Wednesday, May 10, 2006

VA to seek vets who were low balled,1,5837368.story?coll=chi-newslocalssouthwest-hed or,0,6070840.story?coll=ny-region-apnewjersey here was my response to this article
Low pay. The simple fact is that VA Regional Offices have a lot of wiggle room on many of the cases they decide, let's use the big one for the example PTSD. That is in the press a lot, and it is a subject I have personal familiarity with, as I have it.

The shrinks and social workers do the write ups on every visit, they make notes, on things like your wife is wearing a shirt that says F.T .Army or BUCHITS or anything else that they feel like, such as the veteran states that if we don't do this he is going down the hall and call his Congress person or Senator. Stuff that has no place in a medical record. They assign what they call GAF scores, an assessment of how your are functioning at that given hour, to their observations. The score's range from 0-100, most veteran get scores that range from 30 which is not good to scores in the 70's which means yes he has issues, but the veteran is handling it really well.

This gives the Regional Office rater and DRO's plenty of play room, they can pick good news out of your records or they can pick the bad news, they can assess the medications you take for PTSD or they can choose to ignore them. Then there is the dreaded C&P exam, which stands for Compensation and Pension Exam, the VARO's hire outside shrinks to assess you, now a company that is headed by ex VA Secretary Anthony Princippi, named QTC, supplies most of these doctors, or Nurse practitioners at a cost on average of between 400 - 500 per exam, some of these exams last 10 minutes.

Some are very thorough and last the time period of one and half hours as the guidelines call for, but the fact is before QTC came along, they use to pay these doctors about 100-200 dollars. But now the QTC doctors all know what the VARO's want them to fill out and how to fill out their paperwork. It makes the veteran question is this doctor writing the right information down or assessing me so the VA can pay me a lower award for my service connected problems. Even a smart man or woman has to look at this question with a raised eyebrow. QTC corporation enjoys it, when Principi was the head of it before he was named VA Secretary they were billing the VA 47 million a year, they now have contracts that will pay them 1.2 billion in the next five years. Yes, a nice deal for QTC and their stockholders. How good a deal it was for veterans, remains to be seen. But bottom line this excess money is money that could have been used for veteran care, that they will now be deprived of. Was this a good deal for the taxpayers?

My own case for example, I was diagnosed with PTSD by a VA shrink in May 2003, I had been seeing him since January when I had a melt down. I have had problems for years, but like most veterans I found a way to cope with them, work, drinking, drugs etc. I ignored the "problems" until one day, I no longer could. I have many of what they call "stressors" fire fights, training accidents, in service deaths of friends, but the main stressor for my case was the fact that 7 fellow soldiers decided they wanted my wallet on a payday in February 1975, and they beat me unconscious and left me, the problem was the place they did it was Fort Wainwright Alaska and it was 20 below zero, that night.

They were charged with robbery and attempted murder, four of them were sent to Leavenworth Barracks, the military portion of the prison system, in Leavenworth Kansas. The other three were given what they call non-judicial punishment, and I asked for a transfer to South Korea, the Army moved me a month after the court-martials ended in August 1975.

Because of an American Legion Service Officer who refused to file a claim for PTSD for non-combat reasons, I did not get my claim filed until after I fired him and revoked his power of attorney in DEC 2003. In 2004 they denied the claim, in May 2005 they finally approved it but at the 50% rate, I appealed it, my shrink has been saying for 2 years that my GAF score was 30 - 35 and that I was permanently and totally disabled by my PTSD. The VARO denied it again, I asked for a BVA hearing and wrote Senator Larry Craig a letter about my problem with the VARO in Columbia, SC, in October 2005 I received a letter from Renee Szybala, Director of Compensation and Pensions. In November the Columbia VARO scheduled me for another round of C&P exams.

On April 6th I received a new award letter granting me 100% P&T for my PTSD with an effective date of DEC 2003, when I had originally filed for it. The key was persistence, the fact that the VA counts on is that service members usually accept what they are given and do not complain, except to family and friends. They have the attitude if they deserved more then the VA would have given them more. The idea of fighting with the government that they served and fought for, does not usually enter their minds, they just grumble about the low payments, and wonder how Joe got a larger award for the same problem and Joe is not near as physically disabled as I am.

What the VA is doing now is after the investigation last year, it not to go back and re-look automatically at the decisions and re-judge them, they are taking the position that if you want it upgraded, then you have to ask for it, thus creating a new date of eligibility, from the day the increase is asked for, forget about getting back pay to when your claim was first awarded and the veteran may have deserved the higher award from the beginning, it is now an effort to save money at the expense of disabled veterans and or their widows.

Then to have the nerve to blame the new backlog on veterans asking for the new look at the old awards, is just ridiculous, they already have 825,000 cases on appeal to the Board of Veteran Appeals, from veterans who did not agree with their awards or lack of them. The VA just needs to hire more people and get this mess cleaned up, within a reasonable time period, the bad part is no one is mentioning the time lines here, right now the average wait for a claim is 1-2 years, a BVA hearing is 2-4 years and the Court of Veteran Appeals is a minimum of a five year wait, many veterans die waiting on the VA to adjudicate their claims.

Injuries that are cut and dry like a loss of limb are much easier for the VA and veterans to understand, the major problems come from mental issues, and any other problems that have an area where there can be interpretation, some raters interpret better than others, some grant in favor of the veterans, while others are more cynical and grant in favor of the government, they can claim the VA claims process is non-adversarial all they want, the system is broke and in need of a major overhaul. The large veteran service organizations really do not serve the needs of veterans as an individual, they see the big picture, the trouble is each veteran is a snapshot, and all claims need more than a 10 minute meet and greet, some take time, some take investigation and real hard work, in the VA claims system they try and use the KISS method, (keep it simple stupid) great for the SO but lousy help to the veteran and his family.

Veterans have to remember that it is their claim, they need to find the evidence, do not expect anyone else to do it, get and keep date stamped copies of all paperwork, your spouse may need them after you pass away. Remember you do have the right to revoke a power of attorney if your Veterans rep is not doing his/her job the way you feel it should be done, bottom line it is your claim and your benefits, the people that handle your claims are all getting paid if you win or lose your claim, it's your stay on top of it, and fight for your family's benefits and yours, you fought for your country, now fight for what is right.

Michael G Bailey
301 Harbor Heights Dr 21D
Lexington SC 29072

1 comment:

QuestRepublic said...

Very moving and truly informative story. Thank you for sharing your experiences with the VA.

This GAF-Score pre-occupation of the VA can be a big impediment. Here in the Northeast, we have not had the situation with contracted C&P doctors YET, but are starting to encounter some other odd results: (1)the C&P doc ignoring comments by his regular treating psychiatrist on sevity or links to military stressors (2)ignoring verified combat awards and quizzing the vet until some other cause for psychiatric disability other than PTSD can be posited. (3)accusing the vet of lying about his military service!

The best way to get a higher evaluation, in my experience -

work closely with the treating docs and psychiatric nurse-practioners; explain to them that you need documentation in the vet's file BEFORE he/she goes for the C&P exam.

Refer the doc to the guidelines in the VA manual that explain in detail what symptoms the vet needs to show to justify the higher ratings.

Make sure the doc's comments mirror the guidelines in the VA manual by reviewing the vet's medical report before the C&P.

If the vet dissagrees with the decision, check what medical evidence the VA used; if you have NEW MEDICAL EVIDENCE (or evidence that they do not refer to on thier decision) then ask for a reconsideration; it is much quicker and does not result in a black eye for the VA worker.

Remember, there is a place for a Senator/Representative to get involved in certain cases, such as lost files and when all else fails, BUT the first thing the VA does in those case is to clean up the file, send it to a special congressional team and generate extra delays, BEFORE they take one single step to actually solve the vet's problem.