Principi: Eligibility explosion behind a VA claims backlog
July 3, 2013
By Tom Philpott
Those criticizing the Department of Veteran Affairs for its enormous backlog of disability claims are ignoring how recent laws and politics have turned VA into something Lincoln never envisioned: A fount of billions of dollars in payments for ailments likely caused by aging rather than military service, says former VA Secretary Anthony J. Principi.
Principi’s push to restore "integrity" to the VA claims system began with a keynote address June 20 at a Washington D. C. forum on the VA. His speech, however, landed with a thud, ignored by other forum participants and even by its co-hosts, a group called Concerned Veterans for America and the conservative magazine The Weekly Standard.
The compensation claims backlog can’t be solved, Principi argued, until Congress, VA leaders and veteran service organizations acknowledge and address how recent laws and policy decisions vastly expanded disability pay eligibility. Unless a "rebalancing" of priorities occurs, the former VA chief warned, public confidence in the VA claims system is at risk.
He compared calls by politicians and pundits for current VA Secretary Eric Shinseki and key deputies to resign over the claims backlog to "relieving the lighthouse keeper because the fog is so thick no one can see the light."
Ironically, Principi’s remarks were sandwiched between a half hour of fresh attacks on the VA from Republicans on the veterans affairs committees, and a panel of vet advocates who urged VA to work harder and smarter to process the rising river of claims. Overlooked was Principi’s assertion that disability pay eligibility today goes far beyond Lincoln’s charge: "To care for him who shall have borne the battle and for his widow and his orphan."
Disability claims of 50,000 veterans wounded in Iraq and Afghanistan are not what’s "choking the VA benefits system," Principi said. "They are the victims of the sclerosis now overwhelming the VA benefits program."
Eighty percent of the more than one million claims being filed annually are from veterans whose service time predates 2001, said Principi. A decorated Vietnam War veteran and President George W. Bush’s first VA secretary, Principi noted that today "a veteran who spent just one day in Vietnam will be automatically service-connected for Type II diabetes, Parkinson’s disease, prostate cancer, lung cancer and ischemic heart disease…the most common effects of aging in American men."
Forty years after the Vietnam War ended, 37 percent of VA claims are filed by "my fellow Vietnam veterans -- almost double the number filed by recently discharged veterans," Principi said. Eleven percent –more than 100,000 claims –are filed by vets who never served in a time of conflict.
The river of Vietnam-era claims grew wider because of decisions VA secretaries have made to add common ailments of aging, like Type II diabetes and ischemic heart disease, to the list of conditions VA presumes are caused by long-ago exposure to Agent Orange defoliants used in the war.
Yet studies from the Institute of Medicine, on which key presumptive disease decisions are based, found only "limited or suggestive evidence" of an association with Agent Orange exposure, Principi noted.
As VA secretary in 2001, Principi told me, he faced the difficult choice of finalizing a regulation drafted by the Clinton administration to make Type II diabetes compensable for Vietnam veterans or "have the first major veterans' decision of the incoming Bush administration be to take away a major benefit offered by Clinton." He signed the regulation.
"I struggled with that decision and do so to this day," Principi said.
Current Secretary Shinseki opened the Agent Orange claims floodgate farther when, again based on "limited or suggestive evidence" of an association with Agent Orange, he added heart disease and two other ailments to the presumptive disease list. If claimants with these ailments can show they set foot in Vietnam during the conflict, the ailments are deemed service-connected and eligible for VA compensation.
Another factor in the flood of claims is that "no claim is ever final," Principi said. "All claims can be reopened and reopened -- and many are."
As a Vietnam veteran, Principi said, "I will be able to file a claim for prostate cancer, heart disease or any of the other named diseases if I get sick at age 92 or 102. If any of those diseases contribute to my death, at any age, my widow will get the same compensation as the surviving spouse of a service member killed in Afghanistan…You don’t have to be Einstein to predict the effect of this on backlogs and timeliness."
The price of allowing vets to file claims throughout their lives "is paid by the veteran who has lost a leg to a mine; whose ability to think clearly was clouded by an improvised explosive device; or by the grieving widow of a newly deceased young corporal," Principi said. "Their claims for compensation fend for themselves in an environment where every veteran is first priority -- which means, of course, that no veteran is first priority. When everyone applies for disability compensation, those who represent the reason VA exists must lose. They become part of the pack, their claims just one more folder in an ever-higher pile."
VA data help make his case. In 2005, VA paid $26.6 billion in disability compensation. This year it will pay out $60.2 billion.
Principi isn’t calling for current payments to be cut or stopped. He proposes more modest reforms "to restore the trust of the American people in the VA disability compensation system." He wants future disability awards aimed at VA’s "core mission" and not dispersed "to remedy every problem imaginable for every veteran."
He proposes a cut-off date, either of age or years since Vietnam service, for Agent-Orange-related disabilities. Today the system "goes far beyond resolving doubt in favor of the veteran, as VA is required to do. It makes no sense when older veterans, long removed from their service, are compensated for the expected and ordinary effects of aging."
He also criticized how the concept of "individual unemployability" requires VA to compensate vets as though 100-percent disabled if their lesser-rated ailment prevents their working -- even at age 80 or 90.
If vet advocates won’t embrace reasonable reforms, he warned, "we well may face the prospect of reform with a timber ax, rather than a scalpel."
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