VA on Modernizing the Disability Claims Process

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When a Veteran files a clam for VA benefits, there are several administrative actions needed before a decision can be made, such as gathering medical records and military service records. VA is automating many of these administrative tasks, allowing claims processors to focus on more complex and analytical duties. These improvements result in reduced processing times and faster decisions on claims to Veterans and their families. Automation and claims processing Automated Decision Support (ADS) helps automate administrative tasks related to claims processing. ADS helps claims processors make fast, accurate and consistent decisions for Veterans by reducing the amount of time spent on administrative tasks. ADS also provides a summary document of key information required for decision-making, making it easier for decision makers to review records. Making a decision regarding VA disability claims can be complex, and ADS does not replace the need for claims processors to review and make decisions. Instead, ADS is a tool that assists claims processors with administrative tasks to help in the decision-making process. How automation is being used today ADS is currently used for specific medical conditions as the technology is being developed. If a claim includes a condition that ADS can assist with, the claim will be reviewed using ADS. Relevant medical data from a variety of sources, including medical treatment records, military service treatment records, VA claim exams and electronic VA medical center health records will be compiled, and a summary document about the condition is uploaded into the Veteran’s electronic claims folder. Technology is also used to scan handwritten documents and transcribe them into electronic records so they can be easily reviewed. Once all the information is gathered, it is sent to a claims processor for further review and action. Looking ahead As with any new technology, testing is critical to make sure systems are functional and efficient. For this reason, VA initially designated one benefits office to serve as the prototype processing site. As ADS technology evolves, it will be rolled out to more benefits offices. Currently, there are more than 40 disability conditions ADS can assist with, and this technology is being used by 16 benefits offices. Modernizing the disability claims process is all about reducing decision wait times and getting decisions to Veterans and families in days, rather than months. Using technology to automate administrative areas of the claims process—while maintaining the human decision-making element—is just one of the ways VA is working to better serve Veterans and their families. Topics in this story Disability Claim In this article Leave a comment The comments section is for opinions and feedback on this particular article; this is not a customer support channel. If you are looking for assistance, please visit Ask VA or call 1-800-698-2411. Please, never put personally identifiable information ( SSAN , address, phone number, etc.) or protected health information into the form — it will be deleted for your protection. 30 Comments Frank Busby September 13, 2023 at 17:36 What are the 40 disabilities used with ADS? Ellsworth Earl La Fleur September 7, 2023 at 13:31 I am a 30 year Navy Chief . I do not have a miltary disabilty, however I am disabiled with nerve damage. I’m having a hard time figuring out my benifits. Can you help me? Thank you Robert Garcia September 10, 2023 at 08:55 Chief, it would help if you contacted a veterans service officer in your local area and point you in the right direction. David Steppe Sr September 6, 2023 at 10:16 Wish It really benefit us all I have conditions that were service connected and I am still fighting the VA to prove my point. Patrick F Bryan September 5, 2023 at 10:09 This is just a joke and seems does not apply to all VA ROs, DROC’s, nationwide!!! This is only a partial implantation still causing harm to us that have been waiting 10 or more years for final decisions on appeals, not remand after remand after remand!!! Kenneth R Berry Sr August 31, 2023 at 21:12 Wounded Combat Vets; Wounded in Cambodia and Laos during VietNam action, Need daily unit reports and medical records. Falsified records, may hinder this access. Being wounded in these territories may have hindered access to records for decisions on claims. TBI, AGENT orange, affects of combat were not even recognized in old days. Hand written records, diificult to interpret, also prevents information. Inaccurate medical records and treatments by VA. Robert Garcia September 10, 2023 at 09:03 You are so right about record keeping in yesteryear, if I had not kept an old set of flight orders placing me in country, I would have been screwed! Between those orders, my flight and medical records I was able to put together a timeline for my AO claims. Marsha Powell August 31, 2023 at 08:25 My father died from a medical error at a VA Medical Center in July 1998. I have never been able to file a 95-claim after he died because his DD-214, name, and social security number disappeared from the VA database a month after he died. I’m still awaiting his DD-214 from the National Archives twenty-five years later. This does not happen to everyone but it happened to my family. I can not even prove my father served in the Navy during the Korean War. Shame on you Veterans Affairs for the way many Veteran are treated after serving their country. Patrick F Bryan August 29, 2023 at 21:31 Just more false statements by the VA to mislead us. They fiest have to train people to even do their jobs, ans put a stop to ongoing delays with claims and appeals and rulings!!! Ken K August 27, 2023 at 11:05 I have a 100% rating for compensation. After the PACT act exam, I ended up having to have sinus surgery. After surgery I put claim in for a presumptive rating. Presumptive rating came back after 8 months at a 0% rating and claims processor asking me what I am looking for out of this claim. Also, I have to have another exam by another sinus doctor for VA compensation claim. What was the PACT exam for? My question to him, am I covered for follow-up care with Community care, and will VA take care of cost? Ronald Audas August 25, 2023 at 21:28 This comment falls under disability claims.Why can’t we get Travel Pay expedited? This is money out of Veterans pockets. Precious August 25, 2023 at 18:45 This is ridiculous my claim was denied for my aneurysm because it was not in my service medical record even the aneurysm was on the exact side I get my migraines on that are service connected and why would a 9.9 cm aneurysm be in my service record the person who did my exam didn’t call me it was suppose to be virtual and I looked up his credentials he was 78 years old Oworinawe Daniel August 25, 2023 at 14:45 Thanks I was asecurity guard in Iraq ihave aproblem of breathing wat can I do? Robert Garcia September 10, 2023 at 09:09 Better file a claim ASAP! The pact act deadline to file is 9/30/2023.Get your dd214 and find a veterans service officer in your area to guide you through the process. Good luck! Steve August 25, 2023 at 00:27 So far. QTC has scheduled 3 C&P exams, 90 miles away, 120 miles away and 106 miles away… Their phone system has has technical issues for weeks with extended wait times . Like 1/2 hour. They call my home on weekends. The person on the phone has such a heavy dialect that it’s hard for me with hearing issue to understand her and the caption phone can keep up or caption the conversation for that reason and when they talk so fast it can’t keep up. The C&P exam is for audiology and they have no clue what that must mean ! The California office. A gal from Tex. was nice and understanding, She canceled the appointment 106 miles away. My car is 23 years old. I’m 69 and not in good health. it’s 107 degrees here now. I’d die if my car broke down trying to travel 106 miles Xs 2 = 212 miles. It’s like they don’t want to help but what to make it difficult!. There is plenty of cities closer including the largest city in the state that’s closer than the one they made the appointment at. How is that helping? David Duclo August 24, 2023 at 23:10 I was 80% I applied to none higher able 100% took the ptsd test again and supposed to take the hearing and rt arm again but did not take them all I seen gathering nothing else just like to hear something Jenny Bayer August 24, 2023 at 15:38 Should have named the VA locations where this new technology is available.More importantly, should have named the 40+ VA Disabilities for which this new technology can be utilized. Kenneth R Berry Sr August 31, 2023 at 21:19 Agreed, locations using new tech should be listed. C. Ecal September 4, 2023 at 09:53 I didn’t get compensation from the VA, I got disabilities granted but for treatment purposes only. I got more than one enlistment and I acquired my disabilities on my first enlistment as a gulf war veteran. I am homeless and no income veteran. Imagine how how hard my situation now without income. I can’t find a job because of my mental illness. Hope this message will brought to VA’s attention. Rafael Martinez August 24, 2023 at 15:15 How come I have a claim at the Board of Appeal since 2020 waiting for judge to be assigned to review my claim. Could somebody explain. Scott J Drew August 24, 2023 at 14:51 I hope that this new technology helps speed up the claims filing and review process! Currently I am locked in a paperwork duel with the VA over my PACT Act claim for Agent Orange exposure during my two and a half years in the Viet Nam War. They are asking that I PROVE that I had hypertension PRIOR to taking medications, which I have been taking for OVER THIRTY YEARS!! Doctors, by federal regulation are only required to maintain records for TEN YEARS. I will not go off of my meds for fear of stroke, and that probably wouldn’t meet their needs anyway. So like many other Viet Nam Veterans that I talk to, my disability caused by Agent Orange exposure will be ignored by the VA. Shameful. Scott J Drew Viet Nam Oct 1964-Apr 1967 Veteran August 24, 2023 at 17:19 This should be categorized as a presumptive condition, they should be give you a rating as long as you they know you served in Vietnam they can send you on a C&P exam. Robert Garcia September 10, 2023 at 09:18 Go to the CFR38 and find the criteria and ratings for hypertension. If you have heart issues associated with HPT it would help if you got a diagnoses from a cardiologist .This is what I had to do to get 10%SC! Elizabeth Taylor August 24, 2023 at 13:47 The whole system meets overhauled. The Regional office personnel need to be informed on changes and VA OIG updates and policies. Such as the 55yr old rule. I went to the Regional office in my city. I was told that the 55yr old rule did not exist. Upon pulling up the information on VA.gov ebenefits website and sharing it with the Regional office person. Who was thankful that I came in and shared the info. I’m 62 rated at 70%. The 55yr old rule. Is that 55 and older disabled veterans are not to be sent for REVIEWS. charlie Adajar August 24, 2023 at 11:00 I have my disability claim filed for almost a year now and still waiting for the result. my claim has been rejected twice and re submitted claim for the 3rd times. Douglas Robb August 24, 2023 at 08:47 The entire process needs to be revised. If a veteran develops medical problems after service in the military, the default should be that the military service caused those problems. The VA should have to prove that the military service did NOT cause those conditions. Ted Allen Parks August 23, 2023 at 22:56 Automation is good; however, training in the rules of evidence and the legal burden of proof as outlined in federal law is more important. I have been fighting an initial denial of disability for 9 years, mostly because claims processors systematically violate federal law pertaining to these two topics, probably because they have no training in those areas. My claim has been sitting for 3 1/2 years on the docket waiting for a veteran law judge to review it. The VA has, but cannot legally, required a higher burden of proof for my claim, and probably countless others, than what federal law has clearly established. The backlog of appeals is VA’s own fault because they wrongfully deny so many claims based on lack of understanding of the law. david eyer August 23, 2023 at 20:03 I’m currently in the “Evidence Gathering, Review and Decision” stage on my recent claim and days instead of months would be a huge step forward! Robert Garcia September 10, 2023 at 09:23 Sorry, it just doesn’t work that way! you need a nexus and a current diagnosis to move the ball forward. Good luck. Robert Garcia September 10, 2023 at 09:24 Same boat,7 months and counting! Comments are closed. More Stories Ready to secure your loved ones’ tomorrow with VA’s life insurance programs? It's Life Insurance Awareness Month. VA's life insurance options, from VALife to SGLI and VGLI, can protect your family's financial future for years to come. Fraud Alert: Watch out for phishing scams Fraudsters use phishing emails, texts, calls, and QR codes to target Veterans' benefits and personal information. Know the signs and protect yourself. Veterans can use their VA-guaranteed home loan benefit more than once You can use your VA-guaranteed home loan benefit more than once. Many Veterans and surviving spouses think it’s a one-time benefit, but it isn’t. We’re here anytime, day or night - 24/7 If you are a Veteran in crisis or concerned about one, connect with our caring, qualified responders for confidential help. Many of them are Veterans themselves. Call 988 and press 1 Text to 838255 Chat confidentially now Call TTY if you have hearing loss 1-800-799-4889 Get more resources at VeteransCrisisLine.net . 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