VA’s claims backlog shrinks in Michigan

Melissa Nann Burke
Detroit News Washington Bureau

The U.S. Veterans Benefit Administration has reduced the backlog of disability claims from Michigan veterans by 69 percent since 2012, while few vets are using a new opportunity to use private care instead of VA facilities, officials say.

The number of backlogged claims — those pending for more than 125 days — stood at 3,988 at the end of February, down from 12,908 in 2012, said Rodney Cline, a data analyst and spokesman for the Detroit Regional Office of Veterans Benefit Administration.

He attributed the change to increased staffing and the agency’s switch to electronic claims processing in late 2011, allowing it to expedite the timeline for evaluating and closing claims.

The average time for processing a Michigan claim was 186 days at the end of February — down from 323 days in 2012, Cline said. The Detroit Regional Office received 21,983 claims last year and processed nearly 27,500, averaging 2,300 claims a month, he said.

Nationally, the VA has a backlog of more than 209,200 disability claims that it has promised to eliminate by year’s end. That’s not good enough for some veterans advocates.

A bill in Congress called the Quicker Veterans Benefits Delivery Act would allow veterans who have backlogged claims to visit local, non-VA physicians for their initial disability exam.

The agency came under fire last year after reports of VA hospitals failing to track patient appointments and document treatment errors, and of generally insufficient oversight. In September, the VA’s acting inspector general told a House committee that long wait times at VA health care facilities in Phoenix contributed to veterans’ deaths.

All but one of Michigan’s facilities are below the national average for the rate of VA appointments that require a wait of more than 30 days as of March 1. The national average is 6 percent, according to statistics released last week,

Congress last year adopted the Choice Act to give veterans the option of using a doctor outside the VA system for medical treatment if the nearest VA facility is more than 40 miles away or they face a wait of more than 30 days for a VA appointment.

In Michigan, VA facilities in the Upper Peninsula have the highest rates of appointments scheduled beyond 30 days as of March 1 — 7.85 percent in Iron Mountain and 12.2 percent in Marquette, according to VA data.

VA patients wait 10 days on average to see a specialist in Iron Mountain, and an average 14.5 days for mental health appointments in Marquette.

Relatively few Michigan veterans who are potentially eligible for community-based treatment under the Choice Act have participated.

In the Lower Peninsula, 100 of roughly 2,700 eligible veterans have made private appointments since November. In the Upper Peninsula, 143 of roughly 1,600 eligible veterans made appointments, officials said.

“The two likely reasons for that are that people like their VA care. The other reason is there isn’t a specialist, so they’d have to travel even farther for the medical care, or the wait (for the specialist) is longer,” said Brad Nelson, spokesman for the network of VA facilities covering the U.P. “Up here, it’s not like a metro area where we have a lot of doctors.”

Some in Congress have urged the VA to revise the calculation of the 40 miles, which has been measured “as the crow flies” and not by how long it takes to reach the nearest facility when accounting for traffic and routes. Also, vets who reside within 40 miles of a clinic that can’t treat their condition aren’t eligible for non-VA care under the Choice Act.

VA officials said Tuesday the agency will change the 40-mile calculation from a straight-line distance to driving distance. in the coming weeks through a regulatory action. The agency said the change is expected to roughly double the number of veterans eligible for private care under the Choice Act.

Not all veterans who have received a “choice” card in the mail are automatically eligible, noted Derek Atkinson, spokesman for the Ann Arbor VA Healthcare System. Each vet must call to determine eligibility and receive pre-approval for any non-VA medical care.

“There’s a misconception that this is an insurance card and they can go anywhere, but that’s not the case,” Atkinson said.