KARK Investigation: Left to Linger? The Veterans Benefits Claim Process

He sits in his living room, flipping through pictures. They show a 21-year-old in the middle of nowhere, dressed in military fatigues with another soldier who looks like he should be wearing a cap and gown instead of a helmet.

"This is me and my driver," he said looking down at the photo. "We were really just kids."

Nearly 50 years ago, Joe Joslin found himself overseas fighting an enemy from a military tank. While his time in Vietnam is firmly placed in the past, the effects on everyday life in the here and now are always there.

"I've managed to lose my right leg up to mid thigh, " Joslin said, maneuvering the joystick on his automated wheelchair.

Diabetes, linked to exposure to Agent Orange during his time in the jungles of Vietnam, cost him his limb. Within the next few years, it's likely to take his left leg as well.

Left to Linger? Stuck in the Claims Cycle

He's been battling the veterans' benefit claims process for a normal life for nearly a year now. In March 2011, he applied for aid and assistance, in addition to a grant to purchase a van that can be equipped to carry his wheelchair.

"Without somebody to help, I am homebound," he said. "I applied for the grant because I'd like to be able to get in the car and run whatever errands I need, whether that's going to the grocery store, a city council meeting, or the senior center."

As it stands right now, Joslin's wife is forced to load and unload both him and his hefty wheelchair wherever they go.

"If we want to go somewhere, she has to load the wheelchair into the back of our pickup. Then, when we get to where we're going, like a restaurant, she has to unload the wheelchair, get me into the wheelchair, and then we head inside. Coming back out, it's the same process all over again," Joslin said. "Frankly, that's a lot of work and stress not to mention no independence for me at all."

Even being a year into the process, Joslin's gotten no decision. He's expecting it soon, but that's been the case for the last four months.

"Somebody that isn't prone to depression can get depressed trying to deal with the frustration of dealing with the system, " he said, describing his morale this far in the process. " About five months into this process, I went to talk to the VFW and the American Legion. They said, 'Hey, you know, your claim is still young don't get in a hurry. Be prepared to wait a year or better."

He began to wonder why that's the case. There are frustrations he's experienced that he believes explains the delays. After being ordered to have an exam for his claim, he was schedule for an appointment in August (five months after filing the claim). He had the exam done and believed his claim was well on its way, being a straightforward claim related to his service-connected disability.

That wasn't the case.

"It took them from August to sometime around Christmas to send me a letter to tell me I needed another CNP exam," he said. "Because somebody had failed to do a form. Yeah. the form didn't get done. Sometime, I assume, in November or December somebody looked and realized we don't have this form. So, we have to come in to have another exam."

That delayed his claims process for another month to get the exam completed. It's those types of delays Joslin believes is causing a major backlog in the system.

"This country is capable of drafting you, putting you in boot camp, teaching you to kill someone, and then putting you in a war zone within six months. So, why can't they process a claim that fast? "'

Hello, Is Anybody There?

And aside from the frustrations of trying to schedule medical appointments required for your claim, Joslin said there's no way to get in  touch with decision makers to find out what's the hold up on having your claim processed.

"Communicating with the VA regional office, actually talking to someone, the service center is as good as it gets," he said. "Unless you're really persistent  the customer service reps at call centers are who you get to talk to. I spent two and a half hours one day on the phone to track down the Service Center Director's phone number and the phone number to the VA's Director Office."

But he said even with those phone numbers, getting to talk to the person who was actually working on his claim never occurred. It's left him without answers, except that his claim is being processed and is in the decision phase.
 
"Talking to them is virtually impossible, they don't want to talk to you. I'm sure they are busy and they think they are busy," Joslin said "But maybe a five minute conversation would save somebody a lot of time. It's that simple."

According to Joslin, when he has checked into call centers and service centers, representatives aren't able to provide pertinent information beyond what they see on a screen.

"That's been one of the frustrating things. They have a service center and you can go down there.The guys in there will bring you in and I guess. They are as helpful as they can be, but they punch up your Social Security number or your file number, and they can tell you what's on the computer but that's all they can tell you, that you're claim is pending, it's in the investigation phase, or it's in the decision phase."

And asking questions rarely results in answers, he said.

"There's no one to talk to you. You can't get in touch with the people who have your paperwork. You can't ask follow up questions with them."

Denied Claims: Long Road Ahead

Once a decision does come down the pipe, it's possible a veteran's claim could be denied. If that's the case, it could be a long road ahead, according to Arkansas Department of Veterans Affairs Service Officer Dave McCown.

"Things take a lot more time now than they did when I started five years ago.It's just a fact of life," McCown said of both the claims and appeals process.

McCown, a Vietnam Veteran himself, serves as a guide for veterans trying to navigate the confusing and often-times convoluted benefits process from the start of filing a claim to finishing an appeal.

"It's not an easy thing to do anymore, put in a claim or put in an appeal. You've got a long time to go through it," McCown said. "For a lot of veterans it can be an intimidating process, either because they get sidetracked by the language or they're sometimes overwhelmed by the sheer talking to the federal government and dealing with the bureaucracy. Hopefully, we're able to offer them a more homespun, down to earth approach to get them started."

According to McCown, the appeals process is really where his office can come in handy.

"If they're denied, we help them win on appeal. And that's where the real fun is, in appeals because you get to use your imagination and use the VA's own decision against them in many cases," he said. "While it's not an adversarial relationship between us, the veteran, and the VA, necessarily, the VA is naturally trying to make its decision be the right one."

Six Years and Still Waiting

Viola Jones has been in the appeals process since her husband died six years ago.

"My husband died on September 27, 2006, and I filed by claim on October fourth," she said. "I"m going on six years and still fighting."

The story Jones tells is a tragic one. In 2006, her husband Jeffrey had been experiencing chronic, debilitating migraines and depression associated with the constant pain. The VA had rated his migraines as 30% service related to exposure to Agent Orange when he served as a medic in Vietnam.

In early September, Jeffrey Jones overdosed on pain medication at his home in Evening Shade. He was transported to Little Rock for treatment, because Viola wanted him to be attended to by physicians at the VA who had prescribed the medications and had been responsible for his treatment. However, the VA hospital declined to treat him, citing a lack of bed space.

"They wouldn't treat him that day. They wouldn't take him. They'd given him all those medications but wouldn't take him into the hospital, telling me they didn't have a bed right now," Viola said. "So, they sent him to a rehabilitation program geared for drug abuse."

Jeffrey remained there for 21 days. Viola was not allowed to see him for the duration of his treatment. At the same time, she had her own doctor appointments to make to follow up on a diagnosis of Lou Gehrig's disease. Her husband was discharged and taken home by the rehabilitation program without her knowledge on a day when she was actually in Little Rock for a round of doctor's appointments.

"They put him in a van and hauled him two and a half hours to Evening Shade, knowing that not a soul was there to greet him. He arrived to a dark house with not a soul there, still suffering from depression," Viola said. "When I found out I was hysterical. I called the police to go and check on him. When they got in the house, they found him but he'd already used a pistol on himself."

Within 24 hours of being home, Jeffrey had committed suicide. And when Viola tried to file her claim for survivor's benefits, she was denied. She said the VBA told her his cause of death was a gunshot and not a service-connected condition.

"Well, you read all of these papers here and it says services connected. The disease, his migraines were linked to Agent Orange and the constant pain caused him to be depressed," Viola said. "No matter how many years they treated him for this disease, that's what they're going by."

Viola's sought the help of the American Legion, Veterans of Foreign Wars, her senators and representatives. All to no avail.

"It has nearly drove me crazy. If it wasn't for my good Lord above and my trust and faith, if it wasn't for that, I would have already done what he did and joined him," she said.

"I've prayed, begged, cried to the president, to the representatives, the governor. No lawyer will touch it."

Viola isn't sure how or if she will ever win, but she plans to keep fighting.

"This is for my husband. He did his time, he served his country. The VA shouldn't be able to withhold those benefits. So I will keep fighting until my breath is gone."

The VA's Explanation

Claims in our region are handled by the VA's regional office in Little Rock, where the Veterans Benefits Administration processes claims for benefits for disability, compensation, and family survivors.

According to Director Cheryl Rawls, the claims process is rigorous and completely individualized. She said that makes it difficult to generalize on what the process is like for each veteran.

"One of the things we have to do is to ensure the veteran is entitled to the benefits. So, we do take an extensive look at the documentation that's being provided to ensure that entitlement is there. Once we have done that, we look forward to going through our rules and regulations that relate to the different body systems. And then we're able to complete that actual claim for that veteran or family member. So, it is a very indulging process, depending upon what the veteran or the family member is bringing to us as the start of the claim."

When KARK asked Rawls about the amount of time, that average 6 months to a year Joslin was told he would have to wait, Rawls told us that is an average, but an important qualifier should come along with that.

"That is an average. We of course do have the ability to take care of our most needy veterans quite quickly, and we do have veterans who are in special categories that we try to take care of them quickly," she said. "Then we have veterans who will  fit that normal claim process, and sometimes it does take up to 6 months."

In Arkansas there are about 8,000 claims in inventory. Of those, Rawls said about 40 percent are backlogged, meaning they've taken longer than 125 days to complete.

Department of Veterans Affairs Secretary Eric Shinseki has set a goal for all veterans claims to be processed within 125 days by 2015. The Little Rock regional VA has a ways to go, with the average claim taking 204 days, or about seven months to complete at this point.

"Here at the regional office we are averaging an amount of time that's close to that six months average," Rawls said. "It's continuing to become evident that we have to look at how we are processing our claims to keep up with everything coming in the door."

Some ways the VA is aiming to do that is by using technology to make processing claims, and filing information more readily available online through its eBenefits program, an online filing system that has topped 100 million users so far.

But that still doesn't address the amount of time it takes to actually have the claim make it from online to the decision makers, and back to the veteran.

In January, the VA released its current claim numbers to Congress, showing that nearly 900,000 claims were pending in the process across the country. That's up by 100,000 from last year, and it's an increase of nearly 500,000 from three years ago.

Back in 2000, the Government Accountability Office highlighted inefficiencies in the claims process system. Since that time, strides have been made to improve the process, and according to Rawls those efforts continue.

"We don't have a system with zero defects in it, but we strive to ensure we can meet every veterans needs," she said. "We absolutely recognize the amount of time it takes at this point is too long, that's why we have to 125 goal in place. But our staff are diligent in handling these cases, and they're dedicated to the mission."

But many both inside and outside the VA system suggest that it is overloaded with cases and understaffed. Despite completing 1 million claims last year, 1.3 million new claims were filed with VA, which keeps it just treading water. But a question of if the VA Little Rock Regional Office is sufficiently staffed for its caseload in the Natural State was something Rawls didn't want to answer directly.

"I would tell you that we have been approved with the number of employees that are here in Arkansas to handle the work we have on board, and everyone in the country continues to work toward completing that mission," Rawls said.

When KARK revised the question, asking if the regional office could benefit from an expanded staff to handle the number of claims coming in, Rawls said, "The number of employees that we have they are well-trained and working through that mission. we are working through it "

The VA system has talked of expanding its staff, training new claims processors. However, that training takes about two years to complete. At the VA Regional Office in Little Rock, additions aren't being made to the staff. Instead, people who currently work there are being cross-trained to handle claims.

" Actually our regional office has done some internal moves, where we have increased the number of decision makers from the number of employees we already had on hand," Rawls said. " What that does for us is to give us the flexibility to point different employees to do various tasks. We've been very fortunate to have a staff that's willing to be trained on different activities."

According to Rawls, there are ways to ensure the process goes more quickly on the front end.

*Veterans should make sure all forms, medical records, and documents are included in their initial claim filing.

*If they are in active duty, but within 180 days of discharge, they can participate in Benefits Delivery at Discharge, which allows them to file their claim while still in active duty.

"That allows us to review the claim, process the claim, and make a decision while that service member is still on active duty," Rawls said. "That allows us to greatly reduce the processing time. On the day of discharge, the claim should be decided within a month of that discharge date."

Rawls also encourages veterans to file their claims as close to their time of service as possible, which makes it easier for the VBA to gather service records, medical records, and other pertinent information.

However, with more veterans from the Vietnam, Korean, and Gulf Wars getting older and needing assistance it's not always practical to expect all of their claims will come directly after discharge. Many new claims are filed as conditions worsen, new symptoms develop, etc.

If you are about to start out in the claims process and don't know where to begin, are stuck in the middle of the claims process and need an advocate on your side, or if you have been denied a claim and need someone to work with you during the appeals process, click here for a list of resources for Veterans that can be helpful in the process.