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Veterans Benefits Information

Health Care Leaders Discuss Next Generation of Quality and Value Metrics

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Top health care industry leaders from around the country joined for a two-day roundtable discussion about the next generation of health care quality and value metrics. The meeting allowed leaders to compare and contrast how they use metrics to enhance quality of care and value for patients.

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Avoid TFA funding being delayed, denied

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Since its establishment in 1925, The American Legion Temporary Financial Assistance program has awarded cash grants to minor children of veterans eligible for American Legion membership. These grants are used toward providing basic needs for children, such as shelter, utilities, food, clothing and medical. Since 9/11, $5 million has been distributed to families in need.

However, TFA applications are oftentimes submitted incomplete to The American Legion National Headquarters, causing a delay in the funding process or even denial. Therefore, during the Legion's recent fifth annual Children & Youth Conference in Indianapolis, a number of items to remember when filling out the application were mentioned to avoid any conflicts.

1. The application should be filled out by a case investigator, which is anyone at the post level. After completion, appropriate signatures must be obtained from the case investigator, applicant and either the department service, adjutant or children & youth chairperson. If any of these signatures are bypassed, the application will be sent back marked "incomplete," causing further delay in funding.
2. To be eligible for the grant, the child(ren) must be 17 years or younger, or under the age of 20 and still enrolled in approved high school courses, unmarried and living at home full time. Also, the child(ren) must be the biological or in legal custody of a veteran who is, or would have been, eligible to become a member of The American Legion. However, membership is not required to apply for the grant.
3. Don't leave blank or overlook any questions on the application - the applicant's story must be explained in full detail or the grant could be denied due to lack of important information.
4. Under "financial information" on the form, list entire amount of family household income. A commonly left-off item is financial earnings from a live-in boyfriend or girlfriend. As far as the Legion is concerned, they too are contributing to household bills.
5. Do not put "NA" when filling out questions under "other assistance." Make sure the applicant has exhausted all military and non-military resources available to them (i.e., food stamps) because the TFA grant is just that - temporary. If the applicant has not made contact with other resources, that could have bearing whether or not he or she is granted TFA.
6. When requesting for a bill to be paid, the applicant must submit the most current bill and all creditor information must be filled out.
7. Every case gets reviewed immediately. If approved, a check can be mailed as quickly as two days and if not approved, a letter is faxed back to the department stating "incomplete" or "denied" with an explanation why. In either case, the applicant should be contacted for an explanation to the missing details needed for approval.
8. TFA applications should not be available for download on any department's website. If it is, applicants have the ability to fill out and submit the application, bypassing all proper channels needed for a grant to be approved.


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Audit of Compensation Program Claims Brokering\n\r\n\r (9/27/2011)

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This audit evaluated the effectiveness of VBA’s claims brokering. To help address VBA’s major challenge of processing the increased number of veterans’ compensation benefit claims, VBA has increased claims brokering from veterans service centers (VSCs) to resource centers or other VSCs to better align workload with staffing resources. We found VBA can improve the effectiveness of claims brokering by ensuring area offices consider additional factors affecting timeliness and accuracy. For nearly 171,000 brokered claims completed during FY 2009, we projected the average processing time of 201 days would have been 49 days less if VBA had avoided the claims processing delays identified in this report. Of nearly 117,000 claims VBA brokered for ratings, we projected area offices brokered about 54,000 (46.2 percent) to facilities with lower rating accuracy rates than original VSCs. In addition, staff at three of seven VAROs we visited brokered claims without area office approval. Increased effectiveness will reduce the risks of claims-processing inaccuracies. We recommended the VBA revise brokering policies and procedures to help improve claims-processing timeliness and accuracy, include brokered claims-processing timeliness and accuracy performance measurements in director performance plans, and evaluate VSC compliance with revised brokering policies and procedures.

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11-013

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Policy Memorandum to Establish 2012 Monthly Premium Rates for TRICARE Reserve Select and TRICARE Retired Reserve

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Healthcare Inspection Quality of Care Provided at Corpus Christi Community Based Outpatient Clinic VA Texas Valley Coastal Bend Health Care System, Harlingen, Texas (9/27/2011)

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We evaluated the validity of allegations regarding quality of care at the Corpus Christi Community Based Outpatient Clinic (CBOC) in Corpus Christi, TX. We substantiated the allegation that a CBOC primary care provider did not diagnose a patient’s fractured ankle when the patient presented for evaluation. The facility had taken appropriate action prior to our review. We substantiated that a CBOC primary care provider prescribed antibiotics without first obtaining wound cultures. The primary care provider acknowledged that his usual practice to obtain a specimen for culture when drainage was present in a wound prior to starting antibiotics. We identified two factors that affected this patient’s care: Failure to implement the facility’s Skin Integrity Management Program Policy for managing the skin integrity of outpatients. Fee-basis records are not always available in the medical record. The facility identified opportunities for improvement prior to our review. We found their plan acceptable.nrWe recommended that the Medical Center Director ensure that the CBOC follow the Skin Integrity Management Program Policy. The Director concurred with our findings. We will follow up until the planned actions are completed.

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