By Dorothy Meindok
The Post Newspaper Veterans Consultant
Editor’s Note: This is the second of two parts. The first part was run in the Sunday, September 4 edition.
An example of possible fraud is this hypothetical:
You sign a fee agreement of what would amount to 50% of any back pay for the single issue of increased PTSD. You are hoping to be awarded a higher rating from 60% to 100% which will result in back pay, if awarded. The large firm takes almost a year to enter the claim for increase but saves the date by informing VA that a claim is intended within the next year by using the proper form. The pay clock for back pay upon award begins ticking. In the meantime, the firm sends you for a private medical review but fails to enter the new medical evidence and continues to wait in furnishing the VA with the new medical evidence. During that wait period you raise new claims that are valid and have never been seen by the VA (no fee allowed, front end claims). You are suffering and need help so forward the new claims to the firm and ask them to submit them. The response you receive is that he should wait for the PTSD claim to be resolved first and to not file any additional claims in the meantime***.
Then, you are directed to “no show” for any VA compensation and pension examinations that VA may set up for you as to the pending PTSD claim (I’ll circle back on this error later in this article). These are all red flags to take note of. What is the waiting for, is its purpose to generate a larger backpay window to which the firm will then receive 50% of a larger pie? If the firm has the private medical evidence necessary, why make you wait any longer, why not submit it so VA can decide for you? Be sure to ask. If there isn’t a good reason, otherwise, it simply looks suspicious. (Sure, it could be a simple error, and, in that case, ready resolution would be employed.) But another, larger, red flag is raised when the firm has advised you to “no show” for a VA compensation and pension exam (C&P exam). That is simply bad advice. Do NOT ever miss a VA compensation & pension exam without verifiable, worthy cause; they are mandatory if the VA requests one. “No showing one of these exams allows the VA to deny your claim immediately and, in some instances, provide legal avenue to re-review and LOWER your claims award or even sever the award all together. If any of those instances arises, the only redress is an appeal avenue which is very costly timewise. Certainly, if it settles, if found in your favor, there is backpay to cover the gap but you, as the veteran, have suffered greatly in the ordeal especially if you’ve lost financial benefits by way of reduction or severance along the way, not to mention the emotional impact during the process. In this hypothetical, keep in mind that the large back pay upon resolution would be subject to reduction from the 50% contract, by the firm that may have helped create the additional wait and frustration by advising you to “no show” in the first place. ***But what of those new claims the firm told you to not submit? Well, if the new, non-payable front end claims were submitted and awarded before the PTSD increase was resolved raising you to 100% via the new, fee restricted claims alone, once the PTSD claim is awarded there would likely be a significantly reduced backpay or no back pay awarded for the PTSD increase, thus the contractual 50% due to the firm is less or nonexistent. In that event, the firm would be due only provable expenses for services rendered.
There really are people out there practicing like this and taking advantage of veterans purposefully. I call them VA Law puppy mills. VA knows they are active and yes, because of them, we all pay with time and money and additional scrutiny. If you think you are a victim of this kind of fraud, I encourage you to report it to the VA Office of Inspector General at Phone: 1 (800) 488-8244 or FAX: (202) 495-5861. You may do so anonymously. Contacting your local Congressperson is also an avenue to consider if reaching out to VA’s OIG feels overwhelming to you.
Stopping this growing fraud will help safeguard all veterans from these predatory practices.
Here’s a link to VA’s Public Health Website page that provides detailed information and contacts to get started: https://www.publichealth.va.gov/exposures/coordinators.asp
More information –
Agent Orange Registry Exams: https://www.publichealth.va.gov/exposures/agentorange/benefits/registry-exam.asp
Airborne Hazards and Open Burn Pit Registry Exams:
www.publichealth.va.gov/exposures/publications/gulf-war/gulf-war-winter-2017/burn-pit-registry.asp
(Also available via VA’s MyHealtheVet portal):
www.myhealth.va.gov/mhv-portal-web/ss20210222-airborne-hazards-open-burn-pit-registry
Dorothy Meindok is The Post Newspaper’s Veterans Consultant. Ms. Meindok served her nation in the United States Navy and is currently a practicing lawyer advocating for our nation’s veterans. Her column appears on Sundays.
