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How VSO's Expedite Claims Processing

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Jimmy Williams

on 26 February 2014

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Transcript of How VSO's Expedite Claims Processing

How VSO's Expedite Claims Processing
Prepare a Veterans Claim via SEP
Veteran Submits claim via eBenefits
VONAPP Direct Connect (VDC) allows Veterans to file and submit a claim via eBenefits

eBenefits provides secure resources and self-service capabilities to access and manage their VA and military benefits.

Ensure Veterans receive a premium eBenefits account - it is FREE
Once claim is prepared by VSO in SEP and submitted by Veteran via eBenefits the claim is ready for VA processing

A FDC is established electronically and the claim will be processed in VBMS

When completed VSO is notified as the decision is populated in your VBMS VSO Work Queue

How Can You Better Service Veterans?
Submit electronic FDC's via SEP and eBenefits with completed DBQs

VA has automated claims establishment and awards issuance which reduces processing time

FDC submissions with completed DBQs signifcantly reduce the need for clarification and correspondence

Can result in a decision being made shortly after submission

Veteran receives world class service
Use SEP to prepare Veteran claims, check status, and accept representation among other things

Include DBQs and all other evidence to ensure claim is fully developed

Have Veterans submit claims, prepared by you, through eBenefits

Electronic claim submissions with all evidence and DBQs results in world class service for Veterans

When this is done....

We Need Your Support!
Stakeholder Enterprise Portal (SEP) allows VSOs to effectively do their job duties in an electronic environment
Manage POA Requests

View Claim Status

View Pay History

DIC Claims Status and Pay History

Prepare claims for Veterans

Add evidence to existing claims

Submit dependency claims via RBPS
SEP Allows VSO's To
VSOs prepare FDCs in SEP
Compensation claims prepared in SEP are submitted on EZ Forms

When submitted on EZ Forms the claim enters the FDC program (unless elected to opt out)

Compensation claims submitted electronically are a reviewed in the FDC program

Provide the Veteran with a DBQ and upload via SEP to ensure the claim is ready for decision upon receipt
Once your work is done, advise the Veteran to submit the claim via eBenefits
Veteran submits via eBenefits
Once Veteran submits prepared claim via eBenefits the claim is automatically tracked in VA systems
eBenefits allows Veteran flexibility to access various resources and information regarding benefits
eBenefits Features for Veterans
 Apply for Veterans benefits online
 Check on claim or appeals status
 Upload documents to support a claim
 Check Post-9/11 GI Bill enrollment status
 Use the VetSuccess employment search
 View DoD TRICARE health insurance
 Sign up for Veterans' Group Life Insurance
 Search for and select an accredited VSO
 Order prescription medications
 Message your physician securely
 Access your medical information via Blue Button
 Utilize the résumé builder
 Order medical equipment - hearing aid batteries
 Generate a VA home loan certificate of eligibility
 Obtain official military personnel documents
Register for and update direct deposit information
eBenefits: Submitting Claim
Once claim is submitted by Veteran via eBenefits a completely electronic claim is established

The claim is uploaded to VBMS automatically

A FDC is received by VA and available for review for expedited processing

DBQs and a complete FDC ensure the quickest service
Claims Process
Establish Claim
Develop Claim
Decide Claim
Issue Award
By submitting via VONAPP Direct Connect using SEP and eBenefits this process is automated by the system

The End Product is automatically established upon submission which results in decrease in processing time
This is the longest delay in claims processing

Required to get a claim ready for decision

Submitting via SEP and eBenefits reduces processing time because claim is FDC

However, examinations may be necessary which result in delays

DBQs submitted with a FDC significantly reduce the time to develop a claim
Receiving a claim prepared via SEP and submitted via eBenefits with a DBQ will generally result in:

Claim automatically being established
No need to develop the claim
The claim ready for a decision to be made at the time submitted

VBMS Awards Functionality

Updated functionality in VBMS allows for creation of awards and automated notification letters

VBMS-R provides automatic notification letter with reasons and basis for decisions

Notification letter automatically uploaded into VBMS following authorization
Automated with SEP and eBenefits
Not Automated - DBQs and FDC Expedite Processing
Not Automated - DBQs and FDC Allow Decisions to Be Made Quicker
Automated - VBMS Awards Functionality
Currently DBQs are of such interest to VA they are being updated to automatically populate VAs rating schedule criteria
Veterans have access to various features in eBenefits
Veterans Receive World Class Service
What They Deserve
Full transcript