2011 Issues   /   November 2011

GAO: Veterans Not Given Enough Information to Appeal Benefits Denials

By U.S. Medicine

WASHINGTON — Veterans have difficulty understanding the procedures through which they appeal VA decisions on their benefits, and time-saving measures put in place by VA have done little to improve the review process, according to a recent government report.

In an effort to resolve more benefit appeals at the regional level and cut the waiting times experienced by veterans going through the traditional method, VA established the post of the Decision Review Officer (DRO) in 2001.

The DRO became an alternative to the traditional regional office appeal review and was given authority to grant additional benefits to veterans after reviewing an appeal based on a difference of opinion with the original decision.

Under the traditional review, veterans would appeal to the VA regional office that made the initial benefits decision. If dissatisfied with the outcome of that appeal, they could then go to the national Board of Veterans Appeals. Through this method, new evidence is generally required for a grant of additional benefits.

However, an investigation by the Government Accountability Office (GAO) shows that veterans are not given enough information to make an informed decision about which review track to use, noting that the letter given to veterans to inform them of their options does not highlight the differences between the two review methods. According to half of the VA regional office managers surveyed, most veterans could not manage to make an informed choice based only on that letter.

GAO also found that the use of the DRO has not cut down on the number of veterans being seen on the national level by the Board of Appeals.

From 2003 through 2010, VA handled nearly 1 million reviews, 61% of which were handled by a DRO. Veterans who sought assistance from a veteran service organization were more likely to choose DRO over the traditional review, possibly because VA gave DROs the flexibility to interact informally with veterans and the wait time was potentially shorter.

 From 2003 through 2010, 32% of DRO reviews resulted in additional benefits, compared with 23% of traditional regional reviews. Also, veterans choosing the traditional method were more likely to voluntarily end their appeals before they went before the Board. DRO reviews took nearly a month longer — 266 days compared to 235 days using a traditional review. According to GAO, this may be due to a more-thorough examination of the evidence through the DRO review.


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