The VA as an Insurance Company

  Most Vets view the VA as an extension of the military in that they take over responsibility for you and any issues relating to your service. This is true to a certain extent. The VA is also tasked with the job of providing health care for millions as well.  It is divided into two entities which are loosely connected. The VBA, or Veterans Benefits Admin. deals solely with the compensation and pension end of it whereas the Veterans Health Admin. is the medical arm. They work in tandem in that the VBA utilizes the VHA’s medical info accumulated on Vets to make compensation decisions. When Vets only use private medical providers, they must relinquish these records to the VA in order for a claim to be processed or sign a release of Information form.

Veterans have the unrealistic expectation that the VBA is compassionate, caring and created to help them. I’m sure it was at one time in the past. Due to the greed and competition among different agencies in D.C., there is always a fight over limited resources for Americans with “problems”. Be it the inability to work (SSD), retirement after 65 (SSI), extreme poverty (Welfare and Medicaid) or simply retirement from government (pension), the amount available is always being fought over.  Each agency wants to expand and be more powerful. The VA is no different. And like other agencies, they make no effort at economy of size or consolidation of services and assets. Faced with $26 billion a year, there is absolutely no incentive to be a good steward of the taxpayer’s monies. As there is always more where that came from, and they don’t have a conventional profit/loss sheet such as  private enterprise does, they feel no need to husband their resources. Would you? During fat years, VA spreads the largesse around to upper management on the theory that it’s “really hard to attract good help”. During the lean years, they turn the sweater inside out and say that any reduction in employee benefits will result in an exodus for the door to private employment. Huh? Right now there is no private hiring going on to mention. The private sector is in a holding pattern and anyone with common sense isn’t stampeding for the exit to obtain a six figure salary at a private law firm. Nevertheless, the bonuses to VLJs continue unabated.

The maximum most Vets can attain is $2823.00 per month with a spouse($33,876.00/yr.). He can, with an additional 60% or more in disability, obtain an additional $320.00/ mo (SMC-S). For more serious disabilities such as paraplegia, there are other compensation tables. In the event of the Vet or his spouse being severely incapacitated, there are Aid and Attendance allowances. The most remunerative is SMC R.2 which grants $7800.00 a month to a Vet and his spouse. A/A would be on top of that. This gives you an idea of the largesse that VA rewards us with for our disabilities. Ah, padewan. Tax free it is, Yessssss. But anyone in that tax bracket doesn’t pay taxes. Hell, they probably get earned income credits or a refund.  See tables below:

http://www.vba.va.gov/bln/21/Rates/comp01.htm

http://www.vba.va.gov/bln/21/Rates/comp02.htm

With that in mind, look at the remuneration afforded active employees of the VBA. For sitting at a desk as I am now and typing without utilizing more that 30% of my brain, most of those people pull down in excess of 66K/year. If forced to use an Adobe Acrobat pull down menu due to mental underdevelopment, and construct custom denial letters, the rate creeps up to $80K. A 20 year senior employee can expect $105K to 118K.  I do not wish to denigrate VA employees or their work product. Inflation has cut into wage figures harshly over the years and causes financial stress. I only ask you the reader to look solely at the amount tendered to someone injured in defense of his country. These sums are paltry and below the government’s minimum wage figures. That is defined as Poverty with a capital P. Think about the fellow recently awarded a CMOH for fetching a hand grenade and saving his buds. He lost a substantial chunk of his arm doing it. That will net him a 40% rating if he’s lucky. With retained shell fragments and scarring, he may hit 60%. That’s $974.00/mo. or $11,688.00 a year. Whoo-hoo! He won’t have to worry about that pesky slice he used to have. He’ll probably have to sell the clubs to eat eventually so its immaterial anyway.

     The VA would have us believe they are under siege and funds are at a premium. They wring their hands and say that government controls their purse strings. I understand the VA Secretary is a busy man and has a lot of responsibility. I agree that all his minions are similarly situated and have mortgages to pay. In fact, if put to it, I submit that all employees can probably justify their salaries and perks. I would ask them to explain and justify our pay scale in that same paragraph without changing the subject or digressing on how our medical needs are being met. Please spare me the theatrics.

     Like any insurance company, VA is tasked with separating the wheat from the chaff. For obvious reasons, there are those who seek a free ride. Unscrupulous Vets are apparently far more numerous that we were aware of judging by the numbers denied. According to statistics, 85% of you bozos file claims that cannot be substantiated or are patently false. Oddly, this figure is far higher than civilian insurance claims. Is the VA simply a convenient shopping place for deadbeats? Are Vets so financially challenged that they consider defrauding the government at the VA trough rather than the SSD one? Something is amiss.

   When analyzing data, one must realize how easily it can be manipulated. Binoculars actually work in two different directions. Depending on the end employed, the observation can vary. VA, and by extension VSOs, encourage us to file claims for injuries or diseases sustained in service. Unlike their civilian counterparts, we are not allowed legal counsel at this initial stage except for a service officer trained in the legal arts of the VA system. This is an oxymoron. There are none so trained. Were there any, the rate of success would climb dramatically. Stymied in the first instance, the VARO, as trier of fact, is allowed to pretty much run roughshod all over your claim. This they do with utter abandon. This is called ex partejustice. It consists of “show us what ya got”. They then proceed to craft a denial with no rebuttal. You are only accorded a voice at the end to protest or disagree. Occasionally (15%) you prevail. In the eyes of the VA, many of us win on a fairly regular basis. In their mind, we rarely supply the evidence needed to succeed. If you are not a litigious person and have poor legal counsel, it follows that this will be the outcome. VA states that they don’t view their claims process as particularly onerous or complicated, yet it takes them forever to adjudicate a claim because it is a difficult process. VA doesn’t focus on the 85% denied but rather on the 15% approved. An automobile insurance company that only paid out 15% of claims submitted based on the VA criteria would go out of business in short order. People would shop for another provider who provided a true umbrella. Faced with this dilemma, we get abbreviated justice. The BVA, also a trier of fact, permits legal counsel, but artificially limits the amount the attorney can recoup to 20%. It used to be $200.00 max. That was instituted in 1865 and didn’t change until the VJRA of 1988. We now have the EAJA (Equal Access to Justice Act) which, if you prevail, will also pay the attorney a little more. It’s no wonder that there are so few attorneys willing to represent Vets.  Why bother if the pay sucks? Ambulance chasing is far more lucrative.

     In summary, dealing with the VA Insurance Co. will require a change in mindset. Please press delete when caring and compassionate appear on the screen. Consider them a foe rather than your good buddy. If they smile and tell you everything will be okay, move your wallet to a front pocket and sit with your back against a wall. If you want legal help, please do not feel you will get it at a VSO unless you are already well-educated on VA law. There are exceptions to any rule, but experience shows otherwise.  And lastly, in the event you win your claim, do not automatically assume you will be granted a rating that is commensurate with your injury.  $974.00 a month for life-even tax free- for donating an appendage to America is small compensation for the trauma, both mental and physical, that a Vet went through. Trading in a liver to HCV along with the last 20 years of your life for $2823.00 a month is not compensation. We do not advocate for exorbitant  payouts. We simply feel current rates are woefully insufficient in this day and age much like the $200.00 max to an attorney was.  This isn’t the same as SSD which you paid into. Veterans paid with body parts and they have no price attached to them. Currently, they appear to have very little value. Wars do that.

     Unless and until America begins treating her Vets as an asset rather than a liability, we will soon see a marked recalcitrance towards serving. Artificially suppressing compensation pay while extravagantly rewarding employees will eventually be viewed as grossly unfair.  Until the news media focus on that, we are condemned to being viewed as welfare cheats and freeloaders by the VA.