Tag Archives: Disability claim

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…

Back to the Veterans Administration, Part 3: This is not the appointment you were looking for…

Posted by Mike Grice on

In my last blog entry I promised that I would update you on how my first official appointment with the VA went, and, well, that appointment has come and gone.  It was interesting, but not really what I had expected.  Or what I was hoping for.  It was, however, insightful because it provided a glimpse into the road that lay before me as a “customer” of the VA healthcare system as well as introducing me to many of my fellow veterans who frequent the local clinic.

The appointment was with the VA Clinic’s PTSD Services unit.  As I wrote in my last post, I spent an hour or so with my designated social worker whose job it is (among other things) to assess whether or not I needed to be evaluated for the effects of combat stress.  Her assessment was based on our meeting as well as the sixteen page questionnaire that I completed beforehand.  Since the questions were all about combat, and having spent a whole lot of time in and around a significant amount of combat in two different war zones, she determined that it was certainly appropriate for me to go for an evaluation.

A week later, I returned to the clinic for my first appointment: the Post-Traumatic Stress Disorder Services Orientation.  I wandered into the clinic’s Mental Health Services waiting room and, after checking in, was handed yet another set of forms to fill out.  After ten minutes of answering questions about my propensity for self-harm, manic episodes, and depression, I was finished.  Just in time, too, because as my government issued pen scratched out the last checkmark a young woman opened the waiting room door and asked those of us waiting for the PTSD orientation to follow her.

I joined a rather eclectic group as we accompanied her to a smallish room ringed with chairs padded with leather seats and backrests colored in the oddly disturbing green that is prevalent in hospitals and movies about psychiatric institutions.  They must have got them on sale somewhere, because I don’t think they would match anyone’s home decor.  To their credit, though, they were actually pretty comfortable.

Out of the twenty odd-colored seats ten or so were filled by my fellow attendees and me.  There was an elderly veteran of the Second World War, Korea, and Vietnam (as his hat proudly proclaimed), a man in his sixties, a few gentlemen in their 50’s, a young woman who never took off her sunglasses, a tattooed young man barely out of his teens, and me.  Not at all what I was expecting, to be honest.  I had figured that my meeting would be with young veterans from the recent decade of war, but to my surprise we veterans of Iraq and Afghanistan were in the minority.  There were three of us, one veteran of Desert Storm, the aforementioned WWII vet, and the rest were from the Vietnam War.

I know this because the young woman who led the session (another clinical social worker) had us introduce ourselves before we began the session.  In addition to asking where we served, she asked us to share why we were here.  The recently discharged veterans were pretty obvious, but the others were a surprise.  Each of them had been referred to the session by their primary care provider, which I found to be fascinating.  After hearing their introductions and listening to their conversations it became evident to me that many of these veterans were just now entering the VA medical system.  To me, that was a surprise because I had never really considered not entering the system.

That reveals a tremendous difference between the experiences that “new” veterans have in juxtaposition to the “old” ones.  Our transition process from active duty included a mandatory introduction to the VA, along with an education in the basics that the VA provides.  Many veterans of WWII, Korea, Vietnam, Desert Storm, and the Cold War received no such exposure to the Veterans Administration.  As a result, thousands and thousands of veterans who are eligible for help and care never bothered to pursue it until they really need the services that the VA provides.  Unfortunately, for many of them, the help that the VA provides ends up trying to make up for years or decades of neglected conditions.  That was the explanation for why so many of the people in the room with me were there for the first time despite having removed their uniforms back when Disco Fever ruled the dance floor.

Anyhow, back to the session.  After introductions, the social worker ran through a dozen or so power point slides that described the multitude of programs that the VA offered in the clinic.  This particular clinic was focused on combat veterans who were at risk for PTSD, and the services that they provide were all focused on countering and healing the effects of combat stress.  She started with textbook (according to the American Psychiatric Association, who writes such things) definition of PTSD, which included things like experiencing traumatic events, re-experiencing previous trauma, hyper-vigilance and hyper-arousal, and avoidance of things that remind you of traumatic events.  Considering that everyone in the room has served in combat, the probability that at least some of these symptoms would apply to us rocketed up to about 100%.

After the explanation of what PTSD was completed she assured that recovery from PTSD was possible.  They offered over a dozen different methods to assist with recovery; including individual and group sessions on topics like anger management, coping, spiritually based recovery, couples and family therapy, anxiety disorders, and women’s groups.  The goal of each program is to help the veteran reach a positive outcome within three months, with a positive outcome being that the veteran being better able to cope with his or her condition.

Not surprisingly the clinic was overwhelmed with veterans who needed help.  The wait time to join in the programs was eight weeks or more.  The social worker explained the process for getting into one of the groups, and that is where I realized that this was actually not the appointment I was looking for.  Actually it was not even really an appointment, but instead just an introduction and orientation to the clinic.

Towards the end of the session she explained that for us to participate in any of the offerings we would have to set up another appointment in which we would actually meet with a healthcare provider who would then assign us to a group.  An intake appointment, she called it.  That was the first indicator that this was not the appointment I was looking for.  The second indicator was her announcement that the clinic did not have anything to do with disability claims.

As you know from my previous posts, I was actually hoping to get my disability claim back on track.  It had been five months since I had been notified that the claim had been partially settled and that I should wait to be contacted by the VA for further evaluation.  After spending almost half a year listening to the sound of no telephones ringing I called the VA to get the ball rolling.  I had wrongly assumed that once I was in the system that the claims process would proceed as a matter of course.

Nope.

I would need to call another number for that, or I could stop by the Veterans Service Office that happened to be just across the hall.  They would be able to help those of us working on our claims, she said, but unfortunately not today because their office was closed.

D’oh.

She then reviewed all of the forms that we completed prior to the session, and then she called each of us out individually to set up appointments for the intake interview.  I was a bit disgruntled, but resigned myself to just go with the flow and left the session with an appointment for an intake appointment some six weeks in the future and the phone number to the clinic’s VSO office which would help me with my claim.

I also left reminding myself that the VA was a bureaucracy and that patience was a virtue.  I was still disgruntled, though, and not feeling particularly virtuous.  So it goes.

__________

Lessons Learned:

1.  The medical side of the VA is different from the disability claims side of the VA.  Make sure to stay engaged with your VSO to ensure that your claim is moving forward, and also be specific with the VA representatives when you are making your appointments.  I was not specific enough because I made some errant assumptions, and as a result I have lost another month or two of forward progress on my claim.

2.  Be ready to devote a lot of time to the VA.  There are great programs available, but it will take a long time and plenty of seemingly repetitive red tape, paperwork, and meetings to actually see a provider.  Breathe deep, think happy thoughts, and go to your happy place.  Time will pass and you will get the help you need.  It will just take a lot more time than you would like.

3.  Ask questions up front.  Had I asked whether or not this appointment would help with my disability claim I would have saved some valuable time.  Assume nothing!

Back to the Veterans Administration

Posted by Mike Grice on

Several months ago I received a rather large package from the Veterans Administration.  Inside was the copy of my medical record that I had submitted with my claim some nine months earlier as well as a sheaf of rather official looking documents.

Hooray, thought I!  My claim was settled.

Well, kind of.  Actually about half of my claim was settled, and the other half was not.

You see, as I departed active duty I was thoroughly examined by both military and veterans administration physicians as a part of the final physical process.  The Navy doctors and corpsmen checked me out and documented everything that was relevant into my records, and the VA then followed up with an examination of their own to determine what conditions, if any, that I had developed during my service would be considered disabling.  Having the conditions rated as disabling is important because the VA treats those conditions free of charge.

In my case, about half of the conditions that had been identified during my physicals were rated as disability-related conditions and would be addressed by the VA in the future.  The other half were marked as “deferred” because they needed additional information.  The letter went on to say that they had requested a medical examination, and that I would be “notified of the date, time, and place to report.”  It sounded reasonable, so all I had to do was be patient and wait.

One month went by.

Then two.  Then three.  Four.  Finally at month five I decided that my phone wasn’t going to ring any time soon and I needed to do something about it.  But what?

Thinking back to my experience at the Transition Assistance Course I remembered that a representative from the Disabled American Veterans had talked me through the VA medical evaluation process as he evaluated my medical record.  I had signed a limited power of attorney that appointed the DAV as the Veterans Service Organization that would represent me in my VA proceedings, and now it was time to give them a ring and ask for some help.

After rummaging through the rather tall pile of transition related documents that occupies a significant portion of my desk I found his business card.  “Aha!”  thought I.  “A call and it will all be fixed!”

Wrong again.

I did call the number, only to find that I was calling the wrong number.  It turns out that the gentleman that I had worked with during the TAP seminar was not the same gentleman that I would be working with in my dealings with the VA.  The guy at TAPS was fully engaged in meeting new veterans and helping get their claims processes started.  Once the veterans were in the DAV system they (including me!) would be working with representatives at their regional office located in San Diego.

So I called that number.  Unfortunately their offices were closed for the holidays, so I called back once the holidays were over.  I finally linked up with a live person and after speaking to a very nice lady who took down some basic information were instructed to wait for a representative to call me back.

After a day or two of swapping voicemails because of missed calls the DAV representative and I finally linked up on the phone.  I explained my dilemma to him, and he patiently explained what needed to happen next.

“What you have,” he said,” is a partially completed claim.  At this point there really isn’t anything the DAV can do for you because our process begins when the initial VA claim is settled.”

Sensing my frustration, he continued.

“What you need to do is to contact the VA and set up an appointment to get the ball rolling yourself.  You need to do this quickly because if you don’t follow up on the listed conditions they may be disallowed because you are not showing that they are still a problem.”  He then gave me the appropriate phone number for the closest VA office and we said our goodbyes.

Hmm… So I need to get my sore knees and bad back looked at again?  I had signed up for TRICARE Prime, so I could go to the doctor, but my decades of “sucking it up” had precluded me from making an appointment for something that did not involve broken bones or arterial bleeding.

So I called the VA the next day.  After a similar game of telephone and voicemail tag I spoke with a very helpful gentleman who understood exactly what my dilemma was.  He checked his calendar and squeezed me into an appointment this coming Wednesday, where he promised to get my ship sailing in the right direction.

And I promise to tell you how it goes…

__________

Lessons Learned:

1.  Contact your VSO immediately after you receive your VA claim settlement letter.  I lost about five months as I waited for the VA to contact me before I finally got on the ball and started engaging the system.

2.  The VA is buried in claims and the best thing to do is to take charge of your case.  Waiting just means that others who are being proactive are jumping in line ahead of you.

3.  Your VSO can explain the intricacies of the settlement letter in a phone call, but you have to contact them to initiate the conversation.

4.  The next call you make after the VSO should be your local VA office in order to initiate the next steps in the evaluation process.  If your claim is settled, then you need to contact them to be registered in their computer system so that you can access healthcare providers.  If your claim is not fully settled, then you need to get registered and schedule appointments with the appropriate professionals in order to finish up your claim.

Jennifer’s VA story

Posted by Mike Grice on

As you are aware from previous posts, I recently received my initial disability claims information from the VA.  I am still trying to figure it all out.  I am not alone, as I have learned.  Several people have posted comments about their experiences, and I am reposting their comments here because they are very illuminating!

Here are a couple of comments from Jennifer.  She presents a case study in frustration:

Thank you for posting your experience with the VA Claims process. I am currently receiving VA disability at 10% (migraines), but am rated at 0% for both of my shoulders and back (which is simply VA’s acknowledgement that I suffered injuries in these areas while on active duty). Over the past 10 years (ETS 2002), all of the areas in which I was rated have progressively gotten worse. On 2/11/ 2011, I filed a claim with the VA for a disability rating increase. My claim included a request for increase for migraines, both shoulders, and my back. My case for increase is well documented by my family practice doctor and two different neurologists (ten years of documentation indicating my symptoms have gotten progressively worse). My claim went from the gathering evidence phase to the review of evidence phase in July, 2011; however, it only stayed in this phase for about a week before my file was sent back to the gathering evidence phase. During the VSO’s review, they identified several (8) secondary conditions to my existing claim based on the review of my file. When I noticed my status had changed (negatively), I contacted the VA 1-800-# and was told I needed to provide evidence on the secondary conditions the VA had identified. I thought this request was ridiculous, since the VSO had already identified these conditions based on medical evidence I had already submitted; however, I complied with their request and resent in my medical evidence, along with my service records, and made the case to tie the secondary conditions to the service connected disabilities. In August of 2011, the medical records in my c-file were mysteriously misplaced, and I was asked to resubmit my medical records once again. Again, I complied with the VA’s request and immediately faxed the documentation to the Roanoke Regional Office where my claim resided. I waited several months, periodically checking the status of my claim on the e-benefits web site; however, there was no change in my claim’s status. There was an estimated completion date listed on the top of my claim (12/13/ 2011). This date came with no progress or change in my status; therefore, I contacted the VA 1-800-# again requesting a status of my claim. The VA representative sounded very irritated I had called, and gave me a scripted response- something to the tune of: the length of time it takes to process your claim depends of the complexity of your claim and the number of disabilities needing review- I asked them if they needed anything additional from me, and was told no. Once again, I waited patiently for my status to change- no luck! I contacted the VA in March of 2012 and was informed I needed to send in additional documentation stating I had no other medical evidence or supporting documentation to submit. As instructed, I faxed in the document. My claim skipped the reviewing evidence phase in e-benefits and is now in the preparation for decision phase(as of 9/24/2012- 19 months after the initial submission of my claim). Today is 9/26/2012, and I am still waiting for a decision from the VA. I wanted to do cartwheels when I saw my claim move into the preparation for a decision phase (however, my shoulders and back disabled my excitement (grins)).

I am posting my experience because wanted to share my story and let my fellow veterans know just how slow the process really is. I did have an interesting conversation with one of the 1-800-# representatives that I find worthy of repeating:

He told me he was a disabled veteran as well, and said his own experience with the VA claims process was exhausting (no one gets special treatment- not even the veterans who work for VA). He then gave me advice that I wish I had been given at the onset of my claim. He told me that every time I send in a document, my file is sent back to the gathering evidence phase. When I was sending in my medical documentation, I faxed the documentation in as I received it. Hence,VA’s rationale for my claim staying in the gathering evidence phase for so long. He advised me to submit all of my documentation at one-time, if possible, and to be sure my clam was well documented. He said this is important to ensure the VSO did not have to kick the claim back for questions or additional documentation. I then asked the VA representative another question in which I thought would help my claim. Over the course of the year, I had been to the doctor for my disabilities, and had accumulated much more medical documentation; therefore, I asked him for his opinion- Should I submit the additional documentation to ensure my c-file was up-to-date? He told me, in his opinion, NO, I should not submit the additional evidence, especially if my file already provided adequate evidence of my claim. He told me if I did submit the evidence, my claim packet would be pulled so that the additional evidence could be added to my file, then sent to the bottom of the stack for review. I did not realize that every time a document is submitted, your packet is pulled and sent to the bottom of a “pile”. He told me to hold on to the documentation and wait for a decision from the VA so I would start receiving benefits. He also advised, if I was not happy with the VA’s response to my claim, I should then send in the additional documentation I have accumulated and appeal their decision.

With all of this said, I hope I have shed some light on why the process takes as long as it does. I am just as frustrated as every other veteran submitting claims; therefore, I wanted to share my experience and the advice I was given hoping it will help another veteran with the submission of their disability claim.

That was Jennifer’s first comment.  Here is her second one:

Just as I finish typing my blog to you, I contacted VA to learn my claim has been sent back to the gathering evidence phase. The VA service respresentative could not provide me with a reason why… just the typical blanket statement stating they need additional evidedence. Hence, my claim stayed in the decision phase for two days….ugggg!

Keep plugging away, Jennifer!  Thanks for sharing!

Nine months later…

Posted by Mike Grice on

There are a few events in life that take nine months to complete.  Things like a school year, a sailing trip around the world, or having a baby.

None of those things just happened to me.  What did just happen, however, was my VA Disability Evaluation was completed- only nine months after I submitted my paperwork.  I did a little surfing around the internet and found that nine months is about average for a claim to wend its way through the system.

So I have nothing to complain about – my claim was processed in the same amount of time as pretty much everyone else’s.  But hold on….

As with everything in life there is a catch.

My claim packet arrived in the mail yesterday.  A thick envelope was waiting by the door, and upon opening it up I found my medical records and a letter explaining, among other things, my ratings.  It seemed pretty straightforward.

But, as with all things related to transition, it wasn’t.

It turns out that the process is only partially complete.  I have a couple of things that were “not included” in the evaluation because the VA needs more information.  Apparently I will be contacted in the future for a follow up examination to address the remaining issues.

So, it looks like I have received my evaluation results in the mail and now I have to wait to be contacted to complete my evaluation?  To say I am confused is an understatement.

Fortunately there is help for situations like this.  Over a year ago I wrote about my experience with the Transition Assistance Program (TAP).  During the week that I went through the program I met with a representative from the Disabled American Veterans, or DAV.  The rep explained that they were there to help with the VA claims process, and that they would be there to help in the future when things got confusing.

Ding!  Suddenly I find myself in the future he was talking about.

I am confused today, but will be decidedly less so next week when I call the DAV representative for help.  I neither appreciated nor understood what he was saying at the time, but now it has all become clear – the DAV (and veteran’s service organizations) are there to help vets like me and others tackle a byzantine and complicated system and make sense of the whole thing.

I’ll let you know how it goes and what I find out…

An update in my VA Claims Status

Posted by Mike Grice on

As a reader of this blog you know that I have recently transitioned from Active Duty and am now enjoying life on the civilian side of the fence.  One of the big parts of transition is the eligibility for a disability rating from the Veterans Administration, and recently my status in that regard changed.

Let me back up a bit.  I began my transition well over a year ago (in the summer of 2011), and as I went through the required and optional transition seminars I was educated on the benefits that all honorably discharged veterans are eligible to receive.  As a retiring Marine, I learned that I was eligible for more benefits than those who served one or two enlistments (such as pension and access to VA medical care for myself and an entitlement to TRICARE for my family).  Such benefits are great!  They were earned through over a quarter century of service in uniform and no small amount of time getting shot at in combat zones.

In addition to VA medical care I, and all veterans, are evaluated to determine whether or not we are eligible for a disability rating as a result of the maladies, wear, and tear that we experienced while serving in uniform.  It is perfectly reasonable to be evaluated for any such problems, but unfortunately the time it takes for the claims evaluation process to reach completion is far from speedy.

This month I received a couple of notifications from the VA.  The first was a letter that is identical to the letters that preceded it telling me that my claims process was still under review.  Not surprising, really, because the average time to review and approve a case is well over a year, and mine has only been in the hopper for about ten months now.

When I logged into the VA ebenefits website, however, I saw that there was some progress.  Hooray!  My status had changed from “Preparation for Decision” to “Regulatory or Procedural Review”.  I’m not exactly sure what that means, but I am optimistic that it is an indicator of progress.

I drilled into the website to see what the new status reflected.  Here is what the website said:

Claim Received: 08/17/2012
Claim Type: Regulatory or Procedural Review
Estimated Claim Completion Date: unavailableWe are currently unable to provide you with a projected completion date for this type of claim. Please await further claim status notification for this Regional Office.

Hmmm.  That tells me pretty much nothing at all.  I read on…

Next Steps:

We will review all available evidence and make a decision on your claim upon receipt of all requested information as outlined in the headings, “What Do We Still Need from You?” and “What Have We Done?”. 

Several factors will determine the duration of the “Development” phase, including:

  • type of claim filed
  • number of disabilities you claim
  • complexity of your disability(ies), and
  • availability of evidence needed to decide your claim.

Now that sounds promising!  My case is in the “development” phase!  I still don’t know what that means, but I am hoping it indicates progress.

At any rate, my claim is wending its way through the claims process, and it looks like movement forward is occurring.  I hope that those of you out there in the same boat are receiving similar updates, too.  A word to the wise, however: Don’t wait for the VA to tell you about your updated status via the postal service, because they likely won’t.  My letter from them this month didn’t tell me anything new.  You should be checking the VA website (www.va.gov, specifically the ebenefits tab) frequently to see if your status is moving forward.  Otherwise things may be going on with your claim that you are unaware of.

Just a word to the wise….keep up on your claim!  After all, if you don’t, who will?

VA Exam and Disability Rating

Posted by Mike Grice on

Over the last weekend I had the great fortune to run into a good friend of mine who retired from the Marine Corps after thirty years of active service.

He is a great guy who lived one of the hardest lives you can live in the Marine Corps; he started out as a infantryman and then became a reconnaissance Marine and then a Special Operator (meaning he began his career as a grunt who carried heavy loads long distances and lived in the dirt to a recon guy who carried heavier loads longer distances and lived in the mud).

During his career he did all of the high speed things that are the stuff of recruiting posters.  He jumped out of airplanes –  but not just enough times to earn his wings but hundreds and hundreds of times from helicopters and airplanes both at very low and extremely high altitudes.  He became an expert diver, marksman, and small unit leader.

He helped the Marine Corps blaze the trail into the Special Operations world.  He helped build what is now called MARSOC and was a critical leader in the 1st Marine Special Operations Battalion.  He deployed to Kuwait and Iraq and Afghanistan to fight, and in his career he deployed thirteen times.

All of this came at a tremendous cost, however.  He suffers from a long list of physical ailments that are related to doing all of those incredible things; his ears ring from being around gunfire for years on end, his joints and back are so painful that he sometimes can barely move, and he wrestles with PTSD in the same manner as so many of us who have fought for their country and survived.

At the end of his impressive career he did what all separating servicemen do –  he went through the VA evaluation process.  He ensured that his physical problems were recorded in his medical record and was then examined by a VA physician.

With all of his maladies he was certain that he would be assigned a relatively high disability rating.  After all, many people served for far less time and in far less strenuous and physically demanding environments and had received very high disability ratings.  He wasn’t looking for anything he didn’t earn and deserve, mind you, but was just looking for what was fair.

Recently he received his disability rating announcement in the mail.

10%.

For tinnitus.  Ringing in the ears.

To say he was angry is an epic understatement, and upon taking his case to his state VA representative they agree and are challenging the ruling.

How did he end up with such a low rating when he has so many demonstrable maladies?

He attributes it to his physical evaluation.  The doctor didn’t really examine him, but instead just asked him questions about his conditions.  He did not order tests or even check for himself, but instead had a conversation and wrote down some notes.

The point is that in order to receive the most accurate evaluation it is imperative that you take an active role in your VA physical.  Demand that the doctor examine those things that you know are wrong.  Don’t just let the overworked doctor hurry through your exam.

Otherwise you may likely find yourself under-rated for your service connected disability, and to get it corrected will make an already disturbingly long process even tortuously longer.

So this is a cautionary tale.  You may save yourself a lot of time and inconvenience by taking an active role in your VA evaluation, so I recommend going into the doctor’s office with the intent of having each and every issue examined, addressed, and recorded.

After all, if you don’t do it, who will?