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VA plan to cut claims backlog will prioritize cases older than two years

May. 7, 2013 - 04:14PM   |  
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The Veterans’ Affairs Department initiative to quickly and dramatically reduce the claims backlog is making it a priority to process files that have been pending for two years or longer.

VA officials have ordered regional offices to use every resource necessary to review the estimated 41,000 disability claims that have been sitting for at least two years as part of an initiative intended to award provisional ratings based on available information so that disability compensation can be paid.

Reviewing these oldest initial claims should take two months, under VA plans, allowing regional offices to next turn to the 210,000 files that are between one and two years old. A review of these claims is expected to take four months, according to VA press secretary Josh Taylor.

When the VA announced its initiative on April 19, said it was immediately making provisional claims decisions for “veterans who have waited one year or longer” but did not explain that only claims that are two years old or older would receive immediate attention. As a result, there was confusion about the initiative when the Veterans Benefits Administration issued guidance to its employees to concentrate on only the two-year-old claims. This led some to believe the VA was not fulfilling the April 19 promise.

Some regional offices could already be working on year-old claims, Taylor said “Some individual regional offices, based on their inventory, are solely focused on two-plus-year-old claims right now,” but others are working on claims that are over one year old but less than two years old, he said.

Processing claims does not mean approving claims. “The reason a claim has been sitting there for a year or longer is because it does not have the evidence needed to complete, and that lack of evidence could result in a very high rate of denial or lower ratings than a veteran expects,” said a veterans service organization representative who asked not to be identified. “A high rate of denials could lead to a high rate of appeals, which could not really be progress.”

The provisional rating plan includes what VA officials said is a “safety net” where a veteran has up to one year to submit additional evidence or ask the VA to obtain additional evidence to change the decision. Any change would be retroactive to the date of the original claim. If that year passes, a veteran would still have an additional year to file a standard appeal.

VA’s May 6 workload report shows there are 880,000 pending claims, including 845,000 for disability compensation, dependency and survivors allowances and pensions for low-income veterans. About 70 percent of these claims are older than the VA’s 125-day processing goal.

It is taking, on average, 299 days to complete a claim, according to the report.

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