Here’s How the VA Is Partnering with Veterans Groups to Reimagine and Redesign the Appeals Process
The VA is proposing to overhaul the process by which veterans can appeal decisions on their benefits claims, to make sure it’s able to meet the needs of the nearly 440,00 veterans with currently pending appeals.
Veterans agree: The time has come to fix VA’s appeals process.
Since the Board of Veterans’ Appeals was founded in 1933, layer after layer of process has been added in a futile attempt to improve quality and timeliness by adding more and more procedure. The unfortunate result of these well-intentioned reforms has been to create a process that struggles to ever bring appeals to resolution. Instead, many appeals move from one part of VA to another rather than giving the veteran an answer.
In 2012, VA made the commitment to address the growing disability claims backlog. It took too long for too many veterans to receive a decision on their claim. That commitment has resulted in transformational change and a reduction in backlogged claims by almost 90 percent. For veterans, that means better and faster claims decisions.
But as VA has become more efficient in claims processing and it has processed more claims, the number of veterans who want a second look at their decision through the appeals process has risen proportionally. And as that has happened, it has illuminated the unworkability of a process that churns matters from one body to another rather than providing timely, predictable appeals answers for veterans.
In short, the VA appeals process is failing veterans, creating layers and layers of duplicative review that starts back at square one every time new information is added. As VA strives to become an agency focused on better serving veterans, it has become obvious that this is the time for change. This is VA’s next challenge.
Read the story of how one veteran faced challenges at almost every stage of the appeals process:
Say you’re Reggie, a young veteran who injured his leg in Iraq during a train-up for a military exercise. In the years after your initial claim, your leg injury worsens. It begins to damage your back. You file new claims to reflect their deterioration in 2009.
You wait. Your injuries, though, don’t. Use of your right leg and back continue to decline severely. Doctors place a neurostimulator in your back and buttocks to provide relief. While you wait, you go under the knife, again and again, the doctor cutting through the scars of the last operation to make adjustments.
Three years later, VA denies your claim. VA says the pain in your back — never mind the morphine or the days bedridden — is moderate, not severe. You don’t even understand the legalese that denied the leg claim. You appeal.
More waiting. You gradually accept a cane. Pain, and the medication for it, keeps you from working. Depression sinks in. You attempt suicide. You survive. You’re still waiting. That appeal is still pending.
Your claim is old, outdated. Filed years ago. In a logical world, you would update it — things have gotten worse. In fact, VA’s open record enables you to add evidence at any time, unique in the American judicial system. But if you did submit that new evidence, it’d send your claim back to the very start. Reggie explains:
“The whole time you’re waiting, just like me, your ailments are growing. They’re getting worse. And you can’t go back and renew your claim now, and say it’s getting worse because then you’re pushing that first claim back and you’re [basically] starting a whole new claim. It’s a really stressful process.”
Any new evidence punts the appeal back to the start. All that waiting you’ve done will only be repeated as it’s pushed back for a fresh review. It’s rare that Reggie realizes this — most Veterans don’t. They send in new evidence to bolster their claim. They try to help the process along; instead, the process just sends them backwards. It perpetuates an endless churn. The waiting makes Veterans give up.
The VA appeals process is failing veterans like Reggie. Here’s our plan to fix it.
In recent weeks, VA has brought together the nation’s leading veteran advocacy groups for their input. They are our steadfast partners in improving the way we deliver services to veterans.
As a result of weeks of listening, VA has put forward a new proposal that would provide veterans with a simple, fair, and transparent appeals process in which the vast majority would receive a final appeals decision within one year of filing an appeal by 2021. This disentanglement of process is enabled by one crucial innovation — giving veterans multiple paths to adjudicate disputes on a claim, while preserving the effective date that the initial claim was filed.
This simple change, along with a few others, will modernize the veteran appeals process, better serving veterans, taxpayers, and the nation for years to come. And since it was layer upon layer of law that got us tangled, VA will need Congress’ help to untangle it, and has been working to make this legislative change a reality, and soon.
