Monday, February 09, 2009

Restructuring the DVA: Part Two

News reports indicate Congress is being asked to fund an increase of 55,000 new employees for the DVA. Some will go to staff new Rural Health Centers and others will go into the Claims Process system.

We think that without a viable training program, this is merely throwing good money after bad. It grows government where it is not necessary, adding to the bureaucracy.

Instead, we believe a wholesale change in the training and personnel administration of employees of the DVA is what is called for.

Here is what we propose:

NVLSP Involvement
We would like to see the National Veterans Legal Services Program [NVLSP], an organization that already trains people in the DVA Claims system, in conjunction with input from the DVA and the various Veterans Service Organizations, develop a classroom training program for employees of the DVA and Veterans Service Officers from the Veterans Service Organizations [American Legion, VFW, AMVETS, DAV, Veterans of Modern Warfare, FRA, V V A, and so on.] This warrants a grant from Congress to fund the NVLSP's effort and a warrant from the same authorizing legislation that allows the NVLSP to be the final arbiter in any issues raised by either the DVA or the VSOs.

The NVLSP would also be responsible for training the training staff comprised of DVA Instructors, and Veterans Service Officers from the various Veterans Service Organizations. Trainers would be licensed and would participate in training classes as instructors in various regional locations across the Country. Expenses for the VSOs would be funded by their Veterans Service Organizations, but wages for training classes will be paid from the DVA Budget. The classes where trainers are trained will lead to Trainer's Licenses. The training of VSOs and DVA Claim Processors will result in Professional Licensure, required to serve in either capacity. Refresher training shall be required every five years in order to renew the license.

The Program
The training program puts the Veterans Service Officers into the same classrooms at the same time as the Claims Processing Personnel from the DVA are trained. That way, every claim processor, and every VSO is on the same page when handling claims. Further, some portion of each training class will be required by all administrative staff. The Secretary and the Undersecretaries and Assistant Secretaries should also be required to complete the same training course as the VSOs and the Claims processors in order that all shall know what is required of the Veterans to complete a valid claim for benefits. The medical staff personnel employed in any medical or administrative capacity shall be required to attend the classes so they may also see what the Veteran must go through before they even get to the Doctors and Nurses, and medical administrative staff. Finally, legal staff should also participate in the training program to see first hand the fruits of their labors. Finally, attorneys and paralegals that work with Veterans Claims and as Veterans Advocates may take the training also, and should be licensed as well. Their expenses incidental to the training should be at their own expense, including the cost of the training, as they earn money from what they do.

The Details
The course will be covered over a two week period, with classes lasting 6 hours each day, with a half our break at mid-morning and again at mid-afternoon, and an hour for lunch. The last hour of every day is spent in review exams, review and Q&A sessions. The classroom work ends at the end of a full day of review and preparation for the final exam on the second Tuesday. The final exam is on Friday. The Practical Exam, where test claims are filed by the instructors, to be processed by the students on Wednesday and Thursday.

Successful completion of the course is required for licensure. Failure will result in the individual waiting until a review course is available, a 7 day, shortened version with the last five days the same as the full course. A second failure will result in termination from the VSO program for VSOs, or from Claims Processing positions for DVA Claims processors. The DVA may provide alternate employment for those refused licensure, but at no time may that employee ever become a part of the claims process system at any level.

The Kelley Principle
The indomitable Charles Kelley of the website 2nd Battalion, 94th Artillery, is a strong and dedicated advocate for change in the DVA. He emphasizes, among other things, a standardization of ratings, and a common sense/logical approach to claims. If, he posits, a claimant has a head injury and the claim processor approves the claim for 50%, then identical cases of head injuries should automatically be approved for 50%, and after that, if any varations are warranted, a deeper examination of the claim may be in order. I like to call this system of establishing case precedents, the "Kelley Principle".

This, in its simplicity is a major key to reducing any backlog in claims processing. We have embraced his concept from the start, and see it applied here as part of the training.

We believe the claims process should go through a number of steps.

  • Step One: Examine the claim for eligibility based on military record and search for possible service connection.
  • Step Two: Validate Service Connection and select the portion of a claim liable to generate the highest rating. Apply the "Kelley Principle" to DVA System records of precedents and if applicable, assign a temporary rating and approve the claim, so payments begin and medical coverage is authorized in the shortest time possible.

  • Step Three: Examine and validate the claim for variations in the initial rating based on current examinations by DVA Medical Staff, adjust accordingly. Increase the rating of the claim based on other and/or secondary conditions as precedents warrant, again checking the DVA System for "Kelley Principle" precedents. Adjust the rating accordingly and approve or deny as the claim warrants.
  • All of the above subject to review by supervisory staff at each level. Each step is handled by an increasingly senior claim's processor.

    Advancement of these licensed personnel shall be based not just on seniority, but an acceptable level of claim reversals on appeal, or by supervisory personnel, and a satisfactory claim completion rate.

    It is highly recommended that all claim personnel be Veterans of the United States Military.

    Positive Results 2
    We think the adoption of this policy, should Congress embrace it, is a common sense no-brainer. It effectively addresses the regional variations in claim ratings and denials, and provides a clear structure to the claims process. It additionally places everyone in the claim process system except the Veteran into a standardized system that would provide the same results for identical claims at any Regional Office in the Country. It would simplify the claims process, and eliminate the backlog. It would be an efficient method of serving the Veterans of this Nation.

    VNVets

    ”It is a stain on this nation's honor that the Department of Veterans Affairs has become a deadlier and more difficult adversary to the American veteran than any they have ever faced on a battlefield."-- VNVets

    "The concept that Agent Orange, and its effects, stopped dead in its tracks at the shoreline is simply too illogical, and too ludicrous to accept. What does that say about the Bush Administration and his Department of Veterans Affairs?"--VNVets

    "With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan--to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations." --President Abraham Lincoln

    "It follows then as certain as that night succeeds the day, that without a decisive naval force we can do nothing definitive, and with it, everything honorable and glorious."--President George Washington

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    3 comments:

    1. Anonymous12:41

      Any money spent on the current VA system is wasted money. The VA systme does not work. All VA centers should be closed. VA reciepents should have a VA card just like medicare. The card would reflect level of care. Then this card should be used just like an insurance card. The VA beneficiary would get required medical and we can stop spending billions on VA care facilities being built right next to multimillion dollar civiliand hospitals.

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    2. Read the next one down, Time to Start Restructuring the DVA.

      You have the concept down very well.

      Where we differ is in whether to completely scrap the DVA and start over, or attempt to re-make it into the agency it needs to become to fulfill the role that is mandated for them.

      The main thing is to change the mindset of the employees, including the managers and top level appointees. They have long since lost their way.

      Training is the first step.

      VNVets

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    3. I agree,the entire DVA is corrupt.I also believe it is beyond repair and would love nothing more than to see the system sold to the private sector.Buildings,property and all.
      Each time I am forced to seek medical treatment I count my blessings that I am no longer in the "box" called the VA.I have watched good men get butchered and suffer early deaths because they can not afford better health care.
      Veterans deserve the best help available to them,for without them we would have none.There are many gifted people doing all they can to help veterans in any way they can but their hands are tied.
      I suspect a make over will be almost as difficult as procuring an adequate amount of D Con to rid us of our current rodent infestation.
      God luck and God Bless!

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