VA Benefit Appeals Overhaul Takes Hold, Aims To Clear Veterans’ Claim Backlog
The Department of Veterans Affairs has implemented a new law designed to speed up the appeals process for disability claims, which often can drag on for years. Some veterans who have experienced those delays are hopeful — but skeptical — about the changes.
The VA estimates it takes three to seven years on average for veterans to get through the appeals process. In an attempt to reduce that, Congress passed the Veterans Appeals Improvement and Modernization Act of 2017. After a pilot phase, in which veterans were given the choice of opting into the new system, the new process officially went live for all new claims Feb. 19.
“Over time our inventory of appeals just kept growing and growing and growing,” said Dave McLenachen, Director of the VA’s Appeals Management Office. “You just can’t keep throwing more resources at it. At some point, you’ve got to revamp the system to make sure it’s more modern, and that’s essentially what we did.”
McLenachen estimates the VA has more than 402,000 appeals pending. About 265,000 of those are in the Veterans Benefits Administration. The rest have been elevated to the Board of Veterans Appeals.
Sam Flores is among the veterans who experienced the old system. The Vice Commander of a San Diego American Legion Post, Flores was medically retired from the Marine Corps in 2010 after being injured by an improvised explosive device in Afghanistan.
“I was in the back of a vehicle, and next thing I knew, I was outside of a vehicle,” Flores said. “It was pretty drastic.”
Six people in the convoy died. Flores is still undergoing treatment.
Flores filed a disability claim, and like all claimants had to prove his disability is tied to military service. The VA then has a complex system for rating how disabled each veteran is. The veteran can appeal the rating.
The VA initially told Flores the blast left him ten percent disabled.
“And I thought that was it,” Flores said. “Then I eventually spoke to somebody when I came into (an American Legion) post, and they said, ‘You should be getting a lot more.’ I didn’t know what that meant. I was just trying to survive.”
Flores filed an appeal, entering the VA’s backlogged and slow-moving appeals system.
Part of the reason for the delays is the high number of claims from veterans who served in Iraq and Afghanistan. But the VA also is still receiving new initial claims from the Vietnam War.
Rick Bridges was a Navy bomber pilot in Vietnam. He was diagnosed with Parkinson’s Disease in 1999.
“I was out jogging with my wife one day and I fell on the sand,” he said. “I didn’t know what happened. She turned around and said, ‘You having trouble keeping up?’“
The VA didn’t recognize Parkinson’s as a byproduct of exposure to the chemical defoliant Agent Orange until 2010. Bridges is in a wheelchair now. Like a lot of veterans, he has filed new claims each time his condition worsened, so his benefits reflect the new level of disability.
Mary Jane Fisher’s claim also has taken years to pursue. She was in the Navy from 1980 to 1992 and experienced military sexual trauma. One of her shore duties was to inspect barracks.
“You didn’t have a weapon, you had a billy club,” Fisher said. “Rape happened. MST happened. You could report it, and it could be ripped out of a log book. And you could prove it, and it wouldn’t show up in a medical record, and things like that occurred.”
To make the process even harder to navigate, Fisher said over the years the VA lost paperwork, including records it had during earlier appeals.
“I’m still fighting it,” she said of her appeal. “It’s not resolved.”
Under the old appeals system, veterans had to wait - generally for years - for a hearing before the Board of Veterans Appeals.
The new system gives veterans more options. They can submit their appeal for a review, in which they can provide new information. Or they can opt for a higher-level review, essentially by a supervisor, or go right to the appeals board. The hope is that the VA can quickly process cases that are ready for rulings, McLenachen said.
The new law gives the VA 125 days to make a decision. Nationwide, the VA has hired and trained another 605 people in addition to the 2100 nationwide who handle appeals, McLenachen said.
The system is still complex. Congress and the VA worked with service organizations such as the American Legion to design the new program. And the VA is relying on veterans’ service officers from those organizations to help guide vets into the lane that is expected to be fastest for their type of claim.
Casey Davis is a full time veterans service officer with the American Legion in San Diego. He is worried the VA won’t meet its aggressive targets.
“Overall, what you have is a VA system that is trying to upgrade, and they waited too long to do it,” Davis said. “They’re trying to do it in the middle of a war that was not expected to drag on to generate hundreds of thousands of more claims.”
During a pilot program, the VA decided new appeals within 130 days on average. The approval rate was roughly the same as under the old system - an indication that VA representatives in the pilot program weren’t denying claims at a higher rate just to meet the tougher deadline, McLenachen said.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.
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