By: K.N. Barrett

 With a backlog of well over 900,000 claims, the Department of Veteran Affairs (VA) is certainly under pressure to find a faster, more efficient method for processing veterans’ disability claims. Currently, the way applying for disability benefits works, veterans fill out their claims documents and submit them to the Veteran Benefits Administration (VBA) of the VA. Upon receiving these claims documents, the VBA schedules veteran claimants in person medical evaluations, called Compensation and Pension Exams (C&P Exams). At these evaluations, VA approved medical personnel examine veterans and determine the severity of the veterans’ disabilities and provide the VBA with a report indicating their findings. As can be imagined, going through this process for every single claim on behalf of every single veteran claimant is a long and time consuming process, which has contributed to the severe backlog situation. However, the VA may have come up with a solution to help speed this process along and eliminate the in-person examination requirement.

In September of 2012 the VHA issued Directive 2012-025, Acceptable Clinical Evidence (ACE) to Support the Compensation & Pension (C&P) Disability Evaluation Process. The purpose of this directive is to shorten the time claims spend being evaluated by the VHA, allowing the VBA to process claims faster. This initiative allows clinicians evaluating veterans’ claims to use medical evidence that has already been documented in veterans’ claims files, supplemented with phone interviews with the veteran claimants, to prepare veterans’ Disability Benefits Questionnaires (DBQs) without requiring veterans to appear in person for their evaluations. The DBQ is a claims form that helps to ensure that VA ratings specialists have the exact information they need to process veterans’ claims. This change in the process will undoubtedly shorten the wait time for veterans to get through the medical screening process and get their claims evaluated by a VA specialist.

The VA decided to evaluate this new processing system in a 15-month pilot program at one of its regional claims processing offices. During this test period thirty-eight percent of the claims submitted by veterans to the office were eligible for the ACE process, meaning VA medical personnel determined that the records requested contained satisfactory medical information for the processing of these veterans’ claims without the veterans having to physically come in for an evaluation. Percentages of claims eligible for the new process this high will certainly help the VA cut down its backlog numbers and process claims faster.

To read Directive 2012-025 please visit: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2790

 

 

Comments are closed.