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Complicated claims slow down VA payments

Aug. 27, 2012 - 10:04AM   |  
By RICK MAZE   |   Comments
U.S. soldiers from 4th platoon Alpha company 5/2 ID Stryker Brigade Combat Team (SBCT) 1-17 infantry batallion patrol May 11, 2010, in Shahwali Kot district Kandahar. The VA has seen a surge in disability claims for Iraq and Afghanistan veterans.
U.S. soldiers from 4th platoon Alpha company 5/2 ID Stryker Brigade Combat Team (SBCT) 1-17 infantry batallion patrol May 11, 2010, in Shahwali Kot district Kandahar. The VA has seen a surge in disability claims for Iraq and Afghanistan veterans. (Tauseef Mustafa / AFP)

More complex disability claims filed by new veterans and supplemental claims for increased benefits appear to be the major factors in the large and still growing backlog of unprocessed claims.

Veterans Affairs Department officials have cited complexity as one reason for a backlog of 866,928 compensation and pension claims piled up at VA regional offices, including 575,711 that are more than 125 days old.

VA data show that Iraq- and Afghanistan-era veterans are averaging slightly more than nine disability issues per claim, far more than any other generation of veterans since World War II.

Gerald Manar of Veterans of Foreign Wars said he has seen claims with up to 75 separate disability issues — and has heard of one that lists 125 disabilities.

“It looks like some people are going through their medical and personnel records and writing down every time they went to the clinic and every time they saw a corpsman, for a splinter or for something more serious, because they don’t want to leave anything out,” said Manar, deputy director of VFW’s national veterans service.

Iraq and Afghanistan veterans are filing claims with more total disabilities for several reasons, Manar said.

For one thing, these wars have seen much greater use of National Guard and reserve troops than earlier conflicts. Reservists “tend to be older than their active-duty counterparts, making them more subject to wear and tear on their bodies,” Manar said.

He also noted that many troops deployed multiple times to Iraq or Afghanistan or both, while most Vietnam vets — whose claims average less than six disability issues — deployed for one year and then left active duty.

“More deployments means they are subject to greater opportunity to be exposed to [improvised explosive devices] and other hazards,” he said. “The greater time deployed, the greater opportunity for injury.”

Joe Violante of Disabled American Veterans said another factor in claims complexity is outreach.

“When I got out, I barely knew what benefits were available. Today, there is a big difference in awareness,” said Violante, DAV’s national legislative director and a Marine Corps veteran who left service in 1972.

Pre-separation briefings are making troops smarter about getting service-connected medical conditions documented in their records, Violante said.

“I really don’t think they are whiners,” he said. “These are people doing what they should, and what has been recommended to them, so they can receive the benefits they have earned.”

The general rise in awareness also is reaching veterans of earlier generations with medical problems they may not have thought of as service-connected.

Violante said one Vietnam vet recently called DAV for help on finding a private doctor to work on an artificial limb “because the duct tape he’d been using wasn’t working anymore.” The veteran was surprised to learn VA would help him — if only he would ask.

Neither Violante nor Manar said he believes an increase in mental health-related issues is a major reason Iraq- and Afghanistan-era vets are filing more claims.

That in itself “is not a reason for the backlog,” Violante said. “We know about 20 percent of returning veterans have reported mental health issues, but that is just one of the many disabilities they appear to be claiming.”

Since 2001, claims received by VA have jumped 94 percent, with 1.3 million received in fiscal 2011. VA records also show the number of people involved in processing claims has risen 97 percent over the same period.

Of 866,928 benefits claims pending as of Aug. 18, 37 percent were new. The rest were supplemental claims, mostly from people already getting disability benefits seeking to increase their ratings by adding disabilities or showing their disabilities had worsened.

Only 31 percent of original claims in the backlog are from Iraq- and Afghanistan-era veterans; 30 percent are from Vietnam-era veterans or survivors; 19 percent from veterans of the 1991 Persian Gulf War; and the rest from other generations.

VA records show processing time is slowing. In 2001, the average time to complete a claim was 181 days; that’s now 257 days.

Accuracy on claims decisions also has regressed. In 2001, VA had an 81 percent accuracy rate. VA officials said the rate improved to a peak of 90 percent in 2006 but has slipped to 86 percent today.

Violante said he doesn’t put much faith in VA’s pledge to begin reducing the backlog by 2015.

“We’ve seen a change in mindset in the top leadership of VA to get something done, but I don’t believe the culture that has allowed the backlog to grow has changed,” he said.

Despite some improvements, Manar said, “It still looks like it will be more than 20 years before the backlog is eliminated.”

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