The Department of Veterans' Affairs is a federal agency that administers all benefit programs for veterans - health care, education, disability and more. However, even though the department is centrally funded and operated from Washington, D.C., veterans face significant disparities in how their benefits are awarded, their applications processed, and how long they have to wait to see a doctor, receive a decision or get help with a problem. Unfortunately, this means that the timeliness and fairness of VA benefits administration varies enormously, often because of where a veteran lives.
Waiting for Medical Care
This sad fact was underscored by a recent story about the Phoenix office of the VA. It turns out that veterans had to wait a year or more just to obtain an appointment with a primary care physician. The VA health care facility maintained two lists - a secret list that reflected the true amount of time a veteran had to wait for an appointment, and the official list, that showed that wait times were in compliance with VA rules. The bottom-line result of this scheme was the death of at least 40 veterans died while waiting for appointments.
According to an AP story, the same problem exists at the Fort Collins, Colorado, VA clinic, where staff was instructed to falsify records to make it appear that veterans were receiving appointments within the required 14 days. The details of how the staff accomplished this are unavailable, but investigators said that no one appeared to have suffered adverse consequences as a result of the lengthy waiting times.
A similar report on the VA Medical Center in North Las Vegas, Nevada, revealed that patients in the emergency room had to wait much longer than the mandated waiting times. An Inspector General's report requested by members of the Nevada congressional delegation showed that the hospital met its emergency room service targets on only one day during the week the investigation was conducted. The hospital's goal was to limit emergency department wait times to less than six hours in all but 10 percent of cases.
Waiting for VA Disability Benefits
Nevada also has a poor track record when it comes to processing veterans' disability claims. According to a recent story in the Las Vegas Review-Journal, the Reno office was the slowest in processing VA disability claims. The news report said that it takes an average of 350 days for a vet to receive a decision on a claim for VA disability benefits from the Reno office. Other news sources reveal that the performance of the Reno office, which handles disability claims for the entire state of Nevada, was even worse, at 425 days. Either way, veterans wait a long time in Nevada - either for decisions on their disability applications, or for health care at VA medical centers.
It's not just Nevada that has a poor track record. Of the 596,000 VA disability claims pending, almost 10 percent of those claims are pending in just two Texas VA offices, in Houston and Waco, according to an editorial by Senator John Cornyn, R-Texas, in the Odessa Advertiser.
In contrast, the VA regional office in Providence, Rhode Island, processed disability benefit claims in an average of 97.2 days. Another New England VA office in Hartford, Connecticut, has been given claims from other states because of its record of handling disability claims in a timely way. It recently received 1,900 claims from the Indianapolis, Indiana, VA office, where the backlog is significantly higher.
It is not just New England VA offices that take on disability claims from other regional locations with larger backlogs. The Lincoln, Nebraska, office handles claims from California. While this is a great service to California veterans, it means that Nebraska vets wait an average 4.7 days longer for a decision. However, they appear willing to do this if it means that more seriously sick and disabled veterans in California receive the benefits they need, according to news reports.
Reasons for Geographic Disparity
Some of this disparity almost certainly reflects the percentage of veterans in a state's population. Colorado and Arizona, where problems related to scheduling medical appointments are most visible, also have counties that have the highest percentages of veterans. In contrast, urban areas, such as the corridor between Washington D.C. and Boston, Massachusetts, have the lowest concentration of veterans, making it easier to understand why the Providence and Hartford regional offices are able to handle disability claims from other regions.
Another issue related to geography is that the Northeast has the greatest proportion of WWII veterans. One can assume that many veterans who need disability benefits as a result of their service more than 60 years ago have already applied. Similarly, it is probable that the most severely injured veterans from that war have died, reducing the number of complex claims - the types of claims that require so much time to make a decision, according to the VA. This frees up employees in VA offices in that region to handle benefit claims from other offices.
Although some parts of the country are better than others when it comes to handling claims and providing services to veterans, the big story continues to be long wait times, either for services or for claim dispositions. The issue of timely service continues to haunt the Secretary of Veterans Affairs, Erik Shinseki, and it remains to be seen whether he can weather this storm.