Veterans I've talked to probably complain more about delay in getting action on their benefits claims than any other problem -- even the problem of not getting benefits they think they're entitled to. So I decided to take a closer look at the process of handling a claim and what causes a delay.
Decisions on claims for pension and benefits typically take place at the regional-office level; the office for this region is in Winston-Salem. So I tried to call the director of that office to see about coming over there for a day or so, to watch how the work is done, ask questions of the people who work there about where they think any bottlenecks lie, and so forth.
That was my first bottleneck.
There's an 800 number listed for that office, but the voicemail menu isn't much help if you're not, say, a veteran seeking help with a claim. (The department's Web site was no help, either.) So that's what I pretended to be, at least while navigating the voicemail system, until I got hold of a live human being. That person, very polite and helpful, couldn't connect me directly to the regional director or anyone who handles press inquiries, but he offered to relay a message.
Someone from the office got back to me fairly soon afterward, but she ended up referring my inquiry to a press person at departmental headquarters in Washington. He, in turn, asked that I e-mail questions to him. I did that Friday afternoon, asking that he at least acknowledge getting the questions promptly even though I knew it might take a while to answer them all. I have received no acknowledgment, so I re-sent them this morning.
I'm going to list them below. If you can think of any I've missed, or have any other comments, please hit the comment link or e-mail me.
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1. How many claims for benefits filed for compensation and pension are currently awaiting adjudication by rating boards and officials at the Department of Veterans' Affairs' Winston-Salem, N.C., regional office?
2. Once a Form 21-526 is filed with that office, what is the average time period until the board issues a final rating determination on the initial claim?
3. How many rating-board employees does the Winston-Salem regional office currently have authorized to handle initial claims for adjudication being filed at that office? How many of the authorized positions, if any, are currently vacant?
4. What measures have been taken at the VA central office to help the Winston-Salem regional office address issues of heavy caseload and inadequate staffing?
5. What measures have been taken by the Winston-Salem office itself during FY06 to deal with the heavy case load and inadequate staffing complaints made at the regional-office level?
6. How many employees have been hired by the Winston-Salem office in FY06?
7. What is the average age of these new employees?
8. What is the average educational level of these new employees? How many of them have college degrees (bachelor's degree or higher)?
9. How many of these new employees have served in the active-duty or reserve military?
10. If any new employees were hired to serve on ratings boards and had military backgrounds, how many had medico-legal backgrounds or medical backgrounds (e.g., nursing, physician's assistant, physical therapy, etc.), from their military service or otherwise?
11. On average, how much time are new hires given to learn the VA compensation and pension rating system before they begin handling claims?
12. What is the average salary for new employees hired to assist in adjudicating initial claims for compensation and pension filed at the Winston-Salem office?
13. How many physicians does the Winston-Salem regional office have on its staff to render medical opinions regarding VA medical claims at the regional office level? What is the average age of these physicians?
14. What are the criteria of the Winston-Salem regional office for hiring "independent medical opinions" to support its reasons and basis for rendering a rating decision?
15. In what specialties do the office's staff physicians practice?
16. Are all those physicians with specialties certified in those specialties by the American Board of Medical Specialties (ABMS)?
17. Please describe the work process followed by rating-board employees in the Winston-Salem office in processing a typical claim.
18. In the Winston-Salem regional office, what procedures are followed to comply with the "affirmative VA duty to assist the veteran in developing his claim," under the Veterans Assistance Act of 2000 as well as under court case law? What measures are taken to obtain independent medical opinions, service medical records, buddy statements and other documentation in support of a claim? And what measures are taken to advise the veteran of what he needs to do to make his claim successful?
19. If the regional office is going to deny a claim, does the VA affirmatively inform the veteran of what evidence or procedures would be necessary to strengthen his claim to be granted the benefits sought under the VA's affirmative duty to assist the veteran in developing his claim?
20. What is the purpose of a "tiger team"? What effect has the VA's creation and assigning of tiger teams had on case load and average adjudication time of claims, in the Winston-Salem regional office and nationally? Has it cut down on backlog?
21. How is an employee selected to be on a tiger team?
22. Describe the process by which ratings-board employees are professionally evaluated. In particular, is there a quota on the number of cases in which each ratings-board employee must produce decisions regarding veterans claims on a daily, weekly or monthly basis? Are the employees personally rated or graded based on the number of cases that they produce in a given time period?
23. What is the time limit, if any, by which a ratings-board employee in the Winston-Salem regional office must get an initial claim for adjudication to the point of a final rating decision?
24. What is the case load assigned to each employee who is to review initial claims for adjudication at the Winston-Salem office?
25. Are there quotas and/or incentives for production in terms of how many cases are decided by a specific individual in terms of a final rating determination on an initial claim filed by a veteran?
26. What is the percentage of full grants of benefits to veterans who have filed claims with the Winston-Salem office for compensation and pension through a VA Form 21-526?
27. In the Winston-Salem office, what is the average number and percentage of initial rating decisions being appealed through reconsideration, consideration by a decision-review officer or the filing of a reopened claim?
28. In the Winston-Salem regional office, on average, how long must a veteran wait to get a complete copy of his claims folder, upon request by the veteran for such a copy?
29. How many such copying requests are currently pending in the Winston-Salem regional office?
30. What is the average amount of time from when a veteran first files his initial application for compensation and pension with the Winston-Salem regional office to the time he must file any appeal to the Board of Veterans Appeals? This includes any time necessary to adjudicate the notice of disagreement, the statement of the case and any decision-review officer decision.
31. What measures has the Winston-Salem regional office taken to address the complaints of many veterans, particularly elderly veterans worried about dying before they can receive benefits, that claims are languishing in that office?
32. Describe the duties of a decision-review officer. What steps, if any, do decision-review officers in the Winston-Salem regional office typically take under the affirmative VA duty to assist the veteran in developing his claim?
33. If a claim is initially denied or granted at a lower disability rating than sought by the veteran, is the veteran, under the VA's duty to assist the veteran in developing his claim, given an opportunity to rebut medical statements or other evidence relied upon by the Winston-Salem office in denying the claim?
34. What percentage of claims initially denied or granted at a lower disability rating than initially sought at the Winston-Salem office are referred to a decision-review officer?
35. Among cases referred to a decision-review officer at the Winston-Salem office, what percentage are approved and what percentage are denied?
36. After a rating decision has been adjudicated and a claimant files a claim for reconsideration, what percentage are granted reconsideration by the Winston-Salem regional office's VA ratings board ?
37. Of those granted reconsideration, what percentage are granted relief?
38. After the denial of a claim for compensation and pension and the veteran files a notice of disagreement, how long, on average, does it take the Winston-Salem regional office to issue a statement of the case?
39. What is the average time from when the veteran files his initial claim for compensation and pension with the Winston-Salem regional office, through the time the statement of the case is issued and the appeal is filed to the Board of Veterans Appeals?
40. What is the average total time from when a veteran files his initial claim for benefits (with the Winston-Salem office specifically, or, if that figure is not available, with all regional office in the U.S.) to the time the Board of Veterans Appeals issues its final decision?
41. What is the average amount of time from when a veteran files VA Form 9, Appeal to Board of Veterans Appeals, appealing an adverse VA rating decision, that the VA renders a final decision then ripe for judicial review at the U.S. Court of Appeals for Veterans Claims?
42. How many claims for compensation and pension are currently pending before the Board of Veterans Appeals? On average, how long have those cases been pending before the board?
43. How many attorneys are on staff at the Board of Veterans Appeals?
44. What is the average case load of a staff attorney at the Board of Veterans Appeals?
45. How is the work of staff attorneys handling appeals at the Board of Veterans Appeals evaluated? In particular, is there any quota system or case-processing requirement over any particular time period (per day, per week, etc.)?
46. What steps, if any, do staff attorneys at the Board of Veterans Appeals typically take to fulfill their affirmative duty to assist a veteran in developing his claim?
47. What is the rationale behind the Appellate Litigation Staff Group's refusal to provide to veterans, their representatives or counsels, full and complete copies of their claims folders at the time of the filing of the notice of appeal with the U.S. Court of Appeals for Veterans Claims?
48. Please explain what factors contribute to the delay between the time the veteran files his notice of appeal to the U.S. Court of Appeals for Veterans Claims and the time he gets the first opportunity to review his claims folder (typically months later). In particular, after the Appellate Litigation Staff Group has completed its designation of record on appeal under Rule 10a of Rules of Practice and Procedure before the U.S. Court of Appeals for Veterans Claims, please explain the rationale for sending a veteran's case folder back to the originating regional office for the sole purpose of photocopying before making the case folder available to the veteran so that he or his counsel can prepare a counterdesignation of record on appeal under Rule 10b.
49. What problems, if any, exist at the Appellate Litigation Staff Group level of the VA's Office of General Counsel which are resulting in the delay of the processing of appeals before the Court of Appeals for Veterans Claims?
50. What problems, if any, exist within the Appellate Litigation Staff Group relating to inadequate staffing and heavy case load?
51. If such problems exist, have ways to fix the problems at that level by transferring personnel from the central Office of the General Counsel to the Appellate Litigation Staff Group been identified?
52. How many (if any) former Appellate Litigation Staff Group 027 employees, including attorneys, paralegals and support staff, are now working at either the Board of Veterans Appeals, within other staff groups in the Office of General Counsel or elsewhere in the the Department's central office?
53. If former employees of the Appellate Litigation Staff Group 027 are currently working in other positions within the Office of the General Counsel, the central office of the U.S. Department of Veterans Affairs, the Board of Veterans Appeals or regional VA offices, please explain why these employees have not been transferred back to the Appellate Litigation Staff Group 027 to assist with the heavy case load and inadequate staffing, the reasons cited to the court in almost every single case in which a motion for an extension of time is filed by the Appellate Litigation Staff Group 027.
54. How many motions for extensions of time have been filed by the Department's Office of General Counsel in FY05, and in FY06, due to heavy case load and/or inadequate staffing?
55. How many motions for extensions of time, on average, are filed by each side in any case in which there is a notice of appeal filed before the U.S. Court of Appeals for Veterans Claims? What percentage of those motions by each side are granted?
56. On average, how long does it take, after a notice of appeal has been filed with the Court of Appeals for Veterans Claims, for the case to be assigned to the attorney of record?
57. How many appeals are currently pending before the U.S. Court of Appeals for Veterans Claims? On average, how long have those appeals been pending? Upon how many appeals does that Court rule in a typical year?
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UPDATE: The public-affairs specialist with whom I've been dealing just e-mailed to say he expects to have answers later today.