Several decades ago, back in about 1973, it finally struck me that the VA embraced the core tenets of the UCMJ. Rule number 1 is, of course, the Veteran is probably a liar or grossly exaggerating this- ergo he’s not entitled to the benefit. Rule number 2 is the old Murphy u-turn. If he is entitled, figure out how to go back to Rule number 1. Fortunately, things have changed in the succeeding years… or have they? 

With the advent of not only one war (Viet Nam) causing a bow wave into the future from 1965 onwards, our Great White Fathers in Congress decided in their infinite wisdom, to double down and do a new 20-year gig in Southwest Asia. Between the two of them, we even managed to throw in several Caribbean adventures and a test run in Kuwait.

So now we have a huge class of disabled Veterans. Because of the predicted, gradual tapering off of WW II  and Korean War Vets, VA quit building more hospitals and began bonus payments for denying. But we suddenly went into high gear in Southeast Asia before the expiration date on the leftover c rations. The rational conclusion to this tsunami increase would have been to hire more frontline raters as the numbers ratcheted up. But you don’t know the VA.

The old VA I know clung to the idea of paper records like they were the 10 Commandments handed down by God. They had the money to convert or ask for it. They had good examples to follow being used by other Agency-level organizations. Yet they chose to stay in the Dark Ages until nigh on to 2013.  Why? What could possibly be the benefit of delaying the inevitable? Did they suspect that computers would eventually be passé and we’d all revert back to paper?

Somewhere after that brain fart died and they were forced to go paperless, we reached a crossroads. The sheer volume of keyboarding needed, even though more rapid and advantageous, ran head on into the reality of the sheer volume of disabled Vets building up. Whereas in 1989, a rater hand-worked about 40-60 claims at any given time mostly in conjunction with another (with his own 40-60) and a medical doctor/rater as the overall supervisor. This constituted a “Board” at the local level. Average claims time? About 8 months.

With the advent of 1991, the VA engine of justice began to bog down with the new load  of Kuwait/Iraq boys right on top of the beginning of Nehmer and the Agent Orange gullywasher. But, as they say down in Texas, you ain’t seen shit yet, bubba. To add insult to injury, there were a whole new crop of us Hepatitis C Vets who were casualties of- yep- streamlining the  inoculation line in Basic with the jetgun.

Each wave of newly minted disabled Veterans started piling up on the last of the WW II/ Korea dudes. VA’s response was to increase everybody’s workload again. Congress was throwing money at it- but not in serious enough quantities… yet. VA was putting a lot of it into VHA to warehouse the damaged ones and build all the hospitals they neglected to build in the 80’s and ’90s. And then came 2001. Boy howdy, if you thought there was a backlog before this, you needed to listen to them fellers down in Texas.

VA tries. We must give them that. What irks me is the unwritten presumption of lying. While we are usually supported by our records in service -both medical as well as personnel, there are those of us whose records went astray. Some of us went TDY to places that qualify for AO but those records are gone too. Think Laos or Cambodia. Those Vets are screwed. No nexus letter invented can speculate about what doesn’t exist. Go back to Rule #1.

Which brings me to the present and the new AMA. VA is forced to adjudicate hundreds of millions of claims- still with about the same number of raters and worse- some of them are SVSRs, DROs, Coaches and VSCMs. They glance over this stuff, run it though the Artificial Intelligence decyphering device, write a brief synopsis and forward their “idea” of what direction they think the decision should go. That translates into “Deny if You Can. Grant if you Must.”  The orders are passed down to the next level for assignment to the E-2 Eleven Bravo 10 FNGs to “construct” with- wait for it- more AI. This is the well-known M 21-1MR (Manual Rewrite). As with the infantry, there are huge numbers of VSRs who quit due to the bullshit workload requirements while the GS12-14s just update their Faceplace accounts and give orders on what to say or write.

To illustrate how AI can go horribly wrong, I’ve had the pleasure of taking these daisies up to the Board of Appeals. No matter that I show the gross error, few, if any, of the VLJs will take the bait and scold the idiots below. How about:

“It is less likely as not that the Veteran’s Tinnitus was caused by his Toxic Exposure Risk  Activity (TERA). “

The Veteran’s total rating for his PTSD only caused mild incapacity and not a constant need for a&a.”

“You are already receiving a&a. therefore, your request for a&a is moot.”

Now think about this conundrum. VA has an M 21 quote that states “Generally, an award of 100% is the minimum prerequisite for entitlement to a&a. As you have no single rating for 100%, your claim must be denied.” But what happens when you file for being permanently and totally bugf–ky and they grant the 100%? Do they immediately write to you explaining your shiny new a&a rating and pay raise based on your brand new 100% rating? Oh hell no. By operation of law, that 100% malarky should cut both ways.

AI has taken the place of about 10,000 raters. Unfortunately, it is programed with the UCMJ dicta. Nowadays, we also have an ILER (Individual Longitudinal Exposure Record) in our c files. This, like the TERA, identifies your exposure to medical or other external influences which might lead to approval of a claim. But what happens if you were trained as a helicopter repairman and when you got to the Repo Depot in ‘Nam, they were short of door gunners. You were given the short course on the care and feeding of your Pig and shipped out to Camp English, the 1st Air Cav and a year’s free paid vacation.

Hundreds of law dogs have been caught out trying to build legal briefs using AI and have their programs begin to manufacture precedential cites out of whole cloth. Bad idea. But yet VA can crank out something that says “We agree you were exposed to JP 4 and other petroleum products associated with your military occupational specialty (MOS) of a fuels specialist but there is no evidence to connect this to your MDS (Myelodysplastic syndrome).”

Now, the obvious problem here is no nexus letter. VA knows full well that MDS is caused by benzene 99.999 times out of 100. But unless you present the medical ‘nexus’ link, they can play dumb. Again, this is pure AI. VA begins the claims process from the beginning utilizing AI. AI wants to see it written that the etiology of the MDS is JP 4 but no c&p nurse is going to write that. That’s not her job. She just measures what stage you’re at how many times you puke in a 24 hour period.

Claims inflow at the Evidence intake Center (EIC) up in Janesville Wisconsin automatically sorts these things into three piles. New claims (526s), old denials coming in as new supplemental claims (995s) and NODs to the Board (10182s). A CUE filing is rejected and has to be processed manually but goes into that huge pile of denials eventually.

It’s pretty obvious the average IQ of the real human beings at VA Veterans Service Centers (VSCs) and DROCs is borderline 100. Anyone with 120 plus will float higher in the ranks if they have the UCMJ mentality of Rule #1. This is amply confirmed by some of the Coaches’ notes I read in VBMS.

The obvious problem rapidly evolving is the total implicit trust put in what the AI computer generates as gospel truth. We are witnessing a new wave of rebellion at the local Regional level where Quality Control RVSRs are refusing to grant remanded grants coming down from the BVA because- hold on to your hats- it isn’t written in the M21.

For the uninitiated in this area of law, the M 21 is like the assembly instructions you get with your new flat pak IKEA™ bookshelf. The only difference between the two is the IKEA instructions will allow you to correctly assemble the bookcase. The VA’s version is more of an “If…then” model with each choice guaranteed to lead to a denial. Served in Viet Nam? Check. Has Respiratory cancer? Check. Is it a presumptive? Yes… but not so fast. He also has liver cancer so it might have come from the liver and metastasized to the lungs. Denied.

One of the newer techniques is to rephrase the c&p exams they send you to with a zinger. Is the Veteran’s loss of the use of his lower extremities due to Diabetes Mellitus II? The c&p clinician says hell yeah it is. It comes back to the rater and s/he says Denied. You do not have a diagnosis of loss of use of the lower extremities. The favorable finding of fact at the very end will inform you that you are service connected for… wait for it… DMII.

We are entering a new era of VA litigation with AI. I guess you could call it the Deep fake technique. You have to be a wordsmith to discern you’ve been bitchslapped by a computer. For those of you who can get a copy of their c&p exams, I urge you to examine what the medical opinion actually says. This is where you find the VA 3-card Monte trick. The actual question will be phrased as “Is the Veteran’s meniscus tear of the left knee at least as likely as not due to his exposure to petrochemicals associated with his military occupational specialty of generator repairman?”

Once you learn to read every work, no matter how innocent sounding, will you see what’s right before your eyes. Most Vets scroll down to the different choices of answers to find the “It’s less likely as not…” and go into a rage without even seeing the illogic of the underlying question. Garbage in. Garbage out. Now multiply that with two or three IMOs and they all have bogus off base questions asking for idiotic answers.

The last technique, which is older than me by a long shot is the inane “We reviewed your STRs and there is no mention of the fact that you suffered from Parkinson’s/heart problems/ lung cancer/DM II etc. during your period of active duty.” 100% correct. But they’re all on the presumptive list. A 996 HLR won’t fix this even though you argue yourself blue at the informal conference. The hearing officer just uploads it as a difference of opinion and they run it through the AI program for a shiny new retread denial. Going to the Board is basically your only recourse.

I suppose we could all write letters to Uncle Doug and ask him to fix it but they’ll probably run it through the same AI computer to decypher. Until we get back to the old computer attached to our necks, we’re doomed to superior denial technology-even with a well-reasoned nexus letter. If VA suffers a 74% reversal rate on claims at the Court and the Board only finds 29% are wrongly decided, nobody at the AOJ is going to look under the hood of the AI computer to find out why it’s so frequently wrong. Shoot. You gotta remember they long to go back to paper files days.