Battling the VA

Long delays, inconsistent rulings and incompetent advocates mean injured veterans sometimes die waiting to obtain disability payments.

(March 6, 2005 - DRY RIDGE, Ky.) — Alfred Brown died waiting. He was a 19-year-old soldier fighting in Italy when shrapnel from an enemy shell ripped into his abdomen in 1945. His wounds were so severe that he was given last rites. When Brown came home, the government that had promised to care for its wounded veterans shorted him instead.

Not until 1981, however, did Brown realize that his monthly disability payment was less than he should have received. He launched what would become a 21-year battle.

"As a member of the so-called 'Greatest Generation,' I am well aware of the large numbers of us passing away," he wrote the nation's chief veterans judge in 2001. "I am prepared to meet our Creator. My fear is that your court will not make a decision in my case."

Brown was right. He died a year later, and his case died with him. Closing the books on the case, Judge Kenneth Kramer acknowledged the court likely would have ruled in his favor.

Brown is one of tens of thousands of veterans who have had to fight their own government to win disability payments.

A Knight Ridder investigation has found that injured soldiers who petition the Veterans Affairs Department for those payments often are doomed by lengthy delays, hurt by inconsistent rulings and failed by the veterans' representatives who try to help them.

The investigation was based on interviews with veterans and their families from around the country and on a review of internal VA documents and computerized databases. Many documents were made available only after Knight Ridder sued the agency in federal court.

A HUGE AGENCY

The VA is a mammoth agency that serves 25 million veterans with a far-flung health care system and a separate disability and pension operation. The agency spends more than $60 billion a year, more than $20 billion of it on disability compensation.

But the Knight Ridder investigation found that the VA serves neither taxpayers nor veterans well. Some veterans never get what they're due, while antiquated regulations mean that others are paid for disabilities that have little effect on their ability to hold jobs or aren't related to military service.

The investigation identified three points where cases often go wrong: the selection of a special representative, called a veterans service officer; the review by a regional VA office; and the filing of an appeal.

Among the findings:

• Many of the VA-accredited experts who help veterans with their cases receive minimal training and are rarely tested to ensure their competence. These veterans service officers work for nonprofit organizations such as the American Legion, as well as states and counties, but their quality is uneven, and that often means the difference between a successful claim and a botched one.

• The VA's network of 57 regional offices produces wildly inconsistent results, which means that a veteran in St. Paul is likely to receive different treatment and more generous disability checks than one from Detroit.

• Veterans face lengthy delays if they appeal the VA's decisions. The average wait is nearly three years, and many veterans wait 10 years for a final ruling. In the past decade, several thousand veterans died before their cases were resolved.

"How a veteran seeking benefits gets treated should not be an accident of geography," said George Basher, the director of the New York State Division of Veterans' Affairs, one of 50 state agencies that help veterans. "Unfortunately, the current system makes that a virtual certainty."

In interviews late last year, then-VA Secretary Anthony Principi and other VA officials admitted to many shortcomings, but said things had improved since the Bush administration took over. "This agency was underwater in 2001," Principi said. "My people have made tremendous progress."

The current secretary, R. James Nicholson, who was sworn in recently, had no comment.

There have been some improvements in the past three years. However, when it comes to delays, cases that need to be redone and backlogs, Knight Ridder found, things are the same or worse than they were in the 1990s, when the agency vowed to clean up its act.

For the family of Kentucky veteran Alfred Brown, that decade brought nothing but frustration. If a decision had come before he died, Brown could have collected nearly 45 years of back pay, his attorney said. Based on VA payment rates, that would have been worth about $30,000.

"It wasn't so much the money," said his son Clayton Brown, on a day when he visited his father's grave north of Lexington. "He felt he was robbed. He almost gave his life up, and this is what he was getting in return?"

INJURIES RATED

VA workers are reminded daily of the pledge by Abraham Lincoln " … to care for him who shall have borne the battle, and for his widow and his orphan. …"

But the task isn't as simple as it used to be.

The VA makes disability payments for injuries as obvious as an amputated leg and as complex as post-traumatic stress disorder. They include combat wounds and peacetime injuries, since veterans are serving their country whether they're in a Humvee in Iraq or in boot camp. Veterans are given ratings from zero to 100 depending on how severe their disabilities are. Payments ranging from $108 to $2,299 a month are supposed to reflect lost earnings potential.

But, according to the Government Accountability Office, the disability payments are based on 60-year-old labor market assumptions. So veterans who have desk jobs in today's economy can draw checks based on the fact their disabilities would keep them from good manufacturing jobs.

The system stems from a time when war injuries often were less complex. Today's soldier faces mental illnesses unacknowledged two generations ago, as well as wounds that often were fatal in earlier wars.

Beyond that are tough fiscal realities. While most payments can be linked directly to service, veterans also can qualify merely if they're diagnosed soon after their discharge. In all, the VA pays nearly $1 billion a year for disabilities that the GAO says generally aren't directly linked to veterans' service in the military.

HELPERS' EXPERTISE VARIES

Applying for disability benefits requires veterans to navigate a labyrinth of bureaucratic rules and unforgiving deadlines. It can require the skill of an investigator and the knowledge of a physician.

That's why national veterans groups have for decades provided free help. About 40 veterans service organizations, such as the American Legion and Disabled American Veterans, are authorized to handle VA claims, as are many state veterans agencies.

But Knight Ridder found that the network of VA-accredited service officers is a patchwork of well-meaning helpers whose training and expertise vary widely. Contrary to its own regulations, the VA does little to ensure that veterans receive competent representation from veterans service organizations. Yet the agency prohibits vets from hiring their own attorneys until after their claims have been denied, in effect adding years to the appeals process.

Two-thirds of veterans who submit claims are assisted by service officers. Picking the right one can determine whether they get the full payment they're due, a fraction of it or nothing.

"The best advocates can be very good, and lousy ones can be awful," said Ron Abrams, the joint executive director of the National Veterans Legal Services Program, which trains service officers.

For example, the Washington State Department of Veterans Affairs has tracked the outcome of every claim filed by veterans groups that receive state funding since July 2003. The groups' success rates range from 53 percent to 81 percent. Among the busiest individual service officers, those handling 30 or more decided claims, the success rates can range from 35 percent to 98 percent, the state's data show.

The VA, through its national accreditation program, is supposed to ensure that all service officers are responsible and qualified. In fact, the VA does little more than rubber-stamp names submitted by veterans groups. About 11,000 service officers are on the VA's roster — about 80 percent of whom are accredited through nonprofit groups.

VA regulatory files reveal the agency has done little in decades to determine the adequacy of the training provided or check the quality of the claims. Only rarely does the VA suspend or revoke a service officer's accreditation. When it does happen, it's generally the result of criminal charges rather than incompetence.

"What we do is take it on the word of the service organization that the individual has had sufficient training," said Martin Sendek of the VA's general counsel's office.

That training, however, varies widely, according to a Knight Ridder survey of 13 of the largest veterans groups and all 50 state veterans departments.

At one end of the spectrum is Disabled American Veterans, which has full-time paid national service officers and a 16-month training and testing program that's so regimented it qualifies for 10 hours of college credit.

Then there are groups such as American Ex-Prisoners of War and Catholic War Veterans that rely largely on part-time volunteers who aren't required to complete any courses or pass any tests.

"We don't get paid, so we're not going to be that strict with these people," said Doris Jenks, the training director for American Ex-Prisoners of War.

Nonprofits generally have less stringent requirements for service officers than those working for the 33 state veterans agencies that responded to the survey.

Just 62 percent of nonprofits and 73 percent of the state agencies require continuing education for all service officers, something experts consider crucial given the VA's constantly changing rules.

Only 38 percent of nonprofits and 67 percent of states require a test before recommending that the VA accredit a representative. And once accredited, few service officers are ever tested to ensure their competence: While 27 percent of the states require later testing, only one nonprofit, Disabled American Veterans, had that requirement.

NO RECOURSE

VA officials bristled at suggestions that their oversight of accredited service officers is lax and said they are unaware of any systemic problems. Retired Vice Adm. Daniel Cooper, the VA's undersecretary for benefits, said the VA corrects any mistakes that service officers might make. If anything needs to be done to make an application complete, Cooper said, "we do it."

General counsel Tim McClain noted that veterans have extensive appeal rights. "There are a lot of checks and balances in the system," he said.

The U.S. Court of Appeals for Veterans Claims, however, repeatedly has ruled that veterans are out of luck when they've been steered wrong by VA-accredited service officers.

Ask Gerry Corwin.

As the navigator aboard a B-24 bomber during World War II, Corwin survived more than 30 missions over Japanese-controlled waters. He came home to Minneapolis with two Air Medals — and disabling nightmares and flashbacks.

There were images of his buddies burning in planes and of a friend killed on a mission that Corwin persuaded him to take. By December 1984, those nightmares began to overtake the TV executive.

Corwin applied for disability benefits and was denied, in part because the VA couldn't find many of his military records, which had burned in a 1973 fire at a national archive in St. Louis.

So Corwin went to the Minnesota Department of Veterans Affairs and enlisted the help of Kirk Jones, a service officer who had become VA-accredited a year earlier through the state and the American Legion.

Jones submitted a three-sentence letter on Corwin's behalf and didn't take any steps to prove Corwin's claim. He didn't, for example, push for a psychiatric examination from the VA. He didn't round up statements from Corwin's crew to corroborate that they had been sent home in May 1945 for "combat fatigue."

"I should have suggested a VA examination," Jones, who no longer is a service officer, said recently. He acknowledged that he had minimal training when he first handled Corwin's claim.

That 1984 claim went nowhere.

In 1995, Jones, who by then had gained extensive experience plus classroom training, restarted Corwin's claim. He did all the things he hadn't done a decade earlier and more.

This time, Jones helped Corwin win compensation for post-traumatic stress disorder and a heart problem. Jones filed several appeals, and each time the VA granted more benefits, eventually declaring Corwin totally disabled in 1998.

Even so, the veterans court ruled last summer that Corwin can't collect back pay from 1984 through 1995 because the proper documents weren't filed in 1986 to keep his original claim alive.

Corwin's loss is tens of thousands of dollars, he and his lawyer estimate.

"It would mean a home. Let's start with that," said Corwin, 82, who with his wife, Katherine, has been living in a house her family owns in rural Mississippi.

"To have to come back and to fight 20 years to get what you're supposed to be given, and to fight your own government for it, is disappointing," he said.

ERRORS IN 13 PERCENT

Even when a service officer does a good job, veterans' claims often get bogged down in the VA's 57 regional offices, where veterans' claims are processed.

Nationwide, errors are made in 13 percent of claims, more than three times the agency's hoped-for rate of 4 percent, according to a VA quality-control database that reviews a sample of the decisions. That translates to 103,000 errors a year; in many cases they can result in either an overpayment or an underpayment of benefits.

"I don't think anybody is proud of the fact that we have" a 13 percent error rate, said Michael Walcoff, who oversees the agency's regional offices. Errors often trigger appeals, sending thousands of veterans into an ongoing cycle of mistakes, appeals and rehearings.

The percentage of claims that are approved ranges from 89 percent in St. Paul to less than 70 percent in Jackson, Miss., and Cheyenne, Wyo., according to an annual VA survey of veterans.

Perhaps not surprisingly, "satisfaction" among veterans is highest in St. Paul, at 73 percent, compared with 50 percent in Atlanta.

REGIONS VARY

Knight Ridder found that disability ratings, which determine the size of a veteran's monthly check, also vary widely.

An analysis of 3.4 million veterans claims shows that major mental ailments, such as post-traumatic stress disorder and schizophrenia, are subject to bigger regional swings than major physical ailments such as bad backs and knees. For example, veterans with PTSD assigned to the Wilmington, Del., office are more likely to have the highest disability rating than their counterparts in Lincoln, Neb. In Delaware, 34 percent of those with PTSD have the highest rating; in Lincoln, it's 10 percent.

Because major psychiatric disabilities on average pay more than the major physical ones, the wider swings have a dramatic impact on payments. The different ratings may help explain a puzzle noticed by veterans every time the VA releases its annual report: Average disability checks vary by state. The VA wouldn't comment on Knight Ridder's analysis but said in a statement that it is investigating regional differences, which it attributed to "extremely complex" factors.

The GAO last year reported that the VA "cannot provide reasonable assurance that similarly situated veterans who submit claims for the same impairment to different regional offices receive reasonably consistent decisions."

APPEALS A MINEFIELD

The final minefield is the VA appeals system.

It's a problem the VA recognizes. "It takes too long. We all agree on that,'' said Ron Garvin, acting chairman of the Board of Veterans' Appeals.

With the average disability payment now $7,860 a year, back-benefit awards can be substantial. An award is calculated as though the VA made the right decision when the claim was first filed. Some veterans with severe disabilities win $100,000 or more.

But if a veteran dies with his or her case under appeal, the case dies, too. In the past decade, more than 13,700 veterans died while their cases were in some stage of the appeals process, according to a Knight Ridder analysis of a VA appeals records database. (While precise estimates aren't available, the VA said experience suggests a few thousand of them wouldn't have actively pursued their appeals.)

Even if a veteran wins a case but dies before receiving payment, his family is often out of luck. Unless the veteran had an eligible spouse or dependent child, the money stays in the U.S. Treasury.

In an October interview, then-Secretary Principi said he was "stung" when he learned a few years ago how common it is for veterans to die with their cases in limbo. While some deaths are inevitable, given the VA's elderly clientele, "it's not acceptable," he said.

He also suggested that a recently formed commission on benefits could reconsider the legal barriers that prevent heirs other than a wife or dependent child from receiving a deceased veteran's back benefits.

The VA has admitted its processes are too slow and too prone to errors. But the agency has repeatedly ignored recommendations to eliminate redundant steps. One exhaustive review in 1996 declared the entire claims-and-appeals process "cumbersome and outmoded" and in need of an overhaul.

Since then, "I wouldn't say that we have changed the system in any major way," said the agency's Walcoff. In fact, VA data show that delays and the percentage of cases being sent back for rehearing are basically unchanged since the agency vowed to reduce them.

ONE CLAIM

In the mid-1990s, about the time it promised to speed things up, the VA also denied Berlie Bowman's claim.

Bowman, an outgoing kid following in his father's military footsteps, had gone to Vietnam in 1967. "When he was drafted, he went without a fuss," said his sister Paulette. "He was a different person when he came back."

He was skittish, quick to anger, uneasy in crowds. The family trod warily around him — "learned to wake him from a distance by touching his feet with something," his VA file said. Over three decades, he ran through 30 jobs; he lived in a small trailer on a curvy North Carolina road.

His first disability claim, in 1971 for "nerves," was denied. His second try, in 1995, met a similar fate.

That time, though, Bowman pushed back.

Working with an attorney, he assembled evidence to show that he had post-traumatic stress disorder and to document that it had started in Vietnam.

The case received six different rulings, until Bowman fell ill with pancreatic cancer. On June 16, 2004, the Board of Veterans' Appeals finally agreed with Bowman's claim.

It declared that "credible supporting evidence" showed that Bowman suffered from post-traumatic stress disorder caused by his time in Vietnam, just as Bowman had contended for nine years.

Bowman's attorney immediately pestered the VA for Bowman's back benefits, dating to 1995. By then, Bowman's cancer treatment had been stopped.

On June 21, attorney Dan Krasnegor or his assistant talked with the VA every two hours. On June 22, they were told that the official disability rating was complete and that only final signatures were needed before Bowman's check for $53,784 could be cut.

Berlie Bowman died that night, and his claim died with him. No check was sent.

The VA serves 25 million veterans with a far-flung health care system and a separate disability and pension operation. The agency spends more than $60 billion a year, over $20 billion of it on disability compensation.

Source: Knight Ridder News Service

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