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Announcements: Winning your claim for PTSD Disability Benefits ++much more


Winning your claim for PTSD Disability Benefits ++much more 


Winning your claim for PTSD Disability Benefits

David Anaise, M.D., J.D.

Why are Veterans who file for PTSD Benefits frequently denied?

There are three main reasons which used to cause claims for PTSD to be denied:

1. The rating officer provides a lower rating than is justified by the clinical presentation.

2. The VA concludes that the stressor the veteran experienced was not “an event that is outside the range of usual human experience and would have been markedly distressing to almost anyone.”

3. There is no evidence that the veteran was actually in combat.

These conclusions by the VA are no longer acceptable reasons for denial of benefits!

Recent VA rulings, Court rulings, and the replacement of the DSM-III-R with the DSM-IV as the basis for determination of disability, have dramatically changed the way the VA rates, or should rate, veterans applying for disability benefits. The Department of Veterans’ Affairs has recently published a new manual, “Best Practice Manual for Posttraumatic Stress Disorder (PTSD) Compensation and Pension Examinations.” With the publication of this manual, the VA has declared: “The Veterans’ Benefits Administration (VBA) and Veterans’ Health Administration (VHA) are committed to improving these services to veterans, and improving the quality of compensation and pension examinations for PTSD.” The manual changes many of the assumptions that led to denial of PTSD claims in the past. Review of this manual is thus critical to claimants and their attorneys.

What did the PTSD Study find?

The Veterans’ Benefits Administration reviewed 143 initial claims for PTSD. This study revealed that at least 8% of exams were inadequate. A common problem was that the examiner did not describe how the diagnosis met the rating listed in the manual for mental disorders, the DSM-IV. In fact, it was noted that not only did examiners fail to list the DSM-IV criteria, but some examiners erroneously used the DSM-III-R criteria. For example, the criteria that a veteran had experienced “an event that is outside the range of usual human experience and would have been markedly distressing to almost anyone,” is a DSM-III-R criteria, not a DSM-IV criteria, and is no longer acceptable.

Some other frequent errors sited in this study:

Examiners failed to note whether other mental disorders were due in part to PTSD

Less than half of the examiners had the complete claim file for review

Examiners stated “minor PTSD symptoms” without naming them

The study also noted reluctance by the disability rating experts and the VA to grant 100% disability; the highest rating granted was 70% despite clear indication that the veteran had severe symptoms meriting 100% disability. The authors of the study admonished: “It is no longer correct to say that total incapacitation for anxiety disorder is unusual.”

In addition, it was observed that officers were often denied benefits when the Global Assessment of Functioning (GAF) Scale was 60 (i.e. moderate symptoms), while the committee requires that in cases where the GAF is 60, a 30% disability must be assigned.

Upon review of the study, the committee made the following recommendations:

The clinician-administered PTSD scale CAPS, (Blake et al 1995), is recommended as the interview method of choice for conducting compensation and pension examination. It requires approximately one hour, but may be abbreviated.

Psychometric tests must never be used alone to deny rating for PTSD -- only to supplement and substantiate findings.

Professionals qualified to perform PTSD examinations should have a doctoral level training in psychopathology.

What is Posttraumatic Stress Disorder (PTSD)?

The DSM-IV has replaced the DSM-III-R, which focused solely on combat trauma. The DSM-III-R criteria required, for example, that the veteran had experienced “an event that is outside the range of human experience and would have been markedly distressing to almost anyone.” This criterion is no longer acceptable under the DSM-IV.

The DSM-IV Diagnostic Criteria for PTSD:

a) The person has been exposed to a traumatic event in which both of the following have been present:

1. The person has experienced, witnessed or been confronted with an event or events that involve actual or threatened death or serious injury, or threat to the physical integrity of oneself or others.

2. The person’s response involved intense fear, helplessness, or horror. (They note that assault violence, particularly of a criminal nature, is more likely to induce PTSD than a random act of God. Factors surrounding the traumatic incident, such as absence of social support, may also influence the degree to which the stressful event is experienced.)

b) The traumatic event is persistently re-experienced in one or more of the following ways:

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions

2. Recurrent distressing dreams of the event

3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated)

4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

5. Physiological reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

c) Persistent avoidance of stimuli associated with the trauma

d) Persistent symptoms of increasing arousal (not present before the trauma), indicated by: difficulty in falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hyper-vigilance, exaggerated startle response

e) Duration of the disturbance (symptoms) is more than one month

f) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Does a Veteran need to prove that he was involved in combat?

The most common reason for denial of a well diagnosed PTSD claim, is the VA Rating Officer’s conclusion that the veteran did not prove he was involved in combat. While the focus of PTSD stressors is usually of combat stress, the VA now recognizes that that there are less common, but equally important stressors such as sexual harassment or sexual abuse during service. Duties such as grave registration, morgue assignment, accidents involving injury, and even peacekeeping deployment may meet stressor criteria. What is required in a PTSD claim is that the veteran show that he/she was exposed to a traumatic event during his/her military service, not necessarily combat trauma.

In August 1, 2010, the Veteran Court of Appeals in Cohen v. Brown 94-661 10 vet. App dramatically changed the way PTSD is evaluated and rated. The Board of Veteran Appeals denied Cohen’s request for benefits, because he never served in combat. The Court reversed and held that noncombat stressors described by the veteran were sufficient to cause PTSD.

First, the Court sited that the stressor that caused the veteran to suffer from PTSD need not be unusually traumatic. It is the effect of the stressor on a particular veteran that needs be assessed:

“Under the DSM-IV, the mental illness of PTSD would be treated the same as a physical illness for purposes of VA disability compensation in terms of a predisposition toward development of that condition. For example, the court noted [that the] VA does not deny a service-connection award to a veteran whose lack of good balance causes him to fall and be injured during service even though a serviceperson with better balance would not have been injured at all.”

Second, the Court held the stressor need not be combat stress. The Veteran in Cohen v. Brown testified that while in Vietnam he was not a combat soldier:

“The veteran responded to the RO’s inquiry by explaining that although he was assigned an MOS of power generator equipment mechanic he “never performed these duties” and that “most of [his] duties consisted of convoys, heavy equip[ment] mechanic [and] guard duty”. R. at 82. The military experiences he said he had considered “most terrifying, life threatening, or stressful” included the following: (1) Armed combat or enemy action; (2) mortar and rocket attacks; (3) treating or dealing with casualties; (4) convoys; and (5) many hours of work and lack of sleep.”

Finally, the Court held that the veteran’s lay testimony was sufficient to establish the existence of these stressors.

What stressors must be proven? Concerning the adjudication of claims for PTSD, the VBA’s Adjudication Procedures Manual states:

(1) PTSD does not need to have its onset during combat. For example, vehicular or airplane crashes, large fires, floods, earthquakes, and other disasters would evoke significant distress in most involved veterans. The trauma may be experienced alone (rape or assault) or in the company of groups of people (military combat).

(2) A stressor is not to be limited to just one single episode. A group of experiences also may affect an individual, leading to a diagnosis of PTSD. In some circumstances, for example, assignment to a grave registration unit, burn care unit, or liberation of internment camps could have a cumulative effect of powerful, distressing experiences essential to the diagnosis of PTSD.

(3) PTSD can be caused by events that occurred before, during, or after service. The relationship between stressors during military service and current problems/symptoms will govern the question of service connection. Symptoms must have a clear relationship to the military stressor as described in the medical records.

(4) PTSD can occur hours, months, or years after a military stressor. Despite this long latent period, service-connected PTSD may be recognizable by a relevant association between the stressor and the current presentation of symptoms. This association between stressor and symptoms must be specifically addressed in the VA examination report and to a practical extent supported by documentation.

(5) Every decision involving the issue of service connection for PTSD alleged to have occurred as a result of combat must include a factual determination as to whether or not the veteran was engaged in combat, including the reasons or bases for that finding. (See Gaines v. West, 11 Vet. App. 113 (1998))

What evidence is needed to prove combat stressors?

The following conclusive evidence is sufficient to prove combat stressors:

Any evidence available from the service department indicating that the veteran served in the area in which the stressful event is alleged to have occurred and any evidence supporting the description of the event are to be made part of the record. Corroborating evidence of a stressor is not restricted to service records, but may be obtained from other sources (see Doran v. Brown, 6 Vet. App. 283 (1994)). If the claimed stressor is related to combat, in the absence of information to the contrary, receipt of any of the following individual decorations will be considered evidence of participation in a stressful episode:

Air Force Cross

Air Medal with “V” Device

Army Commendation Medal with “V” Device

Bronze Star Medal with “V” Device

Combat Action Ribbon

Combat Infantryman Badge

Combat Medical Badge

Distinguished Flying Cross

Distinguished Service Cross

Joint Service Commendation Medal with “V” Device

Medal of Honor

Navy Commendation Medal with “V” Device

Navy Cross

Purple Heart

Silver Star

Other supportive evidence includes, but is not limited to: plane crash, ship sinking, explosion, rape or assault, duty in a burn ward or in a grave registration unit. POW status, which satisfies the requirements of 38 CFR 3.1(y), will also be considered conclusive evidence of an in-service stressor.

What evidence is required to prove a Personal or Sexual Assault?

Cases involving PTSD as a result of a personal or sexual assault pose a particular problem. Evidence of personal assault may be lacking. The examiner must look at other supporting documents that may prove the existence of a stressor; a visit to a medical or counseling clinic without a specific diagnosis, or a specific ailment, or a sudden request for transfer, may suggest the existence of a sexual assault. Lay statement regarding leave without absence, change in performance, episode of depression by lay statement, increased or decreased use of prescription medication or over-the-counter medication, evidence of substance abuse such as alcohol, and unexplained economic or social behavior changes, may all point to the occurrence of a specific traumatic experience.

Personal assault is an event of human design that threatens or inflicts harm. Examples of personal assault are rape, physical assault, domestic battery, robbery, mugging, and stalking. If the military record contains no documentation that a personal assault occurred, alternative evidence might still establish an in-service stressful incident. Behavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor.

Examples of behavior changes that may indicate a stressor include (but are not limited to):

• Visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment

• Sudden requests that the veteran’s military occupational series or duty assignment be changed without other justification

• Lay statements indicating increased use or abuse of leave without any apparent reason such as family obligations or family illness

• Changes in performance and performance evaluations

• Lay statements describing episodes of depression, panic attacks, or anxiety, but no identifiable reasons for the episodes

• Increased or decreased use of prescription medications

• Increased use of over-the-counter medications

• Evidence of substance abuse such as alcohol or drugs

• Increased disregard for military or civilian authority

• Obsessive behavior such as overeating or under eating

• Pregnancy tests around the time of the incident

• Increased interest in tests for HIV or sexually transmitted diseases

• Unexplained economic or social behavior changes

• Treatment for physical injuries around the time of the claimed trauma, but not reported as a result of the trauma

• Breakup of a primary relationship

In personal assault claims, secondary evidence may need interpretation by a clinician, especially if it involves behavior changes. Evidence that documents such behavior changes may require interpretation in relationship to the medical diagnosis by a VA neuropsychiatric physician.

Is the Veteran’s own testimony sufficient to establish a stressor?

A combat veteran’s lay testimony alone may establish an in-service stressor for purposes of service connecting PTSD (Cohen v. Brown, 94-661 (U.S. Ct. Vet. App. March 7, 1997)). However, a noncombat veteran’s testimony alone does not qualify as “credible supporting evidence” of the occurrence of an in-service stressor as required by 38 CFR 3.304(f). After-the-fact psychiatric analyses which infer a traumatic event are likewise insufficient in this regard (Moreau v. Brown, 9 Vet. App. 389 (1996)).

What other evidence may assist in establishing a stressor?

A stressor is not limited to just a single episode; a group of experiences, such an assignment to a Grave Registration Unit, or a Burn Care Unit have a cumulative effect that can result in PTSD.

PTSD can be due to events, which occur before, during or after service, and not specifically in relationship to the military stressors. PTSD may present after a long latent period; even years. Thus the rating examiner must not restrict the search for corroborating evidence of stressors to service records; other sources must be looked at as well.

In Doran v. Brown, 6 Vet. App. 283, 290-91 (1994), the U.S. Court of Appeals for Veterans Claims (Court) stated, "the absence of corroboration in the service records, when there is nothing in the available records that is inconsistent with other evidence, does not relieve the BVA of its obligations to assess the credibility and probative value of the other evidence." In Doran, the Court cited a provision of the VA ADJUDICATION PROCEDURE MANUAL M21-1 to read, in part, that "[C]orroborating evidence of a stressor is not restricted to service records, but may be obtained from other sources."

The evidence necessary to establish the occurrence of a recognizable stressor during service - to support a diagnosis of PTSD - will vary depending upon whether the veteran engaged in "combat with the enemy," as established by recognized military combat citations or other official records. See, e.g., Hayes v. Brown, 5 Vet. App. 60, 66 (1993); Doran v. Brown, 6 Vet. App. 283, 289 (1994).

When there is a current diagnosis of PTSD, the sufficiency of the claimed in-service stressor is presumed. Cohen, 10 Vet. App. at 144. Nevertheless, credible evidence that the claimed in-service stressor actually occurred is still required. 38 C.F.R. § 3.304(f). And credible supporting evidence of the actual occurrence of an in-service stressor cannot consist solely of after-the-fact medical nexus evidence. See Moreau v. Brown, 9 Vet. App. 389, 396 (1996). Corroboration does not require, however, "that there be corroboration of every detail including the appellant's personal participation in the identifying process." Suozzi v. Brown, 10 Vet. App. 307, 311 (1997).

Mere presence in a combat zone is not sufficient to show that a veteran actually engaged in combat with enemy forces. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991), affirmed on reconsideration, 1 Vet. App. 406 (1991). On the other hand, whether a veteran has submitted sufficient corroborative evidence of claimed in-service stressors is a factual determination. Pentecost v. Principi, 16 Vet. App. 124 (2002). And in both Pentecost and Suozzi, it was held that specific evidence that a veteran was actually with his unit at the time of an attack is not required to verify that attack as a PTSD stressor. Pentecost, 16 Vet. App. at 128 (holding that the Board erred in "insisting that there be corroboration of the veteran's personal participation"); Suozzi, 10 Vet. App. 310-11 (evidence that veteran's company received heavy casualties during an attack, even without specific evidence that the veteran was "integrally involved in the attack" was sufficient to reopen his claim for service connection for PTSD).

Pursuant to the holdings in Pentecost and Suozzi, there does not need to be corroboration of each and every detail of a veteran's personal participation in the alleged combat activity in Vietnam. Rather, the mere fact that his unit was involved in that combat activity is reason enough, alone, to presume that he experienced the type of stressor alleged in that capacity. Thus, his combat stressor must be conceded, particularly when all reasonable doubt is resolved in his favor concerning this. See 38 C.F.R. § 3.102; Alemany v. Brown, 9 Vet. App. 518, 519 (1996).

Alcohol and Drug Abuse in PTSD cases

The VA is prohibited by statute, 38 U.S.C. § 1110, from paying compensation to a veteran whose disability is a result of his own alcohol and drug abuse. However, when a veteran’s alcohol or drug abuse disability is secondary to or is a result of or aggravated by a primary service-connected disorder, the veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001). Therefore, it is important to determine the relationship, if any, between a service-connected disorder and a disability resulting from the veteran’s alcohol or drug abuse. The rating officer should separate, to the extent possible, the effects of the alcohol or drug abuse from the effects of the other mental disorder(s). If it is not possible to separate the effects in such cases, an explanation must be given.

In Allen v. Principi, 237 F.3d 1368 (Fed. Cir., 2001) the Court held:

“We therefore conclude, based on the language of the statute and the pertinent legislative history, that 38 U.S.C. § 1110 does not preclude compensation for an alcohol or drug abuse disability secondary to a service-connected disability or use of an alcohol or drug abuse disability as evidence of the increased severity of a service-connected disability. We would stress that the holding of the case is quite limited. Veterans can only recover if they can adequately establish that their alcohol or drug abuse disability is secondary to or is caused by their primary service- connected disorder. We foresee that such compensation would only result where there is clear medical evidence establishing that the alcohol or drug abuse disability is indeed caused by a veteran's primary service-connected disability, and where the alcohol or drug abuse disability is not due to willful wrongdoing.

On remand, the Board will have to determine whether Allen's alcohol abuse disability is secondary to his PTSD, or whether it demonstrates the increased severity of his PTSD disability. If it finds sufficient evidence demonstrating a causal connection, Allen could be entitled to an increase in his schedular rating. But if the Board finds that Allen's alcohol abuse is willful and did not result from his PTSD, Allen could not receive additional compensation for a willful alcohol abuse disability.”

Psychological Tests in PTSD claims

Regarding psychological tests, the Committee recommended the use of the Minnesota Multiphasic Personality Inventory (MMPI). The Committee did caution that inherent in the test is the risk of over-reporting, citing validity scales that are elevated in people who attempt to exaggerate their symptoms. However, studies of Vietnam combat veterans and child abuse survivors show elevated scores as a result of chronic posttraumatic difficulties or comorbid affective symptoms as opposed to over endorsement.

In 1997, the Veterans Administration mandated that a GAF (Global Assessment of Functioning) score be assigned at regular intervals for veterans receiving mental health care. The GAF score is often used in disability rating boards and was included in the DSM profile. A high GAF may be erroneously assigned to a Veteran suffering from PTSD because his symptom severity and functionality can fluctuate. Studies have also shown that the difference in GAF scores assigned by different raters for the same patient could easily vary by 20 points; where one rater considered the symptoms to be mild and the other judged them to be moderate to severe, and it is often seen that raters vary by as much as 8 points on the same examination. The Committee also noted that Veteran Administration practitioners seem to have a bias against assigning low GAF scores for PTSD; thus a high GAF (>61) by itself, should not be a reason to deny veteran disability benefits.

In addition, there is no published information associated with the DSM-IV, which instructs examiners on the valid methods for partitioning the GAF score by comorbid clinical condition. It is VBA policy that the examiner must assign GAF scores for comorbid disorders. If he does not do so, he is required to explain why. Failure to address comorbid mental conditions, such as depression or anxiety, has been seen as a major error in rating decisions that must be corrected.

The Committee stressed the importance of recording episodes of aggression against self or others. If applied correctly, these behaviors will drop the GAF into a lower range. If these features are present clinically, they should not be overlooked or minimized by the clinician.

Finally, the Committee recommended that the GAF score should only be used as a crosscheck against the examiner's own evaluation, based on reports of signs and symptoms; if they do not match, the practitioner is advised to re-examine the evidence. However, there is no reason to change an evaluation because the GAF score differs in the assessment level of functioning from that of the evaluation

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Stakeholders Lose Confidence in VA Fee-Basis Care

WASHINGTON, D.C.—Today, the Subcommittee on Health held a hearing entitled, “VA Fee Basis Care: Examining Solutions to a Flawed System.”The hearing was in response to findings that the current fee-basis system is having an adverse effect on those it was originally intended to help.

Over the past three years, the VA Office of Inspector General (OIG) has released seven separate reports revealing a multitude of problems facing the program, including serious concerns regarding oversight, as well as millions of dollars wasted through improper payments.

“Recent years have seen tremendous growth in VA’s Fee Care program, with independent assessments estimating growth of close to 300 percent from fiscal year 2005 to today,” said Rep. Ann Marie Buerkle, Chairwoman of the Subcommittee on Health. “Unfortunately, as the program has continued to grow, so have the management and oversight problems that have plagued the system through which VA provides care to veterans outside the walls of a VA facility.”

As an attempt to correct the troubles facing the program, VA has developed two new initiatives. The Subcommittee, however, remained skeptical of VA’s new plan.

“The Department testified today that these two initiatives will address all of the challenges the Fee Program faces and ‘ensure veterans receive effective and efficient non-VA care seamlessly,’” Buerkle said. “I wish that I could believe that was true. However, given the history of failure we’ve seen already, I have serious reservations that the actions VA is taking will address the core challenges it faces and not simply lead to further fragmented care and an inability to deliver quality care in rural communities.”

Correcting the current problems in the system, before initiating new programs, or starting over, remains critical to the success of the program Subcommittee members expressed.

“And, at the end of the day, what fee-basis care is about is the effective and efficient delivery of care to veterans where they need it, when they need it,” said Buerkle. “Getting it right is about honoring their preferences, choices, and daily lives as well as their service to our country.”

For more news from the House Committee on Veterans’ Affairs, please visit: Veterans.House.Gov

Union concerned about VA’s ability to expand access to mental health care

A labor union representing Veterans Affairs Department mental health professionals has expressed doubt that VA can deliver on an Aug. 31 executive order from President Obama aimed at expanding access to care for veterans, military members and their families.

The American Federation of Government Employees in a recent statement expressed concern over VA’s ability to enhance its mental health offerings “in view of the department’s continued harassment of employees who speak up for patients’ needs.”

VAWatchdog has similar concerns but for different reasons. We support AFGE. We know the patterns of reprisal inside the VA follow a distinct pattern and we hear it daily. VA employees are afraid to raise their voices.

However, the VA has been aware of the need to grow and refine veterans mental health care since at least 2007.

That's the year that Veterans For Common Sense (VCS) filed a lawsuit asking the courts to order VA to do its job. In 2011 VCS won that action and the 9th Circuit Court issued a scathing report that pointed out the many shortcomings of the way VA provides mental health services.

VA did what VA always does. Rather than get to work and improve care, the VA appealed the decision of the court. It was no surprise when the court overturned its decision later in the year. Most legal scholars had agreed that the court didn't have the authority to tell a federal agency how to accomplish the goals it set for itself.

In 2012 VA made a splashy announcement and trumpeted that it would hire 1600 mental health care workers to help veterans who were experiencing the flood of psychiatric issues that 10 years of war has wrought upon them. Most who understand how the health care system works immediately knew this was nothing more than glitz and glitter. There aren't 1600 mental health care professionals available for hire in America. Even if there were, and there aren't, how many of them would be persuaded to drop what they're doing and enter into a position with the badly broken VA system?

VA is now trying to fulfill its earlier commitment of hiring 1600 mental health workers by expanding the number of people who work at the VA crisis line. President Obama has somehow been convinced that he should join the charade by signing an executive order for VA to do just that.

Rather than hiring professionals like psychiatrists, psychologists, counselors and social workers to meet the problem of veteran suicide head on, VA and the President are going for the cheap and easy fix. The barely trained people who will be hired to answer the phones won't be psychiatric professionals, they'll be folks just like us with a few hours of training. If you call them, you'll probably reach a caring person who posses few skills and little experience. They will mean well but won't be able to do anything but talk to you.

Talk is cheap.

Now you understand why this administration isn't supporting veterans. There isn't any real effort to supplement the overburdened mental health worker in the trenches. VA plans to talk us to death.

Ask the veterans and active duty members of our military who will kill themselves today. If it's not too late.

Veterans charity, fundraiser accused by AG of lying to potential donors

Bay State Vietnam Veterans, Inc. and Dynamic Marketing Solutions, Inc. - the company the group hired to help solicit donations - are being sued by Attorney General Martha Coakley, who alleges they lied to prospective donors to encourage contributions.

The alleged deception includes professional solicitors claiming to be veterans returning from Afghanistan who were volunteering for the organization.

This brings to mind questions that come up often here at VAWatchdog: Why are there so many of these veterans charities? And then, why are there dozens upon dozens of Veterans Service Organizations?

What do these businesses actually do for veterans?

We receive email every day from veterans who need help. The situation is usually that the vet is waiting for a decision from VA regarding a claim for benefits. The vet is broke, can't work and needs help putting food on the table or paying rent.

When we start calling these charities, we learn that they can't help. Directly assisting an individual veteran isn't part of their mission. They have all sorts of excuses and usually tell us to call United Way or Salvation Army.

So, why do they exist?

The traditional Veterans Service Organizations aren't much different. If you're a joiner you may get a slick magazine and frequent mailings that tell you of all the good your group does. Some, like DAV, actually provide a service by staffing vans to carry patients to medical appointments. Others like MCL, VFW and AL have many programs that benefit veterans and their families with social connections and even scholarships for their children.

Others, like IAVA don't provide anything but press releases touting their latest initiative...usually an initiative already being done by the other organizations. Advising us that homeless veterans need housing or that veterans need jobs isn't exactly helping. We already know all that.

If a Veterans Service Organization or a veterans charity doesn't provide a tangible service that is accessible to all veterans, why does it exist?

The most apparent answer is that it exists only to pay its executives their inflated salaries.

If an OEF/OIF veteran emails me and needs help today and I can't pick up a phone and direct her to someone to assist her right now, what good is her organization? If a Vietnam veteran needs a ride to his doctor because he isn't able to drive himself, why should I give money to some pretend soldier dressed in mock fatigues who takes that money back to pay management their bonuses?

Ultimately, the answer is clear. Veterans are a hot topic these days. Offering us pity is how America reacts to the massive FUBAR of our recent wars. That means money and there are always greedy and unscrupulous types just waiting to pounce and make some money off of our recent popularity.

The greed isn't limited to the non-veteran pestering you for spare change at Walmart. Those Veterans Service Organizations....the "legitimate" ones, are guilty as anyone else.

The next time you get an email asking for your donation to help the poor veteran, ask just where your money will be spent? If you give a dollar and you don't see 95 cents of good to a local veteran, keep the money in your pocket.

Being cheated and scammed should be a crime whether it's one of the supposedly respectable organizations or an obvious ripoff as above.

The bottom line: It's up to you. Think it through before you react with your money. If you take the profit out of it, the scammers will move on to starving children or abandoned pets and forget about us. We vets will be better off without them.

Before you donate: Click over to The Charity Navigator. Enter the key word VETERANS in the Charity Search field. You'll get about 3 pages of groups that Charity Navigator has studied. Look at them for their ratings, executive salaries and to learn of their mission.

Even if they have a 4 star rating, does their mission actually do something that you understand or is it tenuous and disguised? If you don't understand what the organization does, pass it by.

Only after you've done your homework should you open your checkbook.

Who does VAWatchdog give to? We give to the Salvation Army and our local Hospice Savannah and we keep an eye on their end of life program for veterans.

The Salvation Army works. The local Hospice Savannah participates in the We Honor Veterans program.

I can see where our money goes. When you give, can you say the same?

Charity & Veterans; Are We All Destitute & Homeless? Why Are There So Many Veterans Charitable Organizations?

VAWatchdog has long questioned the need for veteran-centric charities. If you're a veteran you've proven that you can accomplish some of the most difficult and challenging tasks that life can offer you. You've traveled extensively, worked with foreign cultures, mastered technologies others only dream of and yet, the public perception is that veterans are helpless.

If we believe the popular press headlines veterans require charitable gifts because without them we'd go hungry, we need special courts because we're not responsible for our lawless activities, without an army of mental health professionals and a warehouse of potent drugs we'll all be dangerous to ourselves and others, and we need free housing or we'd all be sleeping on the streets.

Are veterans really this much of a burden on American society? Are we so incapable, so vulnerable and so demented that we can't be held accountable to care for ourselves and our families?

Or is it because veterans are the latest cause célèbre? Charitable organizations have long known that hot topics can earn a lot of money for company chiefs. Everything from neutering animals to feeding the starving children in countries you've never heard of beg for your money through blaring TV ads and junk mail campaigns.

Almost every web site that features an article with the word "veteran" in it will have the pervasive button encouraging you to leave behind some of your hard earned dollars. (It's worth mentioning that you won't see that on VAWatchdog. We don't ask for nor do we accept donations. There are no charges or fees for any service we provide.)

We did a quick Internet search and discovered that there are hundreds, maybe more, of groups who want you to donate to help save a distraught, helpless vet. It isn't hard to do, click here to see a few of the results you see with a basic search.

Your VA has a few pages on its web site to help homeless vets. This assumes homeless vets have computers. Most of the VA site actually refers veterans to other federal agencies, faith based groups and "other resources".

VAWatchdog likes and uses the Charity Navigator for reliable information about almost every charitable organization. On their page Support Our Troops, you'll find a listing of over 50 groups who claim to need your help so they can help the poor veterans. A few enjoy high rankings and seem reliable. Others appear to have been formed to support the organizers, not veterans.

Back in 2006, Charitywatch dot Org said; "Our Veterans Deserve Better from America's Charities". It appears that is more true today than then. In an update, Now Is The Time To Reform Veterans Charitiesthey go on to tell us, "It is ironic that veterans charities, having one of the most popular causes, are also some of the least efficient with America’s donated dollars. It is a national disgrace that hundreds of millions of dollars raised in the name of injured veterans are not being used to help them. Too many veterans charities are wrapping the American flag around themselves and hiding behind the First Amendment to justify their wasteful, over-solicitation of funds."

VAWatchdog believes that most veterans aren't in the dire straits that the mainstream press would like you to believe. We also know that if the VA were doing the job that is its only mission, that is to properly serve veterans, there would be very little actual need for any sort of charity that targeted vets.

We are the most efficient, motivated, well trained and adaptable citizens in our country. We don't just talk about moving mountains, we have actually moved mountains. We've constructed hospitals and schools and then staffed them. We've flown the world's most advanced aircraft and sailed the most advanced ships on the planet, all over the planet. We've left our footprints in every country in the world. We're made up of every religious and ethnic group anyone can think of and then some.

The great majority of us don't need charity. We need a Department of Veterans Affairs that works as hard as we have. If our government fulfills its end of the bargain we made with it and delivers the benefits we earned in a fair and timely manner, there will be no need for bleeding hearts and yellow ribbons on the SUV's of soccer moms anywhere.

Keep your promises America, and we'll keep ours.

It Can Be Done: Suing The Veterans Administration
Jeffrey A. Milman, Esq. Founding Partner at Hodes-Milman-Lieback

The Benefit of the Doubt

VA drowning in benefits backlog despite expensive paperless system

Despite spending $491 million on a paperless Veterans Benefits Management System, the Department of Veterans Affairs has only installed the system--which has processed a meager 800 claims--in four offices, Gerald Manar, deputy director of the National Veterans Service for the Veterans of Foreign Wars, told the House Veterans' Affairs Committee on Tuesday, according to Nextgov.

The Benefit of the Doubt ; Is this one of the reasons VA is so far behind?

There's no debating that the VA has a backlog. "The Backlog"usually refers to the one million or so claims VA is sitting on in its 56 Regional Offices that are waiting to be adjudicated. Reports of the actual number vary. The VA isn't known for accuracy and truth in the reports of facts and figures.

In recent years VA started to refer to the files delayed in the backlog as being past their 125 day target to process a claim. Previously VA had established that 180 days was the target and anything beyond that target was officially delayed and thus became "backlogged". Why the change from 180 to 125? If an organization can't meet a target, what sense does it make to make the target even more unattainable?

VA can't answer that. The obvious answer is public relations. The 125 figure somehow sounds better than 180. It tells you that VA is really trying hard to set aggressive goals!

What VA refuses to address or acknowledge is the root causes of the current backlog. VAWatchdog has told its readers many times that there is a backlog because there are so many preventable errors that begin the minute a veteran files a claim. Errors in the adjudication process cause flawed decisions. In simple terms, if evidence isn't properly considered by a skilled reviewer, the application for a benefit is denied. The veteran then must appeal. The law makes VA appeals endless. Veterans are allowed to appeal the appeals in a sort of game that lasts forever.

In all stages of the adjudication, at every twist and turn, the veteran is to be given the benefit of the doubt.

38 USC 5107 - Sec. 5107. Claimant responsibility; benefit of the doubt

(a) Claimant Responsibility. - Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. (b) Benefit of the Doubt. - The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.

That little slice of code above isn't terribly difficult to understand. The veteran must present a claim. The claims must be presented using applicable law. Once the claim is received, the Secretary (or his agents) will give it a fair review and if there is a reasonable question of which way the claim should be decided, the claim should be decided in favor of the veteran. How hard is that?

But it doesn't happen that way. In common practice, any benefit of the doubt is never considered. VA declares war and will go to great lengths to tell a veteran just how wrong he is.

In the case of Reeves v. Shinseki, VA has battled all the way to United States Court of Appeals for the Federal Circuit in an Appeal from the United States Court of Appeals for Veterans Claims. The decision date is June 14, 2012.

The veteran is dead.

The claim was for his hearing loss. Many years ago the vet filed for a disability compensation rating. He told VA that his hearing was damaged during his service. VA denied the claim. The Regional Office told him the damage to his hearing hadn't happened the way he claimed it had.

The vet claimed his hearing was damaged in WWII. Between 1942 until and November 1945 he worked as a heavy mortar crewman during several combat offensives and was awarded three Bronze Stars. Mortar fire is loud. Very loud. Beyond that he was treated for malaria. Malaria and the drugs used to prevent and treat malaria are well known to have the side effect of causing hearing loss.

Although all of this was well established in his military service records, VA denied that his hearing loss had anything to do with his service to his country during war. His mistake? He waited until 1982 to file his claim.

In a number of decisions and appeals over the years, VA concluded that the well documented hearing loss was “too remote from [Reeves’] active service” to be caused by either his exposure to mortar fire or treatment for malaria while in service.

I read these decisions every day or every week. There is a consistent theme in VA decisions that says that no matter how ludicrous and far fetched any decision may be, if VA says it, it stands. Well paid VA lawyers will stand before well paid VA judges and argue that men like veteran Reeves weren't harmed by standing next to the muzzle blast of an 81 mm to defend their country. They offer instead that there must have been some other mysterious cause of hearing damage.

Why? Why does VA argue against men like veteran reeves and the tens of thousands of other cases that are backlogged today at every regional off, the BVA, the CAVC and overflowing into the Appeals management Center and elsewhere? Is there really a war declared against veterans by VA?

The only answer that comes to mind is that VA has adopted a sort of misguided belief that it is responsible to the taxpayer to control the budget. The mission of VA is to provide care for veterans...not to manage a budget.

Even if VA were somehow responsible for managing a budget, the way it handles benefits cases is one of the great disasters of our era. Captain Obvious himself could glance at the Reeves case ah the tens of thousands of others like it and conclude that it would have been more cost effective to pay him a few dollars sooner than later.

To staff the BVA and the CAVC isn't cheap. VA doesn't provide the sort of statistics that an analyst could use to determine what it cost to properly and quickly adjudicate a case like this one and compare that to the lengthy process of years in federal courts. But it doesn't take a scientist to see that the VA's war on veterans is another giant fleecing of the taxpayer.

VA recently announced that it needs another 4000 workers to catch up the backlog. This on top of years of budget increases and massive hiring.

VAWatchdog proposes that VA slash the budget and keep it simple. Approve every claim right now. If the claim meets a basic requirement that shows qualifying service, an event and a current diagnosis...award a reasonable rating and move ahead to the next claim. Then audit a random selection of claims to look for errors and fraud. This is the only solution to fix the VA today.

Adding employees and computers and lawyers and judges is only going to cost the taxpayer more money at a time our country can least afford it.

Let's give veterans the benefits they deserve. Starting with the benefit of the doubt.

Toy Soldiers 2012

The Myth of the Expedited Claim

Jim's Mailbag To read more of Jim's Mailbag click here and here.

Dear Jim;

I need all the help I can get right with disability benefits. I got out of the Army in august 2008 with a Chapter 5-17 discharge for PTSD/Anxiety Disorder. I filed my claim in February of 2011, after my family insisted I need help. I was given a 20% rating for a scar on the back of my head I received in Iraq, and tinnitus.

Right now I have unfinished claims for PTSD, mTBI, and a hurt back. I am in memory rehabilitation for the mTBI, on sleep medications and anxiety medications for PTSD and have a PTSD diagnosis from the VA. I just received my first steroid shot in my back on July 11, 2012. I understand that moving from Alabama to California in December of 2011 can set my claim back, however I have been here for over 8 months now and haven't received a single C&P appointment. According to my memory rehabilitation team I am a priority case due to the mTBI and PTSD.

I am currently trying to live off of my 20% rating which is $251 a month, and doing odd jobs for cash. I haven't been able to find part or full time gainful employment in Fresno, and am fighting my ex wife for child visitation. I have a cell bill of $109 a month and $120 a month in child visitation fees. That leaves me $20 to live off of and put gas in my car for a month. Needless to say this is practically impossible. I've submitted all the documentation I have from the army, profiles, physical rehab in Iraq for my back, documentation of CASH visits after being knocked unconscious from IED's and the profiles for receiving concussions.

I'm in dire need of a finished claim and a higher rating. I didn't include chronic fatigue, headaches, or many other symptoms I have on my claim because I feel like I'm already asking to much from the VA even though I know every condition I have is related to my deployment to Iraq, and being Airborne. My knee claim was decided as nonservice connected despite the fact I had no knee problems before joining the army and spent five years in the 82nd airborne division doing combat jumps with equipment that weighed more then I do.

I am represented by the D.A.V. but their representation seems to consist of submitting any paperwork I give them, and sitting and waiting. I need to find a way to get in contact with someone who can put me in touch the right people to find out if there is any way possible to expedite my claim.


A Frustrated Veteran


The best advice I can give you to be patient. There is no way to speed up or expedite your claim. Your claim is in a long line and VA is resolving them one at a time in the order received. The rumors about expediting claims are just that...rumors. Your assessment of your Veterans Service Organization representation is spot on. All the VSO is empowered to do is to accept paper from you and hand it to the VA. That's it. This is one reason why the team at VAWatchdog recommends that veterans adopt a DIY strategy to file their own claims.

I understand that this isn't what you need to hear. However, I live in the real world and that's the reality. I often anger veterans when I tell them that VA doesn't actually care about the individual veterans finances. The VA isn't going to put your claim ahead of others because you're in financial distress. You see, everyone who is waiting on an overdue claim is in financial distress. I get messages from thousands of veterans who can't work, can't pay bills and they believe that if somone at VA would just look at their claim, they could be on the way to recovery soon. The system doesn't work that way. The brutal fact is that the system barely works at all.

The rumors about how you may be able to have your claim expedited originate here;

Expedited Claims

38 CFR 20.1500 - Rule 1500. Expedited Claims Adjudication Initiative.

This program never worked. Not at all. If anything, it made the process even more complex and slowed things down. VA never eliminates work when they add a new program to help an old program. They simply layer the new stuff onto the old stuff and add to the workload of the rater.

There are over 900,000 claims backlogged today. It's taking just around 2 years to adjudicate a claim from the day it enters the building until the day you get your letter. We believe that there are actually well over one million claims backlogged. We can't prove that because VA doesn't do a good job of collecting such data and the data they have is massaged and manipulated to give you the appearance that they're doing something to help you. They aren't.

VA refers to backlogged claims as those that are over 125 days in processing. That's a ruse to make you believe that there are claims being developed in 125 days. There aren't. The typical claim is currently taking about 2 years in 2012. Your VAWatchdog researchers believe that claims submitted in 2012 and 2013 will take closer to 3 years to adjudicate.

The really frustrating part is that when you get the letter, there is a 70% chance that your claim will be flawed and you'll have to appeal it. That adds at least 2 more years. This isn't just you, it's every veteran. It really doesn't matter if you're WWII, Korean or Vietnam era. Our young brothers and sisters of the last 10 years of GWOT, OEF/OIF aren't getting any preferential treatment. All veterans claims are more or less being unceremoniously dumped in the same cardboard boxes and set about in huge disorganized stacks while you wait.

There's a lot of intel about all this on my web site. I suggest that you spend some time reading and then read some more. The more you know, the better you are positioned to deal with VA in the future. And you will be dealing with VA in the future. Once you are in the system, it's a battle for the rest of your life. I can't stress it enough that the veteran who studies the VAWatchdog site is going to fare better than the veteran who hands his claim to a stranger and expects help.

The vets who read the VAWatchdog web site win. They win in the long run...not today or tomorrow but 3 or 4 years from now.

You're in California. I almost hate to tell you this but if you were a regular reader of VAWatchdog you would know that Oakland and Los Angeles VA Regional Offices are the 2 most backed up in the nation. They each have over 90% of all their claims that are long overdue. Oakland was closed last month in hopes of training employees. It hasn't worked...they fell further behind the week they reopened.

If you're depending on a windfall from VA to help you with finances, you need another plan. It's probably going to be 2015, maybe 2016 before you have a letter with any kind of a rating. Then you can begin the appeals.


But wait! There is hope! VAWatchdog recommendations change beginning today.

In the past, VAWatchdog recommended that veterans wait patiently and work with the VA. That is the recommendation today. When you submit a claim or any modification to an existing claim, we urge you to do it right the first time and then sit back and wait for VA to do its job. These steps apply to the DIY veteran who is working without the interference of a VSO.

When your claim has sat without VA action for 12 months, we now recommend that you take aggressive steps. These steps are outlined in detail on the Complaints Page.

First, we recommend that you contact your Congressional Representative. There is a right way and a wrong way to do this. If you do it the right way, you are going to get action. You'll learn more about the proper procedures on the Complaints Page.

Second, we recommend that you consider filing action in the federal courts system. This is a more complex step but it may be very effective. As with the instructions about how to contact your Congressperson, you'll find details about this action on the Complaints Page.

This new way of thinking is work in progress at VAWatchdog. If you have specific questions or comments, you should proceed to the VAWatchdog forum. We urge you to check back here often in the next few days to see any updates.

We owe VA a modicum of patience, no more than that. If VA wages war on veterans, veterans have every right to defend themselves. There are real people, honorable veterans who are suffering while VA leadership talks of how happy they are with the progress (?) being made and how to stay healthy as a VA employee.

That VA employees will continue to enjoy bonuses while deserving veterans can't pay the rent is a national disgrace. It's time for you to step up the pace.

VA improves claims processing for needy veterans


The author of this is piece is Robin Wulffson, M.D. Dr. Wulffson is a "Veterans Affairs Examiner". That means he's a C & P doc. The FDC he reports on is nothing new. In January of 2011 we read, "The Fully Developed Claims (FDC) Program is the fastest way of getting your compensation or pension claim processed."

In about February of 2010 VA released Form 21-526EZ. How many of you have seen this one and had your claim expedited? Then there are those DBQ's. As it turns out, the DBQ's are as problematic as any program that VA has imagineeredyet. The failure of this particular fantasy began when someone recognized that any veteran could complete his own DBQ, sign a fictitious doctor's name to it and add it to his record at the VARO.

The DBQ doesn't rise to the level of being a medical record. The DBQ doesn't require the most basic safeguards against such shenanigans like being on a physician's letterhead or having the signatures notarized. This means that the VARO has to accept it as fact or take time to somehow verify it all. The DBQ includes a small print qualifier, "NOTE - VA may obtain additional medical information, including an examination, if necessary to complete VA's review of the veteran's application." So, in order to assure authenticity of each DBQ the VARO must check to ensure authenticity.

It asks for the physicians medical license number...this isn't a detail that most physicians are pleased to publish and it's not required on any other statements or forms. But...if that veteran who is prone to taking a shortcut should just make up a medical license number, how is VA to know? It takes time to check on such things.

The advocates I communicate with are underwhelmed by the "progress" being made with the oft delayed introduction of the DBQ. It appears to be the typical VA response to a major problem, that is; If the problem is complex, let's add to the complexity by creating dozens of forms to add to the burden of the veteran. That'll teach 'em to mess with us!

Have a look at the chart towards the bottom of this page and ask yourself how well the FDC process has worked out.

Veterans face longer wait for help

Official: Claims might take as long as 520 days to be processed

But...wait...didn't Dr. Wulffson just say...???

VA promises results on claims process fixes

But...wait...didn't we read this elsewhere???

08/31/2010 Shinseki: VA Backlog Will Be Broken This Year

05/04/2007 Veterans Affairs backlog, bonuses stir anger

05/28/2002 VA Slashing Backlog

Ten years of slashing and breaking the ol' backlog. Nice work. Read more by clicking right here.

Hickey praises VA employees for their "sacrifices"

This gives us visions of VBA employees holding hands and singing...


From: Hickey, Allison
Sent: Wednesday, September 05, 2012 5:30 AM
Subject: All Time Record!!! 107K Claims in a single month!!!

VBA Team,

Do you know that you set an all time best record for number of claims completed in a single month? I do!!! So do 107,000 Veterans, their families and survivors whom you served faithfully in the month of August 2012. Thank you so very much for digging deep and delivering for these great men, women and children.

Your dedicated service – your relentless spirit to make a difference –once again validates for me the knowledge that together we WILL tackle this backlog.

Thank you for all that you do every day for so many.

Your Under Secretary,


Allison A. Hickey
Under Secretary for Benefits
Department of Veterans Affairs

I recall an old saying, "The hurrier you go, the behinder you get". One of the problems at VA has always been that in the rush to get files adjudicated and closed, mistakes are made. Enough mistakes that the BVA and the CAVC are growth industries to sort out the tens of thousands of daily errors that your regional office puts out to you.

Of course, at your VBA the more files they close, the better then monetary bonuses are for the employees. You can bet there are some happy RVSR's.

So, workers are being congratulated for closing 107,000 files in August. The way VAWatchdog sees it, that means that there will be 70,000 appeals for the mistakes made as the employees hurried through them to please the boss, and earn a cash bonus.

We know that VA would dispute the VAWatchdog estimate. Your VAWatchdog has long stated that the error rate on first adjudications of claims is about 70%.

Although VA doesn't really account for how many claims require an appeal because of sloppy work at the RO, they would tell you that it certainly isn't 70%. OK, we're always game for a discussion.

What is the number? Is it 50%? 40%? 30%? Are there 30 of every 100 claims that cheat the veteran of his or her earned benefit? Let's lowball it and for fun we'll agree that it's only 30%. Is that OK? If Ford told consumers that they could expect that only 30 of every 100 cars they sold would have to be brought back to the shop to be rebuilt and that would take 2 years, how do you think that would go over?

30% is a lot of errors in any ordinary business. If the local heart surgeon lost 30% of his patients, would you go to her? How about a plumber? He guarantees that no more than 30% of the toilets he installs are going to leak. Of course, VBA is no ordinary business, is it?

We hear that the BVA just added a couple of judges and they need more. We doubt that happens because the RO is doing such a great job. The CAVC is so far behind in their appeals case load that they'll never catch up.

There are 66.4% of all pending claims that are long overdue. While the boss heaps praise in her emails, VA employees are picketing their VARO to tell the world that there isn't any reason for celebration. Well, unless you're one of those receiving the healthy bonus that you'll get on top of your healthy paycheck.

You see, at the BVA employees get extra money for doing their jobs. Poorly.

Enough employees sent us this email that we know not everyone is on the bus that's heading to the park so they can sing, "Someone's laughing, my Lord, kum bay ya, someone's crying, my Lord, kum bay ya".

On second thought, maybe that is the right song. VA laughs, veterans cry. Another day in the life.

Hi Jim,

I just finished reading the message (below) of Under Secretary Hickey in your web site. I was so frustrated with the message that I begin to wonder whether we are talking of the same Veterans Administration.

It appears she is not in touch with the reality of the real daily activities at the VA. She is congratulating her personnel for a job well done. A clear example of incompetence on account of lack of knowledge of the guiding principle they are using in awarding disability ratings is my case. My case was rated a year ago but is severely flawed, but I just kept quiet and just waiting for their corrections.

I am 70 years old, and severely disabled. I applied for Aid and Attendance benefits, and after 2 years of waiting they finally approved it. These were awarded after two successive C&P examinations about 2 months apart for the same medical condition (Peripheral Neuropathy both lower extremities).

It seems they can not even trust the findings of their C&P examiner that the first examination has to be reconfirmed by the second examiner. A second SMC- K for lost of function of both buttocks was awarded. However, their rating was so flawed that they missed the applicable provisions of a higher SMC which apply to this veteran. I sent a NOD last June 18, 2011 and up to the present time there are no responses. From what I can see, the problem is the lack of knowledge on the part of the rater about the provisions of Title 38. I will demonstrate to you as to how incompetent they are:

1. A second SMC - K was awarde for lost of function of both butoocks. However there were no compensation made. I
believed the existence of an earlier SMC - K for erectile dysfunction had confused them, for they thought that we are
entitled only to one SMC - K. However, I sent them a copy of the ruling that each veteran can earn as much as 3 SMC - K
provided it cover different body parts, and function.

2. I received a small retroactive compensation but it has a deficit equivalent to one month of adjustment. All veterans should
have a working knowledge of their compensation for their accounting department is not perfect.

3. In spite of the complexity of my medical problems, they did not apply the provision of section 3 and 4 of SMC-O which is
fully satisfied, which would have resulted in this veteran being paid at maximum rate. I copied the provisions and
highlighted it so they can see their errors.

4 Their C&P examination resulted in an increase of my cardiac condition rating to 60%. They used these to increase my
SMC rating from SMC - L to SMC L 1/2. The justification that they used was the provision of Housebound patient. Under
these provision is the presence of a medical condition with a 100% rating and other medical condition with a combined
rating of 50% or more. These is not the correct or applicable provision which should had been used. The correct
applicable provision is the one under SMC - P. which states that a veteran who is definitely in need of Aid and
Attendance who has a medical condition rated at 50% or more is entitled to a one step increase. They are giving
increases in rating, but they do not know the correct applicable provisions.

It is sad that they are allowed to work on our applications for benefits when they still lack the proper training to do these. Your comment that the underlying cause of these backlog are flawed decision is the proper way to address it. Secretary Hickey seems to be not in contact with reality, or her subordinates is painting a rosy picture to her without her verifying the truthfulness of it at all. I feel so sad for all the veterans for nobody seems to care about us except Congressman Filner and Miller. We are just getting a lot of lip service from all the politician whether Republican or Democrats. Where is our President where the buck should stop.

Good Luck To All Our Veterans.

From: Hickey, Allison
Sent: Thursday, August 02, 2012 12:46 PM
Subject: You are amazing!

To my VBA family and our wonderful partners,

I just wanted you to all know that I think you are amazing! Everywhere I go I hear directly from so many of you about how proud you are to serve our nation’s veterans and how dedicated you are to this mission and making a difference to our Veterans, their families and survivors. So many of you come up to me or send me notes telling me that you are “all in” ready to do whatever it takes to take care of America’s heroes. I have been to 31 different ROs and resource centers over the last year and I always walk away knowing that you have a positive attitude, a strong work ethic and a huge heart full of compassion and “I CARE”.

When I visit with you, I also visit with our partners that help us with this noble mission – our labor partners, VSOs and State Directors/County Service Officers. I am so proud of our team work together and the leadership I see with all organizations working together in a positive, uplifting way to make a difference in our ability to meet the needs of our Veterans. At Seattle and Boise both, as is true in most places I’ve visited, both management and labor stand side by side working through any issues with strong leadership, and respect on both sides.

I saw the notes on the wall of the Seattle RO (Auburn facility) from Veterans thanking you for the extra mile you go to take care of them. I spoke to Veterans in the public contact waiting area in Boise who sang the praises of the service provided them. I saw the energy and enthusiasm of each of you in those two offices – and your desire to do your very best – and then some for Veterans. Across the nation – you are focused on the goal. I can’t begin to tell you how appreciative I am and how proud I am of you.

July was a record month! Not only have you raised our national and local quality by a full 4% (awesome!!!!) but you produced the highest month so far this year at 96,594! You completed 9700 cases last Friday and Saturday alone. WOW! Thank you. You are making a difference.

In case you haven’t heard – we are adjusting the overtime guidance. I had many DROs come up to me in recent visits and ask if they can be included in doing OT to help with the backlog. I heard you and carried that back to OFO with guidance to let DROs work OT on the backlog. I also recently heard from the Seattle RO that they have many of you who are not journey level yet due to timing in the role only – but you have already met and can sustain journey level production and quality standards and would like to participate in the OT effort. We have approved that as well with supervisor concurrence. This will give us some flexibility with employee hardship cases when it comes to OT but still let us get to the end game – to reduce the backlog, maintain our quality improvements, and complete another million claims this year like the last 2.

I am also proud of how many of you are taking your “wellness” seriously–like I am. When I share about my “lean and green” new eating habits and show you my pedometer I wear everywhere, I hear such great stories about your weight loss, increased walking or exercising and other new efforts you are doing to care for yourself. Don’t sit at your desk for hours on end without moving. Stand up. Stretch. Walk more and move more. Just to get things started, I just stood up and did the wave (like at a baseball game)! Let’s see if we can do it across the country all the way to Manila and back!

Again, I am very proud of your dedicated effort to help our Veterans, their families and survivors. Keep up the good work.

Your Under Secretary,


Allison A. Hickey
Under Secretary for Benefits
Department of Veterans Affairs

From: Hickey, Allison (EX), REDACTED
Sent: Wednesday, August 29, 2012 10:14 AM
Subject: Thank you - great day!

VBA Team,

I was reviewing yesterday’s Daily output nationwide and was pleased to see you had a 5142 claim day – bringing our totals to 928,251 claims for the year to date! Thank you for your hard work in answering the needs of our Veterans, their families and survivors. I have been especially pleased to see how you are catching up on the BDD and QS work over the last couple of months – more than tripling your output for these separating or retiring service members and their families today. Thank you for your focus on these claims as well.

I know our ADC is going up across the country – but I also know that’s because I asked you to focus on getting those old claims out the door for nearly 6 months straight -- and that was the right thing to do. ADC going up because we are doing that old work means you are successfully addressing the needs of Veterans who have been waiting while 37% of you did the 260K+ Agent Orange Nehmer claims. Thank you for shifting your focus to the rest of the backlog over the last 2 months and for the difference that has made to the more than 100K Veterans who were in backlog on 30 June 2012 – and now aren’t.

I also want to thank our team members in Wichita, Ft Harrison, Salt Lake and Providence for their support in the development of VBMS. They are working out bugs and issues DAILY and making it better for us all! When I asked these teams to be the first “ALL IN” team, I told them they would be leading and cutting the path for us all. You all will be –like I am – very proud of their inputs and appreciative of the additional burdens they have borne for us all. THANK YOU Wichita, Ft Harrison, Salt Lake and Providence!

As we approach Labor day – I want you to know that this day recognizes ALL OF YOU! Thank you for everything you do – for the energy and dedication you give and your continued focus on BOTH production and quality. Be safe this weekend. Hug your family for me to thank them for all the sacrifices they make so we can all make a difference in the lives of our Veterans, their families and survivors.

Your Under Secretary,


Allison A. Hickey
Under Secretary for Benefits
Department of Veterans Affairs

VAWatchdog readers
won't be surprised to hear that not all VA employees are as happy, warm and fuzzy feeling as their good friend Allison is these days.

Many VA employees sent me this email message. That is, the ones who weren't in the streets picketing their employer. I can't publish their comments, language like that hurts.

The gist of the messages is that VA employees wonder if she works for another VA.

Veterans wonder why she won't talk with them. Veterans write to her at the VACO address, they send letters using the VAWatchdog protocol of certified mail, RRR. They tell me that they follow the protocol and they are polite and brief when they address the VA executive.

To date, no veteran has received any reply that we've been notified of.

VA employees aren't happy. Veterans aren't happy. The VA OIG isn't happy. Members of Congress aren't happy. The Senate and House Veterans Affairs Committees aren't happy. The CAVC, the VBA and even the circuit courts aren't happy.

The mainstream press, veterans attorneys, organizations who represent veterans who are suffering in the streets of America aren't happy.

But...as long as USB Hickey enjoys her long weekend (one of the many generous federal holidays she is privileged to have), all is well with the world.

She heaps praise on VA employees for all their sacrifices.

Yeah, you read that right. They have good jobs, generous salaries, great benefits, BIG bonuses and the finest union representation in America but their families are making big sacrifices and she wants them to feel the love.

Your sacrifices...not so much.

So...from your VAWatchdog...big hugs y'all.

Hang in there. It'll all be OK just as soon as USB Hickey can get to you.

That's going to be 2014 or so if you filed a claim this year. The clock is ticking. She promised...remember?


Created at 9/19/2012 8:13 PM  by IN 77 Webmaster 
Last modified at 9/19/2012 8:13 PM  by IN 77 Webmaster 

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