Phantom Blooper
06-26-05, 04:10 AM
June 24, 2005
The VA is like any other government agency. When there's good news, there's a press release. When there's bad news, there's silence.
Illinois veterans have claimed for years that they weren't receiving benefits at the same level as veterans from other states. They were right. The IG took a look at this and agreed. However, the attitude at the VA was that Illinois vets weren't necessarily getting less, but that maybe vets in other states were getting too much. Also, the Veterans' Disability Benefits Commission has indicated that too many veterans are getting individual unemployability benefits.
These differences of opinion needed some balance. So, in keeping with the bad news dictum, on June 14 the VA instituted the Second Signature Required policy with absolute silence.
Now, if a veteran files a claim for PTSD, any 100 percent disability evaluation, or total disability rating based on individual unemployability (IU), and that claim is granted, there must be a second evaluation and a second signature. A second signature is NOT required if the claim is denied. Then the veteran has to re-file the claim, a process that will take months and sometimes years. The policy was implemented by Daniel L. Cooper, VA Under Secretary for Benefits. (Download complete policy memo here.)
This new VA policy came to light on June 19 in an article in the Chicago Sun-Times written by Cheryl L. Reed. A second article indicates the VA is taking another look at this policy. Not exactly.
I spoke with Scott Hogenson, Deputy Assistant Secretary for Public Affairs at the VA. Hogenson tells me the Second Signature Policy remains in effect but it is being “clarified” for the benefit of the VA Regional Offices.
Hogenson defends the Second Signature Policy stating that it ensures “the equitable treatment of all veterans.” He claims that less than 0.8 per cent of all veterans currently receiving compensation fall into the three categories included in the new policy.
Hogenson had no figures on the number of claims being filed in the three stipulated categories or what the percentage of total claims filed they might represent. But, a VA Regional Office supervisor told me the percentage is quite high and takes up a good deal of their claims analysis time.
When asked about the possibility of further delays in granting a claim, Hogenson said the policy will stipulate a review and second signature within 48 hours. How this could be accomplished when VA Regional Offices are notoriously understaffed was not explained.
It looks like the VA has implemented a “no is no” and “yes is maybe” policy when it comes to dealing with claims for PTSD, 100 percent disability or IU. The VA's assumption, based on the IG report, is that mistakes were being made in granting benefits in these three areas. But, weren't mistakes being made in NOT granting benefits in these areas? It appears the VA is saying that their “no” is absolutely accurate but their “yes” needs a second look.
The DAV says it feels that errors in denying claims are as frequent, if not higher, than errors made in approving claims.
I questioned Hogenson about the fairness of this “no is no” attitude. He said, “This is NOT heavily nuanced. This is black and white. When ‘there is no there there' there is no claim.” The quote from Gertrude Stein aside, the VA's new Second Signature Required policy is open to abuse that could cost veterans dearly.
The most obvious area for abuse in this Second Signature Required process is built right into the policy itself. The second evaluation for a “yes” must be made by a person of equal or higher pay grade at the Regional Office. In reality, we can be sure this decision will be made by someone of higher grade and in a supervisory position.
It is entirely possible to believe the following scenario. The claims processor, after having the claim sit in the “in” basket for six months, reviews all the data in the claim and signs off on an approval. This approved claim now goes to a supervisor for the required second signature. The supervisor doesn't see it quite the way the claims processor did.
If the supervisor denies the claim, according to regulations, the “benefit of the doubt” must go to the veteran and the claim would be approved. But what if the supervisor didn't actually deny the claim?
It is possible that the supervisor, feeling pressure from above to deny the claim, might take the claim back to the original claims processor and ask for a second review. The claims processor, feeling intra-office political pressure and knowing that promotion or job security might be at stake, gets the message and denies the claim.
Now it is simply a denied claim. There would be no second signature because the claim was denied. There, most likely, would be no record of any of involvement of a “second opinion” at the supervisory level in the claims process, just the signature of the claims processor denying the claim.
Unfortunately, veterans have come to expect the worst when it comes to the claims process. The process is too long, plus the Regional Offices are understaffed and overworked. The VA's new Second Signature Required policy will only add to the perception that veterans are not getting a fair shake. It is open to abuse of the worst kind.
The VA should scrap the Second Signature Required policy, recognizing it as the fatally flawed program it is. If a “yes” requires a second opinion, so does a “no.”
The VA is like any other government agency. When there's good news, there's a press release. When there's bad news, there's silence.
Illinois veterans have claimed for years that they weren't receiving benefits at the same level as veterans from other states. They were right. The IG took a look at this and agreed. However, the attitude at the VA was that Illinois vets weren't necessarily getting less, but that maybe vets in other states were getting too much. Also, the Veterans' Disability Benefits Commission has indicated that too many veterans are getting individual unemployability benefits.
These differences of opinion needed some balance. So, in keeping with the bad news dictum, on June 14 the VA instituted the Second Signature Required policy with absolute silence.
Now, if a veteran files a claim for PTSD, any 100 percent disability evaluation, or total disability rating based on individual unemployability (IU), and that claim is granted, there must be a second evaluation and a second signature. A second signature is NOT required if the claim is denied. Then the veteran has to re-file the claim, a process that will take months and sometimes years. The policy was implemented by Daniel L. Cooper, VA Under Secretary for Benefits. (Download complete policy memo here.)
This new VA policy came to light on June 19 in an article in the Chicago Sun-Times written by Cheryl L. Reed. A second article indicates the VA is taking another look at this policy. Not exactly.
I spoke with Scott Hogenson, Deputy Assistant Secretary for Public Affairs at the VA. Hogenson tells me the Second Signature Policy remains in effect but it is being “clarified” for the benefit of the VA Regional Offices.
Hogenson defends the Second Signature Policy stating that it ensures “the equitable treatment of all veterans.” He claims that less than 0.8 per cent of all veterans currently receiving compensation fall into the three categories included in the new policy.
Hogenson had no figures on the number of claims being filed in the three stipulated categories or what the percentage of total claims filed they might represent. But, a VA Regional Office supervisor told me the percentage is quite high and takes up a good deal of their claims analysis time.
When asked about the possibility of further delays in granting a claim, Hogenson said the policy will stipulate a review and second signature within 48 hours. How this could be accomplished when VA Regional Offices are notoriously understaffed was not explained.
It looks like the VA has implemented a “no is no” and “yes is maybe” policy when it comes to dealing with claims for PTSD, 100 percent disability or IU. The VA's assumption, based on the IG report, is that mistakes were being made in granting benefits in these three areas. But, weren't mistakes being made in NOT granting benefits in these areas? It appears the VA is saying that their “no” is absolutely accurate but their “yes” needs a second look.
The DAV says it feels that errors in denying claims are as frequent, if not higher, than errors made in approving claims.
I questioned Hogenson about the fairness of this “no is no” attitude. He said, “This is NOT heavily nuanced. This is black and white. When ‘there is no there there' there is no claim.” The quote from Gertrude Stein aside, the VA's new Second Signature Required policy is open to abuse that could cost veterans dearly.
The most obvious area for abuse in this Second Signature Required process is built right into the policy itself. The second evaluation for a “yes” must be made by a person of equal or higher pay grade at the Regional Office. In reality, we can be sure this decision will be made by someone of higher grade and in a supervisory position.
It is entirely possible to believe the following scenario. The claims processor, after having the claim sit in the “in” basket for six months, reviews all the data in the claim and signs off on an approval. This approved claim now goes to a supervisor for the required second signature. The supervisor doesn't see it quite the way the claims processor did.
If the supervisor denies the claim, according to regulations, the “benefit of the doubt” must go to the veteran and the claim would be approved. But what if the supervisor didn't actually deny the claim?
It is possible that the supervisor, feeling pressure from above to deny the claim, might take the claim back to the original claims processor and ask for a second review. The claims processor, feeling intra-office political pressure and knowing that promotion or job security might be at stake, gets the message and denies the claim.
Now it is simply a denied claim. There would be no second signature because the claim was denied. There, most likely, would be no record of any of involvement of a “second opinion” at the supervisory level in the claims process, just the signature of the claims processor denying the claim.
Unfortunately, veterans have come to expect the worst when it comes to the claims process. The process is too long, plus the Regional Offices are understaffed and overworked. The VA's new Second Signature Required policy will only add to the perception that veterans are not getting a fair shake. It is open to abuse of the worst kind.
The VA should scrap the Second Signature Required policy, recognizing it as the fatally flawed program it is. If a “yes” requires a second opinion, so does a “no.”