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The Battle for Benefits

news1johnbillVeterans wait years for compensation benefits due to backlogged claims at the VA

Josh Shanks, a 62-year-old Vietnam War veteran from Soquel, filed his disability compensation claim with the Veterans Affairs office five years ago. After two years without word on his claim's status, Shanks was informed that his paperwork had been lost.

Shanks' story is similar to that of thousands of veterans across the country, many of whose claims—which, until recently, have been filed on paper—were pending due to unprecedented backlogs in 2010, causing them to wait years on their compensation benefits.

The gridlock has been the result of several simultaneous factors: an expansion on benefits for veterans living with ailments caused by Agent Orange and variations of Post Traumatic Stress Disorder (PTSD); the return of many younger veterans from the recent conflicts in the Middle East; and a huge population of aging Baby Boomer-era Vietnam veterans who are beginning to require new degrees of medical and financial support.

In response to the widespread demand by veterans for more effective processing on their claims and faster turn-arounds, the VA has taken initiatives to reform their claims processing system, including a prioritization on the oldest claims, implementing mandatory overtime for processors at regional offices, an ongoing conversion of their filing system from paper to electronic, and outsourcing claims for processing to states where VA offices are the least impacted.

Shanks, who re-filed with the Santa Cruz County Veterans Service Office (VSO) last year, where he says he received topnotch support from local advocates, had his claim approved last week. The granted monthly pension will help pay for his kids to go to college, he says.

According to the VA, in March, more than 611,000 claims—about 70 percent of the total—had been pending more than 125 days. Following an initiative in April to expedite claims decisions for veterans who have a waited a year or longer, the VA announced on June 20 that more than 65,000 claims—or 97 percent of all claims over two years old in the inventory—had been eliminated from the backlog.

According to the VA, the benefits department processed approximately one million claims per fiscal year in 2010, 2011 and 2012, yet the number of claims received continues to exceed the number processed.

The VA has established a goal to eliminate the backlog, which has been characterized as claims that have been pending for more than 125 days, by the end of 2015.

From July 1 to Dec. 31 2012, a total of 236 new claims were filed through the Santa Cruz County Veterans Services Office, according to J.P. Tremblay, the deputy secretary for communications and legislation at the California Department of Veterans Affairs.

In those same six months, 217 claims were processed and adjudicated, but, Tremblay says, it is more than likely that many of those claims were filed anytime from six months to several years prior to July of last year and contributed to the backlog.

The sum total in pension benefits awarded for those locally filed claims was $3.1 million.

Dean Kaufman, an independent veterans advocate contracted by the county, says that the distribution of claims throughout the nation's regional offices, which began in January, has helped considerably to speed up the process and reduce the backlog.

“It used to be that all of the claims coming through here were filed in Oakland,” he says. “Now I've been seeing claims come out of Montana, Colorado, Nebraska. It means they're going to be decided more rapidly.”

In rare instances, claims have taken as little as a few days, while others have taken 35 years, he says. “Processing times are all over the map,” he explains. 

Kaufman says that waiting a year for a claim to be processed is a reasonable expectation. But for some, longer waits can mean serious impacts on their lives.

On Wednesday morning, July 10, Kaufman met with a homeless veteran whose claim was 900 days old.

“That's not reasonable,” he says.

“It can be frustrating,” he continues. “There are veterans who have a preconceived notion that it's going to get done in three months, and it's hard to break the news that it might take considerably longer.”

The claims process has many variables, Kaufman says.                        

Veterans are coming up against a legal system—the VA is assessing factors like how strong a claim case is and how much proof a veteran has that their condition is related to their military service.

For this reason, he says, attaining assistance from advocates is crucial.

Shanks, for example, says he could not have accomplished the claims process without the help of his advocates from the county.

“Without these advocates, [access to the VA] would be so diluted,” Shanks says. “There would be no bridge. Veterans would be grounded.”

Tremblay says attempting to file a claim without help from an advocate is “like trying to represent yourself in court.”

Santa Cruz County VSO Chris Lopez, an Iraq War veteran, says that the claims process is complicated, but that the future is looking brighter.

Veterans come to the VSO on Emeline Street and organize their claim information with the help of the advocacy staff. The VSO then sends the file up to the regional office where they (eventually) will be processed.

“It's like having all the pieces to a puzzle,” says Lopez. “And it's a very complex puzzle. You're taking someone's life, their history, everything about them, and assembling this puzzle, then sending it up [to Oakland] where they're making sure it all fits.”

Lopez says the switch to electronic will help immensely to streamline the claims process by 2014.

Another factor contributing to the backlog is the number of vets who are coming forward with claims after years of feeling that they have not needed any assistance.

Kaufman calls this “the honeymoon period.”

“Everything is great for six months, maybe a year, maybe more,” he says. “But then problems often set in, like unemployment, family issues, substance abuse, depression. It's down the road a bit. So they don't file with the military right away.”

Just like Shanks, Bill Manich, a Vietnam veteran and director of the Twenty-First Century Vet advocacy group, stationed at the Emeline Street Veterans Center, says he waited 40 years to file his claim. When he finally did, in 2008, it hit the backlog.

Of California's approximate two million veterans, Manich says about half are Baby Boomers in their late 50s and 60s. That age demographic of veterans—Vietnam War guys—are entering a time in their lives where they are starting to have increased medical issues.

Simultaneously, he says, many of those same older veterans have had dormant service-related problems triggered by things like economic hardship, losing jobs, loss of spouses, and confronting old age.

John Ramirez, a veterans representative for Twenty-First Century Vet, says the majority of the veterans whose claims are buried in the backlog are the older ones who are filing for the first time, decades after their service.

Manich believes most of those new claims are psychological, primarily PTSD, and that the condition is “far more prevalent than the government was aware of.”

While the backlog can appear daunting and make filing claims seem hopeless, Ramirez believes that it is always worth starting the process.

He points to a Vietnam Veteran who had become homeless and was living on the streets of Santa Cruz. About two years ago, this vet experienced a life-changing event.

A decade earlier, the man had filed his pension claim with VSO Lorena Vazquez, who works with Ramirez, but the veteran did not follow through with the application forms, Ramirez says.

Vazquez, who, as the man's veteran advocate, had power of attorney over his VA benefits, located the paperwork required to authorize his pension. The pension, which had gone untouched for about 10 years, had accumulated to approximately $170,000 in arrears.

Vazquez searched for the man and, upon locating him, helped him set up a bank account and finance management assistance. He has since cleaned up his life and purchased a small house in Corralitos.

“Even though these claims can get backlogged or misplaced for years, there can be a happy ending,” Ramirez says. “This [claim pension] changed this man's life.”

Kaufman says the most important thing is that veterans take the initiative to get the ball rolling.

“They need to know is that it's not hopeless,” he says. “There is a backlog, and it's going to be bad for some time, but [the VA] is starting to improve the way that they handle claims. It's getting better.”


Photo caption: Bill Manich (left) and John Ramirez (right) are the director and a veterans representative, respectively, for Twenty-First Century Vet, which is headquartered at the Emeline Center in Santa Cruz.

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