Fully Developed Claims Partnership Works

By Thom Wilborn

For a decade, the VA’s Chicago regional office was called the toughest place in America to win a veteran’s disability claim. A major newspaper once said it was “at the bottom for benefits.” Today many veterans are getting their claims completed faster, more efficiently and with greater understanding of the process, thanks to a new partnership with veterans, the VA and the DAV.

In 2009, the Fully Developed Claims (FDC) pilot program began in Chicago and other VA regional offices. It is the intent of the VA to develop new initiatives that will help alleviate the huge backlog of claims. FDC is one of those initiatives which is being deployed nationwide.

“The FDC program is unique because a veteran is told exactly what evidence is needed before formally submitting a claim, which dramatically reduces the time needed to process it,” said Washington Headquarters Executive Director Barry Jesinoski.

The key to the process is for a veteran to submit VA forms 21-526EZ and 21-527EZ and an easy-to-write certification letter stating the intent to apply for compensation or pension benefits under the FDC program. That fulfills the VA’s notification requirements and sets an effective date for entitlement of benefits.

The VA, through the DAV, informs the veteran what evidence is needed. Once the veteran has nothing more to provide, the VA goes to work on the claim.

“We found that 25 percent of FDC claims were rated within 78 days in 2009, and 50 percent were rated before 130 days in Chicago,” said National Service Director Garry J. Augustine. “By 2010, 25 percent of FDC claims were rated in 69 days, and half were decided in 115 days. These are good results.”

The FDC performance for 2011 is still being calculated because claims continued to be submitted in late 2011, and others submitted during the year are still under review.

“When this began as a pilot program, I knew it may not be successful without the partnership of veterans service organizations,” said Duane A. Honeycutt, director of Chicago’s VA regional office. “The DAV took it the most seriously. The DAV here has a young cadre of National Service Officers who are energetically going out to help veterans with FDCs. We now have more FDCs here than at any other regional office in the country.”

“The FDC program changed the way we develop the initial step for the claim,” said Chicago National Service Office Supervisor Steven T. Wolf. “We have an orientation for veterans we represent. The DAV and veterans develop the evidence requirements first, which has proved to be quite successful.

“It has resulted in a drop in the claims backlog and the notices of disagreement (NODs),” he said. “We’re utilizing this program to explain the claim decision to the veteran, and it has greatly reduced appeals. Education and communication with our clientele are the keys to success in this program, along with the cooperation of the VA.”

Chicago National Service Officer Carlo P. Melone, who compiled the FDC study, said there were 331 NODs submitted in 2009, but that declined 32 percent to 225 in 2010. During the first 11 months of 2011, NODs had dropped to 61, a 73-percent decline. FDC appeals declined 82 percent from 2009 through the first 11 months of 2011.

“Using FDC, we are able to better explain ratings decisions to veterans,” said Melone. “The whole claims process is very transparent. The DAV calls veterans as soon as their rating decisions are available, and everything is explained. Veterans no longer have to wait for a VA letter before knowing the outcome of their claims, and we explain the laws governing their ratings.”

“This process has really reduced the appeals rate,” said Honeycutt. “I’m pleased with that, and I want to expand it. The VA has a goal to increase FDCs to all claims received. We’re not there quite yet, but we’re making progress. And the DAV is helping us to reach that goal. I’m all fired up about it.”

“It’s a partnership of veterans, the DAV and the VA,” Melone said. “We are all working together to obtain the quickest possible decision and the best quality rating. It’s part of my mission to apply my knowledge to the system.”

“The VA regional offices and the DAV have worked together to make the FDC a standard for submitting a claim with remarkable improvement in turn around time,” said Augustine. “The Chicago VA and our National Service Officers have altered the way a claim is submitted and processed. The cooperation of the VA has changed the way an FDC is received and reviewed by raters.”

“The two-year analysis of the FDC program shows it is working much to the satisfaction of veterans,” said Jesinoski. “They are now full partners in the FDC process, and 2012 looks to be an even better year to improve claims accuracy and timeliness.”

“We’re going the extra mile by explaining everything in detail, and the VA is working with us,” said Wolf. “If the VA wasn’t on board, it wouldn’t work. We all have to be on the same page.”

For additional information or to file an FDC, please contact the DAV National Service Office in your state. Offices can be found at www.dav.org.