Veterans Affairs Dept says it won't reimburse Vets who were underpaid GI Bill benefit payments: report
The Department of Veterans Affairs (VA) told congressional staffers on Wednesday that it will not repay Veterans who received smaller GI Bill benefit payments than they were owed, NBC News reported.
Committee aides told the outlet that the VA said it could not reimburse those Veterans without auditing past education claims, which, they said, would hold up future claims.
The report comes weeks after computer problems delayed GI Bill payments to hundreds of thousands of Veterans.
The issue first came under scrutiny after GI Bill payments were delayed due to a change in calculating housing allowances under the Forever GI Bill, which President Trump signed into law last year. According to NBC News, the department's computers were unable to process the change, quickly leading to an immense backlog of Veterans' claims.
The issues ultimately resulted in Robert Worley, executive director of the VA's education service, being reassigned earlier this month.
Because of the backlog, the department announced Wednesday that it would delay the bill’s housing allowance changes until next year, also pledging that Veterans who received incorrect GI Bill benefit payments would eventually be paid the correct amount.
Committee aides, however, said VA officials told Capitol Hill staffers on Wednesday that the department will not retroactively reimburse underpaid Veterans due to the housing miscalculations once the system is fixed next year, according to NBC News.
"They are essentially going to ignore the law and say that that change only goes forward from Dec. 2019," one aide told the outlet.
Pressed for comment by NBC, VA spokesman Curtis Cashour said that attempting to implement the new law would put “an enormous administrative burden for schools in which some 35,000 certifying officials would have to track retroactively and re-certify hundreds of thousands of enrollment documents.”
He added that the department would instead be paying housing allowances in accordance with the Department of Defense's previous Basic Housing Allowance rates until next year.
Cashour pushed back in a statement to The Hill on Thursday, claiming “the NBC report is misleading and gives the false impression that some Veterans on the GI Bill will not be made whole with respect to their housing payments."
“Nothing could be further from the truth,” he continued. “Each and every Veteran on the post-9/11 GI Bill will be made 100 percent whole — retroactively if need be — for their housing benefits for this academic year based on the current uncapped DoD rates, and, beginning in spring 2020, we [will] be in a position to provide Veterans the new rates where applicable to meet the law known as the Forever GI Bill.”
Cashour further clarified to The Hill that “every single Veteran will be made whole for their housing benefits this year”
“For many students, this DoD BAH [Pentagon Basic Allowance for Housing] rate will be equal to or higher than their current payment,” Cashour continued. “If a student was overpaid due to the change in law or because of VBA’s challenges in implementing the law, the student will not be held liable for the debt.”
Cashour added that the VA in spring 2020 “will have solved its current information technology difficulties" to comply with the Forever GI Bill changes.
VA Falls Behind on GI Bill Payments
Today, you may not be aware, any US military Veteran with a non-dishonorable discharge is eligible for, at a minimum, a full scholarship to a school of their choosing. The modern GI Bill doesn’t just cover school payments, either — it also pays the Veteran a living allowance equivalent to a sergeant in the army’s housing benefits for their zip code. The program is a vital enhancement to previous GI Bills in its effect of ensuring that Veterans are able to fully participate in the economy when they leave active duty without having to worry about feeding themselves or paying rent while preparing to do so.
However, tens of thousands of such eligible Veterans have been hung out to dry for a quite some time now. It’s not because the money’s not there, although the program is not considered an essential service when budget showdowns occur (in fact, the whole Veterans Affairs department is not). It’s not because the VA does not want to pay them and — for once — even the banks are blameless. The problem, according to VA officials who were grilled last week in on Capitol Hill, is the technology stack being used.
Apparently, due to changes enacted in the Forever GI Bill, a slight enhancement of the Post-9/11 bill, payments have been stalled due to technical difficulties. Paul Lawrence, the head of the Veteran’s Benefits Administration (the part of the VA that handles payments), testified that he had previously made a mistake when he put a deadline on when the program would be repaired. At present, he has no clue when it will be fixed. Officials specifically said that 22 of the 34 changes made in the GI Bill last year required IT work, although they were not specific about what IT changes were necessary or why they were having an effect on payments being made. Lawrence said:
“We did not understand the certainty around it. That is why we are not giving you a date.”
For Everything Else, There’s Blockchain
Now here’s where the author gets a little upset.
First of all, never fix things that aren’t broken. In terms of software development, this means to keep the working version working until you’ve got the replacement tested and ready to deploy. This is to say, whatever they were using before should still be in use today, so that Veterans are paid. There was no mention as to whether or not schools are receiving their payments, but presumably, most colleges can miss a payment or two.
Secondly, why all the opacity around both the development and the payment mechanisms? The author remembers having to call in to check on the status of his GI Bill payments. No information would be available prior to the actual due date, and sometimes they actually did come a few days later. It’s a stressful experience for a Veteran because it always makes one think perhaps they’ve done something wrong in their paperwork, forgot to respond to something or other, or what have you.
Government Software Should be Open Source
It may seem extreme, but the author presents the following contention: all software developed or licensed by any democratic government should be open source. It belongs to the people, after all, either the license or the code itself. If there are engineering problems affecting the implementation of the new system, then an open-source approach would probably yield solutions faster.
Which brings us to the third point: why not blockchain this, as it were? Payments are the heart of the blockchain. Privacy and some degree of opacity are important when dealing with people’s private information, such as benefits they’re receiving from the government, but some form of permissioned blockchain would probably have been more ideal than building a “new” antiquated system that will end up being replaced in 5-20 years anyway.
No, the author’s not advocating that people receive their benefits in cryptocurrencies. Not necessarily. What he’s advocating is that a blockchain — whichever might be best suited — be used to track and make payments. Companies like Ripple have deep connections to the bank industry and could facilitate instant payments some way or another. Enough of the data could be public that a Veteran could simply enter some pre-determined key and see whether or not their benefits had been sent and when they would be expected to be sent. Payments could be tracked through the entirety of the process. Such a move would go a long way to restoring trust in the people running the system.
What do you think, dear reader? Is this an aspect of the government that blockchain could help with? What blockchain technology stack do you think has the most chance of being used by the government for such things as benefits payments and tracking? Ripple? Ethereum? Bitcoin? NEO? Let’s hear your views in the comments!
The VA's regional offices reopened on Monday, but the canceled work came less than two days after a House committee demanded answers on delayed payments to Veterans.
Less than two days after a House committee demanded answers on why computer problems were delaying Veterans' GI Bill payments, the Veterans Benefits Administration unexpectedly canceled its weekend work at three regional processing centers at the last minute on Saturday morning.
A VA spokesman said a system update stymied the agency's attempts to work on its backlog of benefit claims, putting a halt to the mandatory overtime ordered to address the problem. NBC News previously reported that computer problems have caused GI Bill benefit payments that cover education and housing to be delayed or made incorrectly, forcing some Veterans to face dire financial circumstances.
In response to the delays, the Veterans Benefits Administration's (VBA) Education Service placed the regional processing centers on mandatory overtime, including weekend work, and hired 202 additional workers.
At Thursday's hearing before the House Veterans' Affairs Committee, VA officials were unwilling to offer a concrete date — or even an estimate — for when the problem might be fully resolved, but said they would continue with mandatory overtime to address the issue.
“The plan going forward is to continue our overtime work, continue to have the improved processing provided by 200 additional processors,” Gen. Robert Worley, the director of VBA’s education service, testified on Thursday. “We’re focusing, as I said, on the old work first. We’re handling hardships as they come in. And that’s the ongoing effort that we’ve gone through since the peak of this fall, which was 207,000 claims on Sept. 4.”
The VA confirmed that it alerted employees at 9 a.m. ET on Saturday that all overtime work on education claims would be canceled at the three regional offices, but it did not respond to multiple requests for comment on the number of workers who were told to stay home.
Stars and Stripes reported last week that overtime has cost about $300,000 every week since the beginning of August, totaling about $4.5 million.
The House Veterans' Affairs Committee, which held Thursday's hearing, began to investigate the matter on Saturday after they found out about the canceled work, a committee aide told NBC News.
The committee believed it was "an internal communication issue" at the federal agency, the aide said, as VA officials told them the system was not "down." However, the payment system became "unavailable" when they input new compensation and pension rates that are to take effect Dec. 1.
"Education staff were told that this wouldn’t impact processing of education claims but they were wrong," the committee aide said. "As such, they canceled overtime this past weekend.”
Curt Cashour, a spokesman for the Department of Veterans Affairs, said that full operations at the regional offices resumed Monday morning and that the canceled overtime would "have little effect on VA's overall education claims processing, as the department's education claims inventory is trending downward."
Cashour denied that thousands of Veterans had waited months for payment or been made homeless by the delayed payments.
Sen. Mike Enzi, R-Wyo., the chairman of the Senate Budget Committee, however, sent a letter to Veterans Affairs Secretary Robert Wilkie on Friday, asking him to address the multiple reports that the delayed payments have put student Veterans in difficult financial circumstances.
The chairman also asked how much money VA had spent to address its computer system, the number of employees working on it, the status of the IT upgrades, the amount of time it will take VA to correct its payments and send them to Veterans, how much is owed to student Veterans and how VA is communicating with students and schools about the delays.
“These problems have forced our Veterans to go without money to pay for basic necessities like food and rent, with some facing potential eviction or the prospect of getting kicked out of school,” Enzi said in a statement. “They deserve better.”
The VA said as of Saturday that it had approximately 51,000 pending post-9/11 GI Bill claims. According to Cashour, each education claim is processed in 24.3 days for original claims and 17.3 days for supplemental claims.
"VA’s education claims inventory includes claims that are as new as one day old, and not all involve payments, such as initial applications or changes of programs," Cashour said in an email to NBC News on Saturday. "Approximately 1-percent or fewer of VA’s education claims are more than 60 days old. We continue to monitor closely and prioritize these claims."
Computer problems at VA have caused benefit payments to be delayed for months or never be delivered, potentially affecting hundreds of thousands of Veterans.
A House committee will hear testimony Thursday from Department of Veterans Affairs officials over delayed GI Bill payments potentially affecting hundreds of thousands of Veterans. NBC News reported Sunday that computer problems at VA have caused GI Bill benefit payments covering education and housing to be delayed for months or never be delivered, forcing some Veterans to face debt or even homelessness.
On Wednesday, one of the key witnesses called to testify from VA was reassigned by the federal agency to a regional office in Houston, multiple officials told NBC News.
Robert Worley, executive director of Education Service of the Veterans Benefits Administration (VBA), based in Washington, has been appointed to serve as the executive director of the VBA’s Houston regional office, according to two sources close to the VA and an email reviewed by NBC News.
Molly Jenkins, a spokeswoman for Republicans on the House Veterans' Affairs Committee, confirmed Thursday that Worley would be departing his current position to lead the VBA office in Houston.
Higher-ups at VA decided to reassign Worley due to the delayed GI Bill payments, as well as other issues within his office, sources said. Worley was told that he could choose which of VBA’s 52 regional offices he would lead, but that he had to leave his current position.
The VA is expected to say that Worley is leaving his current position because he wants to spend more time in the field, sources said, but the move comes amid ongoing issues around GI Bill benefit payments. Thursday's House Committee on Veterans' Affairs hearing is an attempt to hold VA accountable for the delayed payments to Veterans, they added.
Worley's departure is believed to provide VA leadership an out at the hearing.
“It allows him to take a bullet [at the committee hearing] for the undersecretary,” one former VA official said.
VA Undersecretary for Benefits Dr. Paul Lawrence will testify at the hearing on Thursday afternoon. Bill James and John Galvin, both from VA's Office of Information & Technology, are expected to testify as well. Richard Crowe, the senior vice president of Booz Allen Hamilton, the information technology contractor who worked on the Forever GI Bill with VA will also testify.
The announcement of Worley's move was made internally on Friday. VA and Worley did not respond to NBC News' request for comment.
Worley had been in his current position as the director of education service since March 2012. Prior to coming to VBA, Worley retired from the Air Force as a major general.
Service organizations that advocate for Veterans in Washington said that they are concerned that Worley’s departure will negatively affect their ability to promote Veterans issues.
Patrick Murray, deputy director of the Veterans of Foreign Wars, said that he did not know of Worley's upcoming departure but the VFW had a good working relationship with him. They could easily call him about problems that they were seeing, he said.
"It sounds like another change in leadership,” Murray said. “The honest truth is that we could get someone in that we don’t have a good relationship with and that’s a legitimate fear. Constant turnover is not great.”
Meanwhile, the U.S. Senate is also taking a deeper look at the problems VA is facing.
Democratic Sens. Patty Murray, Richard Blumenthal, Michael Bennet, Sherrod Brown and Debbie Stabenow wrote a letter to VA Secretary Robert Wilkie on Tuesday in response to reports of the ongoing computer issues at VA that delayed GI Bill benefit payments.
"As a nation we have a responsibility to be there for our Veterans, and part of that duty involves fulfilling our promise to ensure they have access to education after they leave the service," the letter said. "These errors and delays undermine the intent of the GI Bill and put unnecessary and avoidable strain on Veterans and their families during a critical time of transition."
The letter asked for the VA secretary to provide an updated number of affected Veterans, average wait time for payments, the number of full-time and contract employees working to fix the technology error, how much the extra work will cost, when the VA learned of the error and the steps it is taking to ensure these types of issues don’t happen again.
Democrats requested in the letter that VA provide updates every two weeks until the problem is resolved.
Murray, D-Wash., who led the minority effort to write the letter to Wilkie, said that Veterans should not have to wait to receive the benefits that are supposed to help them transition into civilian life.
“I expect VA to work as urgently as possible to honor its commitment to our Veterans and process all backlogged housing stipend and tuition payments — and many of us in Congress will be watching closely to ensure they make this right for the thousands of Veterans waiting desperately for relief,” the senator wrote.
"This is — to be kind — a train wreck,” said Rep. Phil Roe, R-Tenn., the chairman of the House Committee on Veterans Affairs.
Shelley Roundtree departed the U.S. Army in 2013 after seeing friends and fellow soldiers die in combat during his tour in Afghanistan. He was committed to transitioning to civilian life, and one of his first steps was to enroll in college with tuition and housing benefits he'd earned under the GI Bill.
Roundtree, 29, began studying marketing at Berkeley College in Midtown Manhattan. He dreams of working in the fashion industry, and he's close to graduating — but now there's a serious obstacle.
The Department of Veterans Affairs is suffering from a series of information technology glitches that has caused GI Bill benefit payments covering education and housing to be delayed or — in the case of Roundtree — never be delivered.
"I’m about to lose everything that I own and become homeless," Roundtree said. "I don’t want to be that Veteran on the street begging for change because I haven’t received what I was promised."
Without the GI Bill's housing stipend, Roundtree was kicked out of his apartment and is now living on his sister's couch, miles from school, where he feels like a burden on his family. The new living situation required him to move all his belongings into a storage container, which he can no longer afford. Now all of his possessions are in danger of being auctioned off by the storage facility.
Roundtree said that because of his extremely strained finances, he is forced to choose between spending money on public transportation to get to his marketing classes or buying food — not both. At the end of the day, the Veteran said he often makes himself go to sleep hungry.
"It’s just confusing," said Roundtree. "Who is there for us? Who is representing us? Who is helping us? Who is doing what they need to do to better the situation for Veterans?"
There are many Veterans, like Roundtree, across the country who are still waiting for VA to catch up with a backlog created after President Donald Trump signed the Forever GI Bill in 2017. The landmark piece of legislation greatly expanded benefits for Veterans and their families, but it did not upgrade the VA's technical capabilities to account for those changes.
While it is unclear how many GI Bill recipients were affected by the delays, as of Nov. 8, more than 82,000 were still waiting for their housing payments with only weeks remaining in the school semester, according to the VA. Hundreds of thousands are believed to have been affected.
The cause of the difficulty lies within VA’s Office of Information Technology, which was tasked with implementing a change in how the housing allowance was calculated, the agency said. The Forever GI Bill required that housing would be based on the ZIP code of where a Veteran went to school, not where he or she lived.
Issues that arose when VA attempted to stress-test their antiquated system, and a contract dispute over the new changes, meant VA waited until July 16 to tell schools to begin enrolling students, according to Veteran advocacy groups. Many colleges and universities waited, however, because the VA told them that they would need to re-enter their student Veterans' certifying information either way.
“That’s when the floodgates opened,” said Patrick Murray, the deputy director of the Veterans of Foreign Wars. “With all the delays trying to get the upgrades in the ZIP code processing, they suddenly got all their enrollments, which usually come during the spring across the summer. Instead they all came a few weeks before the fall semester, and they couldn’t keep up.”
A VA spokesperson told NBC News by email that "further system changes and modifications are being made and testing is ongoing on the IT solution" to fix the delay in monthly stipend payments.
"These changes have led to processing issues," a VA spokesperson wrote, referring to the GI Bill changes, "and VA is committed to providing a solution that is reliable, efficient and effective."
At the end of August, Veterans Benefits Administration had nearly 239,000 pending claims — 100,000 more than at the same point in 2017. As school began, thousands of students faced dire circumstances and some faced eviction, getting kicked out of school or taking on loan or credit card debt.
As the problem appears to have no clear solution, the House Committee on Veterans’ Affairs is holding a hearing Wednesday to investigate the matter.
The contractor hired by the VA to update its system for the Forever GI Bill, Booz Allen Hamilton, a multibillion-dollar information technology company, will be called to testify, a committee aide said. They will be joined by Under Secretary for Benefits Dr. Paul Lawrence and Director of the Education Service Robert Worley. A witness from the VA’s Office of Information and Technology will also be called.
"This is — to be kind — a train wreck,” said Rep. Phil Roe, R-Tenn., the chairman of the Veterans' affairs committee. “It’s really frustrating the amount of money that Congress has appropriated for Veterans, and this is the way VA has rolled it out. This discussion started over a year ago.”
Roe’s office recently visited the VA’s regional processing office in Muskogee, Oklahoma, along with Democratic and Senate Committee staffers and Sen. James Lankford, R-Okla.
In a Nov. 5 letter to Secretary of Veterans Affairs Robert Wilkie, Roe said that employees at the processing center told the group that IT systems at the office froze and crashed so often that tasks that once took five minutes now required 45 minutes. Computers often suffered a “blue screen of death,” which required restarting machines, and “managers had to write off 16,890 man hours due to system crashes or latency issues.”
“While Committee staff never witnessed a ‘blue screen of death,’” the letter said, “they did witness the system crash no fewer than five times in a 10 minute period.”
The VA declined to share how much the IT system failures, overtime payments and the 202 additional workers hired to address these problems have cost taxpayers.
As some Veteran advocates point out, this is not an issue that came as a surprise.
At the July 17, 2017, hearing in the House Committee on Veterans' Affairs — before the bill was passed into law — Deputy Under Secretary for Economic Opportunity Curtis Coy highlighted this as his core worry in response to one of the few questions asked during the hearing.
“My biggest concern is two words: IT,” said Coy at the time. “We have an IT system in much or almost all of these sections that requires some degree of changes.”
After Coy retired this year, the VA cut his position and the Office of Economic Opportunity. Multiple Veteran Service Organizations said the loss of this role, as well as the office, meant that there was no one left at the VA to communicate the issues to Veterans or to lobby higher-ups about the GI Bill issues.
That’s not to mention the huge number of posts that remain unfilled at the agency. More than 45,000 jobs sit vacant at the VA, according to the agency’s own numbers, and it has not had a permanent chief information officer since LaVerne Council departed the office after Trump’s election.
"Right now Secretary Wilkie and Dr. Lawrence have only been on the jobs for months,” Murray said. “People have been coming in and out of the VA like it’s a revolving door, and this is another example where a lack of consistent leadership causes these problems.”
But Veterans like Roundtree are less concerned about the leadership at the VA — they just want to know if they can depend on the money they earned under the GI Bill.
And advocates are similarly concerned as it remains unclear if the VA will be able to catch up before January, or if it will be inundated with new requests next year and fall even further behind.
“I don’t see that there is an immediate fix, and I don’t see how this is going to be addressed in the spring or summer semesters,” said Tanya Ang, the policy and outreach director of Veterans Education Success. “This needs to be something that has a greater focus on it for a lot longer."
Today the U.S. Department of Veterans (VA) announced that it is prioritizing Veterans benefits appeals, effective Nov. 1, for victims in the Northern Mariana Islands who have been impacted by Super Typhoon Yutu.
VA’s Board of Veterans’ Appeals has determined that the significant effects of Super Typhoon Yutu were sufficient cause for the Board to advance the appeals for the Northern Mariana Islands municipalities determined to be disaster areas by the Federal Emergency Management Agency (FEMA).
“During this season of intense weather systems, VA is continually assessing how we can best support our Veterans as they recover from natural disasters,” VA Secretary Wilkie said. “Just as it did with hurricanes Florence and Michael, VA’s Board of Veterans’ Appeals is prioritizing the benefits appeals claims process because it is the right thing to do.”
By regulation, the Board may advance appeals on docket (AOD) by a motion of the chairman if sufficient cause is shown. All Veterans and other appellants with an appeal currently pending before the Board whose addresses of record are in one of the affected municipalities will have their appeal automatically advanced on the Board’s docket.
No action from Veterans or appellants are needed if their addresses are current. The AOD for this storm is expected to last until April 30, 2019, and the Board will reassess the situation after that period has ended. For a comprehensive list of all affected AOD areas, visit: www.bva.va.gov/Natural_Disasters.asp.
In addition to Super Typhoon Yutu, VA also concluded that the significant effects of hurricanes Florence and Michaelwere sufficient cause for the Board to advance the appeals for counties in Florida, North Carolina, South Carolina and Georgia found to be disaster areas by FEMA.
The mission of VA’s Board of Veterans’ Appeals is to conduct hearings and decide disability benefits appeals for Veterans in a timely manner. For more information about the Board, visit www.bva.va.gov/.
The VA offers protections for disability ratings that have been in effect for certain periods of time. Until these regulatory protections kick in or your ratings become permanent, VA may severe or reduce a Veteran’s disability rating based on specific findings.
WHEN CAN THE VA SEVER SERVICE CONNECTION?
Severance is when the VA tries to revoke a finding of service connection. If the VA tries to sever service connection, it will notify the Veteran of the proposed action and give him or her 60 days to submit evidence to show that service connection should not be severed and 30 days to request a hearing. If the Veteran does not submit evidence within that 60-day window or request a hearing within 30 days, the VA will issue a final decision.
In cases of severance, Veterans are given added protection if they have been service-connected for the condition for 10 years or more. Under 38 C.F.R. 3.957 in the VA code of regulations, a Veteran’s service-connected disability that has been in effect for ten years or more “will not be severed except upon a showing that the original grant was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge.” The ten-year period is calculated from the effective date of the award for service connection. For example, if a Veteran was granted service connection for a low back injury effective October 20, 1980 and the VA issued a decision dated August 29, 2018 attempting to sever service connection, the VA would have to abide by the ten-year rule above.
WHEN CAN THE VA REDUCE MY DISABILITY RATING?
Veterans with disabilities that are not considered permanent may be sent for future VA examinations in order for the VA to evaluate the severity of those disabilities and rate them appropriately. If the VA finds that a Veteran’s condition has improved, it can reduce a Veteran’s disability rating.
The VA is required to follow the same process for reductions as they are for severances. This means that if the VA wishes to reduce a disability rating, they must issue notice of the proposed reduction and give the Veteran 60 days to submit evidence and 30 days to request a hearing. However, there is one major difference between the process of a reduction and severance. When the reduction would not change the actual amount of compensation that a Veteran is receiving, the VA does not have to issue notice of the reduction.
WHEN DOES MY VA RATING BECOME PERMANENT?
An easy way to tell if your VA disability ratings are permanent is if the VA has deemed you to be totally and permanently disabled. This means that the VA does not see a reasonable chance of your conditions improving. However, if you are not “permanent and total,” the VA has regulatory protections for reductions of service-connected disabilities.
Under 38 C.F.R. 3.951 (b), the VA cannot reduce a rating that has been “continuously rated at or above any evaluation of disability for 20 or more years” unless it is shown that the rating was based on fraud. So, for example, if you are rated at 20% for a right knee disability from January 1994 and the VA proposes to reduce your right knee rating to 0% in March 2017, they can only do so if they find that your initial 20% rating was based on fraud. If they cannot show that, they cannot reduce your 20% rating. This rule protects disabilities that have been increased over the span of 20 years or more as well. For example, the Veteran who receives 20% for his right knee disability from January 1994 was increased to 30% in 2006. In March 2017, the VA proposes to reduce his 30% to 0%. Although the rating for the right knee condition changed between the initial grant and the proposed reduction, he is still protected under the 20-year rule.
WHAT IF I HAVE TDIU?
For Veterans that have been granted entitlement to Total Disability Based on Individual Unemployability (“TDIU”), the VA can only reduce that rating if “actual employability is established by clear and convincing evidence” (38 C.F.R. 3.3.43(c)). What that means is the VA can only sever your TDIU if you have been found to be employable. For Veterans with TDIU, the VA will send out a yearly employment questionnaire to see if a Veteran participated in substantially gainful employment during that year. In order for the employment to be substantially gainful, a Veteran would have had to be employed for 12 months or more and would have had to earn over the federal poverty threshold.
Check out our video on Permanent and Total disability HERE.
Under certain conditions, VA may reduce your disability rating. Legally, VA is entitled to rating reductions but there are rules they must follow when doing so. But unfortunately, mistakes are still made and VA often does not get rating reductions quite right. So, in this post, we’ll discuss what VA can and cannot do when reducing your rating and what you should do if VA sends notice that your rating may be adjusted.
WHY DOES VA REDUCE RATINGS?
The idea is that some service-connected conditions will improve over time or with treatment and VA wants to make sure they are compensating each Veteran according to their present level of disability. For example, if you had service-connected cancer and but it goes into remission, VA would propose a rating reduction because, presumably, your cancer is less disabling – i.e. has less of an impact on your ability to function in life and at work.
VA normally starts the process of reducing a rating under two circumstances:
- Scheduled re-examinations. Usually, VA will evaluate (after you are granted service-connection) whether your disability should be scheduled for a future re-examination (a C&P exam) to determine if your benefits need to be adjusted. VA usually makes this determination if they believe your disability can be expected to improve. Typically, the first re-exam will be scheduled 2-5 years from the date of your first Rating Decision.
- Evidence of change in condition. VA can also order a re-examination at any time if there is new, relevant medical evidence that your disability has improved.
But disabilities, as you likely know, are complicated. Symptoms of a disability may temporarily decrease but resume at baseline level soon after. Or, for example, symptoms may improve but not enough to significantly (or, as VA would say, materially) improve your ability to function under the ordinary stressors of life or work. So VA has strict rules guiding the process of rating reductions. But, those guidelines are not always applied correctly, so it can help to have an idea of what VA is required to do.
GENERAL RULES VA MUST FOLLOW FOR RATING REDUCTIONS
There are a number of things VA must do when reducing ratings under any circumstances:
- A proposed rating (as well as a final decision) must be based on a review of the Veteran’s entire medical history
- VA must show that there has been an actual change in the disability since the last rating decision
- VA must show that change in the disability reflects material improvement in the Veteran’s ability to function under the ordinary conditions and stressors of life and work
- Examination reports must be based on thorough examinations
Additionally, the procedural manual (M21) that VA adjudicators use to process claims states that VA must outline the time period during which your condition is said to have (materially) improved.
WHAT TO DO IF YOU GET NOTICE OF A POTENTIAL RATING REDUCTION
VA is required to send a letter proposing the reduction of your benefits, if the decrease will affect the amount of monthly compensation you receive. The letter is not a final VA decision and so cannot be appealed, but VA gives you the opportunity to respond to the proposal by submitting evidence and/or attending a hearing.
From the date of the letter, you have 60 days to submit evidence if you believe the reduction is not warranted. Within the first 30 days of the 60-day period, you have the option to request a hearing to be conducted by VA personnel unrelated to the proposed reduction. VA must consider evidence you submit during this period (including the transcript of the hearing, if you choose to attend one) and all previous evidence and medical records associated with your file.
What are some types of evidence you might submit? You do not need to submit treatment records from your VA Medical Center as VA already has access to those documents. But it can be helpful to submit a medical opinion from an outside, independent doctor if your Compensation and Pension exam was not favorable. Additionally, you may want to submit statements from family, friends, or employers who have observed your ability to function in daily life and/or at work. If you choose not to submit evidence within the 60-day period, VA will issue a final decision reducing your rating.
If, after 60 days or the review of your submitted evidence, VA sends a final decision that reduces your rating, you can file an appeal with a Notice of Disagreement form.
For certain special cases, there are rules in place that protect Veterans from rating reductions or severance of their disability benefits.
Stabilized Ratings: 5 Years or more
Any rating that has remained at the same level for 5 years or longer is considered “stabilized.” In addition to the general rating reduction rules that VA must follow (see above), VA must show sustained improvement in your condition.
What does sustained improvement mean? Essentially it means one of two things: Either 1) VA cannot use just one re-examination (C&P exam) to show ‘sustained’ improvement, rather they must show through medical records as well as a C&P re-exam that you are not just temporarily experiencing improvement. Or, 2) VA must show that the evidence in your file predominantly demonstrates ‘sustained.’
VA must provide an explanation of why they are reasonably certain your condition will continue to show ‘sustained’ improvement.
100% (Total) Ratings
VA can reduce a total rating (that is, a rating of 100%) only if there is material improvement in the Veteran’s condition. In addition to the general rating reduction rules, VA must provide evidence that your condition has improved such that there has been an observable change in your ability to function under the conditions of daily life.
Continuous Ratings: 20 years or more
Conditions that have been rated at or above a certain rating level for 20 years or longer are considered “continuous.” VA cannot reduce a continuous rating below the original rating level (unless they determine the rating was based on fraud). For example, if a Veteran’s service-connected PTSD was originally rated 30% disabling and fluctuated between 30% and 70% over the next 20 years (without dipping below 30%), VA could not reduce the rating to below 30 percent.
WASHINGTON (NEXSTAR) -- Some Veterans aren't getting their education and housing benefits and Congress wants to know why. A House committee says it will hold a hearing, after the election, and Veterans’ advocates say the VA needs to be held accountable.
The American Legion says some student Veterans are facing eviction because the VA is behind on GI Bill payments.
”Over 200,000 Vets with late payments.”
John Kamin with the American Legion says some monthly housing payments for student Veterans have been delayed up to 90 days.
“Left moving back in with their parents or couch surfing because the VA was not able to honor these Veterans and their service,” said Kamin.
On top of that, he says some schools won't let Veterans graduate or register for classes, because their tuition is late.
The VA acknowledges it's behind on the payments. In a statement, a spokesperson told us VA employees are working overtime to process the claims, and it has brought on 200 additional people to speed up the process.
“It's not enough. Absolutely not. We're beyond the point where we can take their word for it. we need to see executive action. Why has the secretary not spoken up about this?” asked Kamin.
The VA faced similar problems in 2009 but issued emergency payments to Veterans.
Congressman Jim Banks, serves on the Veterans Affairs committee. He says the VA needs a technology overhaul to keep up with the payments and other services.
“We'll get to the bottom of the matter. We'll do everything we can to see that it's fixed,” said Banks.
Kamin argues the VA knew its technology needed an update.
“The VA did not take it to be a serious problem and that's why we're where we are…Vets are left trying to figure out how to live their lives,” said Kamin.
Banks vows to hold the VA accountable but Kamin is skeptical, and already worried about payments for the upcoming spring semester.
The House Veterans Affairs Committee hearing looking into the issue is set for Nov. 14.
The VA says Veterans who aren't receiving their payments and need help to call its customer service number: 888-442-4551.
The American Legion also urges Veterans who are struggling to contact their offices.
According to the VA, these changes will ensure that only those with a genuine need receive these benefits.
There were four major changes to the qualifications for these benefits:
- Establishment of a clear net-worth limit for income and assets
- Establishment of a 36-month look-back period to review asset transfers at less than fair market value that may reduce net worth
- Establishment of up to a five-year penalty period to be calculated based on the portion of the covered assets that would have made net worth excessive, and
- Updates to medical expense definitions for consistency with VA internal guidelines.
Establishment Of A Clear Net-Worth Limit
Previously, the VA used a complicated formula to compute net worth. The new regulations create an arbitrary amount. VA says this will make computation easier, faster, and fairer.
Under the new regulations, the net worth limit for 2019 is $123,600. This limit will be increased by the same percentage as the annual social security COLA increase, if there is one. A primary residence does not count as part of net worth, also a mortgage does not count as a liability.
Establishment Of A 36-Month Look-Back Period
This rule should keep people from hiding money in order to qualify for benefits. Some bad actors would sell stocks or other assets at a loss in order to qualify for pension benefits, others would "gift" money to a friend or family member in order to bring their net worth down to the qualifying limits.
The new rule requires VA to look at an applicant's finances for the 36 months prior to the application for pension to determine if there are any financial irregularities.
Establishment Of Up To A Five-Year Penalty Period
This rule is related to the 36-month look-back period.
If an applicant transfers money to a non-qualified source as determined above, the VA will withhold the pension based on the amount of money transferred. So, if an applicant transferred $12,000 to an uncle in order to qualify for pension and their monthly pension amount is $2,000, the VA will withhold 6 months of pension ($2,000 x 6=$12,000). This new rule allows the VA to withhold pension for up to 5 years in such cases.
Updates To Medical Expense Definitions
Medical costs have long been used in computing net-worth for pension benefits, however there has been much argument as to what really constitutes a "medical cost".
Previously, the VA didn't include some medical care such as custodial care, assistance with getting around in one's home, and in-home supervision. While this type of care isn't "medical" by definition, it is related to an underlying medical condition, therefore the VA has added it as a cost.
These new rules add these and other types of types of care as qualifying expenses.
Veteran's pension is a monthly payment to certain Veterans with income below levels. The Veteran must have served at least one day during a wartime period and be:
- 65 years or older, or
- permanently and totally disabled, or
- in a nursing home, or
- receiving social security disability, or
- receiving supplemental security income
See our Veterans Pension page for more details.
Survivor's pension, also known as the "death pension", is paid monthly payment to low-income, un-remarried surviving spouses and certain children of deceased wartime Veterans.
See our Survivor's Pension page for more details.
Parents’ Dependency and Indemnity Compensation (DIC)
Parents' DIC is a tax-free income-based monthly benefit for the parents, or parent, of a military service member or Veteran who has died from:
- A disease or injury incurred or aggravated while on active duty or active duty for training, OR
- An injury incurred or aggravated in line of duty while on inactive duty for training, OR
- A service-connected disability.
“The amended regulations bring consistency to the pension process and ensure benefits are available for Veterans and survivors with financial need,” said VA Secretary Robert Wilkie. “They will help maintain the integrity of and provide clarity to our needs-based pension program.”