Source: VA.GOV

The TRICARE Open Season is an annual period when you can enroll in, change, or disenroll from a TRICARE health plan. In 2024, the open season runs from November 11 to December 10. Changes you make during the open season go into effect January 1, 2025.  Whether you’re considering TRICARE Prime (including the US Family Health Plan) or TRICARE Select, it’s important to choose the plan that best fits your needs.

“Now is the perfect time to review your current plan and determine which is best for you and your family for 2021,” says Mark Ellis, chief of the Policy and Programs Section of the TRICARE Health Plan at the Defense Health Agency. “For example, if having a primary care manager (PCM) to oversee your care is a priority, TRICARE Prime might suit you. If flexibility in choosing specialists is more important, TRICARE Select could be a better fit.”

Active duty service members (ADSMs) are required to enroll in TRICARE Prime. However, active duty family members (ADFMs) can choose between TRICARE Prime and TRICARE Select. Here’s a breakdown of each plan to help you make an informed decision this open season.

TRICARE Prime: Coordinated Care with a PCM

TRICARE Prime is available in specific areas, known as Prime Service Areas. You can use the TRICARE Plan Finder to determine whether it’s an option in your location. TRICARE Prime typically involves using military hospitals and clinics, and requires that you select a PCM to manage your care. Your PCM will also provide referrals to specialists when necessary.

For ADFMs, retirees, or their family members, TRICARE Prime offers the option to see a specialist without a referral, but this is under the point-of-service option, which can increase out-of-pocket costs. If you stick to TRICARE network providers, your out-of-pocket expenses will usually be lower.

TRICARE Select: Greater Flexibility in Care

Unlike TRICARE Prime, TRICARE Select does not require a PCM. With TRICARE Select, you have the freedom to choose your own TRICARE-authorized providers and manage your healthcare independently. Generally, no referrals or pre-authorizations are needed. However, out-of-pocket costs will be higher if you opt for non-network providers, so using TRICARE network providers can help you save. Keep in mind, services from non-authorized providers won’t be reimbursed by TRICARE.

TRICARE Prime: Costs Overview

For ADSMs, ADFMs, and transitional survivors, TRICARE Prime has no enrollment fees. However, retirees and their families will need to pay annual enrollment fees.

ADFMs using network providers and obtaining the necessary referrals or pre-authorizations won’t have out-of-pocket costs for covered services. Retirees, on the other hand, will have copayments or cost-shares for services from network providers. All out-of-pocket expenses count towards your catastrophic cap, with the exception of costs incurred under the point-of-service option. TRICARE Prime also does not have a deductible.

TRICARE Select: Costs Overview

TRICARE Select generally involves higher out-of-pocket expenses compared to TRICARE Prime. While ADFMs don’t pay an annual enrollment fee, retirees and their families may need to pay enrollment fees depending on when the sponsor enlisted in the military. Starting next year, most Group A retirees and their families will need to pay enrollment fees for TRICARE Select. Make sure to set up automatic payments to avoid any lapse in coverage.

TRICARE Select also includes an annual deductible for covered services. Once the deductible is met, you’ll pay copayments or cost-shares per visit. Like TRICARE Prime, there’s a catastrophic cap to limit out-of-pocket expenses.

Compare Your Options

To make the best decision, use the tools available on the TRICARE website to compare plans and costs side by side. You can also search for providers through the Find a Doctor tool. Before making any changes to your plan, review the details of TRICARE Prime and TRICARE Select to ensure your healthcare needs are met during this open season.

Tricare Open Season 2024

The Department of Veterans Affairs (VA) provides a wide range of benefits designed to support elderly veterans, many of whom may not be fully aware of the valuable assistance available. Veterans who served during wartime, are 65 years or older, or have significant disabilities could qualify for various forms of financial and healthcare support. This article explores several key benefits for elderly veterans, including the Aid and Attendance program, geriatric care, long-term care, and other home-based services.

Who Qualifies?

Veterans aged 65 and older, especially those who served during periods of conflict, such as World War II, the Korean War, the Vietnam War, and the Persian Gulf War, may be eligible for these special benefits. These programs are designed to help address the changing health, financial, and support needs of elderly veterans as they age.

Key VA Benefits for Elderly Veterans

The VA offers several important programs tailored specifically for elderly veterans:

1. Aid and Attendance (A&A) Program

The Aid and Attendance (A&A) program provides additional financial assistance to veterans who need help with daily living activities, such as bathing, dressing, or eating. This benefit is available to veterans who already qualify for a VA pension and meet specific criteria regarding their health needs.

2. Housebound Benefits

Housebound benefits offer increased monthly payments to veterans who are largely confined to their homes due to a disability. Like the A&A program, these benefits are only available to veterans who qualify for a VA pension.

VA Healthcare for Elderly Veterans

The VA also provides geriatric healthcare tailored to meet the complex needs of elderly veterans. This care can be offered in a variety of settings:

• In-home care: Veterans can receive assistance and healthcare in the comfort of their own homes.
• Community care: For those who prefer, or require, care in a community setting, the VA offers access to services through local healthcare providers.
• VA care centers: Some veterans may prefer to receive their care directly from a VA medical facility.

For more information about VA healthcare programs and geriatric services, visit the VA’s Geriatrics and Extended Care page.

Long-Term Care Options

Veterans who require long-term assistance may also be eligible for VA-sponsored extended care. This includes services for veterans of all ages who need daily support, whether at home, in a VA facility, or through community providers. Long-term care options include:

• Skilled nursing care
• Assisted living services
• Respite care for caregivers

More details about the VA’s long-term care programs can be found here.

Home-Based and Community Services

For veterans who wish to remain at home but still require regular support, the VA offers a variety of Home-Based and Community Services, including:

• Home Health Aide Care: Provides personal care services.
• Homemaker and Home Health Aide Programs: Support veterans with daily activities such as bathing, dressing, and meal preparation.
• Skilled Home Care: Offers professional healthcare services for veterans needing regular medical attention.

Learn more about these home-based services and how to access them on the VA’s Home and Community-Based Services page.

How to Apply for These Benefits

Veterans and their families can apply for elderly benefits in several ways:

1. Apply Online: Visit the VA’s online application portal to begin the application process.
2. Work with an Accredited Veterans Service Officer (VSO): Accredited VSOs can assist veterans in applying for their benefits. A directory of these officers is available here.
3. File in Person: Veterans can also apply in person by visiting a VA regional office. To find the nearest regional office, visit the VA’s facility locator.
4. Submit a Paper Application: Fill out VA Form 21-526EZ for electronic filing, which can be downloaded here.

Veterans can also mail their applications to the following address:

Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444

Next Steps

After learning about the benefits available for elderly veterans, it’s essential to take action. Review the links provided to explore the various programs and determine which ones are most applicable. Don’t hesitate to seek assistance from a VSO or the VA directly if you have any questions. The process can sometimes feel overwhelming, but there are many resources available to ensure veterans receive the support and benefits they deserve.

For further information on VA benefits for elderly veterans, check out the Veterans Affairs Elderly Veterans page.

This guide has covered important VA benefits for elderly veterans, including the Aid and Attendance program, geriatric and long-term care, and home-based services. Understanding these options and knowing how to apply ensures veterans can access the support they need during their golden years.

One of the common frustrations many veterans face is the repeated cancellation of appointments by the VA. It can be incredibly frustrating, and it often seems like the blame gets unfairly shifted onto the veteran. After all, it wouldn’t look good for a VA doctor to admit fault, right?

It’s important to recognize what’s happening and determine which battles are worth fighting. Canceled appointments can impact your ability to gather essential medical evidence, especially if you’re engaged in the VA claims process. Medical evidence is critical in winning disability claims, and each canceled appointment is a missed opportunity to further your case.

There are two main scenarios here:

1. Engaging in the VA Claims Process
   If canceled appointments are interfering with collecting medical evidence necessary for a claim, this is an issue that must be addressed quickly. Without this evidence, your VA disability claim could be delayed or weakened. In this case, consider your options to reschedule or document these missed appointments to avoid damaging your claim.
2. Frustration with VA Services
   If the cancellations don’t directly affect a claim, but are simply a recurring frustration, such as late medications or ongoing scheduling issues, it’s still an issue worth acknowledging. However, this scenario doesn’t necessarily impact your VA benefits.

It’s essential to choose which battles are worth your time and energy. When dealing with the VA, it’s always going to feel like a challenge. But you need to determine how much effort to put into each issue and whether it will help your long-term goals.

For example, if a doctor cancels an appointment and the record states it was the veteran’s fault, it’s essential to correct this immediately. Using tools like My HealtheVet, download your records and contact the provider to clarify the situation. You can request the doctor correct the record to reflect the true cause of the cancellation. But, if it’s an old issue from years ago that won’t affect any current claims, it may not be worth revisiting.

Tackling the VA Claims Process

For veterans involved in the claims process, focusing on the Veterans Benefits Administration (VBA) and gathering medical evidence is crucial. Sometimes, pursuing changes with the Veterans Health Administration (VHA) won’t significantly impact the outcome of a claim. In such cases, it’s more productive to direct efforts toward the benefits side (VBA) rather than health administration (VHA).

For instance, if a missed appointment could affect the medical evidence needed for a claim, consider speaking to a patient advocate or requesting a different doctor. You might also explore using the Mission Act, which allows access to private doctors for VA-covered care. Urgent care visits can also provide the necessary medical documentation without going through VA hurdles.

Remember, the primary goal is to win the claim, not act as an enforcer for every VA issue. The VHA and VBA are separate entities, and while both serve veterans, it’s vital to understand which is impacting your claim and direct efforts accordingly.

Alternatives to VA Care

If dealing with VA appointments feels like running in circles, other avenues can provide the needed medical evidence. Private doctors, urgent care clinics, and alternatives provided under the Mission Act can be viable options for gathering documentation. These solutions may allow you to bypass the VA system altogether while ensuring you have the proper medical evidence to strengthen your claim.

Stay Focused on What Matters

At the end of the day, it’s all about picking and choosing battles that will help further a claim. There are many ways to research and prepare for VA claims—reading VA law, researching nexus letters, and reviewing how other veterans have won similar claims. These activities might be more productive than spending energy on old VHA errors that won’t affect the outcome of a claim.

Before contacting the VA or filing a complaint, ask whether the issue at hand will help move your claim forward. If not, it might be best to focus on more critical elements of the claims process. There’s no shortage of frustrations with the VA, but prioritizing efforts can make a huge difference in successfully navigating the system.

If more guidance is needed on the VA claims process, there are resources available to help veterans learn the ins and outs, including how to document symptoms properly and obtain nexus letters, all critical to winning claims.

By staying focused and choosing the right battles, veterans can maximize their chances of a favorable outcome with their VA claims, even amidst the frustrations of dealing with VA appointments and the broader system.

Disclaimer: The article in a commentary (opinionated)

The Official Military Personnel Files (OMPF), housed at the National Personnel Records Center (NPRC), are administrative records that contain details about an individual’s military service history. While many OMPFs used to include both personnel and active-duty health records, this practice was discontinued in the 1990s by the various military branches.

In the past, all military services transferred a service member’s individual health records to the NPRC upon separation from service, along with the personnel records. The Army and Air Force retired health records with the OMPF, while the Department of the Navy (including the Navy, Marine Corps, and Coast Guard) sent these files separately to the NPRC until the 1980s.

Health records document outpatient, dental, and mental health treatment received during military service. They include induction and separation physical exams, routine medical care (such as doctor visits, lab tests, dental check-ups), but not inpatient records.

Clinical (hospital inpatient) records, which are created during hospital stays, are typically not filed with health records. Instead, they are retired to the NPRC by the facility that generated them. Medical records from the Department of Veterans Affairs (VA) are also not part of these files.

Changes in Record Handling

Starting in the 1990s, the military branches stopped including health records with the personnel portion of the OMPF sent to NPRC. The Army began sending most health records to the Department of Veterans Affairs (VA) in 1992, with other services following suit by 1998. By 2014, the practice of transferring these records to the VA was discontinued. To find out where your medical record is located, refer to the chart below:

VA Records Center and Vault  Source: https://www.rcv.va.gov/

Filing a Claim for Medical Benefits

Veterans intending to file a medical benefits claim with the Department of Veterans Affairs (VA) do not need to request their military health records from the NPRC. Once a claim is filed, the VA will obtain the original health record from the NPRC. Additionally, many health records were transferred to the VA prior to the 1973 Fire at the NPRC.

Veterans who have already filed a medical claim should contact the VA to verify if their records are on file. For assistance, veterans can contact the VA at 1-800-827-1000, which will connect them to the nearest VA office.

This information ensures veterans have access to the correct channels to retrieve their records and file claims for medical benefits.

Source: Archives.gov

In this article, we will explore the top three conditions that VA rating specialists often see veterans claim as secondary to their service-connected sleep apnea.

A Word of Caution:

Before diving in, it’s important to note that nothing is guaranteed in the VA claims process. If someone claims they can guarantee a favorable outcome, they are likely misleading you. There have been many cases where VA rating specialists thought a claim would be approved, only for it to be denied. On the other hand, claims that seemed far-fetched have sometimes been approved. Keep this in mind when submitting claims for secondary conditions.

For secondary conditions, it is essential to provide a Nexus statement—a document prepared by a medical professional that explains how your condition is linked to your military service. Veterans have the option of undergoing a Compensation and Pension (C&P) exam or having their private doctor complete a public Disability Benefits Questionnaire (DBQ), available on the VA’s website.

The Top 3 Conditions Claimed Secondary to Sleep Apnea:

1. Hypertension (High Blood Pressure)

The first condition commonly claimed as secondary to sleep apnea is hypertensive vascular disease, also known as hypertension. Let’s focus on the 10% rating criteria, as this often causes confusion. For a 10% rating, one of the following must be true:

• Diastolic pressure is predominantly 100 or more
• Systolic pressure is predominantly 160 or more
• There is a history of diastolic pressure predominantly 100 or more, and continuous medication is required for control.

It’s essential to meet both requirements for a 10% rating in the third scenario: a history of diastolic pressure of 100 or more and the need for continuous medication. Veterans can track their blood pressure at home and keep a spreadsheet as evidence. If you believe you meet the criteria for a 20% rating (diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more), providing your own records or notes from your doctor is crucial.

Additionally, hypertension or isolated systolic hypertension must be confirmed by readings taken on two or more occasions over at least three different days. So, whether you are monitoring your own blood pressure or having a private doctor or VA doctor take readings, proper documentation is essential.

2. Diabetes Secondary to Sleep Apnea

The second condition often claimed as secondary to sleep apnea is diabetes mellitus, particularly Type 2 diabetes. For these claims, you need a medical professional to provide a diagnosis and a rationale linking the diabetes to sleep apnea via a Nexus statement.

It’s not a bad idea to research medical studies or literature supporting this connection—sources like the Mayo Clinic often provide valuable insights. Additionally, you can refer to the Diabetes Mellitus Type 2 DBQ, which can guide your claim.

In this form, Section 3A asks if the veteran has any recognized complications of diabetes, such as:

• Diabetic peripheral neuropathy (affecting the upper or lower extremities)
• Diabetic nephropathy or renal dysfunction
• Other complications

Section 3B asks if any of these conditions are “at least as likely as not” caused by diabetes, which constitutes a secondary medical opinion.

If you’re dealing with other conditions like hypertension, stroke, skin conditions, or eye conditions, these can also be linked through secondary conditions, sometimes referred to as “stacking.” In this case, the doctor completing the DBQ must provide a clear rationale in the remarks section explaining how they reached their conclusions.

3. Depression Secondary to Sleep Apnea

The third common condition linked to sleep apnea is depression. Veterans claiming depression secondary to sleep apnea must clearly explain to the C&P examiner how their sleep apnea contributes to their mental health condition.

For instance, you could describe how severe snoring or breathing issues force you and your spouse to sleep in separate bedrooms, which may impact your emotional well-being and relationship. It’s also important to familiarize yourself with the General Rating Formula for Mental Disorders to determine if you meet the criteria for a 0%, 10%, 30%, 50%, 70%, or 100% disability rating.

There are proposed changes to these criteria coming in April 2025, so be sure to stay updated if you’re pursuing a mental health claim.

Conclusion:

These are the top three conditions that VA rating specialists frequently see veterans claim as secondary to their service-connected sleep apnea: Hypertension, Diabetes, and Depression. Many veterans succeed in their claims by submitting private evidence or attending a C&P exam.

Disclaimer:

This article is for informational purposes and should not be considered professional legal or medical advice. While the author has had a successful VA rating outcome, veterans should conduct their own research and apply the relevant findings to their specific cases.

If you are a veteran rated 100% Permanent and Total (P&T) or just 100% disabled through the VA, there are important considerations to keep in mind when filing additional claims. It’s crucial to ensure that any claims you submit are compliant with Title 38, Part 4 of the Code of Federal Regulations, which governs VA disability ratings. Failing to do so can lead to unintended consequences, including a reevaluation of your entire disability status.

Some veterans have submitted claims that they thought would increase their compensation, only to find that the VA reevaluated their case and actually reduced their benefits. In some instances, this has resulted in the loss of key benefits, such as the 100% property tax exemption and educational benefits for their children. These are significant losses, and they can have long-term financial and personal impacts.

Before filing a new claim, it’s important to consult with a service organization or claims specialist who is well-versed in VA regulations and fully understands the potential risks. Make sure they are compliant with Title 38, Part 4, and that they provide accurate advice regarding the outcome of your claim.

If you are already rated at 100%, you should carefully weigh whether it’s worth filing for additional benefits unless it will meaningfully increase your compensation. For example, some claims, such as those for Special Monthly Compensation (SMC), can provide substantial additional benefits. However, other claims, like those for erectile dysfunction, are unlikely to change your disability rating and might only provide a minimal benefit—around $120 per month.

It’s worth considering the broader picture. If you are already receiving $45,000 to $46,000 a year in tax-free income, it might not be wise to risk that stable, passive income for a relatively small additional amount. Filing claims that have no chance of increasing your rating could trigger a reevaluation by the VA, and that’s a gamble you may not want to take.

In conclusion, proceed with caution and make sure you’re well-informed before submitting any new claims. Always consult with a professional to ensure you’re making the best decision for your financial security and well-being.

Hope this information helps. Take care, and we’ll chat again soon.

Disclaimer:

This article is a commentary which means opinionated, so do your own research and find the conclusions that best meets your situation, goals, etc.

Why Seeking Assistance from Veterans Service Organizations (VSOs) Like Disabled American Veterans (DAV) Is More Sensible and Cost-Effective Than Hiring a Lawyer for VA Appeals

When appealing a VA decision, especially on conditions like vertigo as secondary to service-connected bilateral hearing loss and tinnitus, veterans often face a difficult choice: Should they hire a lawyer or seek the assistance of a Veterans Service Organization (VSO) like Disabled American Veterans (DAV)? The implications of this decision can significantly impact the outcome of a claim, as well as the financial burden on the veteran.

Here’s why obtaining help from a VSO is often the more practical and cost-effective choice.

1. Cost-Free Representation

One of the most compelling reasons to work with a VSO is that they provide their services free of charge. VSOs like DAV offer trained representatives who assist veterans through the claims and appeals process without imposing legal fees.

In contrast, VA-accredited attorneys charge fees that can be up to 20% of the retroactive benefits awarded. While these fees are regulated, they can still amount to a significant cost, especially in cases where veterans wait years for a favorable decision.

2. Expertise in Complex Claims

VSOs have representatives who are well-versed in the VA’s requirements and regulations, making them highly effective in assisting with complicated cases. Veterans attempting to prove a secondary service connection for conditions such as vertigo, which may stem from hearing loss or tinnitus, can benefit from the expertise of VSO representatives who have experience in similar cases.

For example, in VA Case 0211929, a veteran successfully appealed for service connection for vertigo as secondary to service-connected bilateral hearing loss and tinnitus. The veteran argued that their vertigo was linked to these conditions, and after providing medical evidence and testimony, the Board granted the appeal. Cases like this highlight the importance of presenting the right medical evidence, which VSOs are skilled in gathering and presenting.

3. Access to Resources and Medical Evidence

VSOs have access to critical resources that can make or break a VA claim. They often collaborate with medical experts, specialists, and psychologists to gather the evidence needed to support claims of secondary service connection. In cases like the one mentioned above, where proving that vertigo is caused or aggravated by hearing loss and tinnitus is crucial, VSOs can leverage these resources to provide comprehensive support.

Lawyers may not have the same direct access to these resources unless they hire external experts, which can further increase costs for the veteran.

4. Deep Understanding of the Appeals Process

VSOs work with the VA regularly and have a deep understanding of its appeals process. This expertise can prevent unnecessary delays and common errors that may weaken a veteran’s case. In cases like proving that vertigo is secondary to hearing loss and tinnitus, this familiarity with VA procedures can be invaluable.

In the aforementioned VA Case 0211929, the veteran successfully appealed because the VSO representatives knew how to navigate the VA’s complex system, ensuring that the correct medical evaluations and evidence were provided. These organizations understand how to align their arguments with VA requirements, increasing the likelihood of a favorable outcome.

5. Advocacy and Veteran-Centered Focus

VSOs are focused entirely on advocating for veterans. Organizations like DAV exist solely to serve veterans and are motivated by the goal of ensuring they receive the benefits they deserve. This can make a significant difference in the quality of representation veterans receive.

Unlike attorneys, who may be motivated by financial compensation, VSO representatives are committed to the well-being of veterans, often advocating for cases involving complex secondary conditions like vertigo without financial incentives.

6. Long-Term Support

In addition to providing free and specialized assistance during the appeals process, VSOs like DAV offer long-term support for veterans. They help with future claims, changes in disability ratings, and any other challenges a veteran may face in securing or maintaining benefits.

This is especially important for veterans dealing with chronic conditions, such as vertigo, tinnitus, and hearing loss. The ongoing support from a VSO can provide veterans with peace of mind, knowing that they have dedicated advocates throughout their VA journey.

Real-World Success: VA Case 0211929

A prime example of how VSOs can help veterans succeed in proving secondary service connection claims is VA Case 0211929. In this case, the veteran contended that their vertigo was related to their service-connected hearing loss and tinnitus. Initially, the claim was denied, but through the appeals process, with the assistance of their representative, the veteran was able to present compelling medical evidence, including an expert opinion, which established the link between these conditions.

The Board ultimately found that the vertigo was indeed secondary to the veteran’s bilateral hearing loss and tinnitus, granting the appeal. This case demonstrates how the expertise and advocacy of a VSO can lead to a successful outcome, particularly in cases involving complex medical conditions.

7. Proven Track Record

VSOs have a long history of helping veterans succeed in their appeals. Their proven track record of securing benefits for veterans, often through cases like VA Case 0211929, provides veterans with a sense of trust and confidence in their representation. For veterans with complex claims, such as proving a secondary service connection for vertigo, VSOs are equipped to handle these challenges effectively and efficiently.

Conclusion

For veterans appealing a VA decision, particularly in cases involving complex medical issues like proving that vertigo is secondary to bilateral hearing loss and tinnitus, seeking assistance from a Veterans Service Organization such as Disabled American Veterans is often the more practical and cost-effective option. With free representation, specialized expertise, access to valuable resources, and a strong commitment to veterans’ well-being, VSOs provide a comprehensive and highly effective alternative to hiring a lawyer.

Using DAV or other services VSOs can help a veterans obtain a case of highlight the critical role that VSOs play in helping veterans win their appeals and secure the benefits they deserve.

Take a look at the following from an actuak VA case:

CONCLUSION OF LAW

The criteria for service connection for a disorder manifested by vertigo, secondary to service-connected hearing loss and tinnitus disabilities, have been met.

Citation Nr: 1708783	
Decision Date: 03/22/17    Archive Date: 04/03/17 

https://www.va.gov/vetapp17/Files2/1708783.tx

Successful cases like VA Case 0211929 and others via this Google Search links:

https://www.google.com/search?q=tinnitus+cause+vertigo+VA+Case+approved&oq=tinnitus+cause+vertigo+VA+Case+approved&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQIRigATIHCAIQIRigATIHCAMQIRigATIHCAQQIRigAdIBCTE4MDgyajBqN6gCALACAA&sourceid=chrome&ie=UTF-8

In today’s commentary, we’re going to discuss Project 2025 as it pertains to the recommendations for the Veterans Benefits Administration (VBA). For those who may not know, the VBA handles all veterans’ compensation, so be sure to stick around—you definitely don’t want to miss this video.

Before we dive into today’s topic on Project 2025 and the recommendations they have for the VBA, it’s important to note that we’re only providing our opinion as a former VA rater. VA raters work under the VBA, and while we’re not speaking from a political perspective—whether Republican, Democrat, or Independent—we are offering our feedback on the information being recommended.

Now, let’s get into it. We’ll share our screen to walk you through what we’ve reviewed. We’ve focused on the VBA section, as this is what many of you have asked about. It took us a couple of days to thoroughly review the recommendations, and we’ve color-coded our agreement or disagreement:

• Blue for what we agree with.
• Red for what we disagree with.
• Black for points we’re on the fence about, but we’ll explain our reasoning.

Veterans Benefits Administration (VBA): Need for Reform

One of the most evident and ongoing concerns is the complexity of benefits, which can lead to confusion for veterans. If not mitigated early in the process, this confusion can result in long-term distrust and animosity toward the VA. We completely agree with this assessment because we’ve experienced this firsthand during the process of adjudicating our claim through the Atlanta Regional Office. Veterans often feel as though the VA has turned its back on them, and we felt the same way during our process.

VA Must Improve Timeliness

The VA must improve the timeliness of claim adjudication and benefits delivery. Veterans want the VBA to provide timely responses, offer empathetic customer service, and deliver benefits without frustrating delays—weeks, not months. We agree with this, and it can be done, but it all starts with mindset—management mindset, leadership mindset—from the top down. Additional training is necessary. For example, if a veteran submits a Disability Benefits Questionnaire (DBQ) for an increase, and that DBQ is actionable and sufficient, why is a VA employee requesting a C&P exam when it’s not needed? This prolongs the claims process unnecessarily.

Identify Performance Targets

Performance targets for benefits should be reported publicly each quarter, and these metrics should drive consistent improvement. While the VA does break down performance by regional offices, this data often doesn’t impact veterans directly. Leadership is aware of these issues, yet they’re not being proactive enough, in our opinion. We’ve seen this during our time working under the VBA—managers and assistant managers often just push paper, rather than implementing meaningful change.

Develop Express 30 Commitment

The proposal to develop a new pilot program, Express 30, for a veteran’s first fully developed disability compensation claim and to have the VBA complete it within 30 days is something we believe is possible. Many private-sector individuals, like ourselves, who were trained in process improvement methodologies, could contribute to this effort. However, the VA leadership is often reluctant to tap into this external knowledge, waiting instead for directives from DC.

Hire More Private Companies

The recommendation to hire more private companies to perform disability medical examinations is something we disagree with. We believe pushing DBQs from private doctors is more effective. However, it seems this isn’t being prioritized because third-party contractors have lucrative contracts with the VA. Instead of giving another billion-dollar contract to a private company, why not train more private examiners across the country to perform these examinations?

Hiring Additional Staff

Hiring additional staff to process claims is costly and has yielded mixed results. We agree that the current staff could handle the workload if processes were improved. It all comes back to ensuring that when a claim is ready for a decision, it goes to the rating activity immediately. The real issue is the lack of training and efficient processes.

Use Technology to Perform Work

The best way to provide benefits faster and more accurately is by leveraging technology. However, we believe this would be more of a technological challenge than an organizational one. Any system implemented would need thorough checks to ensure it doesn’t result in underpayments or overpayments.

Improving the VBA Acquisition Workforce

The VBA needs more world-class contractor support. Currently, some top companies have contracts with the VBA, but more outreach to the private sector is necessary, particularly to those specializing in process improvement. Senior leadership engagement in industrial conferences is crucial for bringing in the right expertise.

Establish a Knowledge Exchange Program

We definitely support establishing a knowledge exchange program with top-tier private sector companies that do similar work. The VBA is fundamentally a financial services organization, and much of its work has private sector analogs that could be leveraged to improve service to veterans.

In conclusion, while some of the recommendations in Project 2025 show promise, we believe that without a shift in leadership mindset and a more proactive approach to process improvement, these changes may fall short. Veterans deserve better, and it’s up to us to hold the VA accountable for delivering the benefits they’ve earned.

Project 2025 is not affiliated with Donald J. Trump is not associated with him or any of his organizations / associates.

Disclaimer:

This article is a commentary (opinionated) and is strictly this author’s views, and it is recommended that to research this issue further to draw your own conclusions on relevance and fact-based accuracy.