When your receive the initial decision from the VA you have one year to file a Notice of Disagreement (NOD). When you file your NOD you should request the Decision Review Officer (DRO) hearing. This “non-traditional” method of appeal allows a “de novo” review, meaning a “new review” of the claim. The traditional NOD appeal only allows review based upon additional evidence not already in the claims file and there will be no hearing via the traditional NOD review process.
A September 2011 Government Accounting Office (GAO) report evaluated the NOD DRO review process and found that many veterans were not aware that the DRO request was available. In 2001 the VA established the DRO process in order to limit the amount of claims having to be appealed to the Board of Veterans Appeals (BVA). Although the GAO report revealed mixed results of the DRO review vs. the traditional review there is a higher rate of approval for the DRO process. The main benefit which is missed by the GAO report is that the DRO hearing can give claimant’s a better understanding of what the VA agent needs, in regard to evidence, and there is the “human factor” of actually seeing and talking to a person in the “faceless” claims process which can not be underestimated.
The following is a summary from the September 2011 GAO report regarding their findings when reviewing the DRO process:
The DRO review process has helped some veterans get additional benefits at the
regional office level, but has not reduced the percentage of appeals continuing
on to the Board—the primary purpose of the program. In fiscal years 2003
through 2008, 21 percent of DRO reviews resulted in a full grant of benefits
compared to 17 percent of traditional reviews. A full grant of benefits ends, or
resolves, the appeal at the regional level. However, appeals may also be
resolved at the regional level if veterans who do not receive full grants decide not
to continue their appeal to the Board. VA gave DROs the flexibility to interact
informally with veterans in part so they could explain when the benefits already
granted are appropriate given the law. However, while DRO reviews led to the
grant of full benefits at a higher rate, a higher percentage of veterans not granted
benefits through traditional review voluntarily ended their appeals. As a result, in
fiscal years 2003 through 2008 the overall percentage of appeals resolved at the
regional level was about the same for DRO and traditional reviews—about 70
percent for both.
VA faces challenges in how to most effectively use and train DROs. Since the
DRO process and position were established, DRO duties have expanded beyond
reviewing appeals to performing additional tasks such as quality review.
However, VA officials have not reached consensus on how to balance DROs’
time among different tasks. VA has no performance goal or measure for appeal
resolution at the regional level that could help it determine whether it is achieving
the most effective balance between different tasks. In addition, VA headquarters
offers no nationwide, standardized training for new DROs, which according to
managers and DROs would be beneficial, as they often lack experience with
other tasks that DROs frequently perform such as conducting hearings. Ninety-three
percent of surveyed regional managers said a nationally standardized
training for new DROs would be beneficial.
Source: Highlights of GAO-11-812, a report to congressional requesters (September 2011).
The GAO report reveals the DRO process is evolving, but the VA has failed on many levels to track, train, and ascertain the needs of the DRO agent to maximize the very goal of the program: less hearings before the BVA by making the correct decision on the claim early in the claims process. This program goal will never stop or lessen the appeals to the BVA, but the VA should instead weigh the DRO program on whether the DRO made a correct decision that withstood additional appeals. The tracking of “decision correctness” is not being tracked by the VA which is the true test of the DRO review.
Monday, June 18th, 2012 and filed under Veterans Benefits.