Understanding the VA Claims Process

By Suzette Price, former MI DVSO, now Director of Veterans Services for the Department of Ohio American Legion

This article appeared in the Michigan Legionnaire September Issue 2012 page 10

Greetings Legionnaires, from the 12th floor of the federal building in Detroit,  The American Legion Department of Michigan Veterans Service Office.  For the past 16 months I have had the honor and privilege of working with the best veteran’s service organization in the nation and serving many of you.  During those 16 months I have learned many things about the claims process and as I take phone calls from veterans I understand the frustration many feel from the long wait times for their claim.  Our commitment is to service those claim as best and expediently as possible.

In May of 2011 I was trained that the claims process was anywhere from six to nine months long. Today, the claims process is 18 to 24 months long. The claims being filed has severely increased and the hiring of VA employees has failed to parallel with the growth in claims, thus resulting in a serious backlog.  Please understand if you file a claim today it might take up to 2 years to receive a decision from the VA.

The DVSO’s here at the regional office unfortunately have to work within the same time frame as the Department of Veterans Affairs in order to get things done respectively. The VA is not capable of conforming to the American Legion standards of claims processing which means we have to meet the VA more than halfway the majority of the time.

Three phases to a filed claim

There are three phases to a filed claim, (1) Development (2) Rating (3) Authorization. The development phase can take anywhere from 6 months to a year or more. This phase is where VA gathers and develops the medical evidence, service medical and administrative records, and schedules the C & P examinations.  The more evidence the veterans and the VSO provide the VA the less time it takes.   The claim will not move to ratings unless all of this data is collected and the veteran signs off on the VCAA notice, or one year from the date the claim was filed if the veteran is unreachable.

When the claim is finished with development it may still take 30-90 days or longer to be assigned a rater.  This is because they are busy rating other claims and the VA waits until a rater becomes available to assign the claim. The rater then assigns a percentage for the disability.

Lastly is the authorization phase. This is the shortest process and usually takes one to two weeks for completion.  This prompts the rating decision and award letter to be generated to the veteran and the claim then goes to finance if an award payment is necessary.  Being proactive on your claim and acquiring all the evidence suggested by the service officer or county and VA will help your case.  If you wait for VA to tell you what they need you should probably understand that your claim will sit on a shelf and not get touched for 60 day increments at a time or until evidence arrives.

Another solution, and quite frankly a must, is to be clear, concise, and patient with the people who are helping you.  I love my job and work very hard to bring you the greatest amount of benefits one deserves. Please remember that our job as DVSO’s includes a variety of functions other than claims processing. We perform legal research to help various claims, counsel veterans with employment issues, homelessness issues, and try to answer as many phone calls as we can in an 8 hour period. DVSO’s represent veterans claims in appeals to judges and VA employees at the regional office in Detroit and assist National for an claims being appealed in Washington D.C.  Lest we forget the currently serving military who need our assistance while still serving.  We attend training and giving training to be more knowledgeable officers and exchange ideas on improving the process.  Please, be patient with us because you are our purpose and the reason we do all that we do.  If I have not said this to you while speaking to you on the phone or in person, THANK YOU for your service, WELCOME HOME and please continue to support the your veteran service organization.

 

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