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Disability Compensation Claims Process Shelly L. Peterson Assistant Veterans Service Center Manager Nashville Regional O

Disability Compensation Claims Process Shelly L. Peterson Assistant Veterans Service Center Manager Nashville Regional Office. Women Veterans- Statistics. There are 1.8 million Women Veterans, representing 8 percent of the U.S. Veteran population.

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Disability Compensation Claims Process Shelly L. Peterson Assistant Veterans Service Center Manager Nashville Regional O

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  1. Disability Compensation Claims Process Shelly L. Peterson Assistant Veterans Service Center Manager Nashville Regional Office

  2. Women Veterans- Statistics • There are 1.8 million Women Veterans, representing 8 percent of the U.S. Veteran population. • 12 percent of those who have served in the current overseas contingency operations are Women. • Over 250,000 Women Veterans are receiving compensation or pension benefits. • 15 percent of all awards of service-connection were to women. Source: Department of Veterans Affairs, VetPop07, and Defense Manpower and Data Center, unpublished data as of 30 September 2010. Compiled by the Women’s Research & Education Center

  3. VA Disability Compensation Purpose of Program Compensate Veterans for disabilities caused by injuries or diseases that happened while on active duty, or were made worse by active military service. Key Principals • Compensates for average impairment of earnings capacity • Disability evaluations are assigned at 10% increments from 0 to 100% levels of disability • Monetary amounts determined by Congress • Additional special evaluations (Special Monthly Compensation) are associated with higher levels of disability • No time limit for filing claims • Compensation payments are tax-free

  4. Requirements for Service Connection • Three requirements for a grant of service connection • An in-service event (incurred or aggravated), • A current condition, and • A medical nexus establishing a link

  5. Means of Service Connection • Direct • Aggravation • Secondary • Presumption

  6. Key Components of the Claims Process • Receipt of Claim – Receive and establish control of claim. • Development – VA has a statutory duty to notify a Veteran of the evidence needed to substantiate the claim and a duty to assist a claimant to gather evidence. This includes obtaining all supporting evidence, keeping claimant informed, and ordering VA examination, if necessary. • Decision – VA rater will review pertinent evidence to decide service connection, level of severity of disability, and other ancillary benefits. • Notification – Notify Veteran of the decision

  7. Claims Process Cycle Times (as of 4-23-12) Claim Received Process averages: 13.6 days (National) 7.5 days (Nashville RO) Claim Controlled Process averages: 212.4 days (National) 116.2 days (Nashville RO) Evidence Gathered Process averages: 72.5 days (National) 6.3 days (Nashville RO) Claim Decided Veteran Notified Process Decision and Notify Veteran: 19.8 days (National) 8.5 days (Nashville RO)

  8. VBA Statistics (as of 4-23-12) • National Pending Rating Workload – 865,781 • National Average Days Pending – 242.9 days, 141.0 days (Nashville RO) • Strategic Goal – 125 days • Nationally, 66.3% of inventory pending over 125 days.

  9. General VBA Assistance for Women Veterans • Rating Schedule provides disability compensation for service-connected gynecological and breast disorders • Additional Special Monthly Compensation for loss, or loss of use, of creative organ and loss of 25%, or more, of breast tissue • Benefits to children of Vietnam Veteran Women, based on herbicide exposure, for spina bifida and other birth defects • Every VA regional office has Woman Veterans Coordinator

  10. VBA Assistance for Combat Related Disabilities and PTSD Claims • No difference in VBA evaluation of female and male Veterans regarding combat related physical or mental disabilities • Women or men diagnosed with PTSD by VA psychiatrist or psychologist based on fear related to hostile military or terrorist activity can provide a lay statement to establish stressor, if consistent with places, types, and circumstances of service. • In 2008, more than 48,000 Women Veterans screened positive for MST. • There are over 4,700 Women Veterans service connected for sexual assault/harassment

  11. VBA Assistance for Non-combat PTSD Claims Based on Personal Assault or Military Sexual Trauma (MST) • When women claim PTSD based on personal assault or MST, VBA will develop for supporting evidence in military records and also from outside sources such as: • Law enforcement, counseling center, and hospital reports • Statements from family, friends, and clergy • Indications of behavior changes are sought such as: • Requests for unit transfer or deteriorating work performance • Substance abuse, depression, anxiety, or unexplained economic problems • If the available evidence is not sufficient, VBA will schedule an examination by a trained medical expert to provide an opinion regarding the credibility of the claimed assault or sexual trauma.

  12. Growth of Claims Key Factors • Hairy cell and other B-cell leukemias, Parkinson's disease, and ischemic heart disease presumptives for Vietnam Veterans • Improved and expanded outreach • Current Overseas Contingency Operations • Benefits Delivery at Discharge (BDD), Initial Disability Evaluation System (IDES) and Quick Start • Combat Related Special Compensation (CRSC) and Concurrent Disability Retired Pay (CDRP) • Aging of Veteran population • More Veterans on rolls results in more reopened disability claims

  13. Increasing Complexity of Workload • Multiple conditions claimed (especially with new claims) • Types of disabilities claimed – chronic progressive disabilities (e.g. diabetes, cardiovascular, TBI) • Progression of disabilities as Veterans age • Court decisions

  14. VBA Transformation- Goals By 2015: • Process all claims in less than 125 days • 98% quality • Eliminate Veteran homelessness

  15. VBA Transformation- Initiatives • Integrate claims process with electronic data and services (paperless claims-processing, eBenefits) • Increased focus on quality (inter-rater reliability studies, Quality Review Teams, Evaluation Builder) • Simplify notice requirements (Simplified Notification Letter) • Improved processes (Intake Processing Center, Segmented Lanes and Cross-Functional Teams) • Improved technology (Veterans Benefits Management System, rules-based applications, Unified Desktop) • VA/DoD Collaboration (pre-discharge claims, data transfer, seamless transition, Disability Evaluation System, etc.)

  16. Women Veterans CoordinatorNashville Regional OfficeDonna Pate6156-695-6141

  17. QUESTIONS?

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