For Veterans today it becomes a big concern if the members of Congress are with them or not, I am here to tell you that I am 100% with you. I do not boast about being a Veteran or being disabled because it should not be used to garner a vote out loyalty or any other reason.
With that said, I know the struggles of the VA Claims systems and the failures of the government regarding care.
The wait time for claims can exceed four years, this is uncalled for. The average denial rate at the first stages is 75%, this is also uncalled for. This 75% denial rate can be because of a simple error of a wrong year, something the VSR could correct without changing the outcome of a claim.
For a fully developed claim or an FDC, the claims process should be expedited because the service member has provided nearly all the documentation needed to verify a claim. I want Congress to mandate that all FDC’s be decided within 90 days, during these 90 days it shall be directed that the closest VA or VA Clinic be authorized to treat the Veteran and to maintain the members physical and mental health.
Once a decision is made then it is up to the Veteran to accept the decision or appeal it, the appeal process shall be fast tracked and decided within 45 days. During those 45 days the Veteran shall continue to receive services. Once that appeal is decided, it is again up to the Veteran to accept or ask for court date. A court date shall be scheduled within 60 days and may be done virtually, during this time the Veteran will continue to receive service.
The above will not be a request for the VA to accomplish, it will be an act of Congress mandating it be done. A claim shall be fully processed through all stages of appeals within 195 calendar days. All awarded back pay will go back to the initial claim date. If 195 days passes and no decision is made, the Veteran will be presumptive disabled at 100% until the claim is processed fully. The Veteran will not receive any back pay or SSDI on the presumptive status. The Veteran will also not be responsible for paying back any money if their final rating is lower than 100% but the difference will be deducted from any back pay owed. If the back pay does not cover the balance, it shall be forgiven and counted as an error on government.
To coincide with the VA process, I will ask that the Social Security Administration accept and use all VA Documents regarding healthcare. Any Veteran who receives a Total and Permanent rating or a TDIU rating will automatically receive their SSDI benefits in full and shall be backdated to the VA approval date and full back pay be awarded. It makes no sense as a cost standpoint that the SSA puts zero weight into what the VA Doctors have stated, which is usually outsourced to other Doctors anyway.
For Veteran treatment, I want a choice act. If you live outside 30 miles of a VA or a VA Clinic, then you can choose to use any doctor who accepts Medicare/Medicaid, and you will have no deductibles. Your prescriptions will need to go through the VA mail program.
For any claim that is not an FDC, the above shall apply except for the timeline, double the time in each phase.