Click here for Shelly Peterson VA Disability Claims Process

Veterans Benefits
Disability Compensation Claims Process
Shelly L. Peterson
Assistant Veterans Service Center Manager
Nashville Regional Office
Women Veterans- Statistics
 There are 1.8 million Women Veterans, representing 8
percent of the U.S. Veteran population.
 12 percent of those who have served in the current
overseas contingency operations are Women.
 Over 250,000 Women Veterans are receiving
compensation or pension benefits.
 15 percent of all awards of service-connection were to
Source: Department of Veterans Affairs, VetPop07, and Defense Manpower and Data Center,
unpublished data as of 30 September 2010. Compiled by the Women’s Research & Education
Veterans Benefits Administration
April 28, 2012
VA Disability Compensation
Purpose of Program
Compensate Veterans for disabilities caused by injuries or
diseases that happened while on active duty, or were made
worse by active military service.
Key Principals
• Compensates for average impairment of earnings capacity
• Disability evaluations are assigned at 10% increments
from 0 to 100% levels of disability
• Monetary amounts determined by Congress
• Additional special evaluations (Special Monthly
Compensation) are associated with higher levels of
• No time limit for filing claims
• Compensation payments are tax-free
Veterans Benefits Administration
April 28, 2012
Requirements for Service Connection
Three requirements for a grant of service connection
1. An in-service event (incurred or aggravated),
2. A current condition, and
3. A medical nexus establishing a link
Veterans Benefits Administration
April 28, 2012
Means of Service Connection
 Direct
 Aggravation
 Secondary
 Presumption
Veterans Benefits Administration
April 28, 2012
Key Components of the Claims Process
•Receipt of Claim – Receive and establish control of claim.
•Development – VA has a statutory duty to notify a Veteran
of the evidence needed to substantiate the claim and a
duty to assist a claimant to gather evidence. This includes
obtaining all supporting evidence, keeping claimant
informed, and ordering VA examination, if necessary.
•Decision – VA rater will review pertinent evidence to
decide service connection, level of severity of disability, and
other ancillary benefits.
•Notification – Notify Veteran of the decision
Veterans Benefits Administration
April 28, 2012
Claims Process Cycle Times (as of 4-23-12)
Process averages:
13.6 days (National)
7.5 days (Nashville RO)
Process averages:
212.4 days (National)
116.2 days (Nashville RO)
Process averages:
72.5 days (National)
6.3 days (Nashville RO)
Process Decision and Notify Veteran:
19.8 days (National)
8.5 days (Nashville RO)
Veterans Benefits Administration
April 28, 2012
VBA Statistics (as of 4-23-12)
• National Pending Rating Workload –
• National Average Days Pending –
242.9 days, 141.0 days (Nashville RO)
Strategic Goal – 125 days
Nationally, 66.3% of inventory pending
over 125 days.
Veterans Benefits Administration
April 28, 2012
General VBA Assistance for Women Veterans
• Rating Schedule provides disability compensation for
service-connected gynecological and breast disorders
• Additional Special Monthly Compensation for loss, or
loss of use, of creative organ and loss of 25%, or more,
of breast tissue
• Benefits to children of Vietnam Veteran Women, based
on herbicide exposure, for spina bifida and other birth
• Every VA regional office has Woman Veterans
Veterans Benefits Administration
April 28, 2012
VBA Assistance for Combat Related Disabilities and PTSD Claims
• No difference in VBA evaluation of female and male Veterans
regarding combat related physical or mental disabilities
• Women or men diagnosed with PTSD by VA psychiatrist or
psychologist based on fear related to hostile military or
terrorist activity can provide a lay statement to establish
stressor, if consistent with places, types, and circumstances
of service.
• In 2008, more than 48,000 Women Veterans screened
positive for MST.
• There are over 4,700 Women Veterans service connected
for sexual assault/harassment
Veterans Benefits Administration
April 28, 2012
VBA Assistance for Non-combat PTSD Claims Based on Personal Assault or
Military Sexual Trauma (MST)
• When women claim PTSD based on personal assault or
MST, VBA will develop for supporting evidence in
military records and also from outside sources such as:
• Law enforcement, counseling center, and hospital reports
• Statements from family, friends, and clergy
• Indications of behavior changes are sought such as:
• Requests for unit transfer or deteriorating work performance
• Substance abuse, depression, anxiety, or unexplained economic
• If the available evidence is not sufficient, VBA will
schedule an examination by a trained medical expert to
provide an opinion regarding the credibility of the
claimed assault or sexual trauma.
Veterans Benefits Administration
April 28, 2012
Growth of Claims
Key Factors
• Hairy cell and other B-cell leukemias, Parkinson's disease,
and ischemic heart disease presumptives for Vietnam
• Improved and expanded outreach
• Current Overseas Contingency Operations
• Benefits Delivery at Discharge (BDD), Initial Disability
Evaluation System (IDES) and Quick Start
• Combat Related Special Compensation (CRSC) and
Concurrent Disability Retired Pay (CDRP)
• Aging of Veteran population
• More Veterans on rolls results in more reopened disability
Veterans Benefits Administration
April 28, 2012
Increasing Complexity of Workload
• Multiple conditions claimed (especially with new
• Types of disabilities claimed – chronic
progressive disabilities (e.g. diabetes,
cardiovascular, TBI)
• Progression of disabilities as Veterans age
• Court decisions
Veterans Benefits Administration
April 28, 2012
VBA Transformation- Goals
By 2015:
• Process all claims in less than 125 days
• 98% quality
• Eliminate Veteran homelessness
Veterans Benefits Administration
April 28, 2012
VBA Transformation- Initiatives
• Integrate claims process with electronic data and services
(paperless claims-processing, eBenefits)
• Increased focus on quality (inter-rater reliability studies,
Quality Review Teams, Evaluation Builder)
• Simplify notice requirements (Simplified Notification
• Improved processes (Intake Processing Center,
Segmented Lanes and Cross-Functional Teams)
• Improved technology (Veterans Benefits Management
System, rules-based applications, Unified Desktop)
• VA/DoD Collaboration (pre-discharge claims, data
transfer, seamless transition, Disability Evaluation
System, etc.)
Veterans Benefits Administration
April 28, 2012
Women Veterans Coordinator
Nashville Regional Office
Donna Pate
Veterans Benefits Administration
April 28, 2012
Veterans Benefits Administration
April 28, 2012

similar documents