Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
December 19, 2014

Veterans Affairs Problems Run Deep, Witnesses Tell House Panel (Video)

miller 061 050714 445x296 Veterans Affairs Problems Run Deep, Witnesses Tell House Panel (Video)

Changes are needed in VA facilities, witnesses told Veterans Affairs Chairman Jeff Miller. (Bill Clark/CQ Roll Call File Photo)

On the same day an internal audit revealed 57,000 veterans had waited more than 90 days for their first medical appointments, a House Veterans’ Affairs Committee hearing on the VA signaled that fixing the problems in the sprawling federal bureaucracy will be far more difficult than just upping spending or passing a single piece of legislation.

In a hearing that took a far more conciliatory and fact-finding tone than previous committee meetings on the subject, Veterans Affairs and Government Accountability Office witnesses spoke at length about the challenges in addressing medical wait times.

For one, Debra Draper of the GAO testified, 43 percent of medical consultations at the VA are closed without the veteran ever seeing a doctor, mostly due to no-shows and cancelled appointments, either by the patient or the doctor.

“Blind scheduling,” as Draper called it, which simply assigns a veteran a doctor’s appointment in a letter without consulting with the patient, resulted in far higher instances of veterans missing appointments than scheduling appointments over the phone.

Much of the problem, the VA assistant deputy undersecretary for health for administrative operations, Philip Matkovsky, said, was due to an appointment scheduling system that had not been updated “in any appreciable manner” since 1985.

As Chairman Jeff Miller of Florida noted, the VA has spent more than $127 million in recent years on a new system that has yet to work.

But while witnesses agreed the current scheduling system is riddled with problems and is not “veteran-centric,” they said issues with wait times and access to health care for veterans extended beyond scheduling methodology.

The major issue, witnesses indicated, was that the VA health system is simply overburdened with patients. As Matkovsky said, goals at the VA were “unrealistic,” and tying bonuses to performances that were unrealistic was an error.

“Not understanding the capacity of our system was a mistake,” Matkovsky said.

While lawmakers are currently looking at allowing veterans to go outside of the VA system for health care if the VA can’t schedule an appointment in 40 days, witnesses expressed skepticism that the problem was that simple. Draper said taking veterans out of the VA health system had a number of “potential pitfalls”; it would effectively remove tracking of veterans’ wait times and health outcomes, which could turn into a method for the VA to juke the stats.

As the acting inspector general of the VA, Richard Griffin, testified, VA statistics are already flimsy. If a veteran called for a doctor’s appointment and was scheduled for a consultation 120 days away — simply because that was the next available appointment — the wait time would be “scored” as zero.

That was a process, Griffin said, that needed to change.

Another, more nefarious method of deceiving the statistics, Griffin said, is for a VA official, unbeknownst to the patient, to go into the system every couple of weeks to cancel and reschedule an appointment.

“There’s plenty of evidence of data manipulation,” Griffin said.

Witnesses repeatedly returned to the theme of changing the culture at the VA, and lawmakers seemed genuinely interested in developing the best possible approach to fixing what a number of members characterized as a “crisis at the VA.”

Largely absent from the hearing were the dramatic and heated exchanges that have typified recent meetings, partly because the witnesses were just as interested as the lawmakers in making changes to the VA. At the outset of his remarks, Matkovsky apologized for the performance of the VA, something which Dan Benishek, R-Mich., said he appreciated.

“I feel sorry for you sitting there,” Benishek said, explaining that Matkovsky was there to “defend the indefensible.”

It was, perhaps, Benishek who took the most indignant tone, saying he also appreciated Griffin’s comment that officials needed to be fired.

Once someone is fired or criminally charged, Griffin said earlier in the hearing, “it will no longer be a game, and it will be the shot heard ’round the system.”

  • Jazzy

    EUC problems run deep, renew UI with retro. Attach EUC bill to VA bill, both are bipartisan in Senate. FIRE SECRETARY OF LABOR. JAZZY FOR CONGRESS

  • Jazzy

    EUC Witness tells Roll Call, problems in Labor run deep.

  • http://none.com Jack Everett

    More talk and no action as usual. This congress has to be the most useless creation in world history. Play the blame game instead of creating a working program that takes care of our Vets. McConnell wants to save all the money he can to hand over to the illegal trespassers when they become citizens and to hell with the Vets. Playing politics with veterans lives shows how much both parties think of our wounded warriors. Lets cut politicians free insurance ride and put then on VA insurance and see how fast things improve.

  • http://vato21stcentury.blogspot.com/ Jim S.

    The Miller, hasn’t done a thing for vets, poser patriot!!
    VA ‘scandal’? It’s the Country Served and Their Representatives, mostly from conservative ideology and especially under conservative administrations, free wars and privatize for corporate profit causing problems to compound by obstructing full funding and ignoring many many issues, ‘SCANDAL’! Decades and Wars of Long!!

    The Country that ‘Talks the Talk’ but rarely ‘Walks the Walk’, patriotism posers who loves the free wars and ignore any sacrifice as to the long term results from, while ignoring the many issues of Veterans, those that served them, especially as a result of our wars, their representatives leading that ignoring while attacking the under funded VA, decades now and wars from, they control the purse strings of the Country!

    The Fallen Brothers and Sisters and Our Veterans Community are Not a Corporate Marketing Tool Especially on Memorial and Veterans’ Days!!!!!!!

    “In fiscal 2013, the VA spent about $4.8 billion, or about one-tenth of its healthcare costs, on private care, often for veterans who live far from VA facilities or veterans in need of care unavailable at a VA facility.”

    “Why in 2009 were we still using paper?” VA Assistant Secretary Tommy Sowers “When we came in, there was no plan to change that; we’ve been operating on a six month wait for over a decade.” 27 March 2013

    TX-19 Congressional Candidate Neal Marchbanks – Veteran: 28 March 2014 – “Congress controls the budget for the VA and it is the fault of Congress that the VA does not have enough employees and that the facilities are too small.”
    Congress, in Veteran Marchbanks statement, are the people served and who representatives work for, or are supposed to!

    USN All Shore ’67-’71 GMG3 Vietnam In Country ’70-’71 – Independent**

    • http://vato21stcentury.blogspot.com/ Jim S.

      Veterans Affairs ‘scandals’ Are As Old As The Agency

      WE BROKE IT DECADES AGO!!!
      And by doing so any problems in a much needed growth agency, especially with them poser patriotism flag wavin wars we don’t pay for, are compounded and while grossly under funded brings on more problems!!

      By the way, Congress is Us and especially the 99% served!!

      Yet today’s Congress is “shocked and shocked”

      And in the Shinseki VA they were not only trying to fix what was ignored, by those served, in the agency, they also started addressing the long long…………. ignored issues of previous wars especially. Those few within saw their chance to use politics and their own greed, politics as to the Gen who had a target on him since speaking Military Truth and the bushco firing him!!!

      There’s ‘whistleblowers’ And then ‘political whistleblowers’, and in the grossly under funded for decades VA this is reading like that latter along with greed!!

      And the ones the must upset about are those served who Haven’t Sacrificed, they want everything just hate paying for, especially this whole decade plus and two rubber stamped wars!!

      And being led, especially, by talking heads making multi millions, with huge tax cuts, in the media, all were for them wars, and long time obstructionist conservative pols and followers of and pretty much everyone, easier to attack the VA personal, politics need not matter, being Poser Patriots is true Americanism!!!

      DeJa-Vu all over again!!!

      Sen. Bernie Sanders told Conservatives: “If you can’t afford to take care of your veterans, than don’t go war. These people are bearing the brunt of what war is about, We have a moral obligation to support them.” February, 26th, 2014

      USN All Shore ’67-’71 GMG3 Vietnam In Country ’70-’71 – Independent**

  • Anonymous

    The FBI should also be investigating the Veterans Affairs Office of Inspector General for failing to investigate over 50 anonymous veteran and employee hotline complaints made within a 2-year period about patient scheduling issues. These complaints raised concerns about hospital staff failures to schedule patient appointments within 14 days of the veterans request.

    Veterans Affairs Office of Inspector General has four functions – Audits and Evaluations, Healthcare Inspections, Investigations, and Management and Administration. None of these functions ever bothered to look into these issues despite numerous complaints. Veterans Affairs Office of Inspector General has been ineffective in mitigatibg risk such as this and fallen short of increasing efficiency within the Department despite having received increased budget appropriations for the past four years.

  • Magic Newton

    Clearly, Hussein Obama is a liar, a fraud, and a fool.

  • Metatron von Bardeleben

    It is not just Healthcare at the VA that is broken – it is the
    Disability claims system and other benefits system. The political
    atmosphere of the VA is to view most all claims as being fraudulent and
    you will even find articles from VA perspective focusing on fraudulent
    claims rather than on awarding legitimate claims. The VA is more likely
    fraudulent than the Vet.

  • Metatron von Bardeleben

    Should the VA desire not to award your benefits there is no practical
    way to get those benefits and no effective legal means at all. One knows
    that the system is corrupt simply by looking for an instance in the
    entire corrupt system that demonstrates this – almost 50% of all appeals
    are remanded seemingly in an automatic manner – once in this process it
    has virtually no chance of ever being awarded and they will tie you up
    as years become decades – for instance – you may have a covered
    condition but there is no means to ever prove this – no time frame, no
    mechanism, no effective due process. In my case 1. the condition is
    covered and has been awarded to others, 2. Is there a record of this in
    the Military Record – in my case yes. 3. Can the VA demonstrate evidence
    that this wasn’t a result or aggravated by service – no they cannot.
    But they take the reverse approach of entangling such a claim up with
    insurance like claims examiners who act as both final medical experts
    and adjudicators and say that I have to prove through non-existing
    evidence that it wasn’t the case before service and or that one of their
    medical professionals has to state an absolute cause and effect basis -
    which is not a cognitive or epistemological construct allowed by the
    medical profession – hence fraudulent denial which is in direct conflict
    with the charge that the VA shall act on behalf and in favor of the
    veteran where doubt exists and conclusive evidence to contrary may not
    be offered. They know that it is for all practical purposes a de facto
    permanent denial. It creates the backlog by acting as an insurance
    company vis-a-vis on behalf of the Veteran. The VA’s entire process is
    set up to create grid lock by its philosophical positioning which holds
    truly that the Veteran is attempting to submit a fraudulent claim.

  • Metatron von Bardeleben

    There are actually a few different backlogs and the VA relies on these
    to excuse its delay, deny, demean – and hope that the Vet dies process.
    The VA creats the initial backlog by denying covered benefits. The VA
    assumes fraud or no liability and gives an initial cursory denial. The
    appeals process is not functional in that it seemingly remands almost
    50% of appeals in a cursory manner. Keep in mind the Vet as waited years
    already in the initial claim, then waiting for a BVA inital hearing of
    the appeal, then waiting 3 years in my case for the response for the
    BVA, which was then remanded to the RO – The records sit sometimes over 3
    years just to make it back to the RO – then the wait is as long as the
    VA RO chooses – there is no time obligation on the part of the VA. All -
    just to prove what was already in my Military medical records – covered
    condition. If the RO responds incorrectly the the cycle of appeal and
    remand starts over. If it denies – then must start claim over – not able
    to force to courts unless denial is final. Meanwhile it does not matter
    how much evidence is submitted or even what their expert says. In my
    case – the QTC said yes he has claimed condition. The VA sets up a
    strawman wherein it uses an ex parte method of contact to the medical
    expert and then asks a leading question as a strawman to deny. In my
    case I claimed disability on the basis of condition A which is mentioned
    as early stage by the Army doctor at the time of service. Another
    condition B is also discussed. The VA then asks the QTC can A come from B
    – no, but does not provide information to the evaluator about both
    being mentioned in the records.

  • Metatron von Bardeleben

    The claims processor – an insurance agent essentially – acts as the chief and final medical officer, moral official, and adjudicator – without the training for any of these.

  • Metatron von Bardeleben

    The VA is charged with awarding covered conditions with benefits to the
    Veterans, but instead places claims processors in the role of medical
    expert and judicial expert to deny covered claims without cause. It uses
    deception, simply ignores evidence, and commits fraud in denying
    covered conditions. It denies a large number of claims in cursory
    manner, it denies due process in an endless appeals and remands cycle as
    a de facto denial with some Vets dying or being caught up in the cycle
    for decades with no means to force to the court. Sometimes the courts
    remand back to the cycle. There are no time obligations on behalf of the
    VA for processing such claims. After the appeal and waiting for the
    remand to be sent back just to be reviewed again by the RO – some claims
    are just gathering dust in the records center for over 2 years. It took
    three years just for the judge to make a decision not to decide. The RO
    is not obligated to process in any time period at all – it is when the
    RO gets to it. Decades come and go and covered conditions are not
    covered.

  • Metatron von Bardeleben

    I am sorry but fighting with the VA now for over 10 years has aggravated
    my illness to the point that it is very difficult for me to think or do
    anything anymore – it has basically destroyed my ability to organize
    anything – the 4 anti-epileptic meds that they give- for the claimed
    disability – surely have had a terrible impact on me.

  • Metatron von Bardeleben

    I am quite sure that there most likely are lists that advise processors
    who hold biases to deny those claims that they simply do not like and
    know that since the Veteran has no real means to force a decision
    through an outside and unbiased party they can get away with it forever -
    despite the fact that the right has covered condition – the VA knows
    the Vet has no effective recourse. Come on – we all know how
    organizations really function.

  • Metatron von Bardeleben

    I want to know about ex parte communications with QTC and C&P
    examinations – especially where the medical officer agrees that the Vet
    has the stated covered condition, but the VA used tactics to deny the
    claim simply by simply ignoring or through a process of deception like
    strawman questions. A good Reporter should be able to find this practice
    at the VA through the same investigative methods.

  • Metatron von Bardeleben

    So the Army first identifies my claimed disabling condition in my Army
    Hospital Medical Records – they don’t tell me, later I am struck again
    with same – I seek treatment and have been since in college right after
    the Army, later I am recruited with CIA twice – Harold Ford – but I
    cannot get position due to illness in Army Medical Records, Later I pass
    the State Dept.’s FSO exam and I am invited to DC in April 2002 for
    interview – until they review my medical condition and I cannot be
    employed – The Head Doctor at the Mission Valley VA tells me I qualify
    for disability benefits and that I should apply, I do so and now have
    been fighting for over 10 years – so Army screws me by not informing
    about disabling condition, I cannot obtain employment because of the
    condition, and then VA denies benefits – talk about F-N someone over. It
    has driven me into the Anarchist Camp – the overwhelmingly negative
    interaction with the Official System that is. The Peace Corps even
    rejected me because of my disability.

  • Metatron von Bardeleben

    The Problem with the OIG inspecting the VA is that it is part of the VA.
    The OIG may be able to look at individual corruption effectively but it
    cannot investigate systemic corruption, fraud, and inefficiencies for
    it is not charged nor trained for such and since it is part of that
    systemic corruption itself.

  • Metatron von Bardeleben

    Backlogs – VA – It is not the cavalcade of new applications that the VA
    points to – it is the 1. NOD appeal to the BVA hearing – created by VA
    policy of denying claims without cause 2. BVA decision takes 3 years or
    more it then creates the 3. Remand to RO Backlog and the mostly endless
    appeals/remand cycle 4. If the Vet is finally denied by the BVA then the
    Vet restarts the claim or goes to the Court – the backlog here just
    waiting for it to get to court is at least 4 years – then once the
    decision is rendered again a long wait – often it is sent back to #3.
    and the process starts again.

  • Metatron von Bardeleben

    I am quite sure that there most likely are lists that advise processors
    who hold biases to deny those claims that they simply do not like and
    know that since the Veteran has no real means to force a decision
    through an outside and unbiased party they can get away with it forever -
    despite the fact that the right has covered condition – the VA knows
    the Vet has no effective recourse.

  • Metatron von Bardeleben

    This is specifically fraud as the VA is charged to weigh in the
    Veteran’s favor but the SOPs direct the exact opposite – the Board is
    obligated to weigh the
    conflicting evidence and make a finding of fact that
    resolves all reasonable doubt in favor of the veteran.
    In some of these cases, the Board’s decision resolves
    the factual issue against the veteran even though the
    evidence favorable to the veteran appears to strongly
    outweigh the unfavorable evidence.

  • Metatron von Bardeleben

    So the OIG says no proof that delays at VA caused any deaths but that
    there were delays. I told you so. OIG is part of the VA – it cannot
    conduct an unbiased investigation.
    Additionally – cause and effect in these types of cases is always a “reasonable assumption” and not conclusive proof.

  • Metatron von Bardeleben

    Sadly, it would appear that the system if one of clowns and criminals.
    But I am still wondering who called me after I began posting on the VA
    FB site threatening me with to felony arrest warrants – the number only
    showed up as 010-4702 or 4207

  • Metatron von Bardeleben

    But this is not the case – Over the years, NVLSP has reviewed many Board
    decisions in which the evidence on a critical point is
    in conflict. The Board is obligated to weigh the
    conflicting evidence and make a finding of fact that
    resolves all reasonable doubt in favor of the veteran.
    In some of these cases, the Board’s decision resolves
    the factual issue against the veteran even though the
    evidence favorable to the veteran appears to strongly
    outweigh the unfavorable evidence.

  • dyno2

    When you are brain washed through training which is intended to deny veterans then everything becomes a denial.

  • Metatron von Bardeleben

    Furthermore, it intentionally creates these backlogs – 1. quick denial
    of even covered claims forcing appeals with NOD – then one must wait for
    hearing with the BVA judge, then one must wait for the judge to review
    again – 3 years or more later, and then remand again because the VA RO
    has intentionally not fully complied with its response to the BVA again,
    again after several years of waiting time on behalf of the veteran and
    thus and so on. Why a 2 – step BVA process to begin with with only 65
    judges? No other court like system does this. why can’t the judge make a
    decision within 30 days of the initial hearing? Why? – to create the
    backlog which serves both as a de facto denial and also to perpetuate
    the work of the VA employees through the endless and unaccountable
    circulation of paper at will and according to its own decision to ever
    get to a file – it may be decades.

  • Metatron von Bardeleben

    The VA knows that a denial at the first level is mostly permanent
    without cause – it practices as an insurance company and denies any
    case, including covered cases, that it believes to be fraudulent – most
    cases that is. Once this happens there is almost no chance of obtaining
    benefits and for all practical purposes is a permanent de facto denial -
    even for those cases in error. There are only 65 or so BVA judges to
    handle appeals and about 50% of these appeals are sent into an endless
    remand cycle with the RO wherein the RO has been found to make errors in
    75% of the cases so that the cycle is literally endless with no due
    process.

  • Metatron von Bardeleben

    We need an EZ VA Form and Coverage Award Process – I am sure that the
    IRS does this. 1. Is claimed condition covered and has it been awarded
    to others for same condition? yes – go to #2

    2. Is there any evidence, diagnosis, comment, or other appropriate
    presumptive information concerning the condition in the claimants
    military records, military medical records or substantive evidence in
    later records to support the claim? yes – go to #3

    3. Can the VA prove that the condition pre-existed or was not caused or
    aggravated by Service? No – Award and Award the following Amounts based
    on the claimants condition and employability.

    BUT THE VA BELIEVES ALL CLAIMS FRAUDULENT TO BEGIN WITH – LIKE AN
    INSURANCE COMPANY AND THEN IT EXCLUDES COVERED CONDITIONS AT WILL.

  • Metatron von Bardeleben

    Once in the appeals and remand cycle – one has no effective recourse –
    The BVA makes you wait at least a year or two to get to a Judge for the
    hearing of the appeal – then the judge goes away and reviews at least 3
    years later before making a decision – in almost 50% of these reviews –
    they are seemingly auto remanded to the regional office – at this point
    the records may go dormant up to 2 and 1|2 years – then back to the RO
    for review at its leisure – no time constraints at all – then they
    intentionally make a mistake in the reply to the BVA – then wait a few
    more years and BVA sees the “mistakes” and then back to Regional office -
    and, the cycle repeats ad infinitum – if the final decision is rendered
    and you appeal to court – at least 4 years wait to get to the court –
    then the majority of time it is remanded again. Hence, de facto denial,
    even for covered conditions, then death.

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