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Advocates say ailing vets denied benefits

Chris Roberts
El Paso Times
Sunday, January 15, 2006

Budget pressures at Veterans Affairs are affecting veterans who are having their cases scrutinized, reviewed -- and too often denied -- even when the benefit is deserved, according to local and national veterans advocates.

"It's not that Congress cuts the budget," said Jerry Manar, deputy director of national veterans service for the Veterans of Foreign Wars in Washington, D.C. "What they do is they (Congress) don't seem to fully fund what the needs are. ... Some people who are entitled at the edges will not get the benefits."

Post-traumatic stress disorder and individual unemployability, which means the veteran's service-related disability precludes gainful employment, are two areas that constitute large parts of the federal department's budget and recently have been under scrutiny.

Manar said the Department of Veterans Affairs has been tightening standards, doing additional quality evaluations and generally leaning toward denying claims when the evidence for and against is balanced.

Secretary of Veterans Affairs Jim Nicholson, during an October visit to El Paso, said the VA claims process is not budget-driven.

"We have a responsibility to the people to (provide care) judiciously, but in the law it says that the people (VA raters who deny or approve claims) have to give the presumption to the veteran, and they follow that," Nicholson said.

Although Nicholson said recent reviews "found the VA was a very inefficient place," he added that making changes is "a deliberative process and these decisions will be made very carefully."

Of the budgeting process, Nicholson said, "It's incumbent on us to gauge that and to go to Congress if we don't have enough."

Ron Holmes, a veterans advocate in El Paso who is working about 300 cases, said he has seen a trend toward denying claims.

Late last year, he said, he saw six denials in a period of 45 days, which he called unusual. And he has two current cases in which veterans he believes deserved individual unemployability were denied the benefit.

"We're an advocate for the veteran, so if we can approve it, we're going to do it," said Dave Mojica, an El Paso VA supervisor. He said many regulations influence whether a veteran will receive a benefit.

One of the veterans Holmes is working with is a 50-year-old El Paso resident whose right hand and wrist were crushed in an accident during his Army service in Germany. He is right-handed. He asked that his name not be used because he is concerned it will negatively affect the outcome of his case.

"It's a pain every day to get out of bed ... but the bills are piling up. They're talking about taking away my car," he said. "I may have to let my body hurt and work."

The veteran was given a 70 percent disability for his hand. But when he went to the VA's vocational rehabilitation office, he was advised that he should apply for individual unemployability. His claim was denied, and he appealed.

Now the VA tells him he can't begin vocational rehabilitation until his appeal is settled, which could take as long as four years, Holmes said.

Mojica said the veteran can't have it both ways. He is either unemployable or can work, and if he enrolls in the vocational rehabilitation program, he is indicating that he can work and isn't eligible for individual unemployability.

The veteran says every job he is qualified for requires him to use his hands. He can work, he said, but it causes him pain, for which he takes medication. And he said he has developed other problems from trying to compensate for his injured hand.

The veteran said his bills are piling up and he can't afford to wait three or four years for the resolution of his claim.

Manar said, "Has the VA become concerned over the last few years about the number of people who are collecting individual unemployability? Yes. They are taking a harder look at this."

Manar said that most of the people who get the benefit are entitled to it and that most of the people who need it probably get it.

But Manar said the congressional mandate is very specific that when the case is "balanced for and against, the law says you're supposed to grant it."

The change toward erring on the side of denying claims means some who need it won't get it, he said, adding, "That's not what VA's supposed to be about."

And the timing is "awful," Manar said. "They are working toward restructuring veterans benefits at a time when we have armies in the field fighting a valiant fight. ... They have the possibility of coming home and being hassled about genuine disabilities."

Chris Roberts may be reached at ; 546-6136.