptom applies, but another should be ignored resulting in a lower rating. In addition, it would provide a paper trail. My own claim was denied 3 times over several years. When the VA finally took a serious look at it, the rater admitted my file was so messed up it looked like nobody had ever looked at it. She would not respond when I said the VA had denied it 3 times.
Let me just say this, as I pretty much agree with all the comments people have posted before me. I would damn sure welcome this computer rating MY claim!
Rather than being appalled at the issues involved, if the error rate is only 2%, the VA should be briefing this at every opportunity! That is quite stellar!
The real issue is that eventually, rating decisions will be made almost entirely by the computer based on regulated, clear and up to date processes – negating the variability introduced by rating officials,with their human biases and fallibility. The biggest, and best, part of the automated system is that there is an audit trail of what and how decisions were made – something that cannot be completely documented when a human makes decisions.
The article is certainly a hit job – When I read the portion that said “Due to an additional technicality, the veteran ultimately was granted a 100% disability rating. He currently receives more than $3,100 a month from the VA.”…yes, that technicality is either additional disabilities or Individual Unemployability! So, not a ‘technicality at all’, but rather something that was properly adjudicated.
I have been very lucky to have rating officials that followed the rules, with only an appeal here and there, but part of the luck is what Ben advises – make sure you lay out the current disabilities, the cause and the service connection using the VA’s own terminology. Sure, it takes some work, but only the Veteran, or his advocate, knows and understands the issues.
Good job Ben, in requesting FOIA to see just “HOW” the WSJ were ever allowed to view a Veteran’s mental health and other medical files…I would think the veteran(s) whom these files belonged to would have had to have specifically given them permission to look at their files. I would have thought either the VA’s attorneys, or even the WSJ counsel would have made SURE to state in such a news story that no HIPPA violations were committed since they obtained in writing the Veteran(s) permission(s). I am betting they did not even bother and definitely violated HIPPA Laws here.
We also need to remember that regardless of how ADVANCED “Watson” may be, ANY computer system is entirely DEPENDENT on the ACURACY of data FED INTO IT. That tells me the VA will simply only feed part of the facts or erroneous facts, since they already feel ‘Watson” is too much in a veteran’s “favor”.
This article today is SO revealing of just how deceptive the VA Examiners indeed are because they seemed “put out” that Watson gave proper ratings, and in 3 minutes can do what the VA would manage to take 3 YEARS, at best. Yeah, this is all about job security, never mind the fact that Disabled Veterans cannot easily work at all due to chronic health issues. Self-absorbed…all of these VA Monkeys.
Most if not all va records including the c files are electronic according to my vso. She also mentioned the va allowing them to have access to view the entire claim.
Daniel, I would highly recommend that you get a hard copy of your medical records and your C-file. The electronic records do not have everything in them that the paper version do. I don’t know how your VSO is but remember to look out for number one. I received an increase in my disability claim after five years of denials because I done the work and put together my own version and presented it at my VBA hearing. My VSO had no knowledge of this until we were in there and she was failing so bad. She flat out lied to me and if I would have went with only what she was trying to sell me, I would have received nothing. I always get a hard coly of my medical records every so often. I also get a copy of all of my X-rays and anything else the VA does to me.
Just my two cents worth.
Without knowing more about this software, I would lean towards the software rating being much more accurate based on some educated assumptions. If the software is using keywords and is comparing them to what is in the law, how can it be less accurate than some flunky looking at a claim for months who may not be current on recent laws passed? Software like this is used in many other federal applications, and if it is good enough for them, it should be good enough for vets. I get the sense these VA employees are concerned about their union jobs going away rather than any concern for the taxpayer. I also get the sense that many are worried about it being proven how lousy they are at their job. If they truly were concerned about money being wasted, there are hundreds of other things they could look at and save many millions more…the Denver VA being but one example. Now, will any of these “whistle blowers” be harrassed and fired? Or was this an authorized hit?
Good on ya Ben for filing that FOIA. It will be interesting to hear what their response will be.
Now is this Watson System for PTSD claims only or for all claims? I think the WSJ should investigate all the EBT money that the government shells out every year and brings in more illegals to spread the wealth even more.
Where was this machine when I filed last year? I filed immediately after discharge from the AF, after 36 years service; only to get low balled to 20% and told the rest was not done while in the military. What the heck?
Sounds like at least this machine would give you a fair chance over a VA rater who is looking forward to low balling or screwing with you.
I’m curious. Lowballed at 20%. Did someone get a bonus for that low rating? Do your military records show treatment for conditions denied? Any bets on whether a computer and software gets a bonus?
APPEAL APPEAL APPEAL! Them in writing why they’re wrong; forward Military medical notes
If being an idiot was a service connect disability; this guy would be 110% P&T! That being said… Saying one thing and doing another is a different story. There are many totally disabled VETS that would like to be in the workforce and even think they could be. Some even wonder if they are truly disabled because of this, but the fact of the matter is once they’re put in situations that any employment calls for; their service connected disabilities start rearing their ugly heads. Weather it’s PTSD or a bad back; being able to stay at home to manage these conditions are mush more suitable than struggling thru and being unable to meet the demands of employment. Unemployability and disability all come down to weather or not a person (Veteran) can maintain gainful employment on a consistent basis. Sadly, the WSJ’s rhetoric is twisting and purposefully leaving out these facts
Did ANYONE else focus on the fact that in the first case that the answer of 70% came back in just 3 minutes then the VA rater (who is supposed to be a veteran advocate) spent over an hour trying to prove it wrong? Do they think this is a game? No wonder it takes them years to work claims
It take the machine three minutes to do what a “rater” can do in an hour. I think that is the real problem. If the raters can’t take all of this time (an hour+) and complain that they need overtime and then make it looks as if they are doing so good that they deserve bonuses in excess of what many of us get in a year then they will lose their jobs. The VA can’t have them loosing their jobs. We can if it means we will get rated fairly. Imagine getting rated within a year or sooner. Not having to appeal and appeal until so many years have gone by and the VA is still hoping that us vets will give up.
Once upon a time the WSJ was the most un-biased and factual newspaper out there. Then Murdock bought it… Personally I would love for these jackasses to actually have to pay out what the law actually requires instead of some one size fits all disability system. Any salary finder type program I have ever checked has me making at least $90,000 a year for my education and experience level, or about 4X what the VA pays even at 100%, and a damn sight more than these self-admitted MONKEYS that the VA employes…
But of course. A new system is developed which speeds up claims (thus saving money), while giving a veteran a snowball’s chance in hell against an adversarially stacked system, and people with no personal stake in the matter (WSJ) have to bitch about it. They have no idea how hard the average veteran works to prove a very basic and obvious claim for a minimal rating. Up until now, it feels like beating our heads against a wall.
I am HIGHLY suspicious *anytime* the likes of The Wall Street Journal (indeed, the 1% readership), would be taking ANY interest in Veteran’s Affairs, let ALONE being allowed to VIEW a “few Veteran’s Files”..WTF? Was that alone a HIPPA violation?
This just shows we veterans are viewed upon by the 1% as nothing *more or less* than Insurance Liabilities to their investments and war-profiteering. Maybe they should just start sending “Watson Robots” to fight their damn wars as well?
The fact that a “few VA Empoyees” think the new Disability Rating System is “too much in Veteran’s favor”, well, that speaks VOLUMES! They obviously forgot that little part of giving the Veteran the BENEFIT OF DOUBT…which is wrongfully interpreted by the VA Examiners as “Always Doubt The Veteran”, then DENY, LIE, HOPE TO DIE.
Since we KNOW VA Employees are ONLY $$ motivated by bonuses, OF COURSE they are going to be upset when they see their potential for BONU$ PAYOUT diminished when a computer is fed THE FACTS and GRANTS BENEFITS in favor of the Veteran!!!
This article should be read to the Congressional Veteran’s Oversight Committee by Rep. Jeff Miller to the handful of big cheeses of the VA to show how this article alone just shows how *adversarial* the VA is towards Veterans. If not for Vets these lackadaisical whining VA employees would NOT have a job in first place!
Unfortunately, what will more than likely come of this is the “Stockholders” will demand that “Watson Be Tweaked In Line With Current VA Vulture Culture”, rather than speaking THE TRUTH. Or…the VA will MANIPULATE THE DATA THEY FEED INTO “WATSON” TO ENSURE PROPER DENIALS.
Here’s a novel idea: How about letting “Watson” do ALL THE VA OIG WORK and PUT THE CRIMINALS IN PRISON and give the VA System an employee enema?
If the real human VA Employees actually FOLLOWED THEIR OWN REGULATIONS as they were INTENDED, BILLION$ would not need to be spent on IBM/Halliburton Contractors in first place??!!
This again, is the VA playing their passive-aggressive game since due to technology that allows us to more freely communicate ALSO is being utilized to hold the VA accountable AND report their dangerous and malicious acts on Veterans ALL OVER…so the VA is acting like an entitled snobbish kid that’s not being allowed to have things kept as the status-quo. These VA Employees are again acting as if it’s THEIR $$$ being loss if any Veteran is given a realistic and proper Disability rating accordingly to the VERY Regulations they willfully and systemically ignore AND manipulate.
Notice how this story seems to revolve around just how the VA Examiners and Wall Street Suits are actually ALREADY trying to MANIPULATE “WATSON”? These same 1% folk would be singing a complete song and dance if there was a DRAFT and their precious silver-spoon-fed offspring were having to return BROKEN and experience what we “commoners called Veterans have had to endure”.
That’s why I think the most SIMPLE and FAST CHANGES FOR BETTER in ALL of the VA System would most likely occur if EVERY MEMBER OF CONGRESS AND GOV’T EMPLOYEES WERE *MANDATED TO USE THE VA FOR THEIR MEDICAL*, because they are self-serving bastards. The very fact that they MADE SURE to be made EXEMPT from Affordable Care Act…ALL OF THEM…is the proverbial proof in the pudding.
Ben…again…WHY were Wall Street eyes even ALLOWED on a “few Veteran’s Claim Files” in first place? Seems the 1% would rather that all the soldiers simply died when sent to battle in order to lower or eliminate their “overhead” or real human lives messed-up from the very wars they send us into.
If we Veterans somehow could crap crude oil…well, then we would be considered ASSETS. Again, where’s the MIA VA Secretary and Undersecretary in this story? I bet if Senator McCain *had* to use the VA in Phoenix as his ONLY healthcare, you would see this mess now in rear view mirror perspective. ALL self-serving assholes.
“A monkey could do it”…that statement in story by a long time VA Claims Examiner almost made me choke on my coffee this morning. Monkeys at least would not require a Union and would be higher intelligence than what we currently have to endure! LOL!
I really believe…the VA hires and always has from sources like the Home Depot…most of those handling our claim’s can’t seem to connect the dots so, maybe a machine will may be a intelligent change, it can’t be racial, bigotry, and all around dumbshittery that is most common in the entire VA System…so it seems anyway! FTVA!
There is still the neanderthal thinking that VA examiners have towards veterans disability symptoms. I found out the hard way that these examiners will consistently low ball you on your disability, your symptoms, your rating, and everything else they can. Including your character. VA examiners sling mud on you and also demonize you in order to affect as low a rating as possible or a claim denial. I have no respect for a lot of them!
Yeah, even if the VA were to fully embrace the “Watson Computer”, *nothing* would prevent shredding Veteran’s Claims and manipulating and lying on the data FED INTO such a system.
Why do they not just follow the quite detailed Regulations on Rating Disabilities in first place instead of their damn “interpretation of them”?
Wall Street has absolutely NO BUSINESS looking at Veteran’ Case Files…period!
These are the SAME CROOKS that ROBBED AMERICA while maintaining a crocodile smile all the way to the bank. What a 100% Svc. Connected Disabled Veteran receives $$$ yearly is akin to what those same 1% would spend on PART of a weekend vacation in the Hamptons or wining and dining their ‘friends in D.C.”…this is so laughable that again, you just cannot make this CRAP UP!!