PTSD–DIRECTIONS FOR CYA

Posted on March 9, 2013 by asknod

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I received this from Law Bob and/or Berta from Hadit.com, one of the more outstanding  sister sites which looks out  for the best interests of Veterans.

Veterans have been getting a raw deal for the last sixty years when they come home from wars, skirmishes, territorial “misunderstandings” and the like. The phenomenon began to occur during and after the Korean War when returning troops who had been mentally traumatized were miraculously discovered to be in much better mental health then even they knew. Instead of shell shock or battle fatigue, they were diagnosed with lesser diagnoses of obsessive compulsive disorder when they exhibited a desire to sleep under their bunk beds rather than on the mattress. Similarly, Vets like me who evinced a desire to sit in corners facing out, flinched when a car backfired and avoided crowds were found to be suffering from antisocial personality.

These diagnoses made the afflicted Vets much happier knowing they did not suffer life-threatening major mental disorders. In fact, many of us were able to venture out into society after living in the desert for years trying to heal ourselves. Sadly, many were not. Many became homeless or eventually took their own lives when left untreated.

The collateral damage from wars is only now becoming more known. Studies of PTSD-afflicted Vets reveal a plethora of psychoses in addition to the more obvious ones. One of my good friends, Bubba, was as happy go lucky as the next guy. He had burned through a few wives and lived alone. His life skills were scarce to none. He didn’t have a driver’s licence or insurance and saw no need to. His hygiene was a bit spotty and his clothes were always ready for a visit to the laundromat.  He was perennially moving from apartment to apartment for failure to pay rent on time. Drugs, unfortunately were (and are) still a major part of his daily ritual. Nothing is going to fix Bubba after 42 years of no treatment. The military said he was good to go after he returned from Cu Chi and a year of tunnel hunting.

I came back after two years of this and that and the Air Force noticed I had unshined boots and my hair was unkempt. After losing a stripe in an Article 15, they graciously offered me a discharge if I’d just sign the page saying I was a homosexual. I just as graciously declined and offered to keep out of trouble for another 8 months to my expiration of enlistment. Like the proverbial rotten apple, I was not to be allowed to stay in the barrel. They discovered that all this time (three years and four months) I was actually suffering from the aforementioned antisocial personality compounded by passive aggressive tendencies. This entitled me to an immediate discharge under medical regulations and I even got a General Discharge under honorable conditions because this wasn’t my fault. Since the condition pre-existed service and did not become measurably worse while serving, I was not entitled to any compensation for my ills.

This is where matters have stood for the last forty or more years. Vet joins service. Vet goes to war. Vet comes home with bent brain syndrome. Vet is discharged with personality disorder unless he is certifiable and talks to flies on the wall. If he can be suitably drugged up long enough, he can be released and convinced he’s okay. Besides, tough guys like Rangers and Special Forces are not sissies. They don’t get these problems. Only the whiners and complainers who are too lazy to work ask for a PTSD rating.

The Madigan phenomenon began to emerge as the Army realized three or four deployments to a combat theatre seemed to exponentially increase the number of Vets suffering this misdiagnosis. The VA sent out a flyer to the Military and said “Whoa, dudes. Lighten up. Our hospitals runneth over.” Something had to be done and soon. The Army opted to create a new method that would make a serviceman run the gauntlet before discharge. Anyone who chose to claim this was subjected to numerous tests. Think back on Arlo Guthries’s humorous Alice’s Restaurant and the Group W bench. Madigan’s Group W was intimidated, insulted, accused of malingering and much more. If you survived their gamut of psychiatric sleuthing and still passed muster, you got your diagnosis. If you faltered or tried to be Tough Guy, you were not Group W material but merely one who had slipped through the careful screening years ago.

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The VA, with the implicit blessing of Congress, passed this get out of jail free card shortly after WW2. It has been modified and expanded upon over the years. As is most often the case, it provides an out for having to pay after the military has created a few new wrinkles in your gray matter.

§ 4.127

Mental retardation and personality disorders.

Mental retardation and personality disorders are not diseases or injuries for compensation purposes, and, except as provided in § 3.310(a) of this chapter, disability resulting from them may not be service-connected. However, disability resulting from a mental disorder that is superimposed upon mental retardation or a personality disorder may be service-connected.

(Authority: 38 U.S.C. 1155 )

§ 4.9

Congenital or developmental defects.

Mere congenital or developmental defects, absent, displaced or supernumerary parts, refractive error of the eye, personality disorder and mental deficiency are not diseases or injuries in the meaning of applicable legislation for disability compensation purposes.

[41 FR 11292, Mar. 18, 1976]

Last, but not least, 38 CFR 3.303(c) puts the fork in it.

personality disorders which are characterized by developmental defects or pathological trends in the personality structure manifested by a lifelong pattern of action or behavior, chronic psychoneurosis of long duration or other psychiatric symptomatology shown to have existed prior to service with the same manifestations during service, which were the basis of the service diagnosis, will be accepted as showing preservice origin. Congenital or developmental defects, refractive error of the eye, personality disorders and mental deficiency as such are not diseases or injuries within the meaning of applicable legislation.

Interestingly enough, the military’s doctors are the ones who make these determinations as to whether you had a “personality disorder” prior to entry. Since everyone diagnosed afterwards in service is found to have suffered this prior to entry, there really need not be any further discussion on the topic. Case closed. The exit is to your right, sir. Goodbye.

This is what happened at Madigan. The only problem was that Col. Homas got caught holding the bag. Fortunately he knows someone and got reinstated with no loss of rank or black marks on his otherwise stellar career. What is disturbing is that they still have not finished redacting the investigation report for public consumption.

In sum, we are gradually reaching the tipping point. As Berta so aptly put it..

I found myself repeating again at hadit that I think any member of the Armed Services being mustered out these days, needs a lawyer and a real doctor with them as they do that.

A sad assessment but only too true. Our citizens utilize the military experience to advance their potential in the civilian job market. Others seek a berth for a career. Both are admirable choices as they keep America strong and protect us from our enemies. Who would ever think that the enemy lies within? A Vet is precluded from having meaningful legal representation until he has lost at what is unarguably the most important adjudication of all ( the VARO). Everything henceforth is an appeal to attempt to overturn the injustice. I remember our training sergeant explaining that in the military we were guilty until proven innocent. The concept seemed alien at the time. Apparently that dispensation continues at the VA.

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Posted in ASKNOD BOOK, Gulf War Issues, PTSD | Tagged , , , , , , , , , , , , | 8 Comments

JACK NICKLAUS TO BUILD MY BACK NINE

Posted on March 8, 2013 by asknod

I just received this from Tombo the Proud. Way cool. That’s my golf course. Thank you America and thank you Jack. Now if I can figure out how to last eighteen holes -walking or riding.

Posted in All about Veterans, Inspirational Veterans | Tagged , , , , , , , , , | 1 Comment

VR&E–I CAN’T HEAR YOU

Posted on March 8, 2013 by asknod
I CAN'T HEAR YOU!

I CAN’T HEAR YOU!

My good friends at the Seattle VR&E office have finally received their marching orders from the DC overlords. In what appears to be a case of scarce judicial resources, they gave up on a local attempt to rebut my NOD and sent it out to the cleaners. I will grant them this. They are speedy and must be employing the VBMS. I have never seen a Statement of the Case (SOC) issued in such record time since my filing in 1994. At that time, a NOD filed on December 7th, 1994 was answered with a SOC on January 9th, 1995. This one was a close second in that the NOD was filed in October 2012 and the SOC arrived last week. It took me a few days to digest it. For a while there, I thought that they had me confused with another Vet. After finding all those other Vets’ records in my c-file, I was positive this was the case. After reading further, I realized it was me after all. Anyone here who has been following the claim is probably aware that this is a discussion about one (1) (uno) (nung) (un) greenhouse. Imagine my surprise to read that I have not one but two (or three) greenhouses and am being greedy. I was also informed that my attempt to cheat local merchants out of their due by growing my own veggies ( and flowers) is right out. Apparently I can’t use the Independent Living Program to skirt paying the local truck farmers. My Form 9 will have to include a Miriam Webster dictionary definition of what constitutes a “greenhouse”. I have often talked here on the blog as well as in my book about how VA uses the written word to “bend” the meaning of things. Nowhere is that more evident than their latest opus. I include the decision here for those who will follow after me on this quest. When the battle is won, a clear path through the wreckage will emerge.

This may help many of you to avoid the pitfalls I have   encountered. I can see the battle lines are being drawn along the “independence in daily living” argument I tried to poke a hole in. The word “avocational” also seems to be a big stumbling block as well. It’s rather hard to carry on a conversation with the likes of a Cheez-it® cracker screaming “I can’t hear you!” Yet this is what I am dealing with at the VARO level. Actually, I suspect it is lip synching via the Washington DC Bureau of Denials. Perhaps they just transmit the language back to the local yokels for the steno pool. The long and the short of all this is that once again VA has resorted to taking one small niggling fact you have supplied and running pell mell down the field in the wrong direction. In this case, I suspect the problem lies with my Voc Rehab guru. Mr. K has perused the gardening facilities and come to the remarkable conclusion that I have numerous “greenhouses” on site and therefore do not require additional ones. The additional argument is what should disturb every last one of you who  aspires to ILP greatness. “His intention is to use avocational intervention to sustain his independence in daily living is not necessary, reasonable, or justifiable under Title 38 CFR 21.160” Let’s just overlook for a moment that this is a run-on sentence. There are too many “is”s in it. What the VA is saying is that at no time-ever- will avocational programs be permitted under the IL Program umbrella. The word “avocational” is anathema to them. It is commensurate with flawed dogma. The whole Voc-Rehab program is predicated on one tenet: VA allocates funds/training/ tools to qualifying Veterans to prepare them for reentry into the job market. It is vocational in its thrust. In a word, it seeks to employ you. On the other hand, once you have demonstrated that you are not a candidate for the vocational rehabilitation by virtue of your disabilities, you are a candidate for the IL program. This is where the dichotomy yawns between logic and illogic.

Decades ago at the inception of this program, the concept of avocational pursuits to while away the hours was considered by psychiatrists as valuable to the continuing mental health of Veterans. Gradually they moved away from that pronouncement and gravitated to what could be a proven path to maintaining mental health. Finally, after almost thirty years, the present philosophy of providing grab bars and cordless phones in lieu of photography equipment has emerged. No longer are Vets provided an outlet for their creative juices. They are corralled into a small area and offered devices to put their socks on with. Shoe horns are a big item, too. VA is also big on issuing grab devices to get that can of pork and beans off an upper shelf in order to maintain you independence in everyday living with the reduced help of family and community. Always remember that grabbing said can of beans is purely a vocational pursuit.

At what point do we say enough? Let’s take the term “independent living” and run it through the smell test. Independence is a term that connotes the ability to be free in your person and life to make choices. Independent living as a phrase connotes living with reduced supervision in the ILP context but only from the myopic viewpoint of Veterans. VA’s take on this convolutes the meaning and inserts a means test with an impenetrable barrier. Anything beyond Depends® undergarments is avocational which is now prohibited. How, then, do we explain decades of grants for John Deere riding lawnmowers and snowplow attachments? What about that computer they “issued” many of us? If it wasn’t to obtain that high-paying job as a technical consultant (read vocational), then it was-uh oh- avocational, right? This is the dreaded means test. There must be an unwritten rule of VA ILP that the cost of an item or items is the definitive reason for denial. The Dell computer, all-in-one-printer and software obviously did not break the bank or overstep the financial limits in my case. Mr. Bruce McCartney’s greenhouse grant in Atlanta similarly did not set off alarms other than his protracted fight to obtain it. Another Vet down in Vancouver, Washington (USNDW) has had great success with his Voc Rehab counselor concerning a wide variety of items but is slowly discovering there are limits.

Accepting that there is a means test is not, in and of itself, a barrier to obtaining “things” from VA. The IL program started out as a way of providing us with knick knacks like Tandy leather products kits to make our own wallets and key fobs. This progressed to photography dark rooms and associated equipment. It extended into ham radio gear and eventually into the riding lawnmower arena. At some point the alarm sounded and the eventual cost, if not contained, threatened to engulf the funds available- or so it seems. By 1996 a retrenchment began with Congress’ rescission of all the original rules on this and a new definition of what “is” is. The IL program suddenly got a haircut- modest but noticeable. Again, in 2001, revamping and redefining the limits of largesse came into play. No longer were Vets automatically given their own bowling alleys and vintage cars to ride in at parades. The new paradigm became the “essentials” and the VR&E police began the “Well, bubba. We’d sure like to give you that photo lab but it isn’t necessary and vital to your independence in everyday living.”

Just like God, the IL Program exists. It’s there but intangible. You can find it listed and described in §§21.160 and .162. You can see it in practice here and there but you cannot touch or weigh it. VA insists you qualify for it but that all the things you ask for are not essential for your independence in everyday living. What good is a program that is never employed? What does it accomplish? Who benefits? Why even have it if no one qualifies? I think we know the answer.

VA has a storied history of reciting the mantra at the VBA of “Grant if you can and deny if you must”. This is old hat. With a denial rate in excess of 85% on the first venture, Vets can discern the true nature of the benefit. After you read my book, you better understand the problem and the eventual solution. This works for compensation claims because you can clearly demonstrate a cause and effect scenario-i.e. injury in service, injury now and nexus tying them together. Nowhere in the ILP scheme is there a path or description akin to the seminal CAVC Caluza decision in 1994 that states you need to exhibit these three ingredients to prevail. In fact, all you have to pass is the disability bar. If you are extremely disabled, the fruits of the tree are yours (within reason). The more disabled you are is the predicate for who is granted these dispensations. That’s the paper view at any rate. Were that the case, 2,700 extremely disabled Veterans would be awarded this dispensation annually and be given meaningful “avocational” tools to while away their hours. Not only does this not occur, but the program continues to be wrapped in secrecy and hidden on an upper shelf out of sight of most. For those of us lucky enough to discover it, the next big disappointment is the almost universal denial or bait and switch with grab bars and cordless phones for “independence”. When pressed (read NOD), VA will acquiesce and grant the small potatoes. The big ticket items remain on the top shelf and inaccessible to most, if not all of us. I don’t want to appear greedy. This is inevitably what VA will try to characterize us as. I note with interest the email VA’s congressional liaison sent to Sen. Patty Murray’s VA coordinator last year. The missive centered on the fact that I was in receipt of 100% compensation equaling $2924.00 a month. Shoot, pilgrim. The man is awash in cash and wants a greenhouse too. What the hey? We gave him a computer and he’s still not happy.

Just applying for ILP is not a guarantee of admission. You become a candidate and are measured and weighed. If it is felt that there is nothing that can contribute to your independence in this magical thing we call everyday living, then you are not eligible for the fruits. Since this occurs in about 90% of cases, the barriers to success are even higher than those for compensation. Some other intangible is at play that would get you a greenhouse in Atlanta but no more than a grab bar in Seattle. This is the odyssey I set out on in March of 2011 to discover for all of us. What are the barriers and what is the magic password? Learning VA’s secret handshake has been my mission. VA has been very adroit in performing their Dog and Pony show. They have conducted the home inspections and interviewed me repeatedly. Each time they have collected more info and patrolled the garden. My old computer was carefully searched for pornography to ensure I wasn’t requesting it for prurient pursuits. In the end, the computer, greenhouse and sewing machine were denied because- you guessed it- it wouldn’t contribute one iota to that mythical independence I sought every morning upon arising from bed. In the end, after a NOD, the computer was granted but not for avocational interests. Somehow this is a vocational pursuit that yields employment of an intangible kind. No money changes hands. The occasional Vet I help sends me exquisitely hand-knapped arrowheads (WGM) or a jug of Vermont’s finest nectar-maple syrup (Frank). Some have gone so far as to come to Gig Harbor and buy me lunch (Peter and Azjensmom). Forgive me if I didn’t list it on my W-2. Nevertheless, it is not an “avocational” tool. That is forbidden.

This is where reality flies out the window. VA cannot conceive of anything that passes the vocational test other than cheap plastic tools that improve your independence. How they can then make the argument that the grab bar is “vocational” escapes me. I welcome enlightenment from any of you who are less myopic than me. VA cannot or will not entertain the idea, here in Seattle’s VR&E office, that the IL program encompasses anything other than a vocational interpretation. This conveniently allows them to deny any requests for anything other than what they deem necessary and vital. We know where that leads. It means there is no booklet or list that contains what is permitted and what is verboten. The regulations giveth but the personnel taketh away. If a Veteran can string together a pearl necklace of statutes and regulations that the VA cannot overcome with logic, then the item is granted. On the other hand, the greatest majority go away empty-handed due to their inability to plead convincingly. Few if any lawyers for Veterans will enter this arena because there is no money in it. Envisage a country doctor taking apples or potatoes in lieu of cash for delivering a baby to indigent folks. You get the picture. There’s damn few of those left. Pro bono work in this field is non-existent. VA vainly attempts to characterize it as a viable perk yet steadfastly refuses to grant in most cases. This is evident from the correspondence to Sen. Murray pointing out that I already get tons of tax-free money every month for doing nothing. A greenhouse would simply add insult to injury to the taxpayer.

Until we change the mindset of the VR&E folks on what this program is, we will all continue to marvel at the lucky few who prevail. It is just another adjunct of what I wrote in my book- the squeaky wheel gets the grease. More importantly, the grease is applied when it is evident that the applicant has no intention of giving up. I suspect the VA took one look at the cart employed to move my 7-volume c-file around the VARO and decided to play knick knack, paddy whack, give the Vet a Dell. I am what VA might define as a frequent filer. They have no love for me but they try to remain polite and equitable. By law they are required to. This does not diminish their desire to see me choke on a fish bone and die-sooner rather than later.

Below is the SOC explaining why I will never get a greenhouse. As for the Reasons and Bases, I will let the reader try to wend their way through the tangled semantic thicket and emerge on the far side without shaking their heads in confusion. I see that from one perspective I will be harmed by having additional greenhouses because I will have to slave night and day to maintain them. Then, in following paragraphs, I am attempting to circumvent the whole precept to the ILP by avocational pursuits. 2013-03-08 1413322013-03-08 141332_22013-03-08 141332_32013-03-08 141332_42013-03-08 141332_5

2013-03-08 180211

2013-03-08 141332_7

The VA formula for those mathematically inclined is simple.

ILP ≠AP

where A = Avocational and P= Pursuits. Very simple. Very effective.     As you can see, VA employees are far too modest to take credit for these decisions and do not identify themselves by other than their signatures. Names might imply authorship. I am currently researching new meanings for “greenhouse”. I will submit them with my new Form 9 which is currently under construction by ____________. Here, according to VA, is my current inventory of them.

temporarily out of order due to cold weather

temporarily out of order due to cold weather

temporarily out of order due to weather

temporarily out of order due to weather

winter broccoli that never materialized due to cold weather

winter broccoli that never materialized due to cold weather

actual greenhouse which, unfortunately, is non-ADA compliant

actual greenhouse which, unfortunately, is non-ADA compliant

New (solar-heated) DIY VA-approved greenhouse.(note: for vocational use only)

New (solar-heated) DIY VA-approved greenhouse.(note: for vocational use only)

Posted in Independent Living Program, VR&E | Tagged , , , , , , , , , | 4 Comments

VBMS– WHAT’S NEXT?

Posted on March 5, 2013 by asknod

As we all know from the propaganda fliers VA dropped over us recently, VBMS is getting ready to make a big difference in the backlog. This expected windfall is programmed in to seize the high ground and eliminate  Global Warming by going electronic and reducing our dependence of paper. Spotted owls are visibly breathing a sigh of contentment when they hear this.

VBMS stands for Veterans Benefits Management System. I might have chosen a different acronym for it but obviously someone at VA has a sense of humor. I received a note from a rater via their AFGE union board who contributed that same sentiment. The BM part, anyway. Since we don’t dwell on scatological humor, we’ll move on.

VBMS seeks to consolidate all Veterans’ records (read C-files) into a computer database and do away with the older paper files. This will not consolidate the NPRC records. Those will remain in Saint Louis in their paper format until the next big burn-off  which is scheduled for some time in 2015 . They haven’t announced the date yet but it will happen within a 125-day window according to anonymous sources who are correct almost 98% of the time.

VBMS will revolutionize rating as we know it. It will enable raters wearing color-coded belts to leap tall buildings at a single bound. The claims examiners wearing black ones  are reputed to be faster than a speeding bullet. And the search engines on this puppy are rumored to be more powerful than a locomotive. Those are some mighty large shoes to fill. I don’t care what color sash you’re sporting as long as you’re fast and accurate. What, really will change on this?

A lot of ballyhoo has been published that says this will streamline the process. A Team spirit of hand off and “Kaizen” coupled with the latest app is going to overturn conventional technology. The DROs are walking the hallways dressed like Doc Emmett Brown with their arm around padawan VSRs saying  things like “Roads?. Where we’re going, we don’t need roads.”

VBMS is so versatile and accommodating it will put everything about a Vet at the fingertips of the rater. All his VA medical VISTA and other private medical records will be there word searchable. All his history of claims and the most recent rating sheet will be a fingertap away. What are we missing? What essential ingredient is absent? What can possibly go wrong?

VBMS is a wonderful tool as long as it is viewed a tool and nothing more. The VA has a storied history of trying to turn claims into a mechanical process and remove the distasteful mental anguish of  the rater who ultimately has to deny. If you disrupt the process by bifurcating it, the ultimate outcome is never common knowledge to more than a few. Compare it to assembling a car in Detroit. VA’s assembly line starts with a DD 214 chassis and is built up gradually by a succession of different employees. The gentlemen in the mailroom doing triage do not know what becomes of Veteran John Doe’s claim for hammertoe. It’s not their job nor is it the developer who starts collecting and stuffing all the required records into the center flap of his new C-file. Their job is hunter/gatherer and they, too, will never know the ultimate outcome. Each link in the chain hopefully fills a void. When all the evidence is collected, the decision is made. This, again, goes on up the chain and there is no guarantee that a joyful outcome will occur even if the claim is granted at this level. A supervisor may see flaws and deny based on them. The M21-1MR computer can spit out an incorrect assessment based on an error entry. At this point, the vaunted current 86% accuracy rate VA professes starts to appear a little tarnished.

VBMS is not going to increase accuracy to 98% in our lifetimes. The unvarnished truth is that it isn’t at the storied 84-87% they profess in 2012. The unarguable truth, as published in the 2011 Veterans Benefits Manual, is that it hovers at an annual 60% error rate and has for the last 15 recorded years(1998). Interpolating a 60% error rate yields a 40% success rate-half of what VA touts.

Like any numbers game, regardless of who is citing what, if the party in charge is allowed to police itself, gather and refine it’s own statistics and enunciate only the least damning, they will inevitably look adroit. Thus if 85% of Veterans who file claims are denied and don’t appeal, then VA has a 100% accuracy rate. If 10% of the 85% who are denied file an appeal and the BVA only overturns 20% of them, VA’s accuracy again only suffers several percentiles. These matriculate back to the VARO as a repair order rather than a mistake. If you were on the assembly line in Detroit, this would be reinserted in the line from the “chip and dent” room and clearly labeled as a “rework”. Not an error, mind you, but a chassis that missed the quality control check to see if the Social Security Records had been received and associated with the glove compartment.

VBMS is going to be mated with the Disability Benefits Questionnaire and the Ebenefits electronic records filing feature to produce “fast-tracking” of claims. Like the speeding bullet, this is slated to be cutting edge, Lean Six Sigma, black belt, Challenge training at its finest-right up until it’s not.

VBMS cannot assimilate handwrittten paper files. This means the poor unfortunates who are the oldest among us will now be consigned to the slowest claims process. VBMS will not digest lay statements other than if it connects to a key, searchable,  printed word. You may have some of the most essential evidence needed to prove your case but if it doesn’t surface in the “word check” mode, the little red light illuminates on the M21 screen.  The no shirts, no shoes, no dice light. Electronics are phenomenal at finding things you are looking for. My wife taught me the rudiments of computers and set me loose. I had to learn not only how to search for something but what to search for. This required some knowledge of history. A claim may hinge on where you were and a search for records providing a list of which ship or regiment was involved. I do this for Vets all the time. Not all the evidence is going to be found in a C-file. Some article from Wikipedia may provide the magic clue that fills in the gap needed to complete the claim. VBMS is not going to fill this void because there is no common sense link to the internet. A black belt in tearing C-files in half with your bare hands will not cut this Gordian Knot.

The all-new VBMS does not comprehend turning this back into paper and holding it up to the light. Speed is of the essence now. Remember we’re going off road into a new universe with no roads (or paper). Vets whose claims hinge on old, handwritten SF 92s are going to be  required to not only provide these as evidence, but somehow find a doctor to decipher them and say as much. The nexus letter will no longer avail you if VA cannot locate the medical records that link it to a service connected injury. Hell, in this new mode, your handwritten records might as well have burned up in St. Louis.

In a more perfect world, we would simply go in and sit down with one agent(examiner). He would be in the driver’s seat. He would be able to tell you anything and everything about your claim. He would control the vertical and the horizontal. If you were missing something, you would be apprised of it instantly and check your email inbox for a message describing the defect. Real time efiling would mean you could correct it the same day and the claim could continue to sail merrily(X3) gently down the stream. The claim would be assembled by one person with authority to find things or find out why things were missing. His/her job would be to bull nose this thing through and stay on track. Everyone on that team would constantly ask questions if in doubt. Communication would be the glue that ensured accuracy. There would be no “chief prognosticator”  from Punxsutawny armed with chicken entrails and tea leaves.  He would no longer be permitted to move from desk to desk “construing” that your newly submitted evidence was  an attempt to reopen a brand new claim for a condition currently on appeal. The new black belt, newly energized by Challenge training, would be the arbiter of this. A finding would be made based on strict protocols that were equitable. In this brave new world there would be no “team” in I.

VBMS offers us none of this. In fact, the VBMS is still very much in its infancy as well as already being a dinosaur. As of December 2012, 18 VAROs were reputed to be online with it. Considering the problems  announced in the VAOIG report, I doubt any are using it with more than 15% success yet. Just having a big sign on the wall saying

VBMS COMPLIANT

does not a VBMS-equipped VARO make. Similarly, having VSRs dressed in yellow sashes  shouting Ayy Caramba!  and Kaizen Hai! boosts morale but doesn’t do much for productivity when every ten minutes the program tells you it doesn’t have enough to go on.

One thing I have noticed when working on Vets’ claims here is I have time to assemble a puzzle. Most of you send me sensitive, unredacted documents with you name, rank, airspeed and last known heading. This has helped Cupcake and me become very affluent and we wish to thank you for the yacht and the waterfront property in northern Maui. What it also taught me was the need to print it out and put the ingredients into separate piles. Color-coded highlighters on the critical parts often ties together the “who, when, and what” better. I know my military story backwards and forwards but few else do. Therefore, to me, it is essential to create that other Veteran’s history at my fingertips and jump back and forth to find the smoking gun(s). VBMS will not do this. It is too cumbersome. A rater will be forced to view each item as an open tab or worse, have to go back to a table of contents listing the different documents that have some connection or key word. The results currently described by the Gentleman at AFGE was that the VBMS was shipwrecked and using the older, traditional method was still faster. This may all change but the quest for speed is going to create all the pitfalls due to loss of accuracy. In a nutshell, VBMS will simply manufacture more denials faster and make the backlog appear to temporarily evaporate. My wife’s accountant does something similar with numbers for a living.

VBMS is eventually going to create a bow wave of its own that will push a lot of denials into the future. Just as in a marina where it says Max Speed 5 kts. No Wake!, the bow wave of claims will rock the VAROs again when the appealed claims are remanded back for corrections.

Veterans, as a class of citizens, are becoming very socially adept in communications. It doesn’t take long  on the Jungle Facebook Trail to hear the drumbeats of other Vet tribes and return their messages. VA has also made computer savvy Vets’ job immensely easier, too. With all the Vets sites sounding the drumbeat of appeal, appeal , until you keel (over), the line at the BVA’s front door is growing longer. This bow wave is now washing over the CAVC and they are quickly bogging down with it like sand in the gears.

My attorney tells me it was always common practice to send out an almost perfectly chronologically collated C-file when asked for on appeal to the Court. In the last few years, some vindictive individuals  have hired  VA employees to take these and scramble them as perfectly as possible requiring professional intercession-often over a thousand dollars worth- to collate and sort through  in time to meet the Court’s deadlines for submission.  Remember, these are the essence of your appeal. The CAVC will be relying on these documents in an effort to see if your appeal has merit, too. If their clerks are looking at the same cacophony of  helter skelter mishmash,  how are they to separate the wheat from the chaff? Take it one step further and realize that the attorneys for the General Counsel are also holding the same hand and chances of a fair and equitable outcome start to lose their luster without massive intervention. Arriving pro se is like volunteering to be cannon fodder.

VBMS will help only to create e records. It can supplement the assimilation and location of records. The subcontractors who scan it in are not being given concise parameters to arrange it in a uniform order. VA is still experimenting on the right format that will work while they go about constructing it.  It’s called design/build and is very wasteful. You may have to redesign it several times before you get the results you were hoping for. It will speed up claims processing inasmuch as it will no longer require the VA examiner to get up and go locate the file. Nothing will supplant the HAL 9000 mounted on your shoulders. No computer yet created can surpass the inherent one we possess. VA seems to think they can improve on a system like that.

Last but not least, VBMS merely presages the advent of poor health, obesity and adult onset of Diabetes Mellitus at VAROs due to less physical activity and no more long, leisurely walks down to the file room and back.

USS VBMS  

imagesBOLDLY GOING NOWHERE

Posted in VA BACKLOG | Tagged , , , , , , , , , , , , , , , , , , | 1 Comment

When HCV kills really fast

Posted on March 4, 2013 by Laura

I came across a study* that was a shocker.  In 1994, 30 UK patients with  primary immune deficiencies received a batch of HCV-contaminated human immunoglobulin (that had been screened) and became infected with acute hepatitis.

Of these 30, four developed end-stage liver failure within 18 months (see discussion).  One patient died before transplantation; one died after, one lived and one died of other causes.  Most of the other patients had better outcomes with IFN treatment and/or in clearing the virus.  Study conclusion:

“HCV can cause rapid severe liver disease in hypogammagloulinaemic patients.”

A small percentage of fortunate people with non-compromised immune systems clear the HCV infections; for others, decades pass before any symptoms and subsequent testing reveal the chronic infection and the various stages of liver damage.  According to an article by Kenneth E. Sherman, MD: Advanced Liver Disease: What Every Hepatitis C Virus Treater Should Know, disease progression is not linear; and it moves faster for those who have infections like HIV or have a history of excessive alcohol consumption.

There is no question that HIV/AIDS research benefits research in other infectious diseases but the allocation of public research funds for HCV is pitiful in comparison to HIV funding.

NIH categorical research monies for HCV versus HIV/AIDS

2011 FY actual funded research 114 million for HCV (2-pages of projects).

2011 FY actual funded research 3,059 million for HIV/AIDS; (23-pages of projects).

The information technologists who design and maintain the NIH website, Research Portfolio Online Reporting Tools (RePORT), have done a good job making information accessible with good finding tools.

Besides greater funding for hepatitis research, the government should promote routine HCV testing for all adults.  Putting information about HCV under the AIDS umbrella  will reach a limited demographic; it’s not nearly broad enough to reach everyone.

Imagine going from a normal to end-stage liver disease in only 18 months.

Posted in Guest authors, HCV Health, HCV Risks (documented), Vietnam Disease Issues | Tagged , , , , , , , , , , , , , , , , , , | 6 Comments

AIR AMERICA FINALLY ENTERS THE PICTURE

Posted on March 3, 2013 by asknod

My favorite airlineI had often wondered over the last forty years when this would come to pass. So many of the AirAm guys I worked with were Vets that I figured someone would have come forward a lot sooner. I always marveled at the balls the chopper pilots had to swoop in and grab our downed pilots before 37th ARRS even got off their asses and spooled up over at 20 Alternate. They had rules. No Jolly Green rescue attempt unless they had suppression fire if it was hot.  That meant waiting for some Spads to scramble from NKP. The wait could be interminable before they got up to the PDJ. AirAm pilots, on the other hand, wouldn’t even think twice about it. They’d just detour off from whatever they were doing and zip in for a quick in and out-all with nary a door gunner or any suppression.

It’s long overdue for them to get some presumptives on AO and compensation for GSWs and SFWs.. After all, they probably ate more Roundup than most servicemen in Vietnam. I got this from a friend and was delighted to see they are mad as Hell and not going to take it anymore. Rarely has a group of men done more, asked less and gone without reward than these brave souls. Always remember, AirAm didn’t hand out Bronze Stars or give bonuses for every airman rescued from the jaws of the Pathet Lao. They did it not because it was their job, but because they knew what it would be like if no one came for them. In a word, they thought like Marines- you don’t leave your buddies behind in Indian Country. Most importantly, they didn’t feel the need for the whole 7th Cavalry to swoop in and pick up a downed FAC or a Misty.

Here’s the letter. I hope they get front row seats at the VARO.

AAM_PR

Posted in Inspirational Veterans, Vietnam War history | Tagged , , , , , , , , , , | 1 Comment

FACE STREET JOURNAL

Posted on March 3, 2013 by asknod

And the envelope, please.  From Carrie Stiffler, this week’s winner is….

600023_357516514352674_504551439_n

You find some funny stuff on the Facepage.

Posted in Humor | Tagged , , , , , , , , , , , | 3 Comments

CAVC–McMILLAN v. SHINSEKI– BAD NEWS TRAVELS FAST

Posted on March 3, 2013 by asknod

I suspected this was going to hit the books in record time and I was right. Barely a week later following Walker, we are seeing it being cited. Seriously. A week? When my BVA decision was announced in 1992, no one mentioned Wilson, Shafrath, Bagby and a host of other Vets whose jurisprudence bore a striking  resemblance to mine. Yet here mandate ink is barely dry and decisions that were months in the offing suddenly are sporting this new law. Seriously. Mr. Walker still has an opportunity to appeal this to the Supreme Court so I find it odd that this is now dyed in the wool  precedence.

You heard it here. You will remember for years following this post that we said here the implications of Walker are going to rock the Vets world. This is a single-judge decision but is just the sound of a juggernaut warming up.

Mr. McMillan also argues that where, as here, the record lacks evidence of a nexus, a veteran may be entitled to disability benefits if he establishes continuity of symptomatology between the present condition and in-service injury or disease. 38 C.F.R. § 3.303(b) (2012). However, the U.S.Court of Appeals for the Federal Circuit recently clarified that the continuity of symptomatology language in § 3.303(b) “restricts itself to chronic diseases” found in 38C.F.R. § 3.309(a). Walker v.Shinseki, No. 2011-7184, 2013 WL 628429, at *7-9, 13-15 (Fed. Cir. Feb. 21, 2013) (“Nothing in§ 3.303(b) suggests that the regulation would have any effect beyond affording an alternative route for proving service connection for chronic diseases.”). As neither vitiligo nor ringworm is a chronic disease under § 3.309(a), the Court finds as a matter of law that Mr. McMillan may not establish continuity of symptomatology in lieu of medical nexus. Accordingly, his arguments regarding the credibility of his lay evidence are moot.

One thing is apparent. The landlines of the good Drs Bash and Ellis will be ringing off the hook. I have an idea. Let’s get some venture capital together and set up a corporation like unto QTC Medical Services Inc. Our service will provide low-cost medical nexus letters from a stable of participating doctors schooled in the appropriate sciences. If we wished to be political about it, we could do a means test and charge rich guys enough to make them  blow Starbucks® through their nose. They, in turn, could finance pro bono cases with the exorbitant fees. The client (Veteran) signs an agreement wherein he agrees to pay the amount  due upon the grant of the claim. The doctor will be available to rebut anything VA uses to deny. The nexus will be ironclad and warrantied based on the truthfulness of the claimant. If the Veteran submits a fraudulent claim, his nexus bill would still be due and owing to said corporation.

I vote for Legalnexus.com

YOU REPORT

Legalnexus.com warranties this nexus as viable for all 56 VAROs and the AMC with certain restrictions. Dealer Prep and destination fees not included. Does not include energy surcharge or travel time to and fro from (your VARO here) to Washington, DC. legalnexus.com reserves the right to refuse service to those with no shoes or shirts.

Legalnexus.com warranties this nexus as viable for all 56 VAROs and the AMC with certain restrictions. Dealer Prep and destination fees not included. Does not include energy surcharge or travel time to and fro from (your VARO here) to Washington, DC. legalnexus.com reserves the right to refuse service to those with no shoes or shirts.

WE OPINE

To view Mr. McMillan’s unhappy visit to Indiana Ave. click here  and then click on number 17 which is Mr McMillan- case number 11-3003. Walker was decided February 21st. Mr McMillan suffered this ignominious treatment on the 28th- a mere seven days later. Which means either justice is incredibly speedy at the CAVC or they cut and pasted a new ending to the story. Considering he would have prevailed sans Walker, can anyone see a different outcome other than a win? 

This is, as I have pointed out, merely the beginning of an avalanche of denials. What concerns us all is how many of you will be divested of your ratings for prior adjudications based on 38 CFR § 3.303(b). I shudder to think how many of you are on the cusp of VA CUEing themselves. If it only affected one hundred of you, I wouldn’t sound the alarm quite so stridently. Since I know VA better than most, I fully expect them to fire up the computers and begin searching for the .pdfs with 3.303(b). Keep in mind, too, that VA is now in the process of scanning millions of records into the system for the new VBMS.

Backlog? you don’t know the half of it. 2015 and 125 day adjudications just flew out the window. Whole TIGER teams of Challenge -trained RVSRs fresh out of the Academy with Lean Six Sigma black belts and Kaizen training are going to be on this like white on rice, Grasshopper. The savings from this could potentially fund the next five HR conferences on the French Riviera with bonus money left over. Karaoke en Français anyone?

Posted in CAVC Knowledge, CAVC ruling | 1 Comment

Rep. Jeff Denham distainful of VA

Posted on March 3, 2013 by Laura

This Congressman serves on the Veterans’ Affairs Committee and may be a friend.

Congressman Jeff Denham represents the 10th District of California in the U.S. House of Representatives. His district includes all of Stanislaus County and part of San Joaquin County. He was first elected to Congress in 2010, and is currently serving a second term in the 113th Congress.

Rep. Denham’s public service career began with the U.S. Air Force, where he served for 16 years between active duty and reserve status. He fought in Operation Desert Storm and Operation Restore Hope in Iraq and Somalia, respectively.

 

 

Posted in All about Veterans, Congressional HCV info | Tagged , , , , , , , , , , | 3 Comments

FE-FI-HO-HUM–I SMELL A HARD SELL

Posted on March 2, 2013 by asknod

Mr. Brock's claim

VA’s latest publication on why we are in deep doo-doo is intriguing. The backlog has more excuses than Carter has pills. I know that sounds old fashioned but this needs no tortured explanation. All the flag waving is merely a distraction.

VA Backlog

My daddy said a bunch of things in the course of his life. Most were non-judgmental. They were simply observations about human nature. One that stands out in my mind is that the more a body (or a government agency) explains how they got into a fix, the true magnitude of the problem is inevitably being marginalized.

VA attempts to change their story line and spends beaucoup bucks on PR in the process. In 2009, this was simply a matter of hiring more worker bees and training them. In 2010, we were eagerly awaiting the completion of their training and subsequent deployment. Suddenly, in 2011, we discovered the enormity of the paper file tsunami. In order to go barefoot with VBMS, we had to scan the equivalent, pulp-wise, of all the trees ever cut down in America since 1776. My guess was someone in authority went up to the sixth floor of the Winston Salem Cigarette RO  and noticed all the files stacked up in 1994.  He multiplied that by 57 ROs ( I count the AMC black hole as one) and it dawned on him that it was going to take every reproduction company in America about 10 years to scan, collate and make them .PDF word-searchable based solely on the numbers of Vets back then. The enormity of the problem was so depressing, he went back downstairs and elaborated. They promoted him for being such a far thinker and then did nothing.

Sixth Floor -Lingerie, Sleepware, VA claims

Hand-written records are not, nor ever will be, word-searchable,  so VBMS still is no panacea. This is the ugly stepsister VA hasn’t even disclosed yet. That shoe will fall in 2015 when they can’t possibly meet Revered Leader’s 125-day/98% accuracy goals. In short, failure is once again built in with ultimate deniability. All the Vietnam Vets  through the late 80s, with their hand-written STRs are hitting the wall and they all have illegible, handwritten records that demand a sleuth with a magnifying glass. The current training for VA examiners no longer includes the curriculum. This means the records, for all intents and purposes, are not viable evidence unless a Veteran can provide a translation. That does not guarantee VA’s finest will accept it. Much like the inhabitants in the next state over from Missouri, they’ll see it when they believe it, and not a minute sooner.

The VA  appears as though they live in faery tale land. Either they are convinced in their own minds that what they write for us is true or they are  smoking something better than what the medical marijuana salesmen are hawking.

For decades, the VBA system has carried an inventory of pending claims, and a backlog that was ambiguously defined and sometimes confused with inventory. In 2010, the Secretary of Veterans Affairs defined the backlog as any disability claim over 125 days old…

graph

Silly rabbit. Trix are for Vets. All this time we were using the wrong name for it. Calling it Inventory or backlog is immaterial in that it still doesn’t explain what VA called the identical problem in 1992 or 2008. The delay has always been there regardless of what or how one characterizes it. This didn’t just materialize out of thin air after September 11th, 2001 but now we are expected to believe if we magically add up the “inventory” and the “backlog”, we can better define the problem and solve it. Only in D.C would properly naming a defect simultaneously present the cure for it. That only works in Hollywood movies.

VA has always been a past master at obfuscating, going off on a perpendicular tack or manufacturing a straw man and pointing to it as the sole reason why they are unable to perform. This manifesto is no different. It subtly diverts attention away from their centuries of wastefulness, carpetbagging and featherbedding.

Apparently VA has never noticed the correlation between armed conflict and casualties. You would think that if this is all they do for a living, the Undersecretary for Job Security would sit up one day down at Vermin Ave. and say ” Mikey. Hey, Mikey. Did you know that every time they have a war like Iraqistan a whole bunch of people start sending in claims? I mean, like way more than a normal amount? This is like, totally awesome.  It explains the backlog, dude. Manna, I’mma gonna getta bo-nusssss.” (sung liltingly). The fallout of WW2 must have also come as a big surprise sixty eight years ago. In fact, they may not have even noticed the blip of Korea or Vietnam on their claims radar if they are that dense.

The number of service-connected disability claims grows during periods of armed conflict and economic downturn. The backlog also grows when policymakers establish new presumptive conditions, courts make new decisions, and legislators make laws that establish new entitlements.

The fact that they feel this needs to be restated indicates somewhere, a village is missing it’s idiot.  Who did they write this for? Veterans Service Representatives? Here the VA attempts to blame the internet…

Increased Access

1. Increased use of technology and social media by Veterans, families, and survivors to self-inform about available benefits and resources

2. Improved access to benefits through the joint VA and DoD Pre-Discharge programs

3. Additional presumptive decisions resulting in more claims for exposure-related disabilities

4. Extensive and successful use of VA outreach programs encouraging more Veterans to submit claims

Perhaps we should add that when they created a neetsy keen thing called the Benefits Portal (Ebenefits), this became inevitable. Are they now conflusticated that Vets actually avail themselves of this technology? The military  washes their hands of us like Pontius Pilate when we separate. They encourage Vets to file and wonder of wonders- they do. Now VA cannot fathom why they are filing so many claims. All that is finally covered in this missive.

Increased Demand

1. Ten years of war with increased survival rates, resulting in more claims

2. Post-conflict downsizing of the military

3. Impact of a difficult economy

4. Growth in the complexity of claims decisions as of result of the increase in the average number of medical conditions for which each claimant files.

Gee, where’d you park the squad car, Dick Tracy? So we now have an ample description of what caused the problem. Veterans appear to be at fault for filing in such large numbers and with such enormous numbers of ills. The military (read Bush 41& 43) is also a culprit for being so bellicose and warlike. And lastly, the American populace is indicted for being greedy and crashing the economy. In sum, everyone but the VA was instrumental in causing this perfect storm. They are merely trying to keep their heads above water and cope with it.

To add to this cacophony of dysfunctionalism,  we are beginning to find out that someone is stretching the truth at the DVA. We had hoped to see an eventual melding of the two dissimilar computer systems of DoD and VA into one seamless, integrated network where a Vet could separate from service and file electronically with VA as necessary. His medical records, in this more perfect world, would simply pop up and populate a new Form 21-526 (e) (e for electronic) when he notified VA he was ready. Even better yet, they would be “pre-filed” before separation and the Vet would begin drawing his VA compensation on Day One after walking off base. Not. Panetta and Dear Revered Leader weren’t even on the same page recently at a joint Dog and Pony show. Both spoke but the bubbles they were blowing weren’t the same size and color. It didn’t faze them a bit that their comments were mutually exclusive and contradicted one another. Onward through the fog. More computers. More money. More personnel. More time. More. More. More.

One thing that catches my eye and should be cause for alarm is the straw man mentioned above. He is going to be the fall guy when things don’t pan out. The foundation is being carefully constructed and cardboard cutouts are being erected to appear authentic. The following graph and explanation are an example. Notice everything is couched in ” This is what is supposed to happen” or “We foresee a gradual…”. Planning at VA has been non-existent for centuries and is a spurious combination of “Oh, shit! When did that happen?” followed by lots of “Perhaps they won’t notice” or “I hope this doesn’t affect our tee time.”.

takedown

Take-down chart? This sounds like a Swat maneuver.  Col. (Brevet Maj. General) George Custer had a chart similar to this in his hat when found above Minneconjou Ford. It carefully detailed what the Indians were planning and  the adequacy of his response. I’m sure the captain of the Titanic had a similar one threading a path through all the open sea ice infesting the Northern Atlantic every April. The point I’m trying to make is that VA’s suppositions are manufactured much like a billiards game. Wait until the ball quits rolling to make a decision.  Nothing is committed to paper until failure is imminent. At that time, a new, improved game plan is instituted that will carry the day. Each and every plan fails but that does not dull the enthusiasm of the planners. They dutifully return to their chalkboards and start drawing anew. No mention is made of failure or poor planning. No bonuses are relinquished for failures of judgement. Quite the contrary. Even larger bonuses are dangled in front of them and exhortations to stem the tide are shouted louder. Congress instituted the VJRA in 1989 to fix this. Old habits die hard. Really old habits are immortal and refuse to succumb at the VA.

VA resorted to acronyms several years ago to enunciate how they were taking the backlog fight into the field. We’ve reported some and invented a few humorous ones of our own to make our point that catchy phrases sell cars and potato chips. They do not change reality. Challenge Training is all well and fine in teaching RVSRs the mechanics of the claims process. If you’re still driving a paper model T, the chasm is too wide to ford and no amount of training is going to bridge it. Which leads us to the miracle of technology. Would that this were the case.

VA belatedly launched their VBMS plan in 2012 as a last ditch effort to modernize. They took 4 (four) (quatre) (see) VAROs and said that henceforth all claims would be done electronically. First, a company had to be located on short notice to start scanning in the Vet’s records. Next, the .PDF format had to be word searchable or all they had was an incredibly small filing cabinet where the Vet’s records couldn’t get lost or misplaced. Whoa, hoss. Don’t bet on that one yet. They probably haven’t right clicked and made a copy. VA has a storied history for losing things. Finally, the new electronic file had to be organized uniformly such that each VSR could access them and find everything in the same place.

Think left flap, center flap and right flap. For those of you uninitiated, a C-file is a file folder that opens with three parts and two folds. Take a piece of paper and fold it like a letter into three equal components and you’ll get the picture. Currently the left flap has to do with dependency, wives, kids, etc. The center flap is all about compensation. The right is VR&E, VA loans and other entitlements. If I have the right and left flaps reversed, excuse me. My brain is getting defective.

After collating and scanning, the organization was next. Following that, VSRs were expected to go online into the bowels of the VBMS and use it to manufacture ratings. Who would have thought that the four VAROs would all try to access the national VBMS database simultaneously during daylight hours? The VBMS promptly became the VBSM and crashed. All the VASEC’s horses and all the VASEC’s men couldn’t put VBMS back together again. Soon it was back to the hitting the books with the old analog pencil and paper. VA is now claiming that they have no less that 12 VAROs VBMS operational. As with all that wanders out of the mouths of the VA talking heads, the definition of “operational” is key to understanding this. Here’s the mantra posted on all the bulletin boards of the new VBMS-equipped VAROS…

Through process-improvement initiatives, VBA is rapidly developing and testing streamlined business processes, focusing on eliminating repetition and rework. VBA established a “Design Team” concept to support business-process transformation. Using design teams, VBA conducts rapid development and testing of process changes and automated processing tools in the workplace. This design team process demonstrates through pilot initiatives that changes are actionable and effective before they are implemented nationwide.

This was lifted from Bernie Madoff’s game plan. It also bears a striking resemblance to the expensive Dave Del Dotto Cash Flow System brochure (and cassette tapes) I bought back in the eighties. It sounds good on paper. VA calls that the “paper view” as in “We designed this on paper and it appears as though it will fly”. The numerous IT contractors asked to bid on this hodge podge of new ideas  refer to it as “pay-per-view” as in “Sure, we’ll build it for you just like you drew it here. Unfortunately it won’t work the way you drew it. When you come back with a change order, we’ll build that version so you can pay to view it as well.”

What I think VA fails to comprehend is that their IT gurus are the ones who clung to the paper files systems for decades past when even their very own contemporaries in government realized its neanderthal potential. Now, like newbies wanting to have the shiny new skateboard on the block, they are grasping at anything to appear more modern and knowledgeable. As we all know, you let the geeks figure this out. Give them the parameters of what you need, the stringent mission needs and get out of the way. The worst thing you can do is hire a bunch of your own talking heads, none of whom speak the same language, and turn them loose on a project of this enormity. They’ll tell you anything you want to hear if you’re cutting the paycheck.

VA has been building a Tower of Babel for the last few years. In construction, we have an apt term- Eventually you have to shoot the engineers and begin production. VA cannot bring itself to do this. They endlessly continue to tamper with the model and commit inadequate resources to any one facet of it. Thus you have no national infrastructure set up to scan the C-files but just a few local yokels with no instructions on the parameters and needs. Each varies from RO to RO with no uniformity built in. Computer servers haven’t been set up because no one has allocated sufficient funds for a massive server farm somewhere to accommodate it (yet). Nevertheless, VA has put in place a plethora of cute acronyms to describe what will happen in this new idyllic world they are creating. It’s like taking your Erector Set® down to the World Trade Center and asking “Where do I set up?”

Allow me to pluck from some of the choice phrases that so richly adorn this document.

VBA has also conducted Lean Six Sigma and Kaizen events on these selected targets of opportunity,

I believe these are Karaoke terms. Either that or they are Yoga positions. “Targets of opportunity” leads me to believe former military planners have their fingerprints all over this.

VBA has actively solicited innovative ideas for process improvement from Veterans, employees, and industry stakeholders through a variety of structured mechanisms

Simply read, VA was too cheap to go out and hire think tanks to unravel this. Instead, they installed “structured mechanisms” called “suggestion boxes” in VARO rating rooms, VSOs and VFW bars. Veterans from Rio Linda can be excused for misreading the spelling of “stakeholders” and demanding grass-fed beef with their claims.

VBA also implemented the Simplified Notification Letter initiative

This is one of the few true statements in the document. They did do this. Now your denial letter is couched in fewer keystrokes. Of course, it’s computer generated so it really didn’t speed up anything ratings-wise. The form now simply says “We made a decision-No!” The beauty of this is manifold. By using denial as the default setting more broadly and rapidly, productivity will appear to go through the roof. When the chickens come home to roost from remands two and three years down the road, a new backlog will begin. VA will deal with that when they get there. Anything post-2015 is not programmed in because they haven’t ever faced that eventuality yet.

Fully Developed Claims (FDCs) are critical to achieving VBA’s goals. A fully developed claim is one that includes all DoD service medical and personnel records, including entrance and exit exams, applicable DBQs, any private medical records, and a fully completed claim form.

Whoever dreamed this one up got the “Let them eat cake” award. Imagine making a claimant go out and get everything needed to assess his claim. VA does nothing. Once assembled, the rater simply makes his/her decision based on what the M21 spits out (denial) and sends it up for a signature and the steno pool. What could be simpler? This should, by rights, leave the raters with ample time to brush up on their upcoming Karaoke competition in Orlando this summer. That it will make severe inroads into the backlog is without question. Duty to assist, as an obligation, will fall into disuse and be supplanted by “Dude, you didn’t give me a FDC. I can’t rate it.”

And then there’s the dilemma of scanning I mentioned. VA glosses over this with another acronym (VCIP) that blithely ignores the 800 lb. gorilla with handwritten records. They gleefully point out that they’ll be up and running on this to the tune of 70 million images a month from 5. Really? My C-file contained 3.517 individual sheets of paper to scan. My attorney asked for it on the 26th day of June 2012. We received them in October. This was mandated by the CAVC to be done within sixty days of the filing of the Notice of Appeal. VA must not have gotten that email.

VBA recently established the Veterans Claims Intake Program (VCIP). This program is tasked with streamlining processes for receiving records and data into VBMS and other VBA systems. Scanning operations and the transfer of Veteran data into VBMS are primary intake capabilities that are managed by VCIP. As VBMS is deployed to additional regional offices, document scanning will become increasingly important as the main mechanism for transitioning from paper-based claim folders to the new electronic environment. The VCIP contractors began scanning on September 10, 2012. The ramp-up volume mirrored the VBMS deployment plan for the 18 regional offices on VBMS as of the end of CY 2012. By the end of December 2012, the VBA contractors were providing 5M images per month. By the end of CY 2013, the contractors will be providing 70M images per month.

What VA fails to reveal is that the VCIP contractors came back to the VA and started asking questions almost immediately about how they (VA) wanted the scans organized. The next burning question was what to do with all the hand-written medrecs. Each contractor at the four original VBMS test VAROs  were given conflicting instructions. As for the handwritten ones, VSRs are instructed to revert back to analog on them. So, at best, newer “round peg” claims will fit into the round hole whereas older “square peg” handwritten claims will suffer the same slow “inventory” semantic or is it “backlog”?

There is no simple solution to this. VA should have begun it in the 1990s when they had the foresight to go to the VISTA system employed by their VHA. They didn’t and now they are paying the piper dearly. It wouldn’t be so disagreeable if VA would just own it and get ‘er done. Instead, they erect the staging and call the media for grandiose soundbite news about how they are winning the war on the backlog. The more they try to convince me that they can see the light at the end of the tunnel in 2015 convinces me of my father’s observations. They haven’t a clue what they are about but they can sure talk a blue streak about how to fix it.

How about this one? Count them. No less than six acronyms to cut the Gordian knot. At this rate, by 2015, VSRs will be accosting you in supermarkets or Costco and begging you to file claims because they are under-employed. In fact, they’ll be researching our  e-records desperately in hopes of finding some entitlement they overlooked in years past that is due and owing. After the Fed. Circuit’s Walker decision, you can pretty much count on it.

 A crucially important element of our technology plan is the ability to file an on-line claim through a new DoD-VA shared self-service portal called eBenefits, which is part of the Veterans Relationship Management (VRM) initiative. VRM will provide multiple self-service options for Veterans and their service providers. In addition to eBenefits, VRM includes the Stakeholder Enterprise Portal (SEP), the Direct Electronic Gateway (D2D), and VLER-dependent intake solutions like Access or Direct Connect that provide service treatment records (STRs) from DoD and medical records from VHA, and – with the new DBQs – private physicians.

Well shoot, pilgrims. Problem solved. Them fellers down at Vermont Avenue have this all sewn up. Good thing too. This was threatening to have tremendous repercussions on Veterans as most know. Now, with the insertion of a bunch of letter combinations, all our worries have been addressed. VA has come back down from the mountain with the sacred tablets. They have drawn colorful pictures that even Dick and Jane can digest. One minor problem seems to be cropping up. A lot of the DBQs are about as long as a 21-526 and many private doctors are demanding money to sit down and fill them out. Who woulda thunk it?

Here’s the one I like.

VA fixit

Check out the three month rolling accuracy with the asterisk beside it. Does anyone find it odd that the data is only “available for this metric on a month-end basis”? How is it they can project these mythic percentages? From my readings of the Veterans Benefits Manual from Lexis Nexus, it categorically pokes a rather large hole in their data. Based entirely on the outcome of judicial proceedings, it has been determined that VA is in error at least 60% of the time in their decisions. If this wasn’t cause for alarm, it doesn’t even encompass the vast quantity of JMRs where VA admits no wrongdoing and asks for either a do over or a settlement on the Courthouse steps before you enter. Those “errors” never enter the system as hard statistics and are lost. If included, it would point to an error rate of 70% which is appalling. VA can’t or won’t explain the disparity between their  data and documented judicial percentages.

Why is there no hue or cry when a government agency publishes a document rife with propaganda and lies? How can it be that this will represent the true state of affairs? Do the VSOs of America subscribe to this pablum and swallow it uncontested?  Is there no one who will stand and cry foul? Do we have to wait until 2015 to find out (once again) that but for a glitch in statistics, all the carefully laid plans were for naught ?

Always remember that when someone dumbs down the explanation for the problem and writes it out, it will probably state the obvious like ‘The sun rises in the east in the morning and sets in the west in the evening. This explains that dark stuff in between.”

Try this one on.

VBA’s Transformation Plan includes initiatives directed toward increasing decision output (claims completed) above the volume of incoming claims (claims receipts) in order to eliminate the backlog.

So near but yet so far.

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