It’s time to check in again.

This purpose of today’s blog entry is to help others considering the Notice of Disagreement (NOD) process with the Department of Veterans Affairs. I understand I am not formally employed to help others with this process, so there are some caveats to my guidance. Please keep this information in mind as you consider your options on how to proceed with this process.

Like other veterans, my disability claims process with the VA has not been an easy.

Also like other veterans, I’ve tried using the assistance from DAV (Disabled American Veterans) to build my case, and found–in both instances I’ve worked with DAV–their coordination did not offer any anything I could not do through my own efforts. This latter reality is why in submitting my NOD, I did not reach back to DAV to help me assemble the personal narrative I provided to have the VA.

The best thing to help me navigate this process with the VA was using the research skills I developed during my first graduate program. I went back to the VA’s own publications to see how staff members are informed about their jobs so I could understand how to make my case that the issues I’ve dealt with stem from the circumstances of my first tour in Iraq. Different types of publications are available at va.gov. Since my concern is about an entitlement to pay for my medical care routine I looked at Compensation & Pension Materials.

It is important to recognize when using a website as a tool, there are always moving parts so anything I share might not be the correct hyperlink moving forward. Instead, searching by general terms is likely to be useful to get the most direct route to the information you seek. 

I submitted my Notice of Disagreement back in November 2017, and the website now seems to package information differently from what I could recall from memory. What’s pretty great about what I found now is a section specific to the Adjudication Procedures manual available for review by year at VA Changes By Date. I think this data is important for anyone to peruse because it can be a substantial wait between when a claim is submitted and when the claims examinations occur.

In my case, particularly, the Notice of Disagreement was received by the VA on Nov. 15, 2017 and I received a letter dated August 1, 2018 informing me about the VA’s modernization efforts. The VA rolled out the Rapid Appeals Modernization Program (RAMP) and the letter was an invitation to voluntarily opt-in.

 

In theory, it sounded good but tidbits from the letter made me hesitant to pull my NOD from the queue it was in to the new one for RAMP such as the following information, verbatim from the letter:

“The new law does not take effect until February 2019 at the earliest.” 

And from the Fact Sheet provided with the letter was this not so little detail on “What It Means to Opt-In”:

“[Y]ou will have the ability to appeal to the Board if you determine that further review of VA’s decision is necessary. However, the Board will not process your appeal under the new streamlined process until no earlier than October 2018.”

Since it sounded like I could end up with a longer wait time by opting in to RAMP, I waited out the queue I started with, much like one might decide to stay in the checkout line one started with at the grocery store. It is what it is, and since there is no VA equivalent to the Domino’s Pizza Tracker (shown below for those who have never ordered Domino’s Pizza in the last few years or live in nations without Domino’s) I was largely in the dark about how things progressed.

It is important to note with a vets.gov account, you can “track” your claim but it is not robust in the fact you can see when your “order” was made and who made your “order” and things of that nature like you would with the Domino’s Pizza tracker.

Here’s what my account showed recently:

I am sharing this image to show the VA is taking steps to improve the process for veterans. This reality is good for all stakeholders involved, but it was truly a long wait.

• NOD was received by the VA on November 15, 2017
• Two claims examinations were set up June 13, 2019
  • Here’s a really important step. I was not stuck with a new claims examination appointment with the VA. I was contacted by a company called QTC Medical Services, Inc.
    • The goal was originally to set up my two claims appointments for the same day, which I could not manage with my work schedule.
• First claims appointment: June 21, 2019
• Second claims appointment: June 25, 2019
  • Here’s another important change to the process. I was reimbursed travel expenses and this was made evident to me prior to my appointments.
  • The rate of reimbursement  was 41.5 per mile.
    • My first appointment was only 9 miles from my home, but my second was 40 miles away.
  • I was given a questionnaire specific to each claims examination to complete beforehand and brought that documentation with me to my appointment, plus a copy of medical records that only became available to me after I mailed in my Notice of Disagreement.
• After my appointments, I waited.

The tracker I reviewed for my appeal did not provide any updates regarding when the claims examiners submitted their feedback for the decision review officer. Some days I would log into the website to see if anything changed, but each day it didn’t I grew more nervous this wait would feel like forever. The little bit of hope that this step in the process would be different came from the little “disclaimer” of sorts listed in the image at the top of this post and shared again for greater emphasis:

Not going to lie, I marked my calendar. I waited out July and I waited out August. I took the VA at face value. Considering that my documentation sat around from November 15,2017 to June 13th, 2019 and during that time I dreaded the VA lost my paperwork, I didn’t know to believe what was posted on the website.

I checked my vets.gov account probably every other day looking for follow up. I started to worry the 10-26 months listed as the average processing time posted to my vets.gov account meant it took the decision review officer 10-26 months to make his or her decision on top of the time the paperwork had already been sitting in a national queue. And then one day, it happened. I opened my account during a quick break and found this little–although not helpful–blurb.

I was then stuck waiting on snail mail.

Why the VA doesn’t also include a copy of the letter to the vets.gov account is beyond me, but at least now I had something to go on. I wasn’t going to spend almost two years waiting for more feedback. It was either September 19th or 20th I believe when the letter finally arrived.

The Statement of Case was 21 pages, the bulk of it being the laws, regulations, and rating schedule provisions. To avoid clogging up this blog entry, you can go to Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans’ Relief.  

Finally on page 19 of this packet was some information on what the VA found to be service connected and what was still denied followed by the VA’s reasons and bases for those decisions. The particulars of their decision are not as relevant as what I am about to say.

The decision I made to stopped seeking medical care while I was in the Marine Corps because it continued to be substandard in diagnosing my chest pains and the fact the first civilian doctor I saw in 2007 only put in notes about my visits without diagnosing their origin play a role in the VA not backdating my claim back to 2007 when I originally informed them of the problem. 

I am fortunate, though, unlike many people that I found a medical provider who built up my trust again in the medical community. I met her in 2012, but it wasn’t until 2015 when we started going over my chest pains and over time, she learned more of my background and presented options to me to manage the reality of my situation.

From what I’ve learned both in dealing with the VA and understanding now how much easier things are when you have transparency and the ear of a helpful nurse practitioner is you are important. There is nothing more important than attending to your health. Your job doesn’t matter and your other responsibilities don’t matter if your health is not attended to and you ignore the signs and symptoms that something is wrong.

I know I should have complained more when I was at BAS (battalion aid station) and asked for a second opinion. Or I could have received other opinions after my EKG’s and chest x-rays demonstrated it was not my heart or lungs. We could have continued exploring for the cause and found a solution years earlier than we did.

The other feedback I have for anyone exploring the Notice of Disagreement process with the VA is to not expect the final result to be the solution to your problem(s). 

The below listed compensation tables, copied directly from the VA’s website, show the significant variance in what the VA can pay for disability benefits for those found to have  a service-connected issue.

Individuals can have conditions that get worse or improve over time, so it should not come as a shock the VA can reevaluate someone’s disability rating.

I know this entry is a bit longer than most, but I think transparency is key. The process for the Notice of Disagreement must serve veterans, the Department of Veterans Affairs tasked with administrating the program, and the taxpayers that share in the burden. There is a significant amount of accountability needed with these benefits, just as any other program administration so I found it useful to scour the VA’s website for some data to show the scope of disability ratings, how they’ve changed over a few years, and what sort of breakdown there is by body system.

Just bear in mind as these numbers could give a false sense that an excessive number of people are leaving the military ‘broken’, the Department of Defense is the single largest employer in the United States and according to what I found at Governing in 2017 that meant 1.3 million active duty personnel and 800,000 from our reserve components. The numbers reflected here, instead, represent multiple eras of military service which should not be forgotten.