VA’s NEW PROVISIONAL RATINGS PROCESS


When I heard of (and finally understood) the gist of the new provisional ratings announced with great fanfare last week, Blazing Saddles came to mind. More precisely, Cleavon Little as the Western Union Telegram boy.

CANDYGRAM FOR

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MR. MONGO!

Mr. Mongo, of course representing unsuspecting Veterans.  Many with outstanding claims have been flocking to Vet help sites this week in astonishing numbers asking all manner of questions about the new VA proposal to expedite claims over one year old and adjudicate them “provisionally”.  Many seem to think this will be a blanket grant—period. Others have moved past that to wondering if it will be a blanket 10% rating until the claim can be adduced properly. Chicken coops are filling up with chickens everywhere and the eggs have yet to hatch.

Back the boat back up to the dock, Gilligan. Let’s perform what the Court of Veterans Appeals is fond of doing and parse the meaning of provisional. Miriam Webster is the tome of choice.

Provisional. adjective. prə-ˈvizh-nəl  — serving for the time being : temporary; not permanent. VA has added a few codicils to the definition.

Would that this were what Vets purport it to be- an executive clemency akin to the IRS accepting your tax return at face value and issuing a refund based on it. This is what many mistakenly believe. Nothing could be further from the truth. VA is preparing to adjudicate claims over a year old based on the same stale, prior methodology riddled with errors. In this iteration, the decisions will still be based on what the VA calls the Evidence of Record or EOR. This is nothing new. VA has done it this way since 1812. The difference in 2013 is that it will be based only on what has been amassed during the gathering of evidence phase. If your claim has been on the back burner due to evidence needed from the Social Security, you may be in bad shape. VA is renowned for rating without those records knowing full well it is wrong and will provoke a remand on appeal. Now they have been ordered to do it and rules be damned.

What if the claims file is incomplete? What if a doctor’s nexus letter with the strategic IMO is missing or filed in another Vet’s C-File? Claim denied. Next? Simply  switching from   33¹⁄ ³ RPM to 45 does not fix anything. VA has no plans to do anything quite so daring as to go out on the little branches and grant service connection for big ticket items. Tinnitus and hemorrhoids will make up the majority of this nouveau method-if at all. Hearing loss for 0% will be handed out like plastic necklaces at Mardi Gras.

The majority  of serious, big ticket items like cancers and back injuries will be given the usual lip service and denied. Remember that these folks operate like a major insurance company. Granting claims is anathema to them. If this were an honest poker game, you would expect to see more than 12 to 15% of claims granted. Certainly some of the TBI and more egregious loss of limb claims will be granted but most of those are already expedited seamlessly right out of the service. All the old Agent Orange claims are reputed to have been accomplished. What does that leave? Good question.

Claims to the VA come in all shapes and sizes. VA makes no effort to sort claims out involving combat injuries from §1151 claims for medical malpractice . Increases of existing claims ratings, pensions, burial benefits, Dependency and Indemnity Compensation for widows and their orphan child(children) are all lumped into one big pie of claims at Regional offices. Keep that in mind when you think of a claim being over a year old. Simply getting a copy of your C-file to defend yourself can take as long as having the whole claim adjudicated. I know two Vets who are contemplating filing Extraordinary Writs just to compel VASEC to release them.

And while this drags on, keep these statistics in mind. Fifty three (53) Veterans die every day still waiting for their savior to grant their claims and pay for years of remuneration-interest free, of course. Twenty two Veterans lose all hope and take their own lives every day after being told they’ll be seen by mental health professionals in two weeks- 10 weeks later.

And now the VA has spun the Panacea Wheel of Fortune once again for Congress. When the President took Gen. Shinseki aside last week and politely told him that this was an embarrassment of epic proportions, it was understood that there would be a significant reduction in antique claims.  The clear implication was that the obvious claims could be granted without studious examination. Minituae like correct effective date and proper percentage could be hashed out at a later date. It was assumed that there would be some error and overcompensation but that, too,  that would be ironed out in time. What the hey? They know where we are. We’re not liable to abscond with our $28,ooo.00 retro check to Rio de Janeiro  never to be seen again. The clear mandate was to eradicate the overage and placate Vets.

VA simply cannot bring themselves to do this. Its like calling in an airstrike on your own position. The Under Secretary for Benefits and her minions have now miraculously construed  Obama’s admonition to be nothing more than a greatly speeded-up version of their present, outmoded “You report. We decide.” process. In this brave new version Vets can move right along to their appeals much faster. Thus “provisional” to USB Hickey is subjective and open to interpretation. I envisage Foghorn Leghorn talking to the little Veteran chickenhawk:

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“I say Boy, you don’t seem to be apprehending the general gist of what I’m trying to convey here. Maybe you oughtta take a second, let your head catch up to your tongue before it gets all sunburnt.  Provisional rating? Lawdy, where did you hear of that, boy? Provisional rating? Why, you must be dreaming. Hoo-haaa. Provisional rating indeed!”

And best of all, it was announced today that all bonuses for VBA employees are on hold. Really. That’s not a joke. VA actually had to announce this with a straight face. Only three lucky employees attained the highest remuneration for duty above and beyond the call last year. That would be the top slot bonus of $23,091.00. Veterans are understandably terse of jaw about this considering the 100% service connected Vet only gets $2,813.00 a month for an annual $33,792.00. Were the VBA performing up to par, I doubt anyone would object. They’re not (performing) and we are (terse of jaw). This  cannot bode well for the Orlando HR, Karaoke and Golf getaways in June and July.

About asknod

VA claims blogger
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1 Response to VA’s NEW PROVISIONAL RATINGS PROCESS

  1. david j murphy says:

    On the subject of bonus payments to VA employee’s I have been told several times by VA personnell that the C%P doctors are getting bonus payments based on how much money they save VA. Any truth to that in your experience?

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