USAToday Veterans Affairs Special Section
Thousands wait while VA streamlines its claims process
The lesion on the left side of Sara Poquette’s brain is no bigger than a lima bean.
But its symptoms – severe headaches and memory loss – are not insignificant. Today, Poquette knows she has a traumatic brain injury (TBI), which she traces back to November 4, 2004. As a broadcast journalist serving with the Army National Guard in Iraq, she was riding in a Stryker vehicle when an improvised explosive device (IED) blew up in the street.
“We drove through the explosion,” she explains. Poquette hit her head and blacked out, but TBI wasn’t on the Army’s radar back then.
“At that time, TBI didn’t really exist,” Poquette says. “It was discovered later, based on some of the symptoms I was having.”
In 2009, a Veterans Affairs doctor sent her to a neurologist, who noticed the lesion on an MRI. Poquette had already filed a disability claim for a herniated disk, an injury sustained during her 2008-2009 tour at Guantanamo Bay. In 2005, she filed a claim for post-traumatic stress disorder (PTSD) but withdrew it after a commanding officer implied she’d lose her military commission if she pursued it.
“The VA was not quite sure that they wanted to say that the car bomb is the reason I have the lesion on my brain,” Poquette says.
It didn’t help that the Army had lost the incident and treatment reports from that day. She had no official record of the IED, no official records of her medical treatment in Iraq.
All in all, Poquette spent three years seeking three different disability claims with the Department of Veterans Affairs. (She reopened her PTSD claim in 2011.) Her TBI claim was approved in August 2012.
“I cried,” Poquette says. “I felt like someone finally listened to me. Someone finally paid attention.”
In recent years, it has not been unusual for a vet to spend so much time and energy proving service-related disabilities to the VA. And in June 2012, the number of pending claims was at a staggering 868,000, with more than 565,000 vets and their families waiting longer than 125 days.
But while it’s easy to assume that bureaucratic inefficiencies or pitifully low resources are to blame for the huge backlog, the reasons are not so nefarious.
“A large portion of the backlog is the VA changing its standards,” says disabled Army veteran Richard Allen Smith. “A large portion of the backlog is the VA doing a better job.”
Like many Iraq and Afghanistan vets, Smith’s claim was complex, including not only physical disabilities caused by “five years of falling out of airplanes with heavy things on my back” but PTSD. His claim was finalized after about a year. As a former VA employee, Smith has paid close attention to the backlog tallies. He is currently working as the communications director for a Washington D.C. non-profit.
“Any idea that someone [at the VA] was asleep at the switch is really not fair,” notes Brandon Friedman, a disabled vet and the former director of online communications at the VA. Friedman is now a vice president with D.C. communications firm, FleishmanHillard, and the author of The War I Always Wanted.
In 2009, a claim was considered backlogged after 180 days. VA Secretary Eric Shinseki felt this was too long, so he shortened the definition of the backlog to claims older than 125 days. In an instant, the backlog grew by 60,000 to 70,000 claims.
“Then the VA established the presumptions for Agent Orange and PTSD,” Friedman says. With this change, vets who had been exposed to Agent Orange and suffered from hairy cell and other B-cell leukemias, Parkinson’s disease or ischemic heart disease were entitled to disability status. In addition, vets no longer had to prove their PTSD was connected to a particular combat-related incident.
While PTSD claims had little effect on the size of the claims list, about 250,000 Vietnam War veterans made Agent Orange claims, a staggering workload for Veterans Affairs employees. By October 2012, the pending claims list and backlog had doubled.
Other, less tangible elements also played a role, including a difficult economy, aging veteran population and two wars. In addition, recent disability claims are much more complex, making them more challenging to adjudicate.
“Today’s service members may come home with a multitude of various medical concerns,” says Diana Rubens, the VA’s Deputy Undersecretary for Benefits for Field Operations. On average, today’s disabled vet has eight to 10 disabilities, double that of Vietnam vets.
A backlog of this size is daunting. Yet, the numbers show that the VA is making strong headway. From June 1 to August 31 of this year, it was slashed from 523,536 to 440,114 – an average of about 6,000 claims a week.
“You’re not going to see the backlog go up again,” Friedman says. “Right now it’s in free fall. The backlog is plummeting.”
How did the VA make such progress? “People, process and technology,” Rubens says.
“We’ve made some real adjustments to how we were organized in the regional offices,” she continues. “We have been pulling together as a unit in terms of the oldest claims.”
Since June, 97 percent of claims older than two years have been completed, Rubens reports. For the remainder of this year, the agency will focus on claims older than one year. Employee overtime and the implementation of an eBenefits program have helped streamline the claims process. In addition, service organizations have pulled together to support the VA in its efforts.
“The overwhelming amount of time spent on a claim is spent waiting for other entities to respond,” Smith says. The VA is addressing this problem with “fully developed claims.”
“We’re working hand in glove with many of the service organizations to help speed the time it takes to get that decision to the veterans,” Ruben explains. This means quickly confirming medical diagnoses and incident reports, as well as gathering more basic materials, including service records.
Still, things outside the control of the VA may hamper the process.
“I think many veterans are fearful of taking the step to make the claim,” Poquette says. “We don’t advocate for ourselves at any time in the military. We advocate for our superiors, subordinates and the mission. It’s always mission first.”
For that reason, navigating even the most well-run system can be challenging for a vet, especially one dealing with PTSD or TBI. Poquette wishes the Department of Defense as a whole had been more prepared for the vets coming home from Iraq and Afghanistan.
“It’s all a learning process, but being part of that learning process is very frustrating,” she says.
Regardless, Rubens is confident in the VA’s goal to end the backlog by 2015.
“We are going to continue to ensure that that vet who is waiting the longest is being dealt with quickly,” she says.
“The plan is in place,” Smith says. “It works.”