Disabled Veterans Battle For Benefits

[Navy6064]

Disabled Veterans Battle For Benefits
Philadelphia Inquirer
March 9, 2005

The waiting can go on for years. Bureaucratic mistakes are far too common, by the government's admission. And when veterans finally do win claims for disability compensation, the amount of money they get may vary by the mere happenstance of where they live.

The U.S. Department of Veterans Affairs is falling short of its own standards for serving disabled veterans, according to an investigation by the Inquirer Washington Bureau.

The VA admits its processes are slow and prone to errors. The number of veterans who have taken steps to appeal an unfavorable decision on disability benefits has grown from 60,000 in 2000 to 109,000 last year. Patterns suggest that many will ultimately win their claims, but some veterans and their families wonder if the agency is just stalling.

"I think they think, 'Maybe he'll die and we won't have to pay anything out,'" said Carolyn Cabral of Lakewood, N.J., whose husband, Eugene, an Army draftee in the late 1950s, died in January while waiting for his appeal to be decided.

The VA repeatedly has failed to meet internal and external recommendations to eliminate redundant steps in the application and appeals process. An exhaustive review by the Veterans' Claims Adjudication Commission, completed in 1996, declared the claims and appeals process "cumbersome and outmoded" and in need of an overhaul.





"I think things are basically the same," Michael Walcoff, who oversees the agency's 57 regional offices, said of the appeals process. "I wouldn't say that we have changed the system in any major way."

While the VA concedes shortcomings, Anthony J. Principi, who was secretary of veterans affairs until January, said in an interview late last year that things had gotten better since President Bush was elected.

"This agency was under water in 2001," he said. "My people have made tremendous progress... . We are doing everything in our power with the resources that we have to ensure that veterans are treated fairly and equitably."

The Inquirer Washington Bureau investigation was based on interviews with veterans and their families from around the country and on a review of internal VA documents and computerized databases that had never been released to the public. Many of the records were made available only after the bureau sued the agency in federal court.

Among the findings:

Some groups that provide VA-accredited experts to help veterans with their cases have no set training requirements, and the service officers are rarely tested to ensure competence. The veterans service officers work for nonprofit organizations such as the American Legion, as well as states and counties, but their quality is uneven, and that often means the difference between a successful claim and a botched one.

The average wait to get an initial decision in a case is 165 days, well above the agency's goals of the last decade, which have ranged from 60 to 125 days. For veterans who choose to appeal their cases, the average wait is nearly three years, and many veterans wait 10 years for a final ruling. In the last decade, several thousand veterans died before their cases were resolved, according to a Washington Bureau analysis of VA data.

Errors are made in 13 percent of claims, a VA quality-control database shows. This is more than three times the agency's hoped-for rate of 4 percent. That translates to 103,000 errors a year, many that result in either overpayment or underpayment of benefits. Error rates vary by region. At the Philadelphia office, which serves eastern Pennsylvania and South Jersey, the rate is 13 percent, on par with the national average. The error rate in Wilmington is a far higher 23 percent.

The regional offices also produce inconsistent results when it comes to determining a veteran's degree of disability and amount of compensation. The average monthly sum received by veterans through the Philadelphia office is $682, while the average in Albuquerque, N.M., is $1,008. In Pittsburgh, it is $626; in Wilmington, $616; in Newark, N.J., $591.

"How a veteran seeking benefits gets treated should not be an accident of geography," said George Basher, the director of the New York State Division of Veterans' Affairs, one of 50 state agencies that help veterans. "Unfortunately, the current system makes that a virtual certainty."

The VA is a mammoth agency that serves 25 million veterans with a far-flung health-care system and a separate disability and pension operation. The agency spends more than $60 billion a year, more than $20 billion of it on disability compensation to 2.5 million veterans.

VA Secretary R. James Nicholson is scheduled to appear before a congressional subcommittee today for a hearing on the VA's budget. The House and Senate veterans committees will hold hearings this week to listen to the annual legislative presentations from national veterans groups.

The agency makes disability payments for injuries as obvious as an amputated leg and as complex as post-traumatic stress disorder. The injuries include combat wounds and peacetime injuries, since military personnel are serving their country whether they are in a humvee in Iraq or in boot camp.

Neither department officials nor department critics can wholly account for the regional differences in error rates and payments.

But one factor may be the wildly varying quality of help that veterans receive in compiling the evidence of their disability from military and medical records, and then properly navigating the VA's thicket of rules and deadlines.

The VA is charged by Congress with making it as easy as possible for veterans to pursue their claims. But James Davison, Pennsylvania's deputy director of veterans affairs, said that "what the VA has done for years is try to push their obligations off onto the states... . The states have chipped in where the feds have essentially fallen short."

Despite years of study, VA officials said, many of the agency's problems remain because of the nature of an ever-changing bureaucracy. Responding to changes in the law and court decisions has made it harder for the VA to accomplish what it set out to, agency officials said. "The system has become more complex," Principi said in the interview.

In addition, attempts to streamline the process could have the effect of cutting off veterans' appeals rights, and therefore have met with resistance from veterans groups.

Counties, as well as states, provide help to veterans in filing claims. The lion's share of help comes from veterans accredited by the VA to help other veterans.

About 40 veterans service organizations, such as the Disabled American Veterans, are authorized to help prepare VA claims.

The Inquirer Washington Bureau found that the network of VA-accredited service officers is a patchwork of well-meaning helpers whose training and expertise vary. Yet the agency prohibits veterans from hiring their own attorneys until after their claims have been denied and they are generally years into the appeals process.

Two-thirds of the veterans who submit claims use service officers, and picking the right one can determine whether they get the full payment they are due, a fraction of it, or nothing.

The VA, through its national accreditation program, is supposed to ensure that all service officers are "responsible" and "qualified." But the VA program simply approves names submitted by veterans groups. About 11,000 service officers are currently on the VA's roster; about 80 percent are accredited through nonprofit groups.

VA regulatory files, obtained after the Inquirer Washington Bureau lawsuit was filed, reveal that the agency has done little in decades to determine the adequacy of the training provided by veterans groups or to check the quality of the claims prepared by their officers. Only rarely does the VA suspend or revoke a service officer's accreditation. When it does happen, it is generally the result of criminal charges rather than incompetence.

"What we do is take it on the word of the service organization that the individual has had sufficient training," said Martin Sendek of the VA's general counsel's office.

At one end of the training spectrum is Disabled American Veterans, which has full-time paid national service officers and a 16-month training and testing program that is so regimented that it qualifies for 10 hours of college credit.

Groups such as American Ex-Prisoners of War and Catholic War Veterans rely largely on part-time volunteers who are not required to complete any courses or pass any tests.

"We don't get paid, so we're not going to be that strict with these people," said Doris Jenks, the national training director for American Ex-Prisoners of War.

Rich Hudzinski, a retired Army major now active in the Lehigh Valley Military Affairs Council, has found from his own analysis of VA data that payments to veterans with similar disabilities are not only inconsistent from state to state but can vary from county to county within a state.

That suggests to him that a veteran's chances of getting a good result may depend as much on the service officer who helps file the paperwork as on what happens in the VA office.

Hudzinski blames the state for not doing a better job of helping veterans win their claims. The Pennsylvania Department of Military and Veterans Affairs has four people on staff whose job is to help disabled veterans file their claims. New Jersey has 22 state employees for that purpose.

The Lehigh Valley veterans' group suggested in a November appearance before legislative committees in Harrisburg that the Pennsylvania department should be broken in two - with one part managing the state's National Guard contingent and the other concentrating solely on veterans' needs.

"What it really comes down to is the number of well-qualified people out there [to help disabled veterans get their benefits] and a unified system that the state has control over," Hudzinski said.

Each of Pennsylvania's 67 counties and New Jersey's 21 counties also has a staff member whose job includes helping veterans with their paperwork.

"The VA isn't that bad," said John Dorrity of Ocean County, who heads the National Association of Veterans Service Officers. He said it was the service officers who varied at all levels, from nonprofit to state to county.

"It's the service officers - what they feed into [the VA]," he said.

The VA says it is unaware of any systemic problems.

Retired Vice Adm. Daniel Cooper, the VA's undersecretary for benefits, said the department fixes any mistakes that service officers might make.

Agency general counsel Tim McClain noted that veterans had extensive appeal rights.

"There are a lot of checks and balances in the system," he said.

Veterans, often not knowing where to turn for help, can end up frustrated.

Gordon Frey, 76, of Bethlehem, Pa., fought for more than 10 years to increase the 60 percent disability rating he received after serving in the occupation of Japan after World War II.

While on guard duty, his appendix had burst. He was found almost dead. That led to five operations and a lifetime of, as he puts it, "not being able to control my bowels."

Later married and a father, he tried his best to work as a door-to-door salesman of cookware. He said he would regularly miss two weeks of work a month. When he did work, he would often have to ask to use the homeowners' bathroom.

"I'm a proud person," Frey said last week. "That was hard."

In the early 1990s, he realized he might be able to claim a 100 percent disability. He was denied.

He continued to work but never earned more than the poverty rate. That meant, under VA regulations, that he technically was not employable.

It took more than a decade - until 2003 - for the VA to agree that he warranted a total disability rating. He got $40,000 for two years of back compensation, plus a regular check that now amounts to almost $2,300 a month.

George Wilson, his veterans' group representative, believes Frey was shorted by the many thousands of dollars more he would have received if the VA had not taken a decade to act in his favor.

With the average disability payment now about $8,000 a year, back-benefit awards can be substantial because an award is calculated as though the VA made the right decision when the claim was first filed. Some veterans with severe disabilities get $100,000 or more.

Wilson, a World War II veteran who works with the National Veterans Organization of America, said the VA was getting worse in handling claims.

"I see no improvement," he said. "All I see are the letters that come [to veterans] saying, 'We are working on your claim....' I see letters like that every week. It could use some streamlining."

If a veteran dies with his or her case under appeal, the case dies, too.

In the last decade, more than 13,700 veterans died while their cases were in some stage of the appeals process, according to an Inquirer Washington Bureau analysis of VA appeals records database. (While precise estimates are not available, the VA said experience suggested a few thousand of them would not have actively pursued their appeals.)

Eugene Cabral, who died Jan. 25, had been pursuing a claim for an increase in his disability rating for a little more than three years.

A soldier in Korea from 1958 to 1960, he badly injured his back while changing a heavy truck tire. Over the years, he had worked as a civilian truck driver. But by the 1990s, his wife said, he could not even stand up straight. The doctors told him it all went back to his days in the service.

Carolyn Cabral, now alone, says that without the extra income her husband had hoped for from the VA, she isn't sure whether she can continue in her home or whether she will have to move in with her son in Pennsylvania.

"But don't write that this is about money for me," she instructed a reporter. "This would have been money for my husband... but he isn't around."

[USMCRET6391]

The VA says it is unaware of any systemic problems.

And this ladies and gentlemen, is precisely the problem.

[AmericanGirl]

:tappingne Its a damn shame that we can't take better care of our veterans