Donald R. Lanthorn
Mr. Chairman, members of the Committee. My name is Donald R. Lanthorn. I am the Service Director of The Ohio American Legion, a position I have held for thirty years. I appreciate the opportunity to provide my personal perspective as to why Ohio is last among the fifty states in VA benefit dollars received per compensated claimant.
The issue, in my opinion, is multi-faceted and quite complex, with origins back to World War II in some areas. If the purpose is to lay blame, there is plenty to go around. I will address fault on the part of the Department of Veterans Affairs, and both VBA and VHA; the State of Ohio; County Veterans Service Officers, their Commissioners and the State Associations of both; and Veterans Service Organizations are not without culpability.
However, fault may not be as much of an issue as one may surmise, and in the May 19, 2005 “Review of State Variances in VA Disability Compensation Payments” report of the Department of Veterans Affairs, Office of the Inspector General it is noted, in referring to the dollar averages of the clusters of the six highest and lowest ranked states, that “Preliminarily, this suggests that the high cluster may be more problematic than the lower ranked states.”
There are several factors in determining compensation received by Ohio Veterans that are the fault of no one.
The IG Report analyzed states by high and low clusters of six states each. Ohio is in the low cluster with Indiana, Michigan, Connecticut, New Jersey, and Illinois. New Mexico, Maine, Arkansas, West Virginia, Oklahoma, and Oregon comprised the high cluster states.
It was noted in the DVA IG Report of May 19, 2005 that demographics play a part in the disparity.
Average military officer VA compensation is less than that of the average of enlisted personnel; hence states with more officers serving in the military would likely reduce their average VA compensation. (High cluster states have 63.4% enlisted personnel receiving VA compensation to an average of 44.4% in the low cluster states.)
Military retirees receive more compensation than their non-military retired peers. (Eleven percent more retirees receiving compensation, 27.6% to 16.6%, among high cluster states.)
Period of Service is a factor in computing average compensation. Vietnam service veterans receive higher amounts, followed by Korean War, World War II and Peacetime veterans. Gulf War veterans receive less VA compensation on average than other periods of service. The numbers of veterans from each state and percentage of veteran population make this a no fault demographic statistic factor. (High cluster, 13% WWII; low cluster averages 23 percent.)
Further analysis by Branch of Service indicates that Marine Corps veterans receive the highest average amount of VA compensation.
Veterans with dependents receive a higher average amount of VA compensation per year than their peers without dependents. (High cluster averaged 43.8% to low cluster of 30.3% of veterans with dependents.)
Age of recipients is a factor. The average age of the high cluster states recipient was 58 compared to 61 in the low cluster. This suggests younger veterans receive more compensation, but may more closely relate to periods of service, indicating fewer WWII or higher numbers of Vietnam veterans, by percentage, among VA compensation recipients in the high cluster states.
The more service-connected disabilities a veteran has results in higher VA combined ratings for compensation. There is a correlation between the high and low clusters of 3.0 to 2.4, respectively, a 25 percent difference.
The above fact is especially significant if one accepts the premise that those veterans that file their own claims file for fewer disabilities than those who file with a veteran service organization (VSO) or have advocacy representation. It is generally accepted that VSOs recognize secondary conditions the veteran may not, and review the service medical records, a more accurate list of possible service connected conditions than the veterans’ recollection. Hence, this supports the facts of the IG report that veterans who receive legal help or aid from advocacy groups receive on average $11,162 compared with $4,728 for those who go it alone. The National average is two-thirds receive VSO assistance, however, reportedly forty percent of Ohioans file their own claims. This is a factor that can and should be addressed and will result in increased federal dollars for Ohio claimants, on an average.
The Institute for Defense Analysis (IDA) final report is a scientific study of state-by-state and VA Regional Office variation in disability compensation claims, ratings and benefits. We certainly concur with their findings that 100% and Individual Unemployability (IU) are the most significant factors affecting total payments. Although they represent only 17% of compensation recipients, they represent 58% of total compensation payments. IU and often a 100% disability rating can be subjective. These differences alone reportedly were found to explain the vast majority of the variation in average awards across states.
It is also our opinion that “new” or less experienced adjudication personnel would be less likely to make subjective decisions awarding the highest of compensation benefits. We will address this further later in this testimony.
In another area of the IDA study it was noted that military retirees are over four times as likely to receive compensation as non-retirees.
Ohio has only one major military installation and a notable lack of state incentives for retaining military retirees in Ohio may account for a considerable number of benefit dollars, as the IDA study attributes military retirees alone for over 40 percent of the variation in the percentage of veterans receiving compensation.
The IDA study identifies the “key driver” in the variation across states of veterans receiving compensation as the “application rates.”
Several studies, including the IDA report addressed consistency across VA Regional Offices and the potential for inconsistencies. We concur with the VA position that if VA addresses accuracy in the decision making process, consistency will take care itself. We do support the recommendation of standardized initial and ongoing training for rating specialists.
The IDA report recommends standardized hospital evaluation reporting. For several years The Ohio American Legion would return files to the adjudication officers at Cleveland VARO as “insufficient examination” for PTSD exams where the Global Assessment of Functionality (GAF) score did not match the doctor’s list of symtomology. Rating specialists would use the lesser of the two if we did not, resulting in less VA compensation. We often wondered what happened to those claims without advocates to which we did not have access.
In recent years we send back far fewer for new exams. Have the exams gotten better? Are the doctors more thorough? We doubt it.
We suspect when a claimant has representation that may find an exam suspect the adjudicator gives the examiner an opportunity to “fix it.” Few doctors would remember the patient well enough to add symtomology to their first report. It is our belief that they adjust the GAF score to be consistent with the earlier reported symtomology, which was insufficient to justify the assigned score. This would result in lower compensation ratings.
We earlier alluded that Ohio’s rating specialists are “new” or “less experienced.” As a historical perspective, in 1945 VA “geared up” to handle the wave of incoming World War II claims to be received from returning veterans now offered education benefits, home loan guarantees, and disability benefits, much as a result of the GI Bill. The class of ’45 was born.
Thirty years later in 1975, as these employees were completing their federal service they were replaced with another wave of personnel, many of whom were Vietnam veterans themselves. Again, VA “geared up” to address the needs of this group of returning veterans.
What is different in Ohio in 2005 as the “Class of ’75” finished their thirty years of federal service?
In 2005 VA was in the midst of a 2004-2006 hiring freeze. Key adjudicative positions went unfilled in some instances, filled with lower level employees in others. VA was also experiencing being the victim of their own failed hiring practices of earlier years when efforts were made to hire attorneys and nurses, which they were unable to retain.
In Cleveland, Ohio VA created a “Tiger Team,” a force of senior adjudicators formed by Central Office directive to address the older claims of aged veterans. They developed processing Memorandums of Understanding with other government agencies and excel at handling the claims of our World War II veterans and those claims over a year old from around the country.
As beneficial to the nation as it is, the Tiger Team represents a significant brain drain in Cleveland’s adjudication ranks.
If the driving factor is the number of claims in determining state rank, Ohio is lacking a single, consistent message to veterans regarding the claims process. Each County Veterans Service Commission and Veterans Service Organization operates independently and within their own budget constraints. Few counties do any outreach and since their funding is from the inside mileage, there is little incentive from county officials to urge greater expenditures in promoting their offices, as one of their services is financial assistance to veterans and their dependents and survivors.
County Veterans Service Officers and County Veteran Service Commissioners now receive their training from the Governor’s Office of Veterans Affairs, which utilizes VA personnel at no cost. Several years ago VSOs provided the training, which emphasized advocacy tips. VA training may be fine for most areas of service, but we liken it to learning how to duck hunt from a duck. It should not be the lone source of trainers.
Many CVSOs recognize the need for other sources of training in their desire for professional excellence and belong to the National Association of County Veteran Service Officers. However, their training sessions are often held in resort areas and participation restricted by their employers, members of the Ohio State Association of County Veterans Service Commissioners. VSCs receive all of their required training in Ohio and unfairly expect the same of their CVSO employees.
Veterans Service Organizations (VSOs) have long been a source of outreach to veterans with local Posts, State Service Officers, house organs at the local and state levels, the distribution of pamphlets and benefit information.
This changed in Ohio as the state’s appropriations to VSOs were of slow growth, then flat lined for several of the recent years. VSO appropriations are given the misnomer of “subsidy,” leading one to believe that the State of Ohio is subsidizing VSO operations, when in fact, VSOs are subsidizing a state function in Ohio where we have no Department of Veterans Affairs to file claims and provide claimants representation.
The flat lined revenue from the State of Ohio came at a most inopportune time, for The American Legion, as World War II veteran deaths were on the rise followed by membership declines and subsequent lost revenue. Publications were cut back or curtailed, employees in our Service Division were eliminated by attrition and wages and benefits suffered for those remaining. The American Legion Service Division, once 15 full-time employees, is now 10.5 Full-Time Employee Equivalents (FTEE).
Clerical personnel have been replaced by claims representatives using computers to do their own letters, reports, and “status updates” to inquiring claimants. An increasing VA backlog causes increasing status inquiries, and the spiral goes on. Time spent filing claims and providing advocacy representation is often now directed to other matters. Outreach is no longer a goal, as increasing the workload is not an objective of an over burdened, underpaid staff. Meeting deadlines has become the area of emphasis.
In conclusion, Ohio’s woes can be addressed quite simply. Although the variances in demographics may never put Ohio at the top of the list of benefits by state, our problem areas can be resolved by the infusion of federal and state dollars.
VBA needs to increase its adjudication staff and attract some experienced adjudicators to Cleveland that may be effective now, not following extensive training. Making the “Tiger Team” an advancement desirable to adjudicators around the country in salary, benefits and workload would go a long way in attracting bidding on vacancies from outside of Cleveland.
VHA exams need to be thorough, and complete, and re-done, if not. VAs work measurement system of “End Products” rewards ROs for work reported, not accuracy or correctness. This is a situation that needs addressed, but is not unique to Ohio.
The State of Ohio needs to centralize its veterans programs in one department, an Ohio Department of Veterans Affairs (ODVA), which Governor Strickland, by Executive Order created a Veterans Study Council to investigate and report to him by year’s end.
The Veterans Study Council is addressing the issue of a comparison of benefits available in other states to Ohio. As noted in the IDA report, attracting military retirees back to their roots, into Ohio or retaining those separating from military service as a last duty station will raise the compensation average significantly.
Increased appropriations to VSOs will go a long way in serving veterans. The marketing and outreach by CVSOs or an ODVA would be a wasted effort if VSOs were not prepared at their link in the chain to provide needed services.
The Ohio State Associations of County Veterans Service Officers and Commissioners (OSACVSO & OSACVSC) receive a state appropriation for training. It can be well spent on trainers from beyond VA ranks or sending CVSOs to VSO training programs or the NACVSO schools.
VSOs need to prepare for increased workloads. The Ohio American Legion is addressing salaries and staffing levels as well as we can with available resources. Post Service Officers continue to train to identify potential beneficiaries of VA benefits and get them to claims filing professionals, most often their CVSO.
Ohio has the infrastructure for excellent service to veterans, but its loose knit organization has not served it well during trying economic times.
Piecemeal legislative efforts by well meaning legislators need to be coordinated under a Department of Veterans Affairs and directed into one omnibus legislative bill to correct Ohio’s problem areas.
Thank you for this opportunity to present my perspective on Ohio’s needed answer to trailing other states in average compensation benefits per veteran.