A White Paper Written by Two of VETLANTA’s Leadership Volunteers

[vc_row][vc_column][vc_column_text]first published on LinkedIn 09 DEC 2020 here: https://www.linkedin.com/pulse/social-security-disability-insurance-ssdi-veterans-va-phillips/

Here is an overview of the White Paper (read the entire White Paper below):

Overview:

This White Paper specifically addresses an issue that impacts thousands of Veterans across the United States that have already been deemed, through the Veterans Administration (VA) disability claims process, as having Service Connected disabilities and are also deemed Individual Unemployability (IU) or 100% Permanent (P) or Total (T) disability benefits from the VA.

Those same Veterans when filing a claim with the Social Security Administration (SSA) for Social Security Disability Insurance (SSDI) consideration is broken. There is a process disconnect between the VA and SSA with respect to sharing of medical records between these governmental entities as well as the SSA not recognizing the already completed and vetted medical records of these same Veterans when they file for SSDI. Even if a Veteran has been rated by the VA as IU or 100% P or T disabled, and they have all of their medical records used to come to that VA rating, the SSA does not recognize those VA medical records. What this means is the Veteran must now go through the SSA medical process for consideration of being awarded any SSDI. The process, as it stands today, can take upwards of 2-years to resolve and during that time period it has a direct adverse effect on a Veteran and their family.

It is VETLANTA’s intent to increase efficiency and streamline operations between these two governmental agencies by suggesting an overhaul of the process. Specifically, when a Veteran is awarded a disability rating of IU or 100% P or T, they should automatically qualify for SSDI and the process centered around medical review (physical and mental) is done using the already completed VA medical review. The inherent delays caused by the lack of an optimized process is causing financial hardship, loss of homes which could lead to homelessness of these Veterans and their families.


The White Paper was written to address this significant problem that is impacting Veterans across the United States. Although VETLANTA is a more Atlanta centric organization, we thought this matter was of importance enough that we want to surface it to the Nation and try and get the VA and SSA to the table to talk about possible reforms. Additionally, VETLANTA is already engaged with the Georgia legislators in Washington, DC as well as other Veteran Service Organizations that have seen this document on social media and want to join us. 


Intent is for senior leaders in the VA, SSA, and the executive branch of the government to take not of this inefficient process and take appropriate action to fix the process so Veterans and their families are not adversely impacted. 

 

VETLANTA is an Atlanta-based Veterans Club operated exclusively for Veteran social and business networking and community service purposes. Our mission is to make Atlanta the premier community in the country for Veterans and their families to work and live.

VETLANTA’s purpose is to help Veterans with initiatives within the State and in some cases, initiatives that could have a National impact..

We make Atlanta better by making those that serve Atlanta’s military community better.

VETLANTA is also the Community Veteran Engagement Board (CVEB) for the Veterans Administration (VA) in Atlanta.


INCREASING EFFICIENCY AND STREAMLINING OPERATIONS:

Social Security Disability Insurance (SSDI) and the Veterans Administration (VA) Disability Rating – Process Overhaul

Overview: 

This White Paper specifically addresses an issue that impacts thousands of Veterans that have already been deemed, through the Veterans Administration disability claims process, as having Service Connected disabilities and are also deemed Individual Unemployability (IU) or 100% Permanent or Total disability benefits from the VA.

Those same Veterans when filing a claim with the Social Security Administration for Social Security Disability Insurance (SSDI) consideration is broken. There is a process disconnect between the Veterans Administration and Social Security Administration with respect to sharing of medical records between these governmental entities. Specifically, even if a Veteran has been rated by the Veterans Administration as Individual Unemployability (IU) or 100% Permanent or Total disabled, and the Veteran has all of their medical records used to come to that rating, the Social Security Administration does not recognize those VA medical records which requires the Veteran to go through the Social Security medical process for consideration of being awarded SSDI.

The process, as it stands today, can take upwards of 2-years to resolve and during that time period it has a direct adverse effect on a Veteran and their family. At issue is the unnecessary red tape and bureaucratic roadblocks that simply do not make sense. 

It is VETLANTA’s intent to increase efficiency and streamline operations between these two governmental agencies by suggesting an overhaul of the process. Specifically, when a Veteran is awarded a disability rating of IU or 100% P or T, they should automatically qualify for SSDI and the process centered around medical review (physical and mental) is done using the already completed VA medical review.

The inherent delays caused by the lack of an optimized process is causing financial hardship, loss of homes which could lead to homelessness of these Veterans and their families.

ISSUE:

  1. The process a Veteran has to go through for Social Security Disability Insurance (SSDI) consideration is broken. There is a process disconnect between the Veterans Administration (VA) and SSDI that has a direct adverse effect on a Veteran. 
  2. A secondary effect of the lack of collaboration is SSDI processing time is taking upwards of 2-years. At issue is the unnecessary red tape and bureaucratic roadblocks that simply do not make sense. Often times this delay in processing is too late for the Veteran.
  3. For purposes of narrowing the scope of this proposed modification to the current process, we would first look to those Veterans with Service-Connected (SC) disability in receipt of Individual Unemployability (IU) or 100% Permanent or Total (P or T) disability benefits from the VA. 

DESIRED OUTCOME: 

It is VETLANTA’s intent to increase efficiency and streamline operations between the VA and SSDI by overhauling the process. Specifically, we advocate that when a Veteran is awarded a VA disability rating of IU or 100% P or T, they should automatically qualify for SSDI and the process centered around medical review (physical and mental) is done using the already completed VA medical review.

These revisions are in-line with those done between the military services and the VA for medical records. 

The inherent delays caused by the lack of an optimized process is causing financial hardship, loss of homes which could lead to homelessness of these Veterans and their families. 

DISCUSSION:

The process as it stands today is as follows…when a Veteran is predetermined by the VA to have a SC disability caused by active duty service and the rating is determined to be 70% or greater, there are delays of up to 2-years for approval of SSDI. Medical records from the VA are rarely, if ever, reviewed causing the Veteran to go back through a medical evaluation which further delays the entire process.

By the numbers, per the VA, there are approximately 769,958 Veterans that are 100% SC rated as Permanent & Total and there are approximately 373,859 receiving IU. 

This is not this first time an issue similar to this has occurred. In the recent past, the transferring of medical records from our service members to the VA was primarily done when the service member handed over their records. There was no such thing as an automated transfer of files from the services directly to the VA. The process was slow and often times the Veterans got caught up in the bureaucracy and there were substantial delays in the VA rating awarded to the Veteran. The reverse is also true. SSA has rated Veterans for 100% SSDI yet the VA fights the Veteran for any SC disability compensation when that happens. 

Fortunately for all those service members in recent years have their medical records automatically transmitted or moved from the National Personnel Records Center (NPRC) to the VA when the service member files for a VA disability. It is seamless process and works very well.

RECOMMENDATION:

1. It is VETLANTA’s position that this process as it stands today must be streamlined and warrants change. The changes we are suggesting are completely within the realm of possibility when you consider what has already been accomplished with medical records for our service members that file a disability claim with the VA.

2. Recommend the following:
a. Suggest a two-step process:
i. Short term: Establish an Interagency Agreement at the Secretary level that allows the VA to share complete medical records for a Veteran submitting a                claim for SSDI to the SSA that has a Service-Connected disability of IU or 100% P&T disability benefits.
ii. Long term: Finding a champion in Congress willing to initiate legislative action to change the laws that allow for the sharing of medical records from the               VA to the SSA specifically for SSDI awards, despite what type of rating the Veteran may have from the VA. Further, for those Veterans that are classified               as IU or 100% P&T disabled, award of SSDI is done automatically.
b. Taking into consideration the next level of impacted Veterans with respect to VA disability ratings, create and optimize the linkage between VBA and SSA             when it comes to claims for SSDI from Veterans that have SC VA Disability rating of 70% or higher.
i. Specifically, create a process where the rating that the VA gives a SC disabled Veteran should play a major role in how the Veteran is rated by for SSDI.
ii. All medical records (physical and mental) on the Veteran to include the records used to determine a VA SC Disability rating will be used by the SSA.                    The file should contain all VA medical data and the VA disability compensation letter indicating the SC disability rating as part of the filing package. If                    any further medical evaluation is to be conducted, it should be minimal at best. This measure is a major resource saving step as well as making the                      entire process move more efficiently.
iii. As part of this new process, if a Veteran ends up receiving SSDI, it should not have any adverse impact of the veterans VA SC Disability payments or                  rating.
iv. Expand the interview process by SSA to ask about issues that the Veteran is experiencing with his/her condition that are not yes/no answers.
v. Develop a hot line for Veterans to get answers to questions with respect to these types of claims.
vi. Propose Georgia Congressional District 11 is used as a pilot program.

3. Oversight. Information should be tracked with normal VA and SSA reporting processes. Quarterly standardized reporting and collaboration on issues is highly advised in the short term while the process is being initially implemented.

4. Financial. Process improvements will improve not only the Veteran experience with the VA as well as the SSA but it will have a direct positive impact on the financial well-being and stability of the Veteran and his/her family. It will reduce, across both agencies, manpower and processing requirements. There is absolutely no reason that one government agency does not collaborate and utilize another government agency when the end result is a more efficient process, takes care of our Veterans and is not wasting scarce resources.

 

Point of contact for this White paper is:


ADDENDUM A

 

This addendum is to outline some examples of the issues centered on this matter.

 

RECENT EXAMPLES:

 

  1. United State Air Force female Veteran.
    1. One of the first female F4 Phantom mechanics in the Air Force. 
    2. She was stationed in Ramstein Air Force Base (AFB), Germany in the 1980’sIt was at that duty station that the first occurrence of sexual assault (MST) took place.
    3. She filed a congressional complaint against the Air Force and based on the response and concern she experienced, she felt it was “slow rolled” and ultimately she was discharged from the Air Force for a “Personality Disorder”.
    4. She is also a 100% Service-Connected disable Veteran.
    5. Since that time, this Veteran has fought for more than 25-years with the VA for treatment and recently, she finally got it.  That said, was has not happened is her MST treatment has never passed from the healthcare side of the VA to the VA benefits claims side.
    6. She filed her SSDI paperwork over a year ago based on her interaction with the Social Security Administration (SSA), they never bothered to obtain her VA medical records to see if she had a service-connect disability or to substantiate her claim of being a victim and being diagnosed with MST/PTSD.
    7. She is now going to move from Cherokee County, Georgia to North Carolina. She has been working with Sen. Perdue’s office (Georgia) and the matter will be transferred to Sen. Tom Tillis’s office in North Carolina. She recently contacted Sen. Tillis’s office and has written them a letter along with her appeal for reconsideration for SSDI (see below).

 

Donna Bell

32 Four Paws Lane

Murphy, NC  28906

October 21, 2020

 

Senator Thom Tillis

9300 Harris Corners Pkwy

Suite 170

Charlotte, NC  28269

 

Dear Senator Tillis,

I hope this letter finds you in good health.

I spoke with Channing Sumner in your office today regarding the fact that I am a 100% Permanent and Total Disabled Veteran and was denied SSDI benefits almost one year after applying without ever seeing a doctor for the physical exam assessment.  SSDI made the decision to deny me benefits when the doctor they pulled the records from never saw me.  I have filed an appeal with SSDI.

I am fully aware that SSDI has different criteria than VA for determining eligibility but that is exactly the issue.  Why and who is representing veterans in the state of North Carolina that I can take this up with because this is systemic issue not a personal issue.  I am not the only veteran who is going through yet another vetting process for the same condition that I was vetted for by the VA.  At least the VA pulled records from doctors that actually saw me.

I am requesting an inquiry as to how SSDI took 10 months to deny my benefits, pulled records from a VA doctor that never saw me for the physical exam which I was told was being used to determine my eligibility and claim in the denial letter that I am able to work with the symptoms I suffer with daily when I have not worked since 2018 due to these symptoms.

Who is representing the veterans?  Please help me get to the person who can fight the good fight with me.  I am not going to be insulted or offended by being dismissed by SSDI or anyone else.  I matter.

Thank you for your help.

Best regards,

Donna Bell

 

SSDI Appeal Statement

October 21, 2020

Donna Bell

 

After attending the Trauma Recovery Program at the Atlanta Veterans ‘v Practitioner at the VA who saw me last year and never looked at me when I walked in her office while I was having a severe anxiety attack.  I asked her if she had ever read my extensive mental health records and she stated “no, she had not” and told her nurse that “we better go slow with this one”.  I did not see my doctor on 9/11/2020 when I was schedule to have my annual physical exam done on Telecare due to Covid restrictions since only her nurse got on the call, I was not able to convey to them that I am unable to go out in public without severe tremors severe anxiety and panic attacks, that my night sweats, eating disorder, jumping out of my skin when the dog barks or phone rings & hiding in my house to avoid triggers. Triggers that cause severe reactions to ordinary situations. Once I am triggered I cannot stop it so I have to remove myself from public places and suffer from isolation for years.  Afraid to go outside or drive the car or speak to people due to the symptoms getting exacerbated.  Emotional pain from assaults causes me to feel suicidal but I want to live, I am just trying to find a way to live that is not so debilitating.  There is no cure for trauma.  I can only manage the triggers caused by it. Repeated assaults have changed the pattern in my brain whereas I am in constant alert mode waiting for the next alarm to go off.  It is exhausting because I cannot relax or put my guard down every waking moment.  I have to be physically exhausted to sleep but I still wake up repeatedly and never get rest. The depression feels like grief.  Like I’m grieving my own death.  It feels like I died inside, just an empty existence that has no purpose or meaning.  I fight hard to overcome this but I have learned that no one knows how to deal with it so I have been abandoned by family, friends and children.  I don’t even know how I’ve survived this long.

    1. As of 15 October 2020, SSA informed her that it would take up to 10 months for them to obtain and request her VA medical records! In an effort to further expedite this process, she is going to hand carry a copy of her medical records to the SSA. 
    2. This matter is still open and unresolved.

        2.   United State Marine male Veteran

    1. Initial filing for SSDI was August 2017.
    2. Due to financial hardship, the Veteran also had to file for foreclosure and disabled Veteran hardship.
    3. Veteran was denied SSDI on October 24, 2017 because he had a bank account that more than $3,000.00. After further investigation, the Wells Fargo account that SSA was looking at did not belong to this Veteran. 
    4. On October 26, 2017, the Veteran was contacted by SSA stating they couldn’t process the claim because they were overwhelmed with the amount of submitted evidence documents. 
    5. December 2017, the Veteran was denied SSDI. The reason given for the denial was “Not entitled to disability benefits based on the claim you filed” as well as “Reasons you filed TBI, nystagmus, vision issues, PTSD, hearing damage, migraines, chronic headaches, left shoulder issues and neck issues.”
    6. The Veteran has complete documentation from the Shepherd Center Brain institute outlining his permanently disable status (800+ pages of supporting documents). 
    7. As a follow-up to the denial, the Veteran spoke with Mr. John Henry from SSA to request an in person appointment to help filing an appeal. He was denied the request even after quoting Americans with Disabilities Act and SSA policy to him. 
    8. January 2018, the Veteran received a letter from the SSA stating that the disability would have to keep him from doing any type of work and last at least 12 months and that the disability had to be clinically diagnosed and documented for 3 years. 
    9. February 2018, Veteran was denied SSDI appeal. Appeared only two medical sources were used verses the complete package that was submitted. 
    10. 12 February 2018. Received in person appeals assistance at SSA office this time. 
    11. 23 March 2018. In preparation for a court appearance for SSDI, the Veteran requested all medical records from SSA as well as any communications records they had on file. Initially, the information provided was unreadable and disorganized. After the persistence of the Veteran, he did receive the information he requested. These types of issues not only delay the process, it indicates a lack of attention to detail and any compassion for the Veteran. 
    12. Continuing with a lack of attention to detail, the SSA continued to send sensitive information and communications pertaining to this Veterans case to an attorney that was no longer working on this case for more than 6 weeks after being notified to stop all communications and release of information to the attorney. The impact of these actions effected the Veterans ability to represent himself properly or timely. 
    13. April 2018. A SSA Judge stayed or stopped the process with the VA in that their determinations held no weight in the courtroom.
    14. September 2018. Finally received judgement approving SSDI for 1 year. 
    15. December 2019.  The Veteran received documents from SSA to begin re-approval process for a lifelong permanent injury. Subsequently, it was approved again.
    16. During this entire ordeal, the SSA primary point of contact the Veteran was coordinating with consistently contradicted his conversations when there were conversations with congressional liaison staff concerning needed documentation 
    17. As of early 2020, this Veteran has final approval for SSDI after almost two years of back-and-forth with the SSA. The caveat, this determination is NOT permanent. It will be reviewed again each year as SSA sees fit

       3. United States Air Force male Veteran

    1. Air Force Veteran was involved in an motor cycle accident on post on his way into work.  
    2. He was hospitalized with head injuries as noted by the Air Force Hospital.  
    3. Line of Duty investigation was conducted and was found that the injury was duty related and as a result the VA awarded him 20%.
    4. The Veteran continued to be seen by the VA for headaches associated with the accident but due to the fact that the final hospital treatment records were missing from his medical records, the VA denied any further compensation, but did continued to treat the Veteran.  
    5. The Veteran was unable to hold a job in the private sector due to his headaches and filed with for SSDI and underwent several medical evaluations by the SSA doctors.  
    6. It was determined by the SSA that the Veteran did in fact have what is called cluster headaches, which he had filed for with the VA and was denied twice.
    7. In April 2015, the SSA awarded the Veteran 100% disabled rating.   
    8. In 2017, the Veteran refiled for additional disability compensation from the VA and using the SSA findings as a NEXUS letter with the VA. Additionally, SSA also forwarded all medical evaluations to the VA for inclusion in the VA evaluation.  
    9. Spring 2020, the VA finally awarded the Veteran 100% SC disability status agreeing with the SSA.  
    10. This entire process to obtain the 100/100% rating took over 8 years and financially impeded the Veterans ability to live his life until items were pushed between the VA and SSA

ADDENDUM B

 

This addendum provides definitions, per the VAB, for the three categories being discussed.

 

DEFINITIONS:

 

Individual Unemployability. The Veteran may be able to get disability compensation or benefits at the same level as a Veteran who has a 100% disability rating. The Veteran may be eligible for disability benefits if they meet both of the requirements listed below.

Both of these must be true:

  • You have at least 1 service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more—and
  • You can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment) don’t count.

Note: In certain cases—for example, if you need to be in the hospital often—you may qualify at a lower disability rating.

 

Permanent Disability. Permanent means that a veteran has a disability that has no chance, or close to no chance, of the disability improving. The Department of Veterans Affairs considers a disability to be permanent when the medical evidence shows that it is reasonably certain the severity of the veteran’s condition will continue for the rest of the Veteran’s life. In determining this, the VA is allowed to take into account the veteran’s age.

 

Total Disability. Total means a Veteran’s disability is rated at 100% disabling. Ratings are assigned to disability based on the VA’s rating schedule. A rating is meant to represent how much the disability impairs a Veteran’s ability to function. In other words, the rating reflects the severity of the disability. If a disability is rated at 100%, then that indicates the Veteran is completely, or totally, disabled. The higher a disabled Veteran is rated the higher the disability compensation awarded.

 

VETLANTA is an Atlanta-based Veterans Club operated exclusively for Veteran social and business networking and community service purposes. Our mission is to make Atlanta the premier community in the country for Veterans and their families to work and live.

VETLANTA’s purpose is to help Veterans with initiatives within the State and in some cases, initiatives that could have a National impact..

We make Atlanta better by making those that serve Atlanta’s military community better.

VETLANTA is also the Community Veteran Engagement Board (CVEB) for the Veterans Administration (VA) in Atlanta.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”2586″ alignment=”center” onclick=”img_link_large” css_animation=”fadeInRight” lazy_loading=”true”][/vc_column][/vc_row]

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