VA's red tape squelches veterans' long-overdue disability claims
DRY RIDGE, Kentucky - Like thousands of his fellow veterans of America's wars, Alfred Brown died waiting.
In 1945, when he was a 19-year-old soldier fighting in Italy, shrapnel from an enemy shell ripped into his abdomen. His wounds were so severe that he was twice administered last rites. When Brown came home, the government that had promised to care for its wounded veterans instead shorted him.
Not until 1981, however, did Brown realize that his monthly disability check didn't cover all the injuries he'd suffered. He launched what would become a 21-year battle.
"As a member of the so-called `Greatest Generation,' I am well aware of the large numbers of us passing away," he wrote the nation's chief veterans judge in 2001. "I am prepared to meet our Creator. My fear is that your court will not make a decision in my case."
Brown was right. He died a year later, and his case died with him. As he closed the books on the case, Judge Kenneth Kramer acknowledged that Brown might have been right all along. Had Brown not died, the judge wrote, "I believe that the Court would likely have so held."
Tens of thousands of other veterans have returned from war only to find that they have to fight their own government to win the disability payments they're owed. A Knight Ridder investigation has found that injured soldiers who petition the U.S.
Department of Veterans Affairs for those payments are often doomed by lengthy delays, hurt by inconsistent rulings and failed by the veterans representatives who try to help them.
The investigation is based on interviews with veterans and their families from around the country and on a review of internal VA documents and computerized databases that had never been released to the public. Many of the records were made available only after Knight Ridder sued the agency in federal court.
The VA is a mammoth agency that serves 25 million veterans with a far-flung health care system and a separate disability and pension operation. The agency spends more than $60 billion a year, at least $20 billion of it on disability compensation.
But the Knight Ridder investigation found that the VA serves neither taxpayers nor veterans well. Some veterans never get what they're due, while antiquated regulations mean that others are paid for disabilities that have little effect on their ability to hold jobs or aren't related to their military service.
For America's veterans, plus the thousands of soldiers now returning from Iraq and Afghanistan, the investigation identified three points where cases often go wrong: the selection of a special representative called a veterans service officer, the review by a regional VA office and the filing of an appeal.
Among Knight Ridder's findings:
- Many of the VA-accredited experts who help veterans with their cases receive minimal training and are rarely tested to ensure their competence. These veterans service officers work for nonprofit organizations such as the American Legion, as well as states and counties, but their quality is uneven, and that often means the difference between a successful claim and a botched one.
- The VA's network of 57 regional offices produces wildly inconsistent results, which means that a veteran in St. Paul, Minn., for example, is likely to receive different treatment and more generous disability checks than one from Detroit.
- Veterans face lengthy delays if they appeal the VA's decisions. The average wait is nearly three years, and many veterans wait 10 years for a final ruling. In the past decade, several thousand veterans died before their cases were resolved, according to an analysis of VA data.
- The percentage of all types of claims that are approved ranges from 89 percent in St. Paul to less than 70 percent in Jackson, Miss., and Cheyenne, Wyo., according to an annual VA survey of veterans.
- Perhaps not surprisingly, "satisfaction" among veterans is highest in St. Paul, at 73 percent, compared with 50 percent in Atlanta.
"How a veteran seeking benefits gets treated should not be an accident of geography," said George Basher, the director of the New York State Division of Veterans' Affairs, one of 50 state agencies that help veterans. "Unfortunately, the current system makes that a virtual certainty."
In interviews late last year, then-VA Secretary Anthony Principi and other VA officials admitted to many of the agency's shortcomings, but they said things have gotten better since the Bush administration took over. "This agency was underwater in 2001," Principi said. "My people have made tremendous progress."
The current secretary, Robert James "Jim" Nicholson, who was sworn in recently, had no comment.
There have been some improvements in the last three years. But when it comes to delays, cases that need to be redone and backlogs, things are the same or worse than they were in the 1990s, Knight Ridder found, when the agency vowed to clean up its act.
For the family of Kentucky veteran Alfred Brown, that decade brought nothing but frustration. If a decision had come before he died, Brown could have been entitled to nearly 45 years of back pay, his attorney said. Based on VA payment rates, that would have been worth about $30,000.
"It wasn't so much the money," said his son Clayton Brown, on a day when he visited his father's grave north of Lexington. "He felt he was robbed. He almost gave his life up, and this is what he was getting in return?"
VA workers are reminded daily of the pledge by Abraham Lincoln "... to care for him who shall have borne the battle, and for his widow and his orphan ..."
But the task isn't as simple as it used to be.
The VA makes disability payments for injuries as obvious as an amputated leg and as complex as post-traumatic stress disorder. They include combat wounds and peacetime injuries, since veterans are serving their country whether they're in a Humvee in Iraq or in boot camp. Veterans are given ratings from zero to 100 depending on how severe their disabilities are. Payments for a single veteran range from $108 to $2,299 a month, and they're supposed to reflect the vet's lost earnings potential.
But, according to the U.S. Government Accountability Office, the disability payments are based on 60-year-old labor-market assumptions. So veterans who have desk jobs in today's service and information economy can draw checks based on the fact their disabilities would keep them from good manufacturing jobs.
The system stems from a time when war injuries were often less complex. Today's soldier faces mental illnesses unacknowledged two generations ago, as well as wounds that were often fatal in earlier wars.
Beyond that are tough fiscal realities. The Congressional Budget Office has already indicated that the VA could save significantly if it eliminated new payments for certain diseases not connected to military service. While most payments can be linked directly to service, veterans also can qualify merely if they're diagnosed soon after their military service.
The GAO offered one example: A Navy veteran was hospitalized with a heart condition three months after his induction. Although the disease had its inception in childhood, the veteran eventually received disability payments based on the VA's highest rating. In all, the VA pays nearly $1 billion a year for disabilities that the GAO says generally aren't directly linked to veterans' service in the military.
Many veterans' cases go bad even before they file claims.
Applying for disability benefits requires veterans to navigate a labyrinth of bureaucratic rules and unforgiving deadlines. It can require the skill of an investigator and the mind of a physician.
That's why national veterans groups have for decades provided free help. About 40 veterans service organizations, such as the American Legion and Disabled American Veterans, are authorized to handle VA claims, as are many states.
But Knight Ridder found that the network of VA-accredited service officers is a patchwork of well-meaning helpers whose training and expertise vary widely. Contrary to its own regulations, the VA does little to ensure that veterans receive competent representation from veterans service organizations. Yet the agency prohibits vets from hiring their own attorneys until after their claims have been denied and they're generally years into the appeals process.
Two-thirds of the veterans who submit claims use service officers, and picking the right one can determine whether they get the full payment they're due, a fraction of it or nothing.
"The best advocates can be very good and lousy ones can be awful," said Ron Abrams, the joint executive director of the National Veterans Legal Services Program, which trains service officers for the American Legion and other veterans groups.
New evidence from Washington state illustrates for the first time the odds veterans face in this service officer roulette.
Since July 2003, the Washington State Department of Veterans Affairs has tracked the outcome of every claim filed by veterans groups that receive state funding. The groups' success rates range from 53 percent to 81 percent. Among the busiest individual service officers, those handling 30 or more decided claims, the success rates can range from 35 percent to 98 percent, the state's data show.
"You might be proud of the fact you filed 100 claims. But if pretty much everything you filed was denied, it would cause some concern," said John Lee, the department's deputy director.
The percentage of the Washington groups' claims being granted is on the rise - from about 50 percent overall when the program began to about 70 percent in recent months. Lee attributes it to the accountability the program requires.
Although they fought the effort for years, the state's politically powerful veterans groups now see its merit, and they've changed their training and oversight as a result. The program is "an invaluable tool to see exactly what the strengths and weaknesses are across the state," said Court Fraley, the Veterans of Foreign Wars state service director.
Veterans officials in other states said such performance disparities are certain to exist nationally because the training of service officers is so inconsistent.
That's not the way it's supposed to be.
The VA, through its national accreditation program, is supposed to ensure that all service officers are "responsible" and "qualified." But the VA program does little more than rubberstamp names submitted by veterans groups. About 11,000 service officers are currently on the VA's roster - about 80 percent are accredited through nonprofit groups.
VA regulatory files, obtained after Knight Ridder's lawsuit, reveal that the agency has done little in decades to determine the adequacy of the training provided by veterans groups or to check the quality of the claims prepared by their officers. Only rarely does the VA suspend or revoke a service officer's accreditation. When it does happen, it's generally the result of criminal charges rather than incompetence.
"What we do is take it on the word of the service organization that the individual has had sufficient training," said Martin Sendek of the VA's general counsel's office.
That training, however, varies widely, according to a Knight Ridder survey of 13 of the largest veterans groups and all 50 state veterans departments. At one end of the spectrum is Disabled American Veterans, which has full-time paid national service officers and a 16-month training and testing program that's so regimented that it qualifies for 10 hours of college credit.
Groups such as American Ex-Prisoners of War and Catholic War Veterans rely largely on part-time volunteers who aren't required to complete any courses or pass any tests. "We don't get paid, so we're not going to be that strict with these people," said Doris Jenks, the national training director for American Ex-Prisoners of War.
Nonprofits generally have less stringent requirements for service officers than those working for the 33 state veterans agencies that responded to the survey.
Just 62 percent of nonprofits and 73 percent of the state agencies require continuing education for all service officers, something experts consider crucial given the VA's constantly changing rules.
Only 38 percent of nonprofits and 67 percent of states require a test before recommending that the VA accredit a representative. And once accredited, few service officers are ever tested to ensure their competence: While 27 percent of the states require later testing, only one nonprofit, Disabled American Veterans, had that requirement.
VA officials bristled at suggestions that their oversight of accredited service officers is lax and said they're unaware of any systemic problems. Retired Vice Adm. Daniel Cooper, the VA's undersecretary for benefits, said the VA fixes any mistakes that service officers might make. If anything needs to be done to make an application complete, Cooper said, "we do it."
General counsel Tim McClain noted that veterans have extensive appeal rights. "There are a lot of checks and balances in the system," he said.
The U.S. Court of Appeals for Veterans Claims, however, has repeatedly ruled that veterans are out of luck when they've been steered wrong by VA-accredited service officers.
Ask Gerry Corwin.
As the navigator aboard a B-24 bomber during World War II, Corwin survived more than 30 missions over Japanese-controlled waters. He came home to Minneapolis with two Air Medals - and disabling nightmares and flashbacks.
There were images of his buddies burning in planes crashed on runways and of a friend killed on a mission that Corwin persuaded him to take. By December 1984, those nightmares began to overtake the TV executive.
Corwin applied for disability benefits and was denied, in part because the VA couldn't find many of his military records, which had burned in a 1973 fire at a national archive in St. Louis.
So Corwin went to the Minnesota Department of Veterans Affairs and enlisted the help of Kirk Jones, a service officer who'd become VA-accredited a year earlier through his state and the American Legion.
Jones submitted a three-sentence letter on Corwin's behalf and didn't take any steps to prove Corwin's claim. He didn't, for example, push for a psychiatric examination from the VA. He didn't round up statements from Corwin's crew to corroborate that they'd been sent home in May 1945 for "combat fatigue."
"I should have suggested a VA examination," Jones, who no longer is a service officer, said recently. He acknowledged that he'd had minimal training when he first handled Corwin's claim.
That 1984 claim went nowhere.
In 1995, Jones, who by then had gained extensive experience plus classroom training, restarted Corwin's claim. He did all the things he hadn't done a decade earlier, and more.
This time, Jones helped Corwin win compensation for post-traumatic stress disorder and a heart problem. Jones filed several appeals, and each time the VA granted more benefits, eventually declaring Corwin totally disabled in 1998.
Even so, the veterans court ruled last summer that Corwin can't collect back pay from 1984-1995 because the proper documents weren't filed in 1986 to keep his original claim alive.
Corwin's loss is tens of thousands of dollars, he and his lawyer estimate.
"It would mean a home. Let's start with that," said Corwin, 82, who with his wife, Katherine, has been living in a house her family owns in rural Mississippi.
"To have to come back and to fight 20 years to get what you're supposed to be given, and to fight your own government for it, is disappointing," he said.
Even when a service officer does a good job, veterans' claims often get bogged down in the VA's 57 regional offices, where veterans' claims are processed.
In an electronic age, these regional offices are a throwback to an ink-and-paper world. In Waco, Texas, the records room is almost the length of a football field, with row after row of file cabinets - 2,700 in all - containing records that date back six decades.
Workers wheel massive brown folders with rubber bands around them around on carts, shifting them from one table to the next as they move through the approval process. In the constant shuffle of paper, things get lost and mistakes get made.
Nationwide, errors are made in 13 percent of claims, more than three times the agency's hoped-for rate of 4 percent, according to a VA quality-control database that reviews a sample of the decisions. That translates to 103,000 errors a year; in many cases they can result in either an overpayment or an underpayment of benefits.
"I don't think anybody is proud of the fact that we have" a 13 percent error rate, said Michael Walcoff, who oversees the agency's regional offices. Errors often trigger appeals, sending thousands of veterans into an ongoing cycle of mistakes, appeals, rehearings, mistakes, appeals, rehearings.
In some regional offices, the error rate last year was far worse - as high as 23 percent in Wilmington, Del. (The low was 3 percent, in Des Moines, Iowa.) And such varied performances affect nearly every aspect of a veteran's experience:
Knight Ridder found that disability ratings, which determine the size of a veteran's monthly check, also vary widely.
An analysis of 3.4 million veterans claims shows that major mental ailments, such as post-traumatic stress disorder and schizophrenia, are subject to bigger regional swings than major physical ailments such as bad backs and knees. For example, veterans with PTSD assigned to the Wilmington office are more likely to have the highest disability rating than their counterparts in Lincoln, Neb. In Delaware, 34 percent of those with PTSD have the highest rating; in Lincoln, it's 10 percent.
Diagnosing mental disorders is more subjective, and parts of the country have been slow to recognize them. Different training standards in the past may also have contributed to regional VA differences.
Because the major psychiatric disabilities on average pay more than the major physical ones, the wider swings have a dramatic impact on veterans' payments. The different ratings may help explain a puzzle noticed by veterans every time the VA releases its annual report: Average disability checks vary by state.
The VA wouldn't comment on Knight Ridder's analysis but said in a statement that it's investigating regional differences, which it attributed to "extremely complex" factors. The agency "is committed to treating every veteran's claim fairly and equitably" and has nationwide training programs to help eliminate uneven treatment.
The GAO last year reported that the VA "cannot provide reasonable assurance that similarly situated veterans who submit claims for the same impairment to different regional offices receive reasonably consistent decisions."
The final minefield is the VA appeals system, where claims often linger.
It's a problem the VA recognizes. "It takes too long. We all agree on that," said Ron Garvin, acting chairman of the Board of Veterans' Appeals.
With the average disability payment now $7,860 a year, back-benefit awards can be substantial because an award is calculated as though the VA made the right decision when the claim was first filed. Some veterans with severe disabilities win $100,000 or more.
But if a veteran dies with his or her case under appeal, the case dies, too. In the past decade, more than 13,700 veterans died while their cases were in some stage of the appeals process, according to a Knight Ridder analysis of a VA appeals records database. (While precise estimates aren't available, the VA said experience suggests a few thousand of them wouldn't have actively pursued their appeals.)
Even if a veteran wins a case but dies before receiving payment, his family is often out of luck. Unless the veteran had an eligible spouse or dependent child, the money stays in the U.S. Treasury.
The agency goes so far as to take back money it's already paid. George Wilkes, a World War II sailor, spent the last five years of his life fighting to increase his disability rating, which stemmed from a spinal cord injury. In April 1997, the VA agreed with him and said he was due back benefits of $109,464.
Wilkes, ill with pneumonia, died four days later. Six days after that, the VA wired the money into his bank account.
Once the VA realized Wilkes had died, it wouldn't let his family keep the money. Although he had no immediate family, Wilkes' nephew and niece had tended to him for years, allowing him to stay in his New Orleans home.
Had the money come years earlier, it "would have had a substantial impact on his life," said nephew Ray Wilkes of Covington, La. "His house was pretty deplorable and was deteriorating. But he was determined to live on his own."
In an October interview, then-Secretary Principi said he was "stung" when he learned a few years ago how common it is for veterans to die with their cases in limbo. While some deaths are inevitable, given the VA's elderly clientele, "it's not acceptable," he said. "We need to do something about it."
He also suggested that a recently formed commission on benefits could reconsider the legal barriers that prevent heirs other than a wife or dependent child from receiving a deceased veteran's back benefits.
The VA has admitted that its processes are too slow and too prone to errors. And veterans have told the agency that they suspect the worst: that the agency is "just stalling, waiting for them to die so the claim won't have to be paid," veterans said in focus groups in 1995.
But the agency has repeatedly ignored recommendations to eliminate redundant steps in the process to speed things up. One exhaustive review, completed in 1996, declared the entire claims and appeals process "cumbersome and outmoded" and in need of an overhaul.
Since then, "I think things are basically the same," said the agency's Walcoff. "I wouldn't say that we have changed the system in any major way."
In fact, VA data show that delays and the percentage of cases being sent back for re-hearings are basically unchanged since the agency vowed to reduce them.
In the mid-1990s, about the time it promised to speed things up, the VA also denied Berlie Bowman's claim.
Bowman had gone to Vietnam in 1967, an outgoing kid following in his father's military footsteps. "When he was drafted, he went without a fuss," said his sister Paulette. "He was a different person when he came back."
He was skittish, quick to anger, uneasy in crowds. The family trod warily around him - "learned to wake him from a distance by touching his feet with something," his VA file said. Over three decades, he ran through 30 jobs; he lived in a small trailer on a curvy North Carolina road.
His first disability claim, in 1971 for "nerves," was denied. His second try, in 1995, met a similar fate.
But that time, Bowman pushed back.
Working with an attorney, he assembled evidence to show that he had post-traumatic stress disorder and to document that it had started in Vietnam. The case wound up and down the system, receiving six different rulings, until Bowman fell ill with pancreatic cancer.
On June 16, 2004, the Board of Veterans' Appeals finally agreed with Bowman's claim. It declared that "credible supporting evidence" showed that Bowman suffered from post-traumatic stress disorder caused by his time in Vietnam, just as Bowman had contended for nine years.
Bowman's attorney immediately pestered the VA for Bowman's back benefits, dating to 1995. By then, Bowman's cancer treatment had been stopped.
On June 21, attorney Dan Krasnegor or his assistant talked with the VA every two hours. On June 22, they were told that the official disability rating was complete and that only final signatures were needed before Bowman's check for $53,784 could be cut. "Oh, it's in the computer system," they were told.
Berlie Bowman died that night, and his claim died with him. No check was sent.
At his burial, Bowman's mother accepted a smartly folded American flag from the Veterans of Foreign Wars. Seventeen old soldiers stood in formation in the rain. A bugler played taps; riflemen splintered the silence with a three-gun salute.
"The march of our comrade Berlie Bowman is over," intoned the VFW's chaplain.
The following copy block describes the VA's goals for claims processing:
The VA has repeatedly reset its goals for how efficiently it handles veterans' claims. One of its critical measures is the time necessary to decide an initial claim for disability benefits. At one time in the mid-1990s, the VA had a long-term goal to process claims in 60 days. It later increased that to 74 days, and then to 90 days. Average processing time instead ballooned to 223 days by 2002 before coming down slightly.
Last spring, the VA told Congress it was "on track" to reach a processing time of 100 days by the end of 2004. It didn't reach that target; today, the actual time stands at 165 days.
The agency recently changed its long-term goal again, to 125 days. The increased goals, the VA said, are due to changes in the law and the nature of claims currently being received.
By Chris Adams and Alison Young Knight Ridder Newspapers<>
Charlotte Observer (North Carolina) March 3, 2005> DRY RIDGE, Kentucky (KRT)