(cell phone 240-506-1556)

To: All veterans

Date: Dec 2014

From:

Board of Veterans Appeals (BVA)

Scheduling and award rates

Craig N. Bash, M.D.

Independent Veteran Medical Opinion (IMO)

Veteran Medical Nexus Opinion (VMNO)
Pages: 2

Neuro-Radiologist
www.veteransmedadvisor.com

NPI or UPIN-1225123318- lic #--D43471

4938 Hampden lane, Bethesda, MD 20814
Phone: (301) 767-9525 Fax: (301) 365-2589
E-Mail: drbash@doctor.com

The BVA or sometimes called the board is located in Washington D.C. a few blocks from the White
House and the VA headquarters building. The Board historically has processed about 40,000-50,000
claims a year with a fixed rate of granting awards set between 20-26%. Since the BVA award rates are
essentially predetermined (internally by the Board) the 100 or so Administrative Veteran Law Judges
(VLJ) and their lawyer assistants are presumably under tremendous pressure to look for cases to deny or
remand so as to meet the fixed grant rate. These low fixed grant rates are important to any Physician
who writes veteran medical opinions because the quality of the opinion often determines which claims
are granted or denied because the BVA reviews all the medical evidence. Veterans with awarded claims
are often eligible for additional levels of medical care thus this BVA process can laterally save lives as
veterans without medical care can curcuma to their illnesses.
The BVA allows for personal hearings as a way to gather more medical information for the claims. Based
on my experience, with about 50 hearings, it is my opinion that the best hearing option is the In-person
option in Washington D.C. This option is best because it allows the veteran to review his claims file prior
to the hearing, meet the VLJ and shake his or her hand, an entire morning or afternoon of time for the
hearing, for an expert witness and lay members to attend and this hearing historically has been the
fastest to be scheduled (see below). The next best option is the video hearing as it is also relatively fast
to schedule but the veterans does not meet the VLJ in person and a review of the claims file is more
difficult. The least best option is the travel Board hearing as this hearing is very slow to schedule
(depending on regional office locations and number of pending travel board hearings) and the VLJs can
schedule 7 or more claims a day thus the time allowed for the hearing is limited. Based on my
experiences the historical BVA hearing scheduling times are as follows;
Type hearing

time wait

In person hearing in Washington

Video hearing
Travel board hearing

3-6 months
6-12 months
18-24 months

Often cases go from the BVA back to the RO or Appeals Management Center (AMC) for further development
and additional medical examinations. This process of remand and appeal can occur several times due to the

complexes of the veterans medical records and illnesses. Each appeal cycle is again time limited by the
above listed hearing wait time. Thus these medical diagnostic code dilemmas can linger for years in these
appeal cycles. Once again illustrating the importance of high quality medical opinions at the start of the
patients claim.
The denied cases often are sent forward to the court of veterans appeals which historically only validates the
BVA decisions at a 30-40% rate. Thus 60-70% of the CVA cases are sent back to BVA to reprocess. The
low validation rate of the BVA decisions at the court is often due to complexity of the whole veteran claim
process, legal procedural errors by the BVA VLJs and to inaccurate weighting of the medical evidence (VJLs
are not physicians).
Recommendations:
1. All veterans with large BVA cases should use the above BVA schedule estimate to choose the schedule
that fits their time frame.
2. All veterans should make and keep all medical appointments because the BVA looks closely at all
medical evidence in the file.
3. All medical evidence should be forwarded to the BVA prior to their decisions.
4. All BVA hearing request should accurately list all issues as only the certified issues from the RO are
allowed at the BVA. Often unfortunately many patients are surprised when they go to the BVA hearing
expecting to have 10 issues reviewed but they find out that only 2 claims were certified from the RO.
5. All veterans should seek lay witnesses and medical experts for all hearings as these people add new
important medical information to the file as they provided sworn testimony.
6. All veteran should have high quality independent veteran medical opinions and examinations in their
claims files prior to the hearings because these cases often hinge on the medical opinions and
examinations,
Each BVA appeal should also be accompanied by a veteran medical opinion [Independent Veteran
Medical Opinion (IMO)-Veteran Medical Nexus Opinion (VMNO)], which explains the medical issues to
the VLJ.
7. Of course all veterans should seek physicians who have 15+ years of independent veteran medical
opinions at the BVA level as the BVA medical diagnostic coding process is complex often with multiple
layers of BVA appeals.
Additionally, all physicians who write Veteran Medical Opinions [Independent Veteran Medical Opinion
(IMO)- Veteran Medical Nexus Opinion (VMNO)] should be able to categorize the 65,000 Non VA
SMC type codes into the VAs directory of a few SMC codes. This is not a trivial process, as the VA
codes all have different a complex combinable aspects, which of course excludes pyramiding of codes.
8. Low levels of training and experience by either physicians or advocates hurts a veterans chances of
getting a correct BVA medical diagnostic code as any mistake made at the lower levels of appeals are
magnified under further appeal reviews and amount of needed extra time, medical testing, medical
opinions and associated paperwork to try and correct early errors is substantial and a correction is not
always possible.
Craig Bash M.D. Associate Professor

drbash@doctor.com cell 240-506-1556

Independent Veteran Medical Opinion (IMO)

Veteran Medical Nexus Opinion (VMNO)
based on Veterans medical records