Scam or Service?
Connecting Veterans with Their Benefits
“To fulfill President Lincoln’s promise to care for those who have served in our nation’s military and for their families, caregivers, and survivors.” - VA Motto, paraphrasing President Lincoln
America’s 16.5 million veterans often have trouble accessing the benefits for which their service has entitled them. About 27% have a service-connected disability, but only one in five veterans believe that veterans generally receive their earned benefits. The challenges of transition from active military service back to civilian life and the byzantine complexity of the VA disability system present significant obstacles, often requiring a lawyer or other expert to navigate. As it stands, current law can prevent veterans from receiving the assistance they deserve. Congress is considering two competing proposals to improve access, but neither addresses the underlying unnecessary complexity of the system. The short-term goal of increasing access need not prevent a longer-term planning and more thorough reconsideration of the care we provide those who have given so much for our country.
The Politics and History of VA Benefits. The two government entities who should be most supportive of veterans are often the least supportive: Congress and the VA itself. A 2021 survey revealed that 72% of American adults want to increase funding for veterans’ benefits, but Congress continues to see VA expenses as a drag on the budget. Indeed, in the most recent debt deal, the VA budget will be cut if Congress fails to pass all 12 of the federal government’s budget bills by the end of the calendar year. The VA bureaucracy is no better at protecting its mission. Although past and current combat operations offer good models of veterans’ future needs, instead of adopting those models, the VA most often opts for the role of “good soldier” in both Democratic and Republican administrations, failing to request an adequate budget to provide for these needs.
This conspiracy of neglect leads to delays for veterans. In the most recent example, although the VA and Congress have long anticipated the increase in disability and healthcare-eligible veterans after the 2022 PACT Act, hiring to provide for them has lagged. Delays in adjudicating these claims cause further delays in veterans actually receiving healthcare.
For decades, veterans had to rely on service organizations and publicly funded veterans service officers (VSOs) for claims assistance, as federal law prohibited charging a fee for providing these services. Eventually, Congress allowed lawyers to collect fees for helping veterans, but only for appeals of initial denials by the VA. The VA now allows lawyers and accredited professionals? to collect a limited percentage of back pay when their efforts lead to successful appeals of initial denials.
However, Congress zeroed out penalties for unaccredited assistants who charge a fee. As a result, a two-track system evolved. On one track are law firms with lawyers and accredited agents that assist only with appeals, paid through a percentage of back pay. On the other track, unaccredited agents (who usually refer to themselves as “claims coaches”) can assist with initial claims and generally charge five months of benefits. Of note, both payment systems assume that the VA will not adjudicate the cases in a timely manner and that it will often get the initial adjudication wrong - both historically very good assumptions. Now, both groups of advocates have bills before Congress seeking to “win” for their preferred service.
The GUARD VA Act. The “Governing Unaccredited Representatives Defrauding VA Benefits Act of 2023” (GUARD VA Act), pending before Congress, would reinstate penalties for unaccredited agents who charge a fee for assisting veterans with claims. Proponents of the bill point to unconscionable fees charged by these coaches in some cases, the lack of any competency requirements for them, and the availability of free services from service organizations or VSOs. In essence, the GUARD VA Act enforces the bargain between the service organizations and law firms, giving the former the vast majority of initial claims and the latter the ability to represent veterans on appeals.
The PLUS Act. Opponents of the GUARD VA Act point out that the advocacy of accredited agents and lawyers varies substantially, depending on the capacity of the veterans service organizations, the training and zealousness of the advocate, and states’ willingness to fund VSOs. Further, they point out that limiting fees at the initial application phase dooms veterans to self-help, often leading to appeals and delaying receipt of benefits. Unaccredited claims coaches advocate for the “Preserving Lawful Utilization of Services for Veterans Act of 2023,” or PLUS Act, which would essentially legalize the claims coach model and cap the fee at $12,500 for successful claims.
Fixing Veterans Advocacy. Neither track in the current system benefits veterans. Limiting paid advocacy to support appeals leads to delays and leaves veterans at the mercy of state and non-profit budgets for representation. Similarly, the current lack of oversight and penalties for unaccredited agents opens veterans up to scammers who take their money and do not provide value. Veterans should be able to choose a private sector advocate and those advocates should be able to receive a reasonable fee that does not depend on delays in processing.
A better system exists at the Court of Appeals for Veterans Claims (a tertiary level of appeal). There, successful litigants may recover fees from the government. The government should pay attorney fees when the government is at fault for a wrongful denial. The contingent nature of these fees helps reduce frivolous appeals, an important collateral benefit.
The VA itself also needs reform. It comes under fair criticism for its lax oversight of accredited agents. The agency also needs to staff up more quickly, to improve both benefits processing and healthcare. Congress must also hold it to account for failing to ask for budgets adequate to meet the needs of veterans. It’s fair to criticize Congress for miserliness toward veterans, but only if the agency gives it the information it needs to pass a reasonable budget.
Doing Better Over the Long Term. Congress and the VA should also update the system to reflect the needs of today’s veterans. The VA disability system developed immediately after World War II and now represents an antiquated view of life and labor.
Veterans’ healthcare should be divorced from disability. Congress has taken some steps in this direction, making basic mental health services available without a claim and healthcare for all combat zone veterans for 10 years, but conditioning healthcare on a veteran’s willingness to admit disability creates an unnecessary barrier.
The disability system should, going forward, reflect a more modern vision of work and health. This means continuing to improve benefits for veterans suffering from behavioral health issues and a transition “get well” period of enhanced benefits. It also means getting rid of a strict adherence to certain percentages for certain ailments - “10% for tinnitus, 30% for asthma” - and instead considering the whole person.
The Department of Defense must be held responsible for both its unwillingness to reform practices that lead to disability and for failing to adequately assess servicemembers before they separate. Yes, military service will always carry a risk of death or injury, but we should not accept the inevitability a disability rate of almost a third. Good leadership means doing what we can to reduce those risks thoughtfully and ensuring veterans don’t have to find their own way to get benefits. It also means creating a military disability system that does not routinely “fire” servicemembers for health issues without giving them benefits.
Every veteran should receive an evaluation of their health from the VA upon separation or retirement from the service. Too often, veterans suffer silently, unaware of their benefits. While any veteran could decline a benefit, we should not rely on people we just spent several years training to endure hardship without complaints to suddenly embrace the full and honest disclosure necessary to receive benefits. When the evidence shows that a veteran suffered with a service-connected ailment for a period of time before filing a claim, compensation should date back to when they began suffering, not when they finally filed for benefits.
Conclusion. I served over 28 years in uniform between active duty and the reserves. Like 84% of post-9/11 veterans, I feel military service had an overall positive impact on my life. However, 37% of us feel that their service had a negative effect on our physical health and only about half would recommend military service to our children. By large margins, the public supports benefits for veterans, but the federal government has not delivered on the VA mission. Until we fulfill Lincoln’s promise to veterans and their families, we will continue to see veterans suffer and have mixed opinions about military service.
If you’d like to weigh in on the GUARD VA or PLUS Acts, please write your US Senator or Representative. You can find their contact information here.
Other News
Preserving Veterans Benefits. Veterans may receive back pay for benefits earned before they file their claim in some specific circumstances. In particular, when VA policy changes to cover more conditions, as it did in last August’s PACT Act, veterans have a year to file and receive benefits from that date. If you think you might qualify, please file a claim ASAP. If you’re unsure, you can still file a Notice of Intent to File to preserve your benefits. Reach out to your County VSO for more information and assistance.
Update on the Unhoused. The US Court of Appeals for the 9th Circuit recently denied a further appeal by Grants Pass regarding its responsibility to provide for the unhoused. Putting aside some legal complexities, the fundamental issue is this - does a city have the responsibility to provide a place for the unhoused to go before it may criminally prosecute them for trespassing on public land to sleep? Currently, the law requires that it do so, subject to the city’s appeal to the US Supreme Court.
While I firmly believe our governments have the obligation to provide a safe place for the unhoused to be, I understand the city’s argument that they lack the resources to do so, given state restrictions on local revenue. I would also point out that incarceration is quite possibly the most expensive and least humane way to address homelessness.
Grants Pass and the other cities should provide this service and the state legislature should allow more local revenue generation to allow them to do so. I would also point out that, while Grants Pass is a conservative, anti-tax jurisdiction, it is the liberals in the state legislature that have restricted the cities from raising more funds through marijuana and other “sin” taxes. If we are to hold local governments responsible for providing services, we owe it to them to let them raise the revenue they need to do so.
If you’d like to weigh in on this issue, you can find your state senator and representative contact information here.
Full Disclosure - As noted above, I am a veteran. I also have a disability rating, receive healthcare from the VA, am a life member of two veterans service organizations, Veterans of Foreign Wars and Disabled American Veterans, and will start a job with the VA in a short while. The views expressed are my own and not those of the Department of Defense or the Department of Veterans Affairs.
Links to videos are not intended as endorsementments of those services.
I too am a veteran, of the Viet Nam conflict, where I served some 27 months in a combat role. I am classified as fully and permanently disabled with service connection. I currently get most of my healthcare through the Eugene VA clinic. I am a retired lawyer.
The VA was unprepared for the vast influx of veterans into the healthcare and disability compensation during and at the end of the Viet Nam war. Services were abysmal and staff-oriented, and it often took years to obtain a disability compensation rating. I have seen vast improvement since but the system still suffers from fundamental weaknesses that can only be cured by enactment of universal health care.
Although strides have been made recently in relevant regard, the major problem of the VA healthcare system is that it is not fully integrated with community health care. It was and to a large extent remains true that health care is delayed because of the VA's preference for providing services via VA staff. Far too often, vets are required to wait or travel long distances to obtain health care services that are readily available in the community.
Veteran organizations drastically oppose farming out health care to the community community because veterans without service-connected disabilities are only entitled to VA health care on a "beds available" basis. The only way to get VA health care services to them was to fight for more "beds" than were needed for the service-connected and to resist community health care for veterans. That war in Congress continues to this day under the veteran organizations' "save the VA" banner that aims to keep veteran health care inside the VA system at the expense of community care.
Universal health care (Medicare for All) is the inevitable solution to this problem but we have to fight both the veteran service organizations and the insurance industry to get there. I don't expect to live long enough to see it.
Another barrier is that until recently, the VA's benefits program remained paper-based rather than electronic. The health care system has been building a digital system for many years, but recently took a major hit when someone in the VA decided to phase out the existing electronic system and rebuild its veteran user interface from the ground up. The Roseburg health care system has been one of the guinea pig portions of the system. For more than a year, we lost our ability to communicate with health care staff via secure email. That finally came back last week. But bugs are still blocking the ability to renew prescriptions. VA support staff are still telling us to tell pharmacy services what prescriptions need renewed by secure email, which hasn't worked until last week. That of course shifted most communications to the Rosburg switchboard with voice operators, resulting in interminable phone queue wait times.
And the user interface for the new system has an absolutely incompetent design. For example, prescription refills under the MyHealtheVet system was just a matter of checking boxes in a single column for a list of prescriptions then hitting a refill button. Under the replacement system, a separate process must be launched for each individual prescription that takes over a minute to complete. For my 25 or so prescriptions under the old system: under three minutes to refill all needed prescriptions; under the new system over a half hour.
Our health records that we could review under the MyHealtheVet program are also no longer available with the new system.
It is a guiding principle of software design that changes to the user interface must be only incremental to preserve user ability. But the people who are designing and building the new system have a bad case of "not invented here" as far as the MyHealtheVet system, forcing radical change on users for far worse service. The new service is very slow and is a total kludge. Too often, all we get is a "try again later" message.
It's also noteworthy that design team communication with veteran users has been non-existent and that local staff have been driven nuts by these problems. To this day, we have never been told how long to expect to be without services. VA fell down badly on the new system. I'd very much like to see the Inspector General looking into it. It's a major boondoggle. And I'd very much like to get the MyHealtheVet program back. (It's still in use for most of the VA system.)
Best regards,
Paul E. Merrell, J.D.
Representative Wilde, I have some thoughts about VA health care. I did my internship at the VA Wadsworth/UCLA in 1970. That institution, then, was outdated and the staff was entrenched, bureaucratic, with outdated cumbersome administration. The Sepulvada earthquake resulted in a new Hospital complex. I use the Eugene VA now, mainly for its pharmacy which is convenient, fast and accurate. The staff are competent, up to date and nice. In 1970 the VA system was being touted as a model for National health care.....At the time I found that proposal scary. Now, I think the VA is getting its act together and deserves more support.