The Department of Veterans Affairs headquarters in Washington, D.C., is shown in this undated photo. (Stars and Stripes)
WASHINGTON — A pair of bills that aim to ease the lengthy appeals process for disability claims with the Department of Veterans Affairs would keep the same judge on cases, track delays on pending claims and immediately notify veterans about missing or incomplete forms holding up their review.
The Veterans Appeals Options Expansion Act and the Veterans Appeals Efficiency Act offer technical changes to shorten the appeals process for denied claims and decrease backlogs on benefits decisions that topped 320,000 in March, according to the sponsors of the bills.
Rep. Mike Bost, R-Ill., who is chairman of the House Veterans’ Affairs Committee, is leading both bills, which overhaul the appeals claims process for decisions involving disability compensation and benefits.
Describing the appeals process as outdated and “decaying,” Rep. Elise Stefanik, R-N.Y., is a co-sponsor of both bills. She said the intent is to end cumbersome requirements and “provide much needed reforms” for efficiencies in the process.
Simplifying appeals for veterans is a focus for the lawmakers as the number of claims for benefits processed exceeded a million in March.
But the VA rejects about 40% of claims filed each year, with many veterans moving to appeal.
That was the case for Navy veteran Billy Whyde, 71, who said he was informed an appeal that he filed this year for disability benefits related to central nervous system vasculitis will not be heard for three to seven years.
“It is a rare disease that only two people in a million get,” said Whyde, who served in Vietnam for nine months until March 1973.
Whyde, a former petty officer third class, filed an original claim in November 2022 for disability compensation related to Agent Orange exposure from his military service. But his claim was kicked back to his regional VA office in Cleveland as incomplete.
Whyde then filed a supplemental claim that was rejected in January. The claim is on appeal.
“Other crew members on my ship have been granted disability for Agent Orange exposure. But they got cancer. The Agent Orange affected me differently,” he said referring to his diagnosis of vasculitis, which is an autoimmune disease that attacks the blood vessels. Whyde said his disease was diagnosed from a brain biopsy.
Medical claims for disability are getting more complex, which slows down the process and leads to more delays, according to the VA.
There has been a 200% increase in the last 10 years in claims containing eight or more medical conditions for which the filer is seeking a disability rating and benefits.
The VA will alert filers when their claims are incomplete or if wrong information was provided, which can lead to a denial. But the notifications sometimes do not arrive for months after the claim was filed.
The Veterans Appeals Options Expansion Act would provide veterans with more choices to control how and when their appeal claims are processed by the VA Board of Veterans’ Appeals, Bost said.
Under current rules, veterans must choose whether to have a full hearing before an appeals board judge or request an administrative decision from the VA, which often takes less time.
The bill would give veterans flexibility to change how they want their appeal processed once an initial filing is made.
It also would require the VA to backdate approval for compensation for cases that had required additional information from the veteran for a review and a decision.
The bill also would require the VA to update Congress regularly on the average length of time that a claim is pending after it is sent from the appeals board back to a regional VA office for a second review.
The Veterans Benefits Administration averages 18 months to review appeals and render a decision on some parts or all of a case, according to the VA.
A veteran also may take a case to the appeals board, but the process can take five to seven years because of backlogs, according to the VA.
The Veterans Appeals Efficiency Act would enable the appeals board to “aggregate” cases that involve similar questions of law or fact.
Contributing to the backlog are a high number of disabilities claimed in individual filings. The number has doubled in the last five years, according to the VA, with post 9/11 veterans from conflicts in Iraq and Afghanistan making up nearly half of the inventory, the VA said.
The complexity of the case, availability of medical and service records and the number of pending claims also affect the decision time.
The legislation would authorize the U.S. Court of Appeals for Veterans Claims to certify class actions to include veterans with claims for which no final decision has been issued.
The VA also would be required to give veterans reasons in a timely manner when a claim is deferred or placed on an internal administrative hold because of problems with the filing or incomplete information.
The legislation also would enable a claimant to get a timely explanation for a deferred or suspended claim where action is delayed.
“Right now, the VA makes a mistake, and you can’t hold them accountable,” Whyde said.
