- Hi, today we're gonna be talking about expediting claims.
Who can qualify for an expedited claim?
How long is this taking normally, has AMA made a difference?
And then we're gonna go into hardship, homelessness,
and other factors that can come into expediting a claim,
so we hope you'll join us.
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Hi, and welcome back to Hill and Ponton VA disability vlog,
I'm Natalia Jofre, the company cOO.
- And I'm attorney Alison Reddick.
- And as promised, today we're gonna be talking
about expediting claims.
So I think Alli, we need to start with the basics.
On average, can you give us a ballpark?
How long is it taking for a claim to get processed?
- On average no, I cannot give you a ballpark
but I can kind of let you know what I've dealt with.
So basically, for years it has been taking years,
multiple years to get appeals processed.
The reason why this happened,
I think is because around 2014, the VA had so many claims
that they're like, let's get as many as of these
as done as possible to show positive results.
And yey great!
They did like a million claims.
But a lot of the results were not positive.
So what did that create?
A million appeals.
So it really created a backlog of appeals
at the regional office and the board.
So in legacy which was prior
to the current administrative appeal process,
which is the Appeals Modernization Modernization Act,
which is AMA.
In legacy, it was taking one to two, to three,
to four, five, six, seven plus years
to get positive results or even a decision.
Now on February 19, of 2019, AMA came into effect.
With AMA their push is to get appeals
and claims process quickly.
They say they want to get claims
at the regional office decided within 125 days.
Do I see that?
Not really, a lot of the times at the beginning,
we would see that but it was because there was a duty
to assist error, or it was just a flat out denial.
Going back though, since we brought this
in this new appeal process AMA.
Well, we still have all the legacy claims too.
So they're--
- They're one didn't completely (Allison laughs)
replace the other or they didn't say, fresh start,
we're just gonna do AMA now.
- No, because a lot of the regulations changed
and they couldn't take away or add regulations
to those people who had already been grandfathered
into the legacy program.
So what they're doing now is they're trying
to get rid of all the legacy claims,
so then they can consolidate all of the claims to AMA.
The last meeting that we had with NOVA,
which is the National Organization for veteran Advocates.
They told us that at the Board,
there are about 240,000 pending legacy claims,
and about 40,000 AMA claims.
So they're still a huge backlog.
But what they are trying to do is work those legacy claims
to get everything into AMA.
So that's the best ballpark I can give you.
- Wow, we have clients ask us all the time,
can you make the VA go faster?
And you know, that's I know a super loaded question.
So I guess can you tell us somewhat quickly
is that even a possibility?
- With the expedite claims, the type of expert claims
that we talked about.
Yes, it's a little bit,
it depends on getting into contact with someone at the VA.
At the Board basically, you file for a motion
to advance on the docket,
and there's not really any way to push them.
They're out of the VA, they're their own separate entity.
And the judge will make a decision on whether
to advance on the docket or not.
Once they grant advancement on the docket,
then you know, sometimes if a couple months have gone by,
we may be able to try to get movement on that
but it's really hard to advance the Board,
if you don't get your motion to advance on docket.
Approved at the regional office,
it depends on where your claim is,
in the United States it used to be where you live.
That's where your claim was.
But now with AMA, your claim could be in Cleveland
and you live in Florida.
- Oh, really?
- Yeah, they're all over the place.
They're working off of
what's called a national work queue now.
So basically your claim goes into a queue,
and they go through the queue and move the claims,
they pick them out.
Different offices will just pick claims out
and it's hard to know where your claims are.
At the Board, they also work off of a docket number,
so both kind of work on a system, first come first served,
it's based off of the date of your claim.
So there're ways but it's difficult,
and the VA is gonna do what they want
at the speed they want.
- Gotcha you.
So let's talk about the ways,
the ways you can expedite a claim.
I think that, first and foremost,
I know that there's two in particular that we get a lot,
which are terminal illness and homelessness.
But I think that we should go
over all of the different possibilities.
So tell us a little bit about terminal illness.
Can you give us some examples?
And what happens if the veteran passes away
while they're waiting on benefits?
But yeah, talk to us a little bit about terminal illness.
- So if you do have one of these criteria
for expediting a claim,
I think the four we'll talk about are terminal illness,
advanced age, financial hardship and homelessness.
Then yes, you have much better chance
of getting the process to speed up.
With terminal illness, especially what that is,
it's you have a life limiting illness,
basically meaning that sometime in the near future
it will likely cause death
or for you to be in an incapacitated state.
A common conditions that we see would be ALS,
Lou Gehrig's disease, forms of advanced cancer
where treatment isn't helping or improving,
multiple organ failure like kidney failure.
If you're in kidney failure, that's a common one.
The way to show this would be your medical records.
If you're in hospice, of course, that's indicative
that you have a terminal illness,
or have your doctor write a letter or document
in your medical records that you are terminal,
then you would file that with a motion
to advance on the docket at the Board
or request to expedite at the regional office
and they really do try to push that those cases.
If which happens all the time the veteran passes,
absolutely, there are ways for the surviving spouse,
they can file for Dependency and Indemnity Compensation,
which is also known as DIC benefits
as well as accrued benefits.
Which means they can substitute in for any pending claims
that the vet was working on before they passed.
If there is no surviving spouse,
if there are dependent children or dependent parents
that qualify, they can substitute in as well.
- Okay great, you mentioned advanced age.
So can you tell us a little bit about
what that is and how it's handled differently
in different offices?
- Yes, so at the Board, the advanced age is 75 or older,
and at the regional office it's 85 or older.
I would think this is because the Board has less appeals
than the regional offices.
So that's probably why
they have a lower advanced age requirement.
However, sometimes there are some regional offices
that will take into account 75 or older, not many,
but on occasion, they will.
But normally it's 85 or older at regional office level
and 75 or older at the Board.
- Okay, financial hardship.
Why do we see a lot of clients fall under this bracket?
You know, homes in foreclosure,
they're about to get evicted, utilities are shut off.
I mean, the examples can go on and on.
How do you qualify for an expedite
based on financial hardship.
What is considered extreme financial hardship?
- So that's the way they look at it,
there is extreme financial distress.
How do you define that?
I mean, I think it's very subjective
and it's looked on at a case-by-case basis.
But overall, what it means is you don't have enough income,
you don't have enough money
to pay your mortgage or your rent,
your utility bills, your medical expenses.
But it could also mean that you don't have your bill,
your electricity turned off or you haven't been kicked out
because someone else is paying for your bills.
So let's say you don't have enough money,
but your daughter is paying for them,
but that's causing her distress too.
That's a way to show
that you have severe financial distress as well.
I think, absolutely, it's a case-by-case analysis,
but the way you would do is you would submit evidence
of past due bills, past due medical expenses,
or a sworn statement of something
that someone else is paying your bills
to show that you are in severe financial distress
and getting a decision would help you with your situation.
- Is there any other assistance the veteran can receive
while they're going through this hardship?
- So I know that there are a lot of programs
and resources for veterans.
If we could put a link to our blog on expedites
there are links and programs there that show
that point you in the direction to resources
to help throughout your appeals process.
- Okay, and then the last one,
which unfortunately we see a lot
throughout the United States is homelessness.
So how does homelessness come into play
with having a claim expedited?
- Homelessness as well is taken very seriously.
By the VA, I would think the ones they take most seriously
are terminal illness and homelessness,
obviously because those are the most distressing situations.
Basically, if you're in homeless status,
that means that you don't have a regular residence
that you can go to and sleep at night.
Whether you're sleeping outside, sleeping in your car,
residing in a shelter or you know, couchsurfing,
people are letting you stay a couple days here and there.
You don't have a fixed home.
So that is what is considered homelessness,
and they do really try to move those claims quickly.
- Okay, have you had claims that you've had to expedite
or request expedite?
And have you noticed success
with getting those claims expedited?
- Yes, so, advanced age obviously,
that's you either are that age or not.
They definitely move forward on those quickly.
Terminal illness we see a lot,
I see end-stage renal disease, advanced cancers.
If you're, a lot of people in hospice,
and they do really try to move those quickly.
You just need to get in contact with someone
who's going to help you move those claims.
And then, of course, we see so many financial distress.
It's there times, but there's no strict definition
like advanced age or terminal illness.
It's so difficult, you know,
sometimes they'll get granted and sometimes they won't,
and it's really a case-by-case analysis
of what they're going through.
- Okay, all right.
Well, this was very useful information.
Thank you, Allison.
And thank you for joining us,
we hope that you'll do so again but in the meantime,
if you have any questions or concerns,
please feel free to visit our website
or call our office, thank you.
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