Written by: Rachel Strubel

The U.S. Department of Veterans Affairs (“VA”) recently announced a new initiative in an attempt to simplify the disability claim process for both veterans and the Department. Starting in March 2015, the VA will use new standardized electronic forms, making it easier for veterans to state their disability claims with the necessary information. The VA is also simultaneously creating a new “Intent to File” procedure that preserves the claim’s effective date while giving the veteran up to a year to compile the necessary documentation. Previously, veterans were able to submit their request for benefits in any form, which VA alleges contributed to the delays in processing. With these initiatives, the VA hopes to increase the efficiency in the disability claims and appeals process.

While it appears facially that these new processes will provide more assistance to veterans by increasing the efficiency of the disability compensation, it may in fact be more detrimental to veterans. First and foremost, these processes require veterans to submit additional documentation, increasing the burden on the veteran despite the VA’s statutory duty to assist veterans in the disability claims process.  In other words, these processes are passing the VA’s duty onto veterans.  Additionally, many veterans may not have access to these forms and the requested information as many veterans are homeless or lack the necessary resources. Requiring veterans to complete standardized electronic forms may be even more cumbersome and daunting to veterans, in a system that is already difficult to understand and navigate. While these initiatives may increase the disability claims processing speed, the VA is dramatically increasing the burden on veterans that the VA was designed to serve.

References:

VA to unveil new standardized disability claims forms. The Navy Times, September 24, 2014. http://www.navytimes.com/article/20140924/BENEFITS04/ 309240057/VA-unveil-new-standardized-disability-claims-forms

Druzin, Heath. New Electronic Form to Streamline Chaotic VA Claims Process. Military.com News, September 26, 2014. http://www.military.com/daily-news/2014/09/26/new-electronic-form-to-streamline-chaotic-va-claims-process.html

Written by: Ashely Eick

On August 6, 2012, the President signed the “Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012,” which allows up to a one-year retroactive effective date of disability compensation for fully developed original claims received from August 6, 2013 through August 5, 2015. The motive behind this Act is to incentivize veterans to submit fully developed claims by granting an extra year of disability compensation for successful claims.  This fast-track procedure typically cuts down processing time from 254 days to 110 days and significantly lightens the VA workload.

With over 245,175 backlogged claims over two years later, it is clear that the VA still has a problem with processing benefit claims despite the Act. This leads one to ask – why should only original claims be incentivized?

The vast majority of VA disability claims are not initial entitlements but supplemental entitlements, also known as reopened claims, claims for increased compensation, and secondary claims. Therefore, to truly address the backlog of disability claims, the VA should incentivize fully developed claims of supplemental entitlements not just initial entitlements. Without the promise of an earlier retroactive effective date, veterans’ only inducement for filing a fully developed claim is a quicker processing time. Although getting a rating decision a few months earlier may be enough of an incentive for some veterans, for many others, it is not.

In order to submit a fully developed claim, a veteran must identify where all federal military and medical records are located and the dates of treatment for claimed conditions as well submit any medical evidence of current disability, evidence of the in-service event that caused the disability, and evidence of a link between the current disability and the in-service event. For a veteran suffering from a disability, especially a mental one,  this process may be nigh impossible and require so much work that it is not worth the effort to get the expedited treatment. However, the promise of a year of retroactive payment may be enough to encourage veterans to submit fully developed supplemental claims, despite the difficulty in doing so, just as the promise is doing with original claimants.

Finally, in terms of public policy, there is something fundamentally wrong with granting a financial benefit only to those who submit initial claims. By financially incentivizing original claimants, the VA is discriminatorily favoring new veterans. Older veterans most likely have already applied for disability compensation before this policy came into effect and are reopening old claims or are petitioning for increased compensation. This means that they are precluded from the fully developed claims incentive. Consequently, the law is discriminating against veterans based on their service date.

Written by: Kathleen Zaratzian

On September 24, 2014, Disabled American Veterans (DAV) released a comprehensive report assessing the distinct needs of female veterans and the sufficiency of programs available to them when they leave military service.  The report, titled Women Veterans: The Long Journey Home, urges the expansion of female specific programs and outlines ways in which federal agencies and community service providers do not adequately meet the unique needs of female veterans.  The number of female military service members and transitioning female veterans is increasing, which makes it essential that veterans’ services are restructured to close the gender gap in health care, job training, finance, housing, social issues and combating sexual assault.

Women constitute a growing number of U.S. military service members.  Female roles are expanding to previously “men-only” positions including roles in infantry and armor divisions and special operations.  More than ever before, women are directly exposed to combat and other violence, increasing the likelihood of common combat related injuries such as PTSD and Traumatic Brain Injury.  Last year, the VA cared for approximately 390,000 female veterans at its hospitals and clinics, as compared to the 5.3 million male veterans who used the VA system.  Despite the sizeable difference across gender, this is more than double the number of women who received care in 2000.  And the number of female veterans is expected to increase, while the number of male veterans is expected to decrease by 2020.

Despite the growing prominence of women in the military, the report found that “[w]hen women talk about their military service, a large number will report that they feel invisible, that their ‘non-combat’ role was less valued than those of the men who served and that they do not identify themselves as veterans. There remains a misperception on the part of the American public and women who serve that they are not eligible for full veterans’ benefits.”  The DAV proposes changes to the culture of veterans’ services to broaden services that currently tailor to male veterans and to close the gender gap in veterans’ services that currently leave female veterans feeling devalued and undeserving of the benefits that they earned during service.

Some of the ways in which the needs of female veterans differ from their male counterparts in terms of disability benefits include: higher rates of PTSD symptoms, depression and other co-morbid conditions; different responses to prosthesis and complications with fittings during pregnancy; preferences for female physicians and increased privacy; different types of treatment such as gender-specific group counseling, residential treatment and specialty inpatient programs; and women specific health services.

Evidence that female veterans are not receiving adequate services can be seen in the VA’s finding “that almost one in five women veterans has delayed or gone without needed care in the prior 12 months.”  One third of VA medical centers do not have a gynecologist on staff.  Additionally, reports of military sexual trauma (MST) are growing and one in five women enrolled in VA health care screen positive for MST.  However, a third of VA medical centers and community clinics were unable to provide full MST services as recently as 2013.

DAV recommends expansion of gender-specific programs and a shift in military culture that honors, respects, and fully understands the unique needs of female veterans.  Fortunately, the VA appears receptive to these recommendations.  Dr. Carolyn Clancy, VA’s acting undersecretary, told a group of female veterans and supporters that the report will serve “as our road map for improvements.”  The VA is best situated to provide the best health care to female veterans because VA health care combines social, economic, psychological and physical services specialized for veterans.  However, the differences between men and women in the ways that they experience military service and gender-specific health needs must not be ignored.

Sources:

  1. Matthew Daly, Report: Services for female veterans fall short, Federal News Radio (September 25, 2014), http://www.federalnewsradio.com/538/3708509/Report-Services-for-female-veterans-fall-short.
  2. New Report Reveals Nation Still Not Fully Equipped to Support Women Veterans, DAV (September 24, 2014), http://www.dav.org/learn-more/news/2014/new-report-reveals-nation-still-fully-equipped-support-women-veterans/.
  3. Women Veterans: The Long Journey Home, DAV, (2014), http://www.dav.org/wp-content/uploads/women-veterans-study.pdf.

Written by: Katie Ashley

The Department of Veteran’s Affairs (VA) has recently announced its intention to “recruit [the] best and brightest” health care practitioners through increases in pay in order to better serve our nation’s veterans.  The proposed plan will raise the pay ceiling for prospective Veterans Health Administration (VHA) medical professionals.  Namely, there will be an annual pay bump of $20,000 to $35,000 for future physicians.  In addition to the salary boost, the VA plans to take additional measures such as partnering with local nursing programs as well as the Department of Defense Health Affairs, and developing a program to enlist more corpsmen and combat medics to join the ranks of VHA clinicians, among others.  Moreover, the VA boasts that it is the largest employer of medical practitioners and that more than 70% of all doctors in the United States have received training through the VA.

That being said, a 2014 survey by The Medicus Firm indicated that physicians continue to rank government employment as their last choice.  Health care providers from all over the country consistently show a lack of interest in working for the government, which includes working for the VA.  This disinterest among physicians in VA work, especially in long-term employment, has resulted in “[a] revolving door of short-term physicians,” which ultimately hurts our veterans.  This high degree of turnover explains how the VA can claim to be the largest employer of practitioners.  Having temporary medical professionals, and more notably, professionals who are less than interested in working in these positions, results in a lack of continuity of medical care, lack of attentive medical care, and an overall indifference towards the “noble and inspiring mission” of serving those who served us.

Although this proposed increase in pay may entice physicians to stay longer—ameliorating the continuity problem—I cannot see how dangling money in front of physicians to work in a position that the majority of all medical practitioners do not want is going to improve the care that our veterans receive.  The practitioners should not be in it for the money, they should not be in it as a stepping stool to obtain a bigger and better job, they should not be in it because there are no other jobs to choose from, but rather they should be in it to help those who put their lives on the line to keep us safe.  Even though more practitioners are needed, and the additional money may attract more prominent physicians than in the past, I cannot say that I would want a physician who is more motivated by money than my well-being.  At the end of the day, quality is better than quantity.

If this proposed pay raise results in improved care for our veterans, then I am all for it.  It is baffling to me why working in these positions is so undesired.  Our veterans watched out for our backs, and now it is time for us to better care for theirs.

Sources:

http://www.forbes.com/sites/brucejapsen/2014/06/15/though-veterans-need-physicians-va-isnt-popular-employer/

http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2632