War Veterans Overloading VA

[hrscowboy]

*************
HearldNet
October 4,2004


Thousands of U.S. troops returning from Iraq and Afghanistan with physical injures and mental health problems are encountering an overburden benifits system, and officials and veterans group worry that the challenge could grow as the nation remains at war.

The disability benifits and health care systems that provide services for about 5 million American veterans have been overloaded for decades, with a current backlog of more than 300,000 claims. And as of Aug 1 nearly 150,000 National guard and reservist veterans became eligible for health care and benefits because they were mobilized to fight in Iraq and Afghanistan. That number is rising every day.

President Bush's budget for 2005 calls for cutting the Department of Veterans Affairs staff that handles benefits claims, and some Veterans report long waits for benefits and confusing claims decisions.

I love the military; that was my life. But i dont believe they're taking care of me now, said Staff Sgt Gene Westbrook 35 of Lawton Okla. Paralyzed in a mortar attack near baghdad in april he has received no disablity benefits because his paperwork is lost or missing. He is supporting his wife and Three children on his regular military pay of 2,800 a monthas he awaits a ruling on whether he will receive 6,500 a month from the VA for his disability.

Through the end of April the most recent accounting the VA could provide a total of 166,334 veterans of operations in Iraq and Afghanistan had separated from military service and 26,633- 16 percent-had filed benefits claims with the VA for service connected disabilities, Less than two thirds of those claims had been processed, leaving more than 9,750 recent veterans waiting.

Sound Off... What do you think?

[snipowsky]

I think and know the VA is a big freaking joke!

Us honorably discharged veterans deserve better then what we are getting...

VA = Inadequate medical care for all veterans, not to mention the nightmarish claims process!

WE DESERVE BETTER!

[hrscowboy]

I was hoping and praying that our men and women would get a fair deal when they came home from these wars but i can see that is not going to happen if in fact our commander in chief is going to cut budgets again and do away with staff. Yesterday i was at levenworth Ks VA and watched a Korean Veteran escorted to the front door of the V.A. hospital by security and told not to reenter the hospital. When i asked him what had happened he told me that he applied for services and was refused because he made too much money. he also advised me that he made 1600.00 a month and that his rent for his home and and utilites was almost 1200.00 a month leaving him 400.00 for medicine for his wife and himself and there not making ends meet with the meds his wife has to have and the meds he needs. He also said all he wanted was to get on Medications so he could afford the co-pay. He also stated he was on medicare but the V.A. still refused him.

What kind of bulls**t is this when a honorable discharged veteran can not get help with the V.A. when he is barely surviving because the V.A. only ask about how much you make and not what your paying out to qualify for help.

[HardJedi]

The VA, as with so many other benefits for those who have given all they have, falls FAR FAR FAR short of what they deserve. The ONLY reason I would EVER set foot in a VA instalattion of ANY sort is if my life depended on it and it was my absoulte DEAD LAST option. As Former United States MArine who served Honorably, I should NOT be made to feel like a beggar and a Burden, and neither should these fine troops returning from war.

[yellowwing]

Maybe the home grown Veterans organizations can step in and help. I bet various chapters of the Marine Corps League is already doing something for these young lads. You know, making sure they are keeping the lights on and are eating better than KD and wieners.

[airframesguru]

This is soooo wrong. I'm speachlese.

Mike

[Sgted]

Originally posted by HardJedi
The VA, as with so many other benefits for those who have given all they have, falls FAR FAR FAR short of what they deserve. The ONLY reason I would EVER set foot in a VA instalattion of ANY sort is if my life depended on it and it was my absoulte DEAD LAST option. As Former United States MArine who served Honorably, I should NOT be made to feel like a beggar and a Burden, and neither should these fine troops returning from war.

In 1996 I becamed disabled by Muscular Distrophy.
I lost my job and my health insurance.
Up till then, I had never considered the VA.
After that, the VA was my only option.
My care is mediocre, my doctors are overwhelmed, under paid and the system needs alot of work.
This situation has existed for decades.
It will continue to exist despite promises to change, update or improve it.
Almost every visit I make to the VA (4 in the last 2 weeks alone) is an unpleasant experience peppered with a facility full of Vets that are angry, lack of communication, employees that haven't a clue what being employed in the service industry is all about, rushed and incomplete exams and a tense atmosphere.
In 1998 I went on a rampage of letter writing to the Director of the VA hospital I go to (E. Orange, NJ), one Congress Woman, 2 Senators.
This resulted in a brief "heads up" at the VA but quickly reverted to staus quo.
I just can't imagine how many qualified Vets just give up rather then deal with the stress and hassle of trying to get whats due them.
Sad.

[MillRatUSMC]

It been awhile since I last set foot in my local VA clinic.
Makes it hard to commend on all this.
But the extra burden of these returning injured members of the military.
Surely is going to swamp the systems in place.
Now there might be a need for the hospitals and staff that was cut.
Cutting funds and staff isn't the way to go.
Things are starting to unravel on this government and all this reports are not going to help on this election.
Maybe they're being lucky that many mail-in ballots are not available to the troops, especially the Nation Guard...

Semper Fidelis/Semper Fi
Ricardo

PS A friend of mine also got escourted out VA in Chicago,IL after telling a doctor;
"Are you telling me! eat $hit and die!"
That was in regards to this young doctor saying that Agent Orange wasn't dangerous...

[hrscowboy]

well gentlemen you can bet that i am not done with this. I am going to print out these pages of this thread and start mailing them to senators and governers of each state, so they can see what the Veterans response is too this. I am also sending copies of this thread to our Commander in Chief and advising him this needs to be fixed and pronto, because if people find out this is going to happen what makes them think our young people are going join the military if they know our government is going to drag there feet and not help them after they helped this country.

[seandayley]

Medical care for our Nation's finest, injured or retiered, should be free medical, as it was promised to my grandfather 56 years ago before he served in WW II and Korea. It should be good at any hospital in the nation. The politictions should not litimt our finest to certain areas of the nation, we never limited our service or our sacrifice to this nation so it should be returned in kind. It is said that voting is a duty that as citizens we are obligated to participate in, well I see that the government has the same obligation to us, for we gave them the right to run for their office, for we paid with our blood, sweat, and our lives.

Semper Fi
Sean

[TracGunny]

I have never had a problem with the VA; perhaps its location, or perhaps it is attitude (theirs & mine), but my experiences with the local VA are positive. Are there problems? Sure, there are problems in all health care sectors, not just the VA.

The original article posted at the begin is very vague.

How many of the claims are bogus, tying up valuable resources?

How many of the whiners are complaining because they did not get the free handouts (VA benefits) they thought they "deserved"?

What is the turn-around time between application & answer; best-case/worst-case?

How many of the complaints are bandwagon? Over 26,000 claims
since Iraq/Afganistan?!? WTFO? Semper Fi, Mac, I've got mine...? Sounds like a scam to me.

Too many lose ends for my taste, and I've been face to face with too many Veterans who are looking for handouts they have not earned to jump on this "bash the VA" bandwagon.

So, hrscowboy, are you going to post the opposing views to your little crusade?

[TracGunny]

Honoring Our Commitment to America’s Veterans

President Bush is committed to our Nation's veterans, and has proposed unprecedented levels of funding for veterans. His Fiscal Year (FY) 2005 budget represents an increase in overall funding for our Nation's veterans by almost $20 billion – or 40 percent – since 2001. The President has increased funding for our veterans more in four years than funding was increased in the previous eight years. The FY 2005 budget includes a 41 percent funding increase in veterans' medical care spending alone since FY 2001.

The President also supports tomorrow's veterans and their families. In 2003, President Bush requested $87 billion in supplemental funding from Congress to help ensure that the American military fighting the War on Terror has the resources, including body armor and other vital equipment, to accomplish their mission. Since 2001, the President's budgets have provided an increase in basic pay for men and women in uniform by almost 21 percent, improved military housing for families living on base, and reduced to zero the average housing expenses for military families living off base.

Honoring Today's Veterans

President Bush is committed to honoring America 's veterans who have sacrificed so much for our Nation. Under President Bush's leadership, the Department of Veterans Affairs (VA) has dramatically improved health care services and the disability claims process. The President also kept his promise to reduce the claims backlog and waiting times to receive medical treatment, thereby ending the bureaucracy, delays, and unfair denials that were occurring when he took office. President Bush's VA medical care budget requests enable the VA to meet its core medical mission – to serve those highest priority veterans, including low-income veterans, those with service-related disabilities, and those who need VA's specialized services. The President also honors the families of veterans and military retirees who have made tremendous sacrifices for our country.

Improving Access to Health Care for Veterans

Increased Health Care Service to Veterans: Since 2001, President Bush's budget requests have allowed the VA to enroll 2.5 million more veterans in health care services, increase outpatient visits from 44 million to 54 million, and increase the number of prescriptions filled from 98 million in 2001 to 116 million as of August 2004. Under the President's leadership, 194 new community-based clinics have been opened since 2001 and are now available for veterans.

Additional Prescription Drug Coverage: Last year, President Bush took the unprecedented step of allowing veterans waiting for a medical appointment who already had a prescription from their private physician, to get those prescriptions filled by the VA – saving veterans hundreds of dollars in drug costs.

CARES (Capital Asset Realignment for Enhanced Services): President Bush is seeking to modernize VA facilities and provide more care to more veterans in more places, where veterans need it the most. He has committed $1.5 billion in the FY 2004 and FY 2005 budgets, and additional funding will be requested in the future to increase outpatient health care services for veterans, build new hospitals, and replace outdated, pre-World War II facilities. The VA is working to better distribute its network of clinics and hospitals, so the vast majority of veterans are within 30 miles of a VA community-based outpatient clinic or similar facility.

Expands Access to Long-Term Care in the Most Non-Intrusive Settings: President Bush's FY 2005 budget request continues to expand long-term care for veterans through VA facilities, private and state facilities, and non-institutional care programs that allow veterans to live and be cared for near or in the comfort and familiar settings of their homes surrounded by their families.

More Responsive to Veterans

Eliminating the Wait List for Medical Care: This year, the list of veterans waiting more than six months for basic medical care, which peaked at 300,000, will be essentially eliminated.

Cutting the Disability Claims Backlog: The President promised to reduce the disability claims backlog, and at his request, Congress has provided VA with the resources it needs to reduce claims. Claims backlogs have dropped from a high of 432,000 and are approaching the VA goal of 250,000. The volume of claims decisions per month has increased from 40,000 to 68,000. The average length of time to process a veteran's compensation claim has dropped from approximately 230 days to 160 days. VA is working to meet its processing goal of 100 days this year.

Priority Scheduling for VA's Core Medical Mission : Treating veterans with military disabilities, lower incomes, and special needs has always been VA's core medical care mission and its highest priority. President Bush's Administration has established a new scheduling system to ensure that veterans seeking care for a service-connected condition are first in line. No veteran disabled in the service of our country will ever be turned away.

Concurrent Receipt of Benefits: The President twice signed legislation providing “concurrent receipt” of both military retired pay and VA disability compensation for those military retirees most deserving – combat-injured and highly-disabled veterans – finally reversing a century-old law preventing concurrent receipt.

Help for Homeless Veterans: The Bush Administration has launched a $35 million program to provide permanent housing, health care, and other support services to our homeless veterans most in need.

Serving America's Newest Veterans and Caring for Families of Veterans

Benefits Delivery Available upon Discharge from Military Service: Under President Bush's Administration, the VA and the Department of Defense have developed a proactive partnership to better share valuable resources benefiting veterans, military beneficiaries, and taxpayers. VA staff is reaching out to 136 military bases to provide America 's newest veterans with the services they have earned and to bring about a seamless transition for new veterans from military to civilian status. To date, more than 15,000 veterans who served in Afghanistan and Iraq have been provided VA care.

Caring for Families: The VA makes pensions based on need available to surviving spouses and unmarried children of deceased veterans with wartime experience. President Bush signed the Veterans Benefits Act authorizing new and expanded benefits for disabled veterans, surviving spouses, and children.

Fulfilling Our Nation's Promise: Under President Bush's leadership, VA is honoring veterans with a hallowed, final resting place. The President signed H.R. 1516, the National Cemetery Expansion Act of 2003 into law, establishing, within four years, six new national cemeteries in the following areas: southeastern Pennsylvania; Birmingham, Alabama; Jacksonville, Florida; Bakersfield, California; Greenville/Columbia, South Carolina; and, Sarasota, Florida.

http://www.whitehouse.gov/infocus/veterans/

[TracGunny]

“When President Bush took office, the number of claims waiting to be processed had soared to over 600,000, mainly because of expanded benefits that increased the number of claims in need of review.”


“…veterans were waiting an average of over 230 days for a claim to be processed. One of the President’s top priorities was to reduce this processing time, and VA established a goal of 100 days.”


“VA trained nearly 1,800 employees in proper claims processing procedures, and specialized teams were set up to process claims for those older veterans who had been waiting the longest.”


“As a result, the number of days to process a claim dropped to 156 at the close of 2003 and is on target to drop to the 100 days goal in 2004.”


“By 2005, VA spending on this program will be 50 percent more than four years earlier.”

http://www.whitehouse.gov/omb/budget/fy2005/va.html


my recomendation to everyone, including myself, is to do a little research on both sides of the story before openning mouth and...

also, the original article quotes the 2005 Budget; follow the link & read it for yourself...

[Sparrowhawk]

President Bush's budget for 2005 calls for cutting the Department of Veterans Affairs staff that handles benefits claims, and some Veterans report long waits for benefits and confusing claims decisions.

<hr>

WHERE DOES THIS INFORMATION COME FROM; Bush does not cut back these funds, he has raise the financial amount of benefits for the servicemen 20%.

Besides this its Congress that makes this determination, and they are not about to do it. Even if this was not an election year do you really think Bush would do that?

<hr>


166,334 veterans of operations in Iraq and Afghanistan had separated from military service and

26,633- 16 percent-had filed benefits claims with the VA for service connected disabilities, Less than two thirds of those claims had been processed, leaving more than 9,750 recent veterans waiting.

WOW what an enormous amount of claims to have already processed, when the VA hasn't grown in employees, since the start of the war.



Encountering an overburden benefits system...

WHERE IS THAT HAPPENING?

I help veterans apply for benefits, within weeks they are notified and within less then a year their claims are processed and a decision is made. If there is a delay most often it is on the individual that has not filed the paper needed to move his claim along.

I always file double or triple the amount of papers they ask for and most claims are filed and settled in less then a year.

But typically it’s always taken a year to process these claims; most recently I have had some claims completed in less then half a year...



There are some offices where teh government employee is just plain lazy, a phone call here and there usually clears that up...


So far everyone I have filed claims for have receive a 100% rating in less then a year.


SF

Cook

[snipowsky]

You don't even have the right to speak your mind in a VA facility without some VA policemen up in your face like they are with the VA gestapo ready to beat you down or worse, shoot you!

I know so many veterans who have been escorted out of the local VA hospital here in Indy for speaking their minds about all the BS that goes on, and they weren't even getting irate with the staff. This includes me also.

WE WERE JUST PRACTICING OUR 1ST AMENDMENT RIGHT TO FREEDOM OF SPEECH!

Freedom of speech is non-existent in any VA facility. Ask any veteran who has complained out loud around other veterans. You don't have the right to say anything negative about the VA!

The VA gestapo are definitely the "THOUGHT POLICE"!

[hrscowboy]

Cook i too have helped several veterans get with the people they needed to get with trying to get benefits, but never have i seen anything like this that i witnessed at the VA in leavenworth Ks. I have never encountered anything like that since i have been in the system since 1992. I hear rumors and only rumors which i hope are not true that the VA is trying to cut out the Vets that are not service connected and i hope its only rumors because again if our military people now that they can not get help after these wars or if there in dire need and are not service connected were going to have a real problem getting anyone to serv in the military...

[TracGunny]

cut out the Vets that are not service connected Can you clarify that? I do not follow your intent... it seems you are saying that anyone who serves one day or thirty-plus years deserves full access and compensation in the VA... even if they have no injuries/ailments connected to their actual time in uniform.

[Sgted]

Originally posted by TracGunny
Can you clarify that? I do not follow your intent... it seems you are saying that anyone who serves one day or thirty-plus years deserves full access and compensation in the VA... even if they have no injuries/ailments connected to actual time in uniform.

TracGunny....

I personally believe there has to be a threshold.
What that may be is a real problem.
Those who have "No injuries / ailments connected to actual time in uniform" should be using the public sector where possible.
Of course, service connected should always have priority.
I also believe (strongly I might add) that the system is abused by some.
I am in the process of trying to get increased service connection (now only 20% for type II diabetes) because complications are setting in (perepheral neuropathy). Those who have PN know that it is painful and can affect ambulation.
I recieve a non service connected disability pention from the VA for muscular distrophy.
The combination of the 2 ailments makes my life difficult.
I served 6 1/2 years in the Marines honorably.
No page 12 and good scores on my performance.
I don't expect a red carpet nor do I think I'm the only one in the system.
I do expect competent, average care from qualified professionals.

[hrscowboy]

It has always been my understanding that if your an honorably discharged veteran you where intitled to VA medical services but not compensated unless you had injures due to your service in the military but you had to have a honorable discharge. I seen my grandfather use the VA hospital for Medical services and he was not service connected what so ever. It was also told to me along time ago that our government promised the veterans that there would be medical help for all veterans that was honorably discharged now if that has been changed someone needs to let these people know this before they enlist in the military. I dont see a damn thing wrong with helping veterans with medications and there not service connected as long as they can pay the Co-pay on the drugs.

[TracGunny]

Thanks, hrscowboy (you too, Ed), I believe I have a better understanding of where you are coming from, and I agree with some, disagree with some, of your points. I also understand that I do not have a full appreciation of the scope of what the VA does, or at least tries to do, for honorably discharged Veterans who are not "retirees,” medically or otherwise...

I certainly did not know, nor think the VA (i.e. U.S. Government) gave compensation for injuries/ailments "not their fault", or caused off of "Government time."

Therefore, to heed my own suggestions, I think I will do some more research.

Still, my basic feeling is that the VA is getting a bum rap...

[HardJedi]

Ya know, here basically is how I see it. If you served your country, and did so in an honorable manner, then you deserve to be able to go to the VA for help. Not to use them for a free ride, but for HELP.

There have been times since I left the service, when I had no private medical coverage, either through lack of funds, or through a lapse due to changing of jobs. In those times, I feel that I should at LEAST be entitled to a checl up or a prescription for some flue medicine or something. I have never in my life asked for a handout, and would pay as much as I could, gladly. But come ON! the Government of the United States OWNED me for 4 years, so why should I NOT be allowed to use Government services, if I could not COMPLETELY afford them on my own? even if it is NOT a service related illness or injury?

That being said, No, I did NOT join to get benefits. I joined because I saw it as my duty, and would do so again, even if there are NO benefits at all. HOWEVER, There IS a VA. NOT a VAFPWSRII ( vetrans administration for people with service related injuries or illnesses)

[hrscowboy]

This is why all this is so upseting to me, We as a government can give people on welfare all kinds a money to raise there children and feed them.. We as a government can send millions of dollars to feed other countries and help in medical assistance. But we as a government SAY NO to a korean vet or any other vet that served his country in a time of war or peace. I didnt join the corp for the benefits i joined because i was raised if uncle sam needed me it was my duty to protect my rights my country and america. I myself think we as a government need to take care of our veterans. as hardjedi said if a veteran has fallen on hard times and can no longer afford the medications that have been prescribed to him from a private doctor, and this veteran can afford the Co Pay what the hell is wrong with helping that veteran
I see nothing wrong with it what so ever...

[greensideout]

I guess I'm going to have to step in with my personal experience with the VA. Some bad but mostly good.

I was offered a chance to apply for benifits upon discharge. I would have to stay another two weeks for that. At age 21, two weeks were too many, I was out of there! I would take care of it on my own.

Well the price of it all seemed to grow faster then my income. So after 23 years of asking for no help I decided to apply and to ask for a little help with the service connected disabilities. The ansewer? I was turned down---"It's not in your record." After a fight, I was so flustrated that I just let it go.

Another 12 years later and I decided to ask again. Again the reply was, "It's not in your record". I put up a fight to the end this time and after a year I was seen by a doctor at the VA to make the call.

A brief talk and the doctor opened my medical records. After untying a string, removing a few pages and reading them, the doctor looked at me and said, "It's right here in your record".

I could not help but think,"No sh*t, that's what I have been saying for years"! I figure that no one really ever looked before.

Ok---that was the down side. Now the up.

I received as good of care and in many ways better care then I had received anywhere before! I was treated, I'm not kidding, like someone special.

The doctors were outstanding,
The care was outstanding,
The wait times were very short.

My grade for the VA? Getting into the system sucks---big time!

The care and service were for me, outstanding!

My two bits.

[Sgted]

Originally posted by TracGunny
I certainly did not know, nor think the VA (i.e. U.S. Government) gave compensation for injuries/ailments "not their fault", or caused off of "Government time."

The VA has a program in place that provides medical care, prescriptions and a monthly check (small) for disabilities that are, in their opinion, not service connected. In 1996 when I applied it was called a "non-service connected pention" (Compensation & Pention).
It is, more or less, a disability program that is based on income and ones ability to earn a living. Even in this program, if you have health insurance there are co-pays.
I have none of those luxuries like health insurance and an income so I get all my medical care and prescriptions free.
They even removed my gall bladder with no charge to me.

The VA does take care of us.
And, it does depend on what facility you go to as to how good that care might be.
The E. Orange facility in NJ is overwhelmed with clients so the waits are long and the tempers are short.
I attend other clinics in NJ at the Lyons facility. At that location there are no long wait. Usually, I am seen within 15 minutes of my appointed time. Attitudes are kinder, tempers are in check.
Still another clinic I attend is in Morris Plains, NJ where my primary care provider is located. This is not a hospital but a sattellite clinic that opened about 4 years ago to expedite Veterans care, ease the load on the larger hospitals and make it easier for Vets as far as having to travel long distances is concerned.

All my problems with the VA centered around the E. Orange facility.
I have a rare form of Musclar Distrophy called Myasthenia Gravis (translation: Grave Muscle Weakness). Because the VA deals with this disease so sporatically the Neurologist at the hospital knew little about treatment protocal concerning my condition. He wanted to treat me in ways that were inappropriate with the current medical community's outline concerning MG.
I, on the other hand, had educated myself on the disease and refused his suggestions.
The disease can be fatal if treated the wrong way especially during surgery. This centers around breathing which is affected by MG.
This doctor refused my being pro-active in my own care and when I protested guards were called (much like another Marine in this thread posted). I never became threatning or physical but was still treated like a common criminal.
That is when I decided to involve the Director of the hospital (Mr. Mizack) 2 Senators and a Congresswoman.

The long term result of all this is that the VA Neurologist I see now treats me based on the suggestions of a MG specialist OUTSIDE the VA. I see her through the MDA a couple of times per year through the Jerry Lewis MDA funding.
She cannot treat me in any way but lets the VA know what to do. The VA USUALLY carries out her suggestions.

Overall, I am thankful for the care I recieve but still feel the system needs improvement. They need to catch up, accelerate the process so qualified Vets can get the care they need, when they need it and in a manner that is fair for the Vet, the VA and the taxpayers .

[hrscowboy]

The shocking thing about this ordeal is that i found out that this veteran had already been in the system since 1994 had his VA card and was asked to do a financial report again listing the same income he had in 1994 and the VA said they couldnt help him because he made too much money. This veteran is on all kinds of meds for high blood pressure, depression, and a diabetic.. his income is 1600 a month.. his house payment is 450.00 a month utilites according to him is around 250 a month. His insurance for his wife is 250 a month... and her medications average 400 to 450 a month.. not leaving him very much to live on to buy grocerys. Both himself and and his wife are on medicare and have no other outside insurance. all this man wanted was to be able to get his medications thru the VA even if it meant using medicare and they refused him. he is able to pay the Co pay but was still refused. When he asked what the hell is going on here he was then surrounded by VA police and escorted out the door.

[CAS3]

then you are part of the problem.

That is why I am where I am and do what I do.

hrscowboy...please do not publish my statements without specific authorization to do so.

First, yes there are many problems with the system. Lack of funding, lack of qualified medical professionals, waiting times, etc.

I have attended meetings with Mr. Garfunkel, Director of the Washington DC VAMC. I can get minutes from those meetings to anyone who requests them.
In these discussions, I have learned much about the medical side of the VA. Remember, I work on the benefits side. First, the two do not speak to each other electronically or otherwise. If you are requesting benefits, the VAMC will not know it. If you are at the VAMC the VA will not know it. It is your responsibility to contact the VA regional office and the medical center and notify them of any changes in health, address or dependency.
Priority groups were established a few years ago. Technically, everyone is entitled to benefits but just as the same with your HMO, a co pay may be required.
NO VETERAN IS KICKED OUT OF A VAMC FOR BEING TOO RICH. There are other reasons, look closer. Does the vet have PTSD? Was he going off on staff? Does he have a veterans representative? Did he go to the patient advocate?
As a service- connected, wartime veteran, I receive care at the VA. All of my needs are taken care of. Yes, I have to wait to be seen for long periods of time. It is something we all do, even at our private physicians offices.

About benefits...
The VA has started transition assistance. I know for a fact that service members returning now are given a briefing on their entitlements. ( I have given the session).
Out of the thousands at Walter Reed, only 90 have applied for benefits and have been granted already. The decisions have taken less that 120 days. (All records and important documents were included in filing for benefits)
VA pension is the welfare system for veterans. Yes, the goverment has provisions for this just as they do for families with children welfare. You can not make too much money and still get money for doing nothing. Welfare is there for honest people who really need it. That system is abused just as much as the VA system.


About medical records:
You all know where to get them.(If not, I can give you that info) Ask for copies per the Freedom of Information Act.
Service members today are told to make copies of everything.
It is your responsibility to have information pertaining to your health. The VA does not keep track of your private doctors records. Your doctor has no idea what is inside your VA (benefits)file. He has your medical file only.

[CAS3]

DEPARTMENT OF VETERANS AFFAIRS
Veterans Benefits Administration
Washington, DC 20420


July 21, 2004

Directors (00/21) In Reply Refer to: 214B
All VA Regional Offices and Centers Fast Letter 04-15

SUBJECT: Compensation and Pension Examination Improvement Initiative

To improve the Compensation and Pension examination process, the Veterans Health Administration and Veterans Benefits Administration created the Compensation and Pension Examination Program (CPEP) office in Nashville, TN. This office is jointly staffed and funded by both administrations and tasked to coordinate and lead efforts for change in this vital area.

By using a variety of approaches to help improve the quality of examination reports, the CPEP office has accomplished the following:
Ø Established a credible and objective examination report quality measurement system
Ø Implemented a system of independent quality reviews
Ø Provided a variety of training opportunities including satellite broadcasts, training videos, on-line searchable clinician’s guide and extensive training sessions (Collaborative Breakthrough Series) attended by key staff from 133 medical centers
Ø Required each medical center to now develop and maintain a quality improvement plan for their C&P examination programs
Ø Included quality of examination reports (as measured through the CPEP process) in each VISN director’s performance requirements, effective this fiscal year

These efforts have had and will continue to have a positive impact on the C&P examination process. Information on CPEP initiatives including results of examination quality reviews can be found at the CPEP homepage (vaww.cpep.med.va.gov).

CPEP is charged with improving all areas of the examination process. A critical element of the examination process is the adequacy and accuracy of examination requests. When conducting reviews, examination reports are frequently encountered that cannot be evaluated because the examination request was in error, unclear, or incomplete. Problems include the following:
Ø Indicating the incorrect AMIE worksheet (i.e. an original PTSD worksheet for a claim for increase or a neurological exam worksheet for an orthopedic disability)

Page 2.
Examination Improvement Initiative


Ø Failing to clearly identify the disability to be examined
Ø Requesting inappropriate medical opinions
Ø Using acronyms or VBA jargon in examination requests
Ø Failing to provide claims folder when required

To address these concerns, CPEP initiated a standardized review of examination requests. This review is now an integral part of the CPEP review program. A review of the request is now completed for every examination report randomly selected for CPEP review. Regular result reports will be maintained on the CPEP homepage and on C&P Service’s STAR report page beginning this month.

Attachments to this letter consist of a “ready reference” examination request guide; a summary of the initial review results with examination request review criteria; and a spreadsheet summary of examination and medical opinion requests along with an associated spreadsheet of baseline requests.

Improvement in the area of examination requests is critically important. Each regional office must have an active examination coordinator. This individual should play a pro-active role in addressing examination problems. Activities should include:
Ø Reviewing examination requests to assess quality and identify problems for corrective actions
Ø Reviewing a sample of completed examination reports for sufficiency to identify problems or trends requiring corrective action
Ø Establishing a rapport with VAMC examination unit staff to encourage informal problem resolution

The examination process remains the single most critical element in effective claims administration. We know that most regional offices have worked hard to establish effective working relationships with their servicing medical centers. The purpose of this letter and the CPEP initiative, in general, is to support the efforts of both regional offices and medical centers to ensure a system-wide consistent and effective cooperative program that supports and facilitates timely and fair resolution of veterans’ claims.


/s/
Renée L. Szybala, Director
Compensation and Pension Service

Enclosure: (4)

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Department of Veterans Affairs VHA DIRECTIVE 2003-062Veterans Health Administration Washington, DC 20420 October 23, 2003
PRIORITY SCHEDULING FOR OUTPATIENT MEDICAL SERVICES AND INPATIENT HOSPITAL CARE FOR SERVICE CONNECTED VETERANS
1. PURPOSE: This Veterans Health Administration (VHA) Directive outlines policies and actions required in support of Department of Veterans Affairs (VA)’s commitment to providing priority care for non-emergent outpatient medical services and inpatient hospital care for any veteran with service connected (SC) disabilities. NOTE: As always, medical care for emergent or urgent cases takes precedence over a priority of service connection.
2. BACKGROUND: Public Law 104-262, the Veterans Health Care Eligibility Reform Act
of 1996, mandated VA to establish and implement a national enrollment system to manage the delivery of health care services to veterans. The enactment of this legislation generated a significant increase in the number of VA enrollees and patient users. The result has been a steady increase in the number of veterans on wait lists or scheduled in excess of 6 months for non-emergent outpatient appointments. VHA Directive 2002-059 outlines VA’s policy on providing priority access for care to veterans who are 50 percent or greater SC. Additionally, VA has identified the need to provide priority access for care to veterans who require care for a SC disability regardless of the percentage of SC rating.
3. POLICY: It is VHA policy to provide priority access to outpatient medical care and elective inpatient hospital care for any veteran who requires care for a SC disability. In addition to ensuring that this priority for access to care is provided to veterans requiring care for a SC disability, every effort must be made to provide clinically appropriate care to every enrolled veteran. NOTE: Service connection in and of itself, does not justify cancellation of a current appointment for another veteran as a mechanism for accommodating priority scheduling for the SC veteran.
4. ACTION: Network and medical center Directors must ensure health care facilities implement the following procedures to manage appointment scheduling for new enrollees and established patients who require care for a SC disability. NOTE: While staff at the health care facilities may place these veterans on wait lists, their appointments must be scheduled within the timeframes as outlined in subparagraph 4a.
a. All new enrollees and/or new patients who are rated less than 50 percent SC requiring care for a SC disability, and who request VA care, must be scheduled for a primary care evaluation within 30 days of desired date. If the outpatient appointment cannot be scheduled within this timeframe, arrangements must be made to have the patient seen at another VA health care facility or to obtain the services on fee basis or under a sharing agreement or contract at VA expense within the 30-day timeline.
THIS VHA DIRECTIVE EXPIRES OCTOBER 31, 2007
VHA DIRECTIVE 2003-062 October 23, 2003 2 b. Appointments for established patients (i.e., a patient who has received care anywhere in the VA system within the past 2 years) who are less than 50 percent SC requiring the appointment for a SC disability, must be scheduled within 30 days of the clinically appropriate appointment date based on the clinical need of the veteran as determined by the veteran’s VA treating clinician. If an appointment cannot be scheduled within the specified timeframe, arrangements must be made to have the patient seen at another VA health care facility or to obtain the needed services on a fee basis or under a sharing agreement or contract at VA expense.
c. If non-VA care at VA expense is authorized, close coordination must be maintained with the veteran and the local authorized care provider to ensure coordination of the veteran’s care. Alternative arrangements for appointments are intended to provide interim medical care for veterans who require care for a SC disability. These veterans need to be scheduled at the preferred VA health care facility or at another VA health care facility as soon as possible.
d. Any veteran less than 50 percent SC needing admission for an elective procedure related to a SC disability must receive priority admission scheduling over other elective admissions. NOTE: In no case should priority scheduling of any SC veteran impact the medical care of any other previously scheduled veteran.
e. Veterans rated less than 50 percent SC who are on a wait list at the time of implementation of this Directive, must be provided priority access as outlined in subparagraphs 4(a) and 4(b).
5. REFERENCES
a. Public Law 104-262.
b. Federal Register (FR) Notice published September 17, 2002, at 67 FR 58528.
c. VHA Directive 2002-059, dated October 2, 2002.
6. FOLLOW-UP RESPONSIBILITY: The Chief Business Officer (16) is responsible for the contents of this Directive. Questions may be referred to this office at (202) 254-0324.
7. RESCISSIONS: None. This VHA Directive expires October 31, 2007.
S/ Jacquelyn Vassanelli for Robert H. Roswell, M.D. Under Secretary for Health
DISTRIBUTION: CO: E-mailed 10/24/03 FLD: VISN, MA, DO, OC, OCRO, and 200 – E-mailed 10/24/03

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Administration Seeks $67.7 Billion for VA in 2005
February 2, 2004


WASHINGTON – Secretary of Veterans Affairs Anthony J. Principi announced today that President Bush will seek $67.7 billion in the fiscal year 2005 budget for the Department of Veterans Affairs (VA), a $5.6 billion increase in budget authority, primarily targeted for health care and disability compensation.

"The budget proposal reaffirms the president’s support for providing the best possible health care and benefits to our veterans,” Principi said.

The budget request represents a $1.2 billion, or 3.8 percent, increase in discretionary funding over the enacted level for 2004. Overall, the 2005 budget requests $32.1 billion in discretionary funding (mostly for health care) and $35.6 billion in mandatory funding (mostly for disability compensation, pensions and other benefits programs).

"With the resources requested in this budget, VA will continue to increase veterans' access to our health care system, reduce the time it takes to process claims for benefits, and ensure our national cemeteries are lasting memorials commemorating veterans," Principi said.

Improving Access to Health Care

The president’s budget requests $29.5 billion for VA’s medical care, an increase of $1.17 billion, or 4.1 percent, over the 2004 level and more than 40 percent above the level in 2001. The medical care budget includes $2.4 billion in collections from third-party health insurance and co-payments from veterans.

"The president's proposal includes ending copayments for several categories of veterans, including the poorest of the poor and our POWs," Principi said. "We will eliminate the pharmacy copayment for our most disadvantaged veterans. We will pay for emergency room care or urgent care for veterans in non-VA hospitals."

With the total resources for medical care, VA will be able to provide care to nearly 5.2 million patients, over 1 million more than in 2001, which marks a 20 percent increase.

The department has taken several steps during the last year to reaffirm its health care commitment to the highest priority veterans, particularly service-disabled veterans. VA recently issued a directive that ensures veterans seeking care for service-connected medical problems will receive priority access to VA’s health care system. This new directive says that all veterans requiring care for a service-connected disability must be scheduled for a primary care evaluation within 30 days of their desired date.

As a result of the new policy and other regulatory changes presented in the budget, the number of patients within the core service population -- service-disabled veterans, those with low incomes and veterans with special needs such as spinal cord injuries -- will grow to nearly 3.7 million in 2005. Veterans in the highest priority groups will comprise 71 percent of the total patient population in 2005, up from 66 percent in 2003. VA devotes 88 percent of its medical care budget to meet the needs of these highest-priority veterans.

The policy and regulatory changes included in the 2005 budget would require more advantaged veterans to assume a small share of the cost of their health care. These proposals are consistent with recent Medicare reform that addresses the difference in the ability to pay for health care. Among the most significant legislative proposals in the budget are:

· ending pharmacy copayments for veterans in Priority Categories 2 through 5 with incomes between $9,894 and $16, 509;

· ending all copayments for former prisoners of war;

· authorizing the department to pay for emergency room care or urgent care for enrolled veterans in non-VA medical facilities;

· ending hospice copayments;

· increasing co-payments for pharmacy benefits for veterans in Priority Categories 7 and 8 -- those not being paid for service-connected disabilities with income above an income threshold -- from $7 to $15; and

· establishing an annual user fee of $250 for veterans in Priority Categories 7 and 8, who have higher incomes and no compensable service-connected disability.

"My top priority in health care is to ensure that resources are available to care for those veterans who are most deserving of VA’s medical services," Principi said. "The proposals in this budget will assist us in continuing that focus on our core service population in our health care system."

In a major initiative, the 2005 budget would allow the department to pay for emergency room care or urgent care for veterans in non-VA hospitals who have insurance if they have enrolled for care in VA’s health care system. This provision would ensure that veterans with life-threatening illnesses can seek and receive care at the closest possible medical facility. In addition, VA proposes to eliminate the co-payment requirement for all hospice care provided in a VA setting and all co-payments assessed to former prisoners of war.

The medical care resources included in the president’s 2005 budget will allow the department to continue to improve veterans’ access to health care. During the last three years, VA has opened 194 new community clinics, bringing the total to 676.

Nearly nine out of every 10 enrolled veterans now live within 30 minutes of a VA medical facility. This expanded level of access has resulted in an increase in the number of outpatient visits from 44 million in 2001 to 51 million in 2003, as well as a 26 percent rate of growth in the annual number of prescriptions filled to a total of 108 million last year.

To further highlight the emphasis on the delivery of timely, accessible health care, the department has set a 2005 performance goal of 93 percent for the share of primary care appointments that will be scheduled within 30 days of the desired date; 99 percent of all appointments will be scheduled within 90 days. For appointments with specialists, the comparable performance goal is 90 percent within 30 days.

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Veterans of the nation’s recent conflicts are among those for whom the department provides care. Of the veterans of the war in Iraq who have been discharged by the military, 12 percent, or 9,700, have sought and received VA medical care. More than 9 percent of discharged veterans of Operation Enduring Freedom -- nearly 1,400 -- have received VA health care.

The 2005 budget includes $524 million to move forward with the Capital Asset Realignment for Enhanced Services (CARES) program, more than doubling funds from last year to modernize VA's health care infrastructure.

"CARES is about caring for veterans' future needs," Principi said. "We want the highest quality of health care closer to where most of our enrolled veterans live."

Reducing the Time to Process Claims

VA administers six benefits programs – disability compensation, pensions, education, housing, vocational rehabilitation and employment, and life insurance. The 2005 budget includes $1.9 billion in funding to support the management of these programs. This funding level is $26 million, or 2.2 percent, above the level for 2004, and includes resources for about 12,200 full-time staff.

The proposed budget will enable VA to meet an increasing workload in processing claims for financial benefits, such as disability compensation. One of the key initiatives the president identified when he assumed office in 2001 was to improve the timeliness of claims processing.

Between 2001 and 2003, the average number of disability compensation claims completed per month grew from 40,000 to 68,000. Last year, the backlog of pending claims for compensation and pension peaked at 432,000. By the end of 2003, the department had reduced this inventory to just over 250,000, a drop of over 40 percent.

At the same time, VA has reduced the time a veteran waits for a decision on a claim. In 2002, it took an average of 223 days to process a claim. Today, it takes about 150 days.

"I am gratified with our recent success in improving disability claims processing, and we will continue to work to have the level of service delivery veterans deserve," Principi said. "We are on track to reach an average processing time of 100 days by the end of 2004 and expect to maintain this standard in 2005."

Among the programs supported by the budget are VA's "benefits delivery at discharge" operations at 136 military installations around the country. The department has assigned rating specialists and physicians to bases where servicemembers can have their claims processed before they leave active duty in the military. This initiative makes it more convenient for separating servicemembers to apply for and receive the benefits they have earned, and helps ensure claims are processed more rapidly.

The 2005 budget will continue to support outreach to separating servicemembers and their families through transition assistance workshops, now held at 176 military installations. Additional briefings will be held not only for separating and retiring active duty member, but also for Guard and reserve members. In 2003, more than 110,000 active duty personnel attended transition workshops and 86,000 people attended the briefings.

Meeting the Burial Needs of Veterans

The president’s 2005 budget, which requests $455 million for VA's burial program, sets in motion a multi-year expansion, the largest expansion of the nation's cemetery system for veterans since the Civil War. When completed, the expansion will increase the capacity of VA's national cemetery system by 85 percent.

Of the FY 2005 total, $181 million is for VA burial benefits and payments, and $274 million in discretionary funding for operating and capital costs for the National Cemetery Administration and the state cemetery grant program. The discretionary total is $9 million, or 3.4 percent, over the level for 2004.

"With the resources requested for the burial program, VA will be able to significantly expand access while continuing our progress toward maintaining national cemeteries as shrines," Principi said.

During 2005, five new national cemeteries will provide service in the areas of Atlanta, Detroit, Pittsburgh, Sacramento, Calif.; and south Florida. Collectively, these new cemeteries will offer a burial option to more than 1.7 million veterans. The number of veterans living within 75 miles of a national or state veterans cemetery will increase to 83 percent in 2005 with the opening of new national cemeteries and state veterans cemeteries. The figure was 73 percent in 2001.

The budget requests $81 million in construction funds for the burial program in 2005, including initial development of the new cemetery in the Sacramento area as well as expansion and improvements at the Florida National Cemetery (Bushnell, Fla.) and Rock Island National Cemetery in Illinois. Funds are also requested to initiate planning at six new national cemetery sites directed by Congress. These areas include: Philadelphia; Jacksonville, Fla.; Sarasota, Fla.; Birmingham Ala.; Columbia/Greenville, S.C; and Bakersfield, Calif. In addition, $32 million is requested for the state cemetery grant program.

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Management Improvements

One of the president’s management initiatives calls for VA and the Department of Defense (DoD) to enhance coordination of the delivery of benefits and services to veterans. VA and DoD have established a high-level Joint Executive Council to develop and implement collaborative efforts. The two departments are focusing on three major issues:

• facilitating electronic sharing of enrollment and eligibility information for services and benefits;

• establishing an electronic patient health record system that will allow rapid exchange of patient information between the two organizations by the end of 2005; and

• increasing the number of shared medical care facilities and staff.

VA has several initiatives underway that will lead to greater efficiency and will be accomplished largely through centralization of several major business processes. The department is realigning its finance, acquisition, and capital asset management functions into business offices across the department.

In addition, VA is establishing an Office of Business Oversight that will provide stronger oversight of these functions by the Chief Financial Officer, will improve operations through more specialization, and will achieve efficiencies in staffing. As a result of this realignment, VA will strengthen compliance and consistency with finance, acquisition, and capital asset policies and procedures.

The department continues to make excellent progress in implementing the recommendations of its Procurement Reform Task Force, with 43 of the 65 recommendations completed. These procurement reforms will optimize the performance of VA’s acquisition system and processes by improving efficiency and accountability. VA will realize savings of about $250 million by the end of 2004 as a result of these improvements, a figure that will rise after all 65 recommendations have been implemented.

During 2005, one of the department’s primary focuses in information technology will be cyber security. VA will provide continuous protection to VA systems and networks. This will require purchases of both hardware and software to address existing vulnerabilities.

"I am excited to join President Bush in presenting the 2005 budget," Principi said. "The resources requested in this budget will help ensure that VA continues to honor our nation’s obligation to the men and women who served this country in uniform."

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Enrollment Priority 1

Veterans with service-connected disabilities rated 50% or more disabling
Enrollment Priority 2

Veterans with service-connected disabilities rated 30% or 40% disabling
Enrollment Priority 3

Veterans who are former POWs
Veterans awarded the Purple Heart
Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty
Veterans with service-connected disabilities rated 10% or 20% disabling
Veterans awarded special eligibility classification under Title 38, U.S.C., Section 1151, "benefits for individuals disabled by treatment or vocational rehabilitation"
Enrollment Priority 4

Veterans who are receiving aid and attendance or housebound benefits
Veterans who have been determined by VA to be catastrophically disabled
Enrollment Priority 5

Nonservice-connected veterans and noncompensable service-connected veterans rated 0% disabled whose annual income and net worth are below the established VA Means Test thresholds
Veterans receiving VA pension benefits
Veterans eligible for Medicaid benefits
Enrollment Priority 6

World War I veterans
Mexican Border War veterans
Compensable 0% service-connected veterans
Veterans solely seeking care for disorders associated with:
exposure to herbicides while serving in Vietnam; or
exposure to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki; or
for disorders associated with service in the Gulf War;
for illness possibly related to participation in Project 112/SHAD; or
for any illness associated with service in combat in a war after the Gulf War or during a period of hostility after November 11, 1998
Enrollment Priority 7

Veterans who agree to pay specified copayments with income and/or net worth above the VA Means Test threshold and income below the HUD geographic index

Subpriority a: Noncompensable 0% service-connected veterans who were enrolled in the VA Health Care System on a specified date and who have remained enrolled since that date
Subpriority c: Nonservice-connected veterans who were enrolled in the VA Health Care System on a specified date and who have remained enrolled since that date
Subpriority e: Noncompensable 0% service-connected veterans not included in Subpriority a above
Subpriority g: Nonservice-connected veterans not included in Subpriority c above
Enrollment Priority 8

Veterans who agree to pay specified copayments with income and/or net worth above the VA Means Test threshold and the HUD geographic index

Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date
Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date
Subpriority e: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003
Subpriority g: Nonservice-connected veterans applying for enrollment after January 16, 2003Veterans with service-connected disabilities rated 50% or more
Additional Information:

The term service-connected means, with respect to a condition or disability, that VA has determined that the condition or disability was incurred in or aggravated by military service. Some veterans may have to agree to pay copayments to be placed in certain priority groups.

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The Veterans' Health Care Eligibility Reform Act of 1996
Public Law 104-262

The Veterans' Health Care Eligibility Reform Act of 1996 mandated VA to establish and implement a national enrollment system to manage the delivery of health care services. This legislation led the way for the creation of a Medical Benefits Package to provide a standard health plan to most enrolled veterans and to certain groups of veterans who do not need to enroll. Please see Enrollment Benefit Guide for more information.

The law mandated that the enrollment system be effective October 1, 1998. After that date, most veterans must be enrolled to receive care. Veterans may apply for enrollment at any time during the year. The following veterans do not need to enroll:

Veterans who need treatment for a VA-rated service-connected disability
Veterans who are VA-rated service-connected disabled 50% or more
Veterans who were released from active duty within the previous 12 months for a disability incurred or aggravated in the line of duty
The provisions within Public Law 104-262 include:

Eliminating the distinction between outpatient care and hospital care;
Permitting VA to provide health care services in the most clinically appropriate setting;
Giving VA the authority to furnish health promotion and disease prevention services, primary care; and
Allowing greater flexibility in applying state-of-the-art health care techniques and more efficient use of VA resources
Whether a veteran needs outpatient treatment, hospital care, or at-home medical services, VA is committed to providing the level of care required in the setting best suited to addressing their medical needs.

For addtional information, see Enrollment Page

For veteran inquiries call the toll free number 1-877-222-VETS
(1-877-222-8387)

[Sgted]

Thanks CAS3 for providing a wealth of information concerning the VA.
I know it's all out there but it's nice to see this info in one place.