Category Archives: VA

Crossing the finish line – my VA disability claim is finally complete!

Posted by Mike Grice on

Well, it finally happened.  Nearly two years after beginning my VA disability claim process I learned today that my rating has been assigned and the case is closed.

Whew!

Looking back on the process, it has indeed been a long and occasionally painful ride.  Now that it is done, however, I think that the VA did a fair and objective evaluation of my various service related conditions.  It took much longer than I had expected, but now that it is finished I am pretty happy with the results.

So now what?

Although I am content with the results of my evaluation, I know that many veterans are not.  If my case was not settled to my satisfaction, I would pursue an appeal to have whatever condition that I felt was inadequately reviewed examined again. It is not at all uncommon for veterans to submit an appeal; in fact 60% of claims are “supplemental”, which is how appeals are classified.  Here are some interesting facts from the VA website about supplemental claims:

  • 60% of pending claims are supplemental, 40% are original.
  • 77% of Veterans filing supplemental claims are receiving some level of monetary benefit from VA.
  • 11% of Veterans filing supplemental claims already have a 100% disability rating (receive $2800 or more per month) or qualify for Individual Unemployability (compensated at the 100% disabled rate).
  • 40% of Veterans filing supplemental claims are already rated at 50% disability or higher.
  • 43% of supplemental claims are from Vietnam-era Veterans; 19% are from Veterans of Iraq and Afghanistan conflicts.

I am not personally going to appeal my decision, but for those who would like to do so here are a few pointers on how to start the process:

1.  Don’t even think about going it alone.  I have written extensively in earlier posts about the great work that Veteran Service Organizations (VSOs) perform to assist vets as they navigate the VA claims and appeals process.  I personally have consulted with the Disabled American Veterans (DAV), and they have been fantastic (and they don’t charge a dime to help, either!).  There are hundreds of VSOs to choose from, and to help you find one that best suits your needs you can consult the VSO-Directory_2012-2013, which is published by the VA on an annual basis.

2.  Recordkeeping is CRITICAL!  When you begin the appeal process you are in effect going back and starting the process all over again.  You will be filling out forms (with the help of your VSO!) that identify the condition that you are appealing and why, presenting evidence as to why you disagree with the determination (such as documentation that supports an injury, additional medical records from outside the military or VA system, etc.), and scheduling additional evaluation appointments with VA providers.  Just as you did with your original medical record, you will need to provide copies of all documents to the VA, and you are nuts if you don’t keep an organized file of originals for yourself.

3.  Be prepared to be very patient.  Just because your case has already been reviewed and completed by the VA it does not mean that your supplemental claim will move any faster than the original one.  Your appeal will have to go through the same wickets as your original claim did, and it will take just as long.  There is no “special” appeals pipeline.

4.  Do some research in order to fully understand why your ratings were determined in the manner that they were.  The VA does not compensate based on pain or inconvenience, but instead on the factors that contribute to a medically diagnose-able condition.  For example, your knee may hurt like crazy, and you may have injured it while jumping out of airplanes, but if a tangible medical condition (such as torn cartilage or joint damage) can be identified and documented you will be out of luck.  Follow this link to see the the details of how the VA determines how to rate medical conditions: Title 38: Pensions, Bonuses, and Veterans’ Relief  PART 4—SCHEDULE FOR RATING DISABILITIES .  It is a very informative and interesting read.

Good luck!

Nearing the end of the VA claims tunnel…

Posted by Mike Grice on

Well, the big day is nearly here.

Which big day, you ask?

Why, the day when my VA Disability claim finally gets decided.  That day!

You see, I have been going back and forth with the VA for over a year and a half now, and after a lot of trials and tribulations it looks like my case file may have reached the last step on the journey to adjudication.  It is now “Ready for Decision”, which means that all of the required examinations have been completed, all of the paperwork filled out, and all of the supporting documentary evidence has been gathered.

As I wrote a few posts ago, I had initiated another inquiry into the status of my claim because it had stalled after my last round of physical exams.  Today I received an email from the VA explaining just what was up with my case just as they promised.  The system works!  I asked for information and they provided it within the timeline that was promised.  Sweet!

From the email:

Your claim has been determined as Ready For Decision, and as such there is no further update pending. You will receive a notification letter and rating decision copy via US Mail once our decision is complete.

You have not received a rating decision because there is a back log of claims in the same status, and your claim is pending a review and determination by your rating specialists case manager.

Barring any determination by the rating specialists responsible for your claim that additional information may be needed, your next update will be your actual notification letter and rating decision. At this time we do not know the time frame for completion until your case manager begins the process of rating your claim; this will be accomplished in an order based on date of receipt, in fairness to all claimants.

• Please be advised that we do not provide estimates for completion, as there are a multitude of factors that impact the speed at which each claim is rated, making it impossible to estimate said date. 

We can appreciate your desire to have your claim rated; please know that we are working to accommodate your desire in conjunction with that of each and every other claimant seeking completion of their claim.

We appreciate your continued patience during the process, and will inform you of our decision as soon as it has been accomplished.

So, in a nutshell, my case is resting on desk of the team which will determine my disability rating.

All I have to do is wait.

I wonder how long this stage will take?

A continuing test of patience: Yet another update on my VA claim

Posted by Mike Grice on

Well, I woke up early again this morning.  To be honest, I wake up early every morning, but this morning was earlier than most.  I was up at about 0400 (4:00 am for you nonmilitary folks), and the purpose of my early rising was to make yet another call to the Veterans Administration in regards to settlement of my disability claim.  I have learned that the only way to get through to the VA is to call them early before all of the lines are busy and the VA representatives are swamped.

The quick back story for those of you who may not be familiar with the saga of my VA claim, it began in the autumn of 2011 when I was on terminal leave as I was retiring from the Marines.  As a part of my transition from steely eyed killer to middle age and longer grey hair it was necessary for the Veterans Administration to examine me and determine whether or not I had incurred any service related disabilities.

Being rated for disabilities is a big deal because if you have sustained an injury which is chronic or if you have a condition that is directly attributable to your military service, then you are covered medically for that issue by the VA for life.  That is a pretty great benefit these days when you consider skyrocketing medical costs.

So anyhow, I began almost two years ago and have ridden the VA claims rollercoaster ever since.  I was examined and evaluated, and then my paperwork went into the mysterious void that is the VA ratings process.  Some nine months later I received a partial settlement of the claim, with the notification that I needed further evaluations before all of my conditions could be adjudicated.

Six months after that I reported to the clinic for another round of examinations.  At the completion of those exams I was informed that it should take a few weeks to get them into the file and evaluated.

After over two months of fruitless waiting I decided to give them another call, hence my early assault on the coffee pot this morning.

The gentleman I spoke with was very helpful and presented me the facts of my case in a professional and straightforward manner.  It was a very refreshing conversation!

Here is what is up with my case:

My case had run through the initial stages of evidence gathering and evaluation, and had actually made it to the adjudication phase.  It was then that the raters found that they needed more information, so my case was kicked back to gather more evidence that would come from another medical examination of yours truly.

Here is where my stock in the VA representative soared to unprecedented levels because he actually took the time to explain why a second set of exams was needed.  It turns out that when you are treated for an injury or condition, the doctor records the extent of the injury and how it is treated.  That is very relevant information for a health care provider, but the VA disability raters have a different set of responsibilities in terms of medical conditions.  The raters need to compare the injury or condition to a set of standards in order to determine if they are indeed disabling, and if so, just how disabling they are.

The example that the representative shared with me was what is needed for a joint injury (which, after nearly three decades of walking around with heavy things on my back in unseemly places, I had several of).  A doctor wants to cure the patient’s damaged cartilage and bone, and will prescribe medications, physical therapy, and perhaps surgery to alleviate the symptoms and heal the joint.  The VA raters need to know the extent of the damage that the injury or condition has incurred, which is different from trying to cure it.  For a joint injury, the raters need to have a documented range of motion test that the joint is capable of articulating that can be compared to the appropriate standards for a disability determination.  It turns out that very specific information about the condition or injury is necessary in order to rate the disability properly.

So that is why I found myself back in the VA clinic and wearing a modesty-shattering gown and sitting on a chilly paper-covered exam table.

Once the exam was completed, the information was supposed to be sent back to the rater and re-adjudicated in a timely fashion.  Certainly within a couple of months.

After assiduously checking the VA’s ebenefits website for weeks on end and seeing no progress, I decided it was time to pick up the phone and give them a call.

The VA rep was professional and told me the facts of my case as he found them.  He reiterated that my case was still in the gathering evidence phase, but that the results of my most recent examinations had been scanned into my file at the end of March.  The timeline for review of the case is supposed to be less than sixty days, and seeing as it is almost mid-June now that timeline has passed.

The representative offered to initiate an inquiry to the team who is reviewing my case to see what was up, and he said that they will contact me (via email this time) with their response.  Although I have heard that before (from the last inquiry on my case), I will be a glass half full optimist and see if my email inbox “bings” with the sound of an arriving email from the VA.

I won’t hold my breath, but I also won’t complain too much about the VA either.  They really are doing the best that they can in an overwhelming situation as they deal with me and literally millions of other veterans.  I’ll continue to be patient.

And wait.

 

Learning a new skill: Salary and benefits negotiation part 2

Posted by Mike Grice on

A couple of posts ago we started talking about the final step in the job search: negotiating your salary and benefits.  The company has already offered you a job, and in that sweet and exciting period of time between receiving the offer and accepting it comes the negotiation to determine your compensation package with the company.

We have already looked at many of the differences between military and civilian employment benefits, so we won’t go too deeply down that rabbit hole other than to point out that many of the benefits on the military side of the fence are not freely offered by civilian companies.  Take, for example, the military subsistence (meal) and housing subsidies.  You get them while in uniform, but they don’t come freely in the corporate sector.  All of those special pays and allowances that fattened up your military paycheck helped mitigate the comparatively low pay that comes with wearing the uniform.  An added benefit is that those pays are tax-free, which in the corporate sector is almost unheard of.

As a military man or woman you are also free to shop in the commissary, gas station, and PX, all of which provide subsidized food and goods that are free of state and local sales taxes.  While retirees can still enjoy shopping on base, for those who do not stay in for 20+ years or move home and have no base nearby it is no longer possible.  The subsidies, coupled with tax free shopping, are not offered by the corporate sector.  Once you get out you get to pay full price for your groceries and consumer goods, and you get to pay sales tax, too.

My point is that many of the monetary and non-monetary benefits that you receive whilst in uniform went a looooong way towards stretching your paycheck.  When you get out all you have to pay your bills, buy food, and fill your tank with gas is the salary that you are paid by your employer.  Since that is how the “real” world works, you need to make sure to get the best benefit package you can from your employer, and to get such a package you need to be able to negotiate.

Negotiation is a skill, just like any other.  You can get better at if you work at it, and the best way to improve is to practice and rehearse, just like you should for a job interview.

Before you start rehearsing, though, you need to do your research (as discussed in the previous post about negotiation) and then you need to craft a plan of action to prepare yourself.  Just like you would do in the military.

Unlike military plans, though, yours does not have to be intricate or complicated.

Your plan should contain those elements of compensation that you feel are important to you.  It should also contain those elements of compensation that are not important to you.

Why should the unimportant bits be included you ask?

Because they are all part of the plan.  The art of negotiation is based on meeting mutual agreement, and getting to a point where both you and the Human Resources manager agree on your pay and benefits is based on the give and take that you both engage in during the negotiation process.  If you only have those things that are important to you on the list then you are at a disadvantage because negotiation invariably requires you to give a little to get a little.  You can give a little by sacrificing those things that are unimportant to you and, in turn, get a little something back that you truly want.

Here is an easy example.

You feel that flexible work hours are very important to you.

You also feel that health insurance is not important to you because you are single and already covered by the VA and TRICARE.

In the world of civilian employment the cost of health insurance is high and by all accounts only going to get higher.  The fact that you are willing to give up employer-provided healthcare is a significant savings to the employer.  Even though you never planned to use the company’s insurance you can “offer” to keep your current insurance plan (and save the company a lot of money) if you can have a flexible work schedule.

If you don’t have a plan to give up those things that you don’t really want or need then you are giving up a significant amount of leverage.  Be smart and plan your negotiation out!

Here are some basic planning considerations that I recommend you think about as you plan for your pay and benefits negotiation:

1.  What do you want from the company?  (Sure, you want a job, but what do you want in return for your time and dedication?)

2.  What does the company want from you? (Sure, they want an employee but generally want to pay as little as possible for one —  you will need to show the company that you are worth whatever you identify in the first question)

3.  What is the absolute minimum that you are willing to accept from the company?  (This is very important.  The Human Resources person has a lot more experience negotiating than you do, and if you are not careful they may well negotiate you out of the things that you think are very important).

4.  What is your alternative?  In official negotiating terms this is known as the “BATNA”, or Best Alternative To a Negotiated Agreement.  In other words, what are you going to do if the company is unwilling to meet your absolute minimum?  (This is also important because you want to leave the negotiation with a job and not burn any bridges.  The best BATNA is to leave the negotiation on good terms that can be leveraged into another negotiation with the company that is ultimately successful for you both).

After you put together your simple plan you need to do a little rehearsing just like you did for your job interviews.  Find someone to conduct a mock negotiation with, and then listen to their feedback.  It will pay huge dividends.  I guarantee that you will be surprised at just how difficult negotiating can be!  By rehearsing you will learn if you are too brusque or direct or overbearing, all of which are very common traits that come with military service.  You want to be convivial and professional because it is what the company expects, and by rehearsing with another person you can fine tune your style of engagement.

Here are a few things that military people tend to do while they negotiate that end up working against them:

– Being too rigid and organized.  Just because you have a plan doesn’t mean that you need to unyieldingly stick to it.  Do not treat your plan as a checklist and start at the top and work your way to the bottom.  The negotiation is a conversation that will go in many directions before it is completed, and if you are too mechanical and inflexible it will hurt you.

– Being unwilling to engage in a dialog.  Often, military folks are used to just accepting “no” a bit too easily.  Remember, the Human Resources manager wants to hire you as cheaply as possible, and if you just roll over every time he or she says no then you are making his or her job pretty easy.

– Being ignorant of what benefits are available for discussion.  This goes back to the previous post about interview preparation: make sure to do your research!  If you do not ask for something I guarantee you will not get it.  At this stage of the game nobody is looking out for you except you!

– Being ignorant of how much money they really need to make.  A good rule of thumb is that you need to nearly double your base military pay to obtain the same level of compensation in the civilian world.  Taxes go up and tax-free benefits go away.   In the civilian world you get to pay bills that you may not have thought about: for example, if you lived in the barracks or in base housing you did not have to pay for electricity, water, natural gas, or trash removal.  Guess what- in the civilian world you get to pay for all of those things and more!

__________

Lessons Learned:

– Do some research on your own finances and see just how much money that you are going to need in the civilian world.  Remember- taxes take a big bite!  If you were in the civilian world you could count on 30-40% of your BAH and Subsistance Allowance to go to the IRS because it would be counted as income.  Find out how much money you really need.

– List out those benefits that are important to you and also those that are not.  You will use both lists during your negotiation.  Make sure that those benefits you want are offered by the company!

-Rehearse with someone — you need the practice.  Remember, the Human Resources manager does this a lot more than you do.

– Find out what your BATNA is and stick to it- it is OK to walk away from the negotiation if the result would be below your absolute minimum level of acceptability.

The call I was waiting for from the VA. Really!

Posted by Mike Grice on

It finally happened!  The VA called and scheduled my final disability evaluation appointment.  Hooray!

For those who are wondering why this is a big deal, here is a quick backstory.  My veteran’s disability claim has been turgidly moving through the system for nearly a year and a half, and during that time I also entered the VA medical system.  As I learned, the VA has two distinct and different sides when it comes to disability claims and healthcare, and they do not talk.

This became a problem for me because I did not understand that important fact.  My disability claim was partially settled six months ago, and with the notification letter came the promise of a call to finish the process.  Soon after, I was contacted by the VA on numerous occasions to schedule and attend various appointments at the local clinic.  Foolishly, I thought that the clinic and the disability claim evaluation were one and the same.  As I said earlier, they aren’t.

As it happens all of the calls from the VA clinic were for the medical side and were unrelated to the disability claims side, and none of the appointments had anything do to with my claim.  Good news for my medical coverage, but still a lot of frustration on my disability claim.

So, months of frustration, I called the VA.  After a few weeks of phone tag, my case was reviewed and I was again promised that I would be receiving a call to schedule my follow up appointment.  I was not optimistic.

My pessimism was abated when they called.  Actually, they contacted me by mail. I received a letter that explained that I needed to be seen by the VA’s contract provider for a few things that were not completely documented by my initial visit, and with the letter came a questionnaire regarding the issues in question.  I filled out the questionnaire, and within a day or two I received a call from the provider’s office to schedule an appointment.

Yesterday I went to the contract provider that takes care of the claims side of the VA house.  It was the same provider that I had seen a year earlier, and to their credit they were very efficient and polite.  I was in and out of their office in less than 45 minutes, which was a pleasant surprise as I had anticipated spending the afternoon in the waiting room.  With that appointment I had, in theory, finished up my claims process.  I hope it is done.  According to the VA representative that I had spoken with earlier the only items remaining in my case were the evaluation from the contract provider and a few administrative corrections in my file.

The evaluation is done.  Now I just have to wait for the administrators to correct my file and then my disability claim should be completed.

I’ve heard that story before.  We’ll see…and I’ll keep you posted!

__________

Lessons learned:

– The Medical side of the VA is completely separate from the Disability claims side of the VA.  In my case, the clue to the difference was that all of the medical issues were addressed by my local clinic while all of my disability evaluations were performed by a contracted provider.

– Be proactive.  Call the VA and determine your status.  I think it helped, as my case was languishing for months until I made some inquiries.

– As always, be patient!

A call from the VA. Finally!

Posted by Mike Grice on

Well, the VA finally called me back.  For those readers who may be unfamiliar with my ongoing saga with the Veterans Administration, here is a quick recap:

My disability claim is well into its second year.  Some six months ago I was informed that my claim was partially completed, with about half of the identified conditions being adjudicated.  I would be “contacted” by the VA to schedule appointments which would take care of the unresolved issues.

So I waited for the call.  For five months I waited, and finally decided to take the initiative to call them instead of spending another day being deafened by the sound of no telephones ringing.  After a week of failed attempts, I finally reached a real live VA representative!  Together, we reviewed my case and initiated an inquiry that required the team that was actually working on my case to contact me and explain its status.  In ten working days.  Or less.

They never called.  So, at day twelve, I called them.

I eventually ended up speaking with another VA representative who (again) reviewed my case.  She determined (and was quite annoyed to report) that the team who was evaluating my case had indeed seen the inquiry, but had simply marked it closed and not bothered to contact me.

Nice.

She apologized and placed a note in the electronic file to her boss and the team that was supposed to contact me.  Whether or not they would actually call me back she could not say.  To her credit, she was very professional and really helpful.

Well, two weeks later the VA called back.

I don’t know if the gentleman who initiated the call was on my team or not, but he did explain the status of my claim.  It turns out that one of the remaining conditions requires an actual physical re-examination, but the others required administrative corrections (which, in his words, consist of checking different boxes on the processing forms).  Don’t worry, he said, I would be contacted soon (!) by the VA to schedule the appointment.

I won’t hold my breath.

He followed by instructing me to call two weeks after the appointment as a follow up.  Apparently, since my case is in the review stage it will not lose its place in line and go back to the beginning because all that is required is for the printouts from the examination and the corrected process forms to be placed in the file.  If I call, he said, it will make sure that the file keeps moving forward.

So now I am in week two of waiting for the call to schedule my appointment.  I’ll keep you posted…

__________

Lessons learned:

– Be proactive.  My experience shows that the squeaky wheel gets the grease, and particularly if the VA promises something that they do not deliver.  Make sure to record names, dates, and times of your calls and reengage with the administration immediately after they fail to achieve a timeline milestone.

– Be patient.  It is not going to be a rapidly resolving process.  If you get angry, all you will do is slow it down.  I know it is incredibly frustrating at times, but the people on the other end of the phone are overwhelmed by a byzantine bureaucracy.  Don’t vent your frustrations at the messenger because you may find your file at the bottom of the pile.

 

The sound of no phones ringing as my VA saga continues

Posted by Mike Grice on

In my most recent post I lamented about the languishing status of my service connected disability claim.  It had been partially settled, but half of the conditions under review still required action and that action was very long in coming.  It is month seven and counting since I was informed that “I would be contacted” by a VA representative to continue the work on my claim.

At month five or so I called to see what was up.  After many failed attempts, I got up extra early and called when the call center opened, and after being on hold for a half hour I was able to speak to a representative.  Long story short, he initiated an official inquiry which included the promise that I would receive a telephone call from the regional office that was working my claim.  In ten working days or less.

Well, ten days came and went, so this morning I again got up extra early (well, not that extra early because I get up before 0500 anyhow) and I called the VA.  After navigating the automated menus I was informed that I would be on hold for 22 minutes, so I waited.  45 minutes later a voice broke the elevator-esque hold music monotony and asked how she could help.

I explained my dilemma, and she pulled my information up on her computer.  I heard the clattering of her typing on her keyboard along with a sigh.

“They did not call you?” she asked.

“Nope.”

“They marked it closed, but there are no notes that show a call was conducted…”

Great.

It turns out that my Official Inquiry had been marked closed with no action taken.  No call.  No notes.  No action on my claim.

I was a bit annoyed, and she was a bit perplexed.  I got the feeling that I was not the first person that she had spoken to with this problem.  To her credit, she calmly explained the next steps as she typed away.  She notified her local supervisor as well as the supervisor and the team that was supposed to contact me about the problem, and apologized for the whole incident.  She went so far as to say that whoever closed my inquiry had actually lied about it and not done their job.  She said that someone may call me to update me on the status of my claim, but she also wisely did not promise that anyone would actually pick up the phone.  Neato.

As for my claim, she further explained that the crux of the problem was that while my issues had been partially resolved (with a completed disability rating for half of my identified conditions) the remaining issues would be addressed in the future.  How far in the future she could not say.  Eight months was the average for the initial claim (which was close to my timeline), but there was no expected timeline for the rest of the issues.  It could be a day, a week, a month, a year, or more.  Neato again!

So there you have it.  My first call resulted in a promise of a call back that never came.  My second call resulted in a complaint that nobody called, and I don’t know if anyone ever will.  Time will pass, I suppose, and maybe my phone will ring.

I won’t hold my breath.

__________

Lessons Learned:

1.  Stay on top of the process!  If you are promised a phone call, follow up if you do not get it.

2.  Call early in the day and you will get through.  Eventually.   My experience is that your wait time is twice the amount of time announced, so get a cup of coffee or two and read the paper because it is going to take a while.

3.  Don’t get angry.  The person on the other end of the phone is a person too, and they had nothing to do with your particular issue.  If you make them angry they will not be helpful.  Remember the golden rule!  Be nice and help them help you.

Still waiting for the call that may never come…

Posted by Mike Grice on

My last post left all of us hanging in anticipation of a call from the VA in regards to my disability claim.  You see, I had called and called the VA’a customer service number during the day with no luck whatsoever.  After finally getting up waaaaay before the crack of dawn I called again and finally got ahold of a VA representative.  We reviewed my case, and he agreed that something was amiss.  He promised that a representative would call in the next ten working days to let me know what was up.

I cheerily hung up and waited by the phone like a thirteen year old waiting for a girl to call and invite him to the Sadie Hawkins dance.

Well, it is now working day number nine.  No call.  No dance.

I have been holding my breath so long that I have gone from blue to purple.  They are not late yet.  One day to go!

I wonder if they will call?

The anticipation is killing me!  If they do, I will write a post to tell you how it went.  If they don’t, I will write a post to tell you how it didn’t go.

I think I see a zero dark thirty phonecall to the VA in my future…again.

It was the appointment I was looking for…sort of. The continuing saga of my life with the VA

Posted by Mike Grice on

Every once in a while things make sense.  Unfortunately for my journey into the world of the Veterans Administration, that once in a while has not happened yet.

You may recall from my last post that two seemingly unrelated and paradoxical events occurred that centered around my VA disability claim.  Within the span of a single week I first received a telephone call to invite me to an appointment at the local veterans hospital, which I took as an augury that my claim was turgidly stumbling forward, and I secondly found out that my claim was marked “CLOSED” on the VA’s ebenefits website (which is the interface that veterans use to access their VA benefits information: ebenefits.va.gov ).

One step forward and a huge leap back?  To say I was confused would be a gross disservice to the concept of understatement.

At any rate, I showed up for the appointment earlier this week and learned a little more about how the various processes at the VA work, or at least are supposed to work.

Unbeknownst to me, my appointment was based on the interview that the VA social worker had conducted on the day I officially became a consumer of VA health benefits.  The survey identified some items in my history that required further evaluation, and the appointment that I attended a few days ago was one of those items (in this case, it was for a Traumatic Brain Injury, or TBI, evaluation that was warranted because of my close proximity to noisy exploding things while in Iraq).

Fast forward to earlier this week.  I checked into the medical center, and after filling out yet another questionnaire about various things related to my mental state I was called to see the doctor.  After a brief introduction, I followed her through the physical therapy section of the hospital to a small office tucked away behind the treadmills and medicine balls.

I spent the next 45 minutes or so answering questions about the noisy things that exploded in my vicinity and the possible effects that they could have on me these many years later.  She then performed a series of physical examinations.  After getting whacked on the knee and following her finger with my eyes and a dozen or so other tests she announced that I was unlikely to be suffering from any long term effects of getting my bell rung in combat.  “Maybe a slight concussion,” said she, “but you seem fine to me.  Any questions?”

Ahhh.  Finally.  I did have a question or two.

I inquired as to the purpose of my visit.  Was I here for a disability related evaluation?  I explained my confusion, and she gave me the patient smile of someone who has explained this to people a time or two before.

“No.  This exam is based on the social worker’s evaluation from the VA clinic.  It has nothing to do with the disability claim process.”

She saw my blank and vacuous stare, and continued.

“We don’t have anything to do with claims.  The systems are completely separate.  If they want, they can access the records of this appointment, but that is up to them.  We are the medical side, not the disability claims side of the fence.”

With that bit of insight the lightbulb went on in my head.  Suddenly I understood why the two events that had occurred a month previously had confused me: I mistakenly thought that I was dealing with one agency when in fact I was dealing with two.  And neither of them talks to each other.

How governmentally bureaucratic!

The medical side had set the appointment, and it was proof positive that the system (or at least their half of it) worked.

The claims side, on the other hand, clearly had something wrong.

With that shocking bit of knowledge, I set out to find out just what was amiss with my disability claim.  I called the toll-free number for the VA.  Not once.  Not twice.  Not three times.

I won’t bore you with how many times I pounded the keys on my phone trying to reach a VA counselor, but after many fruitless attempts I resorted to calling at 5:20 in the morning in an effort to get through.  It worked.  After waiting on hold for nearly 30 minutes, I finally found myself at last in contact with a real live VA person!

I explained my dilemma to the gentleman, and he looked into it.  Apparently the ebenefits website was depicting the results of the most recent review that my case file had received and was incorrectly showing my status as closed.  What had occurred was that my file was being reconciled to determine what still remained to be done, and once that reconciliation was completed that review was posted as closed.

For whatever reason (which the VA rep could not explain) the ebenefits site “sometimes” picks up the wrong status.  I was one of the lucky few to fall in the wonderful world of “sometimes”.  Fortunately, my case was still open.  The status on the website was wrong.  Unfortunately, there was also no indicator of progress in my case, so it really didn’t matter what the website said.  I was still going nowhere fast, but apparently I am making good time.

Sensing my consternation, the VA rep offered to initiate an inquiry.  The inquiry, he explained, means that someone in the office that held my claim would have to call me within the next ten working days to explain what was going on.

Hooray!  All I have to do now is wait for the phone to ring and then I will be able to talk to somebody who can explain just what is happening with my disability claim.

All I have to do is wait.

__________

Lessons Learned:

1.  The VA medical system and the VA disability claims system are two unrelated and unintegrated silos.  They each are performing their own important mission, but they do so independent of each other.  Make sure to find out which side of the fence your appointments fall on, or you will end up confused like I did by assuming that a medical appointment was for my disability claim or vice versa.

2.  Calling the VA during working hours is pointless and annoying.  There is supposedly a callback feature that you can use if you call after working hours, but I could never get it to work.  I resorted to calling early in the morning, right about the time that the call center opens, which is listed as 7:00 am Eastern time.  The number is 800-827-1000.  Good luck!!

3.  Write everything down, including the inquiry tracking number and the name of the person that you talked to.  It will be useful later on in case the inquiry gets lost or the information that you received turns out to be erroneous.

A Call from the VA and a change in claims status…

Posted by Mike Grice on

My last post discussed the confusing world of disability claims, healthcare, and appointments within the VA system.  This post offers no clarity in that regard; in fact, I am now even more confused than I was before.

I have gone from being simply puzzled to a state of complete consternation.

Two things occurred in the last week that have a direct impact on my VA disability claim.  The first is that I actually received a call from the VA to schedule an appointment for an examination that is a part of the regular (and sadly quite lengthy) evaluation process.  That was good!  The next day I checked my status on the VA’s website (www.ebenefits.va.gov) and discovered that my case was officially closed, but that an appeal was possible.

Huh?

A call on one day to schedule an appointment the following month is immediately followed by a notification that my case was closed?

You can imagine my furrowed brow and skyrocketing blood pressure as I reached for the phone to call and find out what was going on.

Well, that did not unfurrow my brow or reduce my blood pressure.  Instead, It added a nervous twitching to the hand that held the phone as I navigated my way through automated menus that resulted a complete waste of time.  Call volume was too heavy said the automated voice, but I could call back later or request for a specialist to contact me at a later time.  Unfortunately, the call was terminated before I could request a callback.

So I tried again, with the same result.  Awesome.

So I am now more confused than ever, and in serious need to talk to someone about it.  I will be making some calls in the next few days to the VSO as well as the VA to see if I can get to the bottom of this new and incredibly annoying mystery.

I’ll tell you how it goes!  Wish me luck…