Feedback from any VA folks?

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Aitrus
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Feedback from any VA folks?

Post by Aitrus »

For any members here who work at VA - especially on the disability claims side of things - maybe you can help me understand this. Here's the timeline:

- July 2018: Retired from the WA ANG.

- Late Feb 2019: I went to a local VA assistance rep in late Feb '19, and got a checklist of documents that were needed. Private medical records, letters from the doctor, etc. On this date I submitted an intent to file.

- Dec 2019: Checklist completed, all documents turned in to VA. Shortly thereafter, VA account online states that the estimated time for the completion of my case is 2 Jul 20. I sit back to wait to get called for medical appointments. I have a lot of things that I'm claiming, so I know that this might take a while. I can be patient.

- Mar 2020: COVID 19 kicks up. I haven't gotten any calls about my VA appointments yet, so I call the VA hotline to inquire about if there's anything more that I can do to help move the process along before the world loses its collective mind. I'm told that they have everything except medical records from the ANG.

- 18 Jun 20: VA account online says that they finally have all my records from ANG. Good; now that they have all my records, I'm expecting to start getting calls for medical appointments within a few weeks.

- 10 Jul 20: I check my VA account online; the estimated completion date has been changed to Mar 2021.

- This morning: I check my VA account online; the estimated completion date has been changed to Sep 2021.

This is frustrating as hell. I know that I have a lot of claimed issues to go through, so I was expecting a long wait, and COVID was bound to slow things down a little. That the ANG was dragging its ass on getting the records to the VA didn't help matters either. But over a year before my case is settled? C'mon, that's just silly. I'm willing to let the process work, but is a full year really necessary once all records are received?
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ArrieS
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Re: Feedback from any VA folks?

Post by ArrieS »

Aitrus wrote: I'm willing to let the process work, but is a full year really necessary once all records are received?
This maybe a little late for you but one thing that can speed it up is helping them. I don't know how large your medical file is but it is worth while to point to where in your medical records the evidence for your claimed condition and even better provide it for each claim.

Otherwise they are left to read (but lets be honest, skim) all your records trying to find something.

For example with myself, I claimed tinnitus. So I sent copies of my medical record for my medical evaluations following my IED incidents attached to the claim.

I did this for each of my claims.

Are you working with a veterans group? If you aren't I would suggest the Military Order of the Purple Heart. You don't need to be a recipient of a Purple Heart for them to represent you with the VA. Most people don't realize this so they don't have as large a number of veterans so they aren't as over worked as say the Disabled American Veterans.
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Aitrus
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Re: Feedback from any VA folks?

Post by Aitrus »

I didn't hand them the entirety of my civilian medical file, just the pertinent parts. I also included a list of all the issues I'm claiming and the dates they occur in my record, as well as my civilian doctor's letter stating that the claimed items were caused / exacerbated by military service. I also included a written response to the Form 21-0781 (personal testimonial statement of my issues). They wouldn't take my copy of my military records, they said that it wouldn't do any good as they would just end up asking for a fresh copy from the DoD anyway.

The contact I'm working with is with a local county Veterans Service office. I'm not working with a specific veteran's group yet, but I may have to look into it. Thanks for the suggestion.

The mistake we made was that we were counting chickens before they were hatched. College funding plans were made, early house payments were paid, and more were all based on a pessimistic estimation of what I'd be rated at as well as a similarly pessimistic date of when payments would start (based on the va.com estimated date of completion).

A friend of mine submitted his package in October '19, and he was receiving payments by Feb '20 (a month before his estimated completion date on va.com), so we figured that the estimates were good. We anticipated the worst case scenario for payment amount and start date, and planned accordingly - but that worst case scenario didn't happen (it's worse than that). So far, the date of payments is blown entirely out of the water, and that's causing us to do some major cutbacks and adjustments in our budget.

We're fine for now, but six months to a year down the road we start to get squeezed a bit, so we're cutting back now in order to prepare. We'll be ok in the long run, but it's frustrating.
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ProduceMan
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Re: Feedback from any VA folks?

Post by ProduceMan »

If you live near a military base, the base will have retirement classes/seminars. Lots of good info!!!! I’m guessing classes are once a month.

Do you have official copy of med rec? I think you can request one at nearest med fac .

For all your claims, look for earliest appointment you have to support your claim. Then and probably most important chronic issues for each claim.

YOU WONT BE GETTING A PHONE CALL. APPOINTMENTS WILL COME VIA MAIL. DO NOT BE A “NO SHOW”.
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Aitrus
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Re: Feedback from any VA folks?

Post by Aitrus »

ProduceMan wrote:If you live near a military base, the base will have retirement classes/seminars. Lots of good info!!!! I’m guessing classes are once a month.

Do you have official copy of med rec? I think you can request one at nearest med fac .

For all your claims, look for earliest appointment you have to support your claim. Then and probably most important chronic issues for each claim.

YOU WONT BE GETTING A PHONE CALL. APPOINTMENTS WILL COME VIA MAIL. DO NOT BE A “NO SHOW”.
I work at a medical facility on an AF installation. However, I wasn't eligible for the retirement classes / seminars (the USAF calls them Transition Assistance Program (TAP) classes) because I was ANG when I retired. I was told that the reason is because ANG can't attend active duty TAP classes, only the ANG-specific ones at Maxwell AFB ever quarter or so. Since my unity didn't want to pony up the funds, I couldn't go. Which was ok, I attended a TAP class in 2008 when I separated from active duty and joined the Guard.

I do have an official copy of my med records. However, the VA rep said that it wouldn't do any good to give them a copy since they would be requesting a copy that couldn't be altered directly from the service.

For all the claims I have, I created a list of specified all dates within my medical records where I was seen for each issue. That list was submitted as part of my package.

Maybe it's my local VA, but a buddy of mine who went through the process in fall '19 said that they called him first, and then he got the letters. I absolutely plan on attending whatever appointment they give me - my boss already knows this and is good with it.
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Navig8tor
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Re: Feedback from any VA folks?

Post by Navig8tor »

I don't know if this will help you; however, it worked wonders for me. I made use of the DISABLED AMERICAN VETERANS (DAV) to complete and process my claims. I had no issues whatsoever.

On the advice of a coworker to avoid the local VA rep (overworked, unprofessional and couldn't care less about YOU), I drove 215 miles (one way) from my duty station, spending the night prior in a local hotel, and visited the DAV Rep during a scheduled appointment. There was no waiting and the entire evolution was conducted in a thoughtful and respectful manner. The DAV rep interviewed me, reviewed my medical record WITH ME, completed the claims paperwork, and mailed my medical record to the appropriate VA office.

A couple weeks later, a VA medical appointment "scheduler" called me and notified me of 5 medical "evaluations" I was to complete on 5 successive days. That part kind of sucked as every appointment was 45 miles from my house, and all were scheduled between 0800-0900...the height of rush-hour traffic. However, I met all of my appointments. Walk in; get evaluated; they tell you nothing, and out the door you go. About 5-6 months later I received a Compensation letter and final rating.

Now, THIS has happened to 4 folks that I personally know >>>> Pay attention to your rating effective date because the VA tends to "start" benefits relative to when THEY complete THEIR processes rather than to your actual discharge or retirement date (as it's supposed to be). I KNOW they know better than this. I SUSPECT they do it on purpose thinking most folks won't bother if it's "only a month or three." In my case, it amounted to 4 months worth of back-pay since I started the process several months before I retired.

I personally didn't pursue the matter. Upon the beginning of the new year following my retirement, my previous agency sent me a letter indicating, "...based on our calculations, the VA underpaid you 4 months of benefits..." I let it go that year - didn't care. The following January, a full year later, my agency sent the same letter to me again and again I didn't pursue it. Sometime beyond the 2-year mark of my retirement (maybe mid-February) I suddenly received 4 months of back pay in a totally separate deposit to my account. Will that "underpayment" catch up with everyone - I doubt it. Caught up with me without me having to get involved to run it down. Frankly, I wouldn't have wasted by time battling it out with them via the "1-800" number the VA has for All-Hands.

In the end, I can't rave enough on the DAV. Several of my buddies have used them as well. NONE OF THEM have a single complaint. If I had to choose between a VA Rep and a DAV Rep, I'd drive 500 miles to see the DAV every single time. I don't mean to disparage VA Reps (I don't personally know any) - I just went with the knowledge and experience of those who went the process before me and it was smoooooth sailing!

Good luck!!
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Scarfinger
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Re: Feedback from any VA folks?

Post by Scarfinger »

This may or may not apply to you. But with talking to Veterans who have filed claims, I hear it can take up to 18 months. I have also heard from some of the Vietnam Vets that it can take several years. But the good point is that the Vets I have talked to have gotten back-pay from the date of the initial claim. For some it was around $30,000 dollars.

Good Luck
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IRQVET
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Re: Feedback from any VA folks?

Post by IRQVET »

After you submit your medical records, you need to be scheduled for a C&P exam by the VA. That is the make or break appointment where they either concur with your medical files about your medical condition(s), or they downplay the severity of said injuries. With COVID, it would not supprise me if they pushed your date out to September.

Most of my injuries where combat related, so they didn't have a leg to stand-on in terms of denying ANYTHING in my file. I was awarded 80% and the entire process for me was around 4-5 months +/-. But that is not atypical! My best friend (grunt with the 82nd) with two combat tours is still fighting his case with the VA, I beleive he is going on 5-6 years and still counting because of all the different appeals and reexaminations he's gone through.

Keep in mind the online VA comp system is a garage in- garbage out. Meaning, it usually less accurate than it is accurate. My file still said it was pending review when all of a sudden my first back payment arrived. It wasn't until 3 months later that their online system caught up and said my file had closed, so don't put alot of ownesss in the accuracy of the data in there.

If your having issues, I suggest reaching out to your local congressmen's VA liaison. That usually gets the ball rolling; BUT- by doing this its a double edged sword. They will rush your case through but it can (and has) backfired on some people I know, because they ended up getting less compensation; and were then forced to go through the appeals process. The success to failure rate was 50/50. It really depends on which regional office is handling your file.

Good luck to you, but in any event, use every program the VA offers. They paid for my associates, bachelors, and masters degree program; home loans, you name it. Even when I was lied to and told I didn't qualify. Its hard to wade through all the misinformation out there, especially when its the VA themselves are spreading the false information. I can't tell you how many times I watched them flat out lie to veterans. Its important to get an advocate; whether its the DAV, VFW, or the American Legion. They can wade through the BS like no other . . .
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ProduceMan
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Re: Feedback from any VA folks?

Post by ProduceMan »

Anyone looked at the “combined VA disability ratings table (table used for final rating if you have multiple claims).
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xencfw
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Re: Feedback from any VA folks?

Post by xencfw »

Hi there I'm a VA DRO - the senior position above a RVSR who is the one typically decides disability cases. I've been in compensation benefits for 11 years. In other words I can overturn a RVSR based solely on my opinion and I serve in the higher-level review lane (like of appeals) to review decisions already made. NG/R cases are typically a whole different story than regular AD and they are very far from cut/dry answer as I would have from an AD retiree. Depending on what you did in service and what you are claiming you may be surprised to find the VA may not actually even consider you a "veteran." If you had no Title 10 activations you're looking at an uphill process. The initial ADT (does not equal "veteran" for VA purposes unless you have a disease or injury from your basic training. As far as the IDT/weekend/2 weeks a year stuff you basically need to have a line of duty reported injury for most of that to get an exam. Any diseases like hypertension (there are a few exclusions like heart attack/stroke) are a no-go on non-active time. Full time duty in the NG could be a different story. Regular active duty is the easy stuff. There are of course other exceptions like congenital conditions, pre-existing stuff, etc. There are presumptive conditions depending on when you served and when the condition was diagnosed. Lots of possibilities to think about.

For most cases the best think you can do for yourself is to help any VA decision maker answer the following questions:
1. Do you have an current diagnosed disease or injury and/or worst case at least recurrent symptoms of a disease or injury + where/when were you diagnosed (good example: I a claiming lower back pain - I was diagnosed with DDD/DJD L4-L5 at XXXX on XX/XXXX)
2. Why do you think this is related to service (good example: I hurt my back after I fell down from XX at Ft. Bragg Sep 1984 and I was seen for back pain and given a profile. My back has never been the same again and has always hurt from then to present.)

As far as that timeline stuff on ebenefits. That's totally made up. If you want a case status you're probably better off calling the NCC line 18008271000 or asking your representative.

More than likely one of two things will happen once all your records are together. You'll probably either get sent to an exam . An exam = VA's thinking you have a chance at a grant or two you'll just get denied. If you don't get an exam you're probably on the denial track.

The thing that gets people is they may have a bunch of medical problems but none of them have anything to do with their service. So they are a "disabled veteran" yes but not for VA purposes = no benefits.

Usually a poor idea to wait more than 1 year after you discharge from AD to file a claim as the whole process gets more complicated at that point. I think you said you left AD in 2008.
Claims within 1 year VA virtually gives you $$ if you have a condition and it was shown in service. Outside a year you have to in most cases convince a Dr. that your current condition is related.

If you filed for PTSD (you said you submitted an 0781) and served anywhere in a combat zone and/or hearing loss/tinnitus you're virtually guaranteed to be sent to an exam. If you are claiming anything noted in active duty; almost certainly should get an exam. Anything from a NG period - good luck on that without a line of duty or some strong evidence of an injury.

One last thing - you said you were retired. If you are receiving military retired pay don't count on any back pay anytime soon. Even if the process is completed today in almost all scenarios VA is required to withhold all of the retroactive payments until either the 1st of the current month or the 1st of the next month until DFAS or CG does and audit and gives VA the OKAY to pay you. That means you'll just get a monthly payment for a while until that audit comes through.

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Aitrus
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Re: Feedback from any VA folks?

Post by Aitrus »

Thanks for all the advice, guys. Lots to think about.

xencfw,

I did 10 years active duty, then joined the Guard for another 10 years before retiring to "grey area" status. I'm on the Retired Reserves list, and won't start getting a retirement paycheck until I turn 60.

Almost all of the things I'm claiming come from my active duty time, or if in the Guard then they happened on Guard time and have a Line of Duty determination. All items I've explained in my personal testimony how they were related back to the military and the jobs I performed while in the service. I was told by multiple sources in the Guard that I couldn't claim anything until I retired, so that's why I waited. If I was lied to...well, it wouldn't be the first time.

As far as PTSD and service-related issues, judging by what you're saying I'll definitely be getting an exam then.
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stilljammi
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Re: Feedback from any VA folks?

Post by stilljammi »

My ex had a claim that lasted almost a decade, with all appeals and the appearances before a judge, meeting with the doctors and gathering all the info. It wrapped up last year, but even then, they were so far behind on the claims. I get the feeling that they auto-deny everything, just to weed out the folks who don't have the endurance for it. I don't even want to know what their backlog is during and after corona.

xencfw
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Re: Feedback from any VA folks?

Post by xencfw »

Aitrus - sounds like you are on the right track. I concur you'll probably be hanging out at a VA C&P exam sometime.

About filing a claim while in NG/R there is no restriction to receiving VA benefits. The only thing that happens is that VA withholds money each year for however many "days" are considered paid training time where each 4 hour period in a weekend is counted as a day (4 "days" in a 2 day weekend) or each "AD" calendar day is just one day. So basically it's annoying on the VA side because you'll have a VA over payment every single year until you retire. We internally refer to this as drill pay. I think some folks don't want to file because they're afraid the NG/R will kick them out based on their disability rating. It's pretty well known VA disability ratings are extremely inflated (essentially made up) such that a 100% total and permanent disability evaluation doesn't functionally mean anything - can still work full time and maybe have no actual limitations in the work place. I've heard this happening to some folks in the NG/R as VA grants 100% or IU (unable to work) but their still fully worldwide deplorable and functional service members.

Anyways most claims have been going through in 125 days or less. I suspect you had a delay because of the NG holding your records (typical problem). Now I suspect you probably have a COVID delay. Could be something else with records being a problem also because we have delays in various specific development actions (like researching some events) due to COVID.

If you call the NCC or ask your POA ask them to see if your claim is flash for "force majeure" which would indicate your case is held up due to COVID either due to records or due to exam.

tashabh
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Re: Feedback from any VA folks?

Post by tashabh »

Hi! VA employee here-RVSR. Claims are extremely backed up due to COVID. They had to halt exams for months, all while still receiving new claims. The amount of claims in what we call backlog (claims older than 125 days), doubled from 60k last year, to 120k now. They worked really hard over the last few years to get it under 100k, and had just made significant progress. Once the process of scheduling exams gets back to normal, everything will speed up. More telehealth exams than usual are being scheduled in the interim, but with VAMCs and contract examiners unable to operate at full capacity things are moving at a crawl. I can't really think of anything that you can do on your end that will help to speed anything up. Maybe call and leave a note in your file that you are willing to do complete telehealth exams. Other than that, just try to be patient and not let it drive you crazy. I totally understand how hard the wait is. My daughter has been waiting 19 week for unemployment. On a brightside, if you are in line for exams, thats a good thing! That means they aren't just denying you out right. Only problem is you're waiting for exams behind people who may have been waiting since the beginning of/before COVID. Hang in there Atrius!!! Its not if, its when, and keep in mind they will backdate you to your date of claim. By the details that you provided about your claim, I see no problems. You did not have to retire from the Guard first, by the way. You could have claimed right after active duty discharge. On behalf of the VA, I'm sorry for the wait, and thank you for your service!!

Oh! And PS, I highly doubt it will take a year for your claim to fully process. My guess is that they don't know how to project processing timeframes going forward this year, especially with current ongoing uncertainty, and are just throwing out worst case scenario projections so that people aren't expecting the usual 125 day timeframe.

Scorpio70
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Re: Feedback from any VA folks?

Post by Scorpio70 »

My final claim took 18 years and $80K in legal fees. We went to CAVC, and my claim was decided by the Chief Justice. He smacked the VA's hand pretty hard. No matter the rating, always appeal. They low ball most people out the gate.

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