Buffalo, NY — The Veterans Administration (VA) recently reported it “has made significant progress toward our goal of eliminating the claims backlog in 2015,” by reducing the backlog from 611,000 to 344,000 claims pending for more than 125 days. According to the Center for Investigative Reporting (CIR), however, the typical wait time nationwide for a decision on an initial application is 300 days. As of June 9, 2014, in the Buffalo area 7,292 vets had claims on file, and those waiting for decisions on initial applications waited an average of 355.
These contradictory numbers result from the criteria the VA uses to identify the backlog. The 344,000 claims include only those pending for more than four months —the actual total number of claims in the system is 1.3 million.
“There are approximately 275,000 claims mired down in the appeals process, which the VA is choosing to ignore when it reports its numbers,” said Jeffrey Freedman, managing partner, Jeffrey Freedman Attorneys, PLLC.
When a veteran disagrees with the VA’s decision on his or her claim, the next step is to appeal that decision. Currently, the agency is rushing to eliminate the initial claims backlog, and in its hurry is making a large number of erroneous decisions. The American Legion estimates the error rate to be as high as 55 percent.
“To reduce the backlog of initial claims the VA has transferred resources from appeals to initial claims, thereby cutting initial claims but increasing claims in the appeals process,” said Eric Gang, an attorney who handles veterans disability cases for the Freedman firm. “And when a case moves on to the appeals process it can languish there for up to 1,700 days.”
In addition to throwing up a smokescreen by failing to include appealed claims in the number of backlogged cases it reports, the VA is planning to impose new regulations that will make it even more difficult for a veteran to file a claim and appeal a denial. Currently, veterans can file an “informal” claim by submitting a letter to the VA and appeal in the same format. The first new regulation will require veterans to file a complicated set of forms for the initial application. Then, prior to being able to hire an attorney and in order to start the appeals process, the VA wants veterans to file a complex, four-page legal pleading that is beyond the typical abilities of a lay person.
“The VA wants to force disabled veterans to identify why the VA’s decision is incorrect, to provide the VA with the exact disability rating for each medical condition they’re seeking benefits for (the majority of veterans suffer from several medical conditions resulting from their service), and to list the date the veteran believes benefits should have started,” Freedman said. “All without the assistance of legal counsel.”
These regulations, Gang said, will be a sea change in the claims process. For decades, the VA system has been non-adversarial, but with the new rules, it will become more cumbersome and legal training will be required to complete applications correctly. Many veterans will unfairly lose out on their benefits.
“It’s going to increase litigation at the higher levels of the appeals process and require more veterans to retain legal counsel,” Gang said. “Currently, the VA and other service organizations are able to provide free services helping veterans with initial applications — they have not needed to retain an attorney in the early stages.
“I don’t see that as an option if these new regulations take effect. The VA attempts to appear friendly to veteran interests, but at the end of the day, it acts out of self-interest.”