Lightening the VA's Rucksack: A Proposal for Higher Education Medical-Legal Partnerships to Assist the VA in Efficiently and Accurately Granting Veterans Disability Compensation

The struggles of veterans to navigate the Department of Veterans Affairs’ (VA) mammoth bureaucracy flash across our news screens every evening and Congress regularly holds hearings to address the many billions of dollars spent on unsuccessful solutions. According to the VA, 1.5 million new claims for disability benefits are expected to be filed in 2015, which represents an increase of 20% over 2014 numbers. Veterans who wait many months to years for a decision, often accept the VA’s denial of benefits and never file an appeal. For many veterans, this is a bad choice. Only approximately three and a half percent of claims are appealed past the first level of administrative review to the Board of Veterans’ Appeals. The Board remands or reverses an incredible 73% of the VA decisions it reviews. Appeals to the federal court, the Court of Appeals for Veterans Claims, account for approximately one half of one percent of all veterans’ claims filed. In the VA and Board decisions it reviews, the court consistently finds that in a majority of the cases the government is unjustifiably withholding benefits from veterans. Add to these statistics the VA’s heavy reliance on what the VA’s Inspector General has called “incompetent” medical evidence to make these decisions. It is easy to see that the VA needs help to administer benefits to veterans and why veterans need assistance navigating this process.This article is written in recognition of the facts and statistics that point to the reality that the VA is a titanic bureaucracy that is unlikely to deliver benefits to veterans efficiently or effectively in its current state. While change of the entire system is desirable, radical change is doubtful to happen quickly or efficiently. In light of this reality, this article proposes a unique solution to the problem: a medical-legal collaboration between law and medical schools. This interdisciplinary approach allows veterans to benefit from skilled advocacy and advice at the most essential stages of a claim at no cost to the veteran. Veterans can also receive thorough, competent, and specialized evaluations and opinions at little to no cost from medical students under the supervision of licensed faculty. Through this partnership, law and medical students learn critical skills that will impact their future practices. They also gain the essential ability to understand and appreciate the impact of other professionals on the client/patient they engage. Finally, this type of collaboration helps the VA make accurate decisions more efficiently.This type of cutting-edge medical-legal collaboration has been successfully implemented only at Stetson University’s College of Law and William & Mary Law School to date. The data from these collaborations demonstrates, among other things, that when medical (including mental health graduate clinical) students and law students collaborate they convince the VA to reverse a previous decision on a veteran’s claim 82% of the time. Adding to these statistics that point to higher than normal grants of benefits in complicated claims for post-traumatic stress disorder, the quantitative results of a medical-legal collaboration are immeasurable.To examine this distinctive proposal, Part I of this article will discuss the VA disability compensation benefits system and the challenges facing the VA in delivering these benefits. Part II will argue that the veteran’s need for a trained advocate during the claims process is absolute and should be filled, despite the VA’s hesitancy to allow attorneys to enter the fray. Part III will examine the veteran’s need for independent medical evidence. Finally, Part IV will propose that law students, medical students, and other professional graduate students are a vast untapped resource that are distinctively equipped to fill these needs by discussing results realized from this type of collaboration and the benefits to all involved. The conclusion of the article is a recognition that all involved in this collaboration, veterans, students, and the VA, benefit tremendously from this partnership.