A 21st Century System for Evaluating Veterans for Disability Benefits (2007) / Chapter Skim
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1 Introduction
1 Introduction
Pages 21-35
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1 Introduction The story of the Cuban missile crisis is well known. In the summer of 1962, in response to evidence of a significant increase in shipments from the Soviet Union to Cuba, President Kennedy ordered Air Force U-2 reconnaissance flights over Cuba.
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established the Veterans' Disability Benefits Commission to "carry out a study of the benefits under the laws of the United States that are provided to compensate and assist veterans and their survivors for disabilities and deaths attributable to military service." The law requires the commission to make recommendations to the president and to Congress about (1) the appropriateness of such benefits under the laws in effect on the date of the enactment of the act, (2)
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The law also requires the commission, in its report, to include an evaluation and assessment of the following: • the laws and regulations that determine eligibility for disability and death benefits and other assistance for veterans and their survivors; • the rates of such compensation, including the appropriateness of a schedule for rating disabilities based on average impairment of earning capacity; and • comparable disability benefits provided to individuals by the federal government, state governments, and the private sector. In carrying out these tasks, the commission developed a comprehensive set of research questions for study in determining whether the current disability compensation design is appropriate or whether more appropriate alternatives exist.
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Examine the base rating level to identify patterns. Determine if the Rating Schedule description of the condition provides a barrier to assigning the base disability rating level commensurate with the veteran's true vocational condition.
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In addition, members of the committee and staff visited several VA regional offices and a VA medical center to observe compensation claims processing. They spoke with a variety of individuals, including regional office directors and assistant directors, clinicians, veterans service representatives, rating veterans service representatives, and decision review officers.
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Veterans benefits include, but are not limited to • health care; • compensation for service-connected disabilities; • assistive devices and special benefits for service-connected disabilities; • disability pension; • education and training; • vocational rehabilitation; • home loan guaranty; • life insurance; and • burial and memorial benefits. A variety of stakeholders are involved in these veterans benefit programs, with separate, but interrelated, roles and interests.
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active duty, then direct service connection is established. The concept of "incurred while/during" active duty should not be confused with the medical concept of "caused by." The subtle difference is intentional and undoubtedly represents a manifestation of the nation's gratitude explained earlier.
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However, there are persistent questions about the extent to which the Rating Schedule compensates for impairment of average earning capacity. As one obvious example, although the disability ratings increase in 10 percent increments, the associated dollar payments do not.
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VETERAN Public Contact Triage Team Predeter- Rating Team Postdeter Team mination Team Makes decisions on mination Team Processes incoming Handles walk-in, Develops evidence claims requiring Processes awards mail and routes claims telephone, and email for claim and prepares consideration of and notifies veterans and evidence to teams inquiries administrative decisions medical evidence of decisions VA REGIONAL OFFICE COMPENSATION & PENSION EXAMINATION BY VHA OR CONTRACTOR FIGURE 1-1 VA claims application and development process. NOTE: This process is likely to vary somewhat among regional offices.
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In 2006, Veterans Benefits Administration (VBA) regional offices received over 654,000 claims for disability compensation.2 Just over 81 percent of these were reopened claims (claims that were initially denied or where the veteran was not satisfied with the disability rating)
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Receives copy Reviews hearing held of decision evidence and and decision makes decision made Veteran Gathers more evidence and Remand claim to RO? Regional Office Appeals Team returns claim to BVA Board of Veterans Appeals No Yes 31
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However, changing to a new coding system could be difficult and costly. Beyond the issue of impairment coding, there are also widely used and regularly updated disability rating systems, such as the AMA Guides to the Evaluation of Permanent Impairment, that could be used instead of the Rating Schedule and might provide for a more valid and reliable assessment process.
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an IU rating decision is based on an individualized assessment of the applicant's vocational capacity rather than on the standard Rating Schedule concept of average impairment of earning capacity, and (2) the number of veterans granted IU has more than doubled between 2000 and 2006.
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To carry out its work, the committee reviewed known historical and current evidence, including detailed information on the Rating Schedule updates that have been carried out since 1945, and heard from numerous experts in the relevant subject areas. Many committee members visited regional offices in different parts of the country to try to better understand firsthand the operations of the current system, particularly the handling of claims as related to the medical questions they had been asked to address.
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2004. VA disability compensation program legislative history.
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