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This article from last month talks about the increase in VA disability claims and the potential for increased fraud:
http://online.wsj.com/articles/va-disability-claims-soar [login to see]
This isn't necessarily new, but lingering problems from deployments, current operations, and the increase in veterans leaving the service certainly makes the volume of claims higher and fraud along with it. Particularly troubling is the VA's effort to process veterans as soon as possible and how that can lead to marginal and fraudulent cases being awarded disability.
During my senior year of college, I experienced regular back pain after an extended period of relatively strenuous ROTC training the previous year. I eventually brought it up to one of my instructors and I'll never forget the exchange that followed:
Me: Are injuries that we sustain during ROTC covered by the Army or anything?
Instructor: No, not until you commission. Why, what's up?
Me: My back has been killing me since [whenever]. It started after [that painful training thing we did], sucked all throughout LDAC, and hasn't stopped in the few months since I got back.
Instructor: Hmmm...are you sure you didn't hurt your back during your next deployment?
What do you think? Have you had any experiences like this, or known someone who has made a false claim to get disability payments?
http://online.wsj.com/articles/va-disability-claims-soar [login to see]
This isn't necessarily new, but lingering problems from deployments, current operations, and the increase in veterans leaving the service certainly makes the volume of claims higher and fraud along with it. Particularly troubling is the VA's effort to process veterans as soon as possible and how that can lead to marginal and fraudulent cases being awarded disability.
During my senior year of college, I experienced regular back pain after an extended period of relatively strenuous ROTC training the previous year. I eventually brought it up to one of my instructors and I'll never forget the exchange that followed:
Me: Are injuries that we sustain during ROTC covered by the Army or anything?
Instructor: No, not until you commission. Why, what's up?
Me: My back has been killing me since [whenever]. It started after [that painful training thing we did], sucked all throughout LDAC, and hasn't stopped in the few months since I got back.
Instructor: Hmmm...are you sure you didn't hurt your back during your next deployment?
What do you think? Have you had any experiences like this, or known someone who has made a false claim to get disability payments?
Disability
Benefits
VA Claim
Fraud
Posted 10 y ago
Responses: 15
11
11
0
First of all - there's fraud. Period. It exists.
With that said - let's clear the air about some misconceptions. The VA benefits sections, the one that deals with VA benefit claims is not the same as the military's MEB system. The methodology is different and the metrics are different. The military's MEB system is used to determine if you can continue to be a fully functional and productive member of the military. This is how SM's get a zero percent rating from the MEB and discharged. I hear it constantly - people tell me they can't apply to the VA because the already have a zero percent disability from the Army/Navy/Marines/Air Force. When I am finally able to talk them into going through the process with the VA claim - well, lo and behold, they have a 10% or a 40% or a 50% disability rating from just what their military records say at first glance. HOLY Mackerel Batshite!
VA's disability rating is not the same as Social Security or the military's MEB - don't make the mistake of thinking that someone on 20% VA disability is shamming. The VA's rating only means that the evidence provided and confirmed by the Compensation and Pension exams says there are at least one and possibly two injuries that occured in the military and are still having a negative effect on the claimant at the time of the rating award. That could be as simple as a hand injury while on AD or training that was seen by the unit medic, treated and the SM was returned to duty with appropriate annotations on the SM's medical file - but now, 5 years, 10 years or 20 years later, after the SM is out of the service and there are lingering issues on that hand today. Maybe the unit medic sent you to get an x-ray and the x-ray tech forwarded the x-rays for evaluation BUT the evaluation by the expert didn't get back to the unit medic until months or years later. Turns out, the SM suffered a series of broken bones - albeit small "green-tree" fractures and though the SM kept coming back to the medic for pain (and the SM earned the title of "sick-bay commando" in the process) for which the medic issued what? oh yeah....MOTRIN and told the SM to get back in the field. Trust me, it happens all the time. By the time the evalutation is forwarded back to the unit, the breaks have fully healed - and no further action is needed. But 20 years later, the bones are again causing pain - evaluation and x-rays reveal issues that might range from total inability to use the hand to mild arthritis. VA evaluations sez: there was an injury in the military and now there are continuing issues - the issue is attachable to military service as the probably original cause, ergo the claimant can be issued a 10% disability rating (*****warning! There way too many possibilities to take into account - this is only a possible example *****). Sure the money isn't a lot, but any care on that hand for anything related to the broken bones, etc is now the full responsibility of the VA healthcare system - and it's all at the expense of the VA.
So, now a friend of the claimant, who served with them - but only knows the part where the claimant was called the "sickbay commando" for his hand pain - but NOW sees and hears the claimant saying they got a disability from the VA for their hand and who is proud as a rooster for actually getting anything from the VA. So now the friend is thinking FRAUD!
Is every situation like this? - nah. But there are enough situations similar to this to suggest a caution - yes there may be fraud involved. A disability rating by the VA does NOT automatically mean someone cannot have a full time job and work hard.
With that said - let's clear the air about some misconceptions. The VA benefits sections, the one that deals with VA benefit claims is not the same as the military's MEB system. The methodology is different and the metrics are different. The military's MEB system is used to determine if you can continue to be a fully functional and productive member of the military. This is how SM's get a zero percent rating from the MEB and discharged. I hear it constantly - people tell me they can't apply to the VA because the already have a zero percent disability from the Army/Navy/Marines/Air Force. When I am finally able to talk them into going through the process with the VA claim - well, lo and behold, they have a 10% or a 40% or a 50% disability rating from just what their military records say at first glance. HOLY Mackerel Batshite!
VA's disability rating is not the same as Social Security or the military's MEB - don't make the mistake of thinking that someone on 20% VA disability is shamming. The VA's rating only means that the evidence provided and confirmed by the Compensation and Pension exams says there are at least one and possibly two injuries that occured in the military and are still having a negative effect on the claimant at the time of the rating award. That could be as simple as a hand injury while on AD or training that was seen by the unit medic, treated and the SM was returned to duty with appropriate annotations on the SM's medical file - but now, 5 years, 10 years or 20 years later, after the SM is out of the service and there are lingering issues on that hand today. Maybe the unit medic sent you to get an x-ray and the x-ray tech forwarded the x-rays for evaluation BUT the evaluation by the expert didn't get back to the unit medic until months or years later. Turns out, the SM suffered a series of broken bones - albeit small "green-tree" fractures and though the SM kept coming back to the medic for pain (and the SM earned the title of "sick-bay commando" in the process) for which the medic issued what? oh yeah....MOTRIN and told the SM to get back in the field. Trust me, it happens all the time. By the time the evalutation is forwarded back to the unit, the breaks have fully healed - and no further action is needed. But 20 years later, the bones are again causing pain - evaluation and x-rays reveal issues that might range from total inability to use the hand to mild arthritis. VA evaluations sez: there was an injury in the military and now there are continuing issues - the issue is attachable to military service as the probably original cause, ergo the claimant can be issued a 10% disability rating (*****warning! There way too many possibilities to take into account - this is only a possible example *****). Sure the money isn't a lot, but any care on that hand for anything related to the broken bones, etc is now the full responsibility of the VA healthcare system - and it's all at the expense of the VA.
So, now a friend of the claimant, who served with them - but only knows the part where the claimant was called the "sickbay commando" for his hand pain - but NOW sees and hears the claimant saying they got a disability from the VA for their hand and who is proud as a rooster for actually getting anything from the VA. So now the friend is thinking FRAUD!
Is every situation like this? - nah. But there are enough situations similar to this to suggest a caution - yes there may be fraud involved. A disability rating by the VA does NOT automatically mean someone cannot have a full time job and work hard.
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1LT(P) (Join to see)
Thanks for the information, PO1 (Join to see)! And some very good points that also make me wonder - how many service members are eligible for disability but never thought to apply? The total outlays for disability payments may be vastly smaller than it could be if every single eligible person was evaluated and given a rating. However, I'm sure that in this case, the VA would have to change eligibility requirements, if for no other reason than to not bankrupt the Treasury.
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That's an excellent question, 1LT(P) (Join to see). I don't know of such cases for sure, but I suspect that some people are milking the system for all they can get. And that's a problem for the rest of the deserving veterans who should get disability for honest-to-goodness problems they have from time on active duty / deployment. I believe that's part of the reason why the VA disability physical process can be such a challenge.
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MSG (Join to see)
Exactly right. I was distressed when I received a benefits guide from VA that was customized for me--my information--who I needed to contact for this or that for my location--that's a lot of money to produce something like that they they could be spending on other people.
And, yes, should my circumstances change, I can still re-enroll.
And, yes, should my circumstances change, I can still re-enroll.
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SGT Thomas Lucken
I to am like SGT Northacker! I did not use the VA when I got out, felt that issues from the military were minor then. But years later they caught up to the point, I am limited at work I can do!!!! Neuropathy is taking it's toll on my arms and legs!
If detected earlier, would I possible be in better shape? Dioxins is one that seems turn up later in life. Even my own son who has spinal bifida (direct birth defect of Dioxins/Agent Orange), we did not know about his issue till 24 and was the VA the caught it...... I have several Dioxin related diseases that has cropped up on me the last few years, that is taking it's toll now.
My 2nd initial claim has been in for 9 months now, part of it is also my son's claim that is in, who is dealing with PTSD, back, and right knee issues!
If detected earlier, would I possible be in better shape? Dioxins is one that seems turn up later in life. Even my own son who has spinal bifida (direct birth defect of Dioxins/Agent Orange), we did not know about his issue till 24 and was the VA the caught it...... I have several Dioxin related diseases that has cropped up on me the last few years, that is taking it's toll now.
My 2nd initial claim has been in for 9 months now, part of it is also my son's claim that is in, who is dealing with PTSD, back, and right knee issues!
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SGT Craig Northacker
The sad part is that it is so unnecessary for all of us. All we want is to do the right thing, and when that does not happen we revert to our PTSD, and now the VA becomes our foe. I have related that to top brass at the VA, land their are great people there, but the inbred policies are horrendous.
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4
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I once saw this guy who was suppose to be in a wheel chair he had all he placards for being in a wheel chair and i could tell he didn't need to be in a wheelchair jumping all around his ford F350.....
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