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Veteran left to fight for benefits after VA denies claim

November 8, 2012 12:00:00 AM PST
In 2008, the U.S. Department of Veterans Affairs denied Hosea Roundtree's disability claim for post-traumatic stress disorder and depression.

"What do you got to do? Go get shot before you get PTSD? There's more than just one way of getting wounded. I was mentally wounded," Roundtree said.

The VA didn't deny Roundtree had PTSD, but the agency said it couldn't find any evidence he was in combat.

"I just did a quick Google search on military history sites, and I was able to verify that his ship that he was on was actually in combat," said Jamie Fox, who was a claims processor at the VA's Oakland office. She discovered Roundtree was on a Navy destroyer in 1983 that engaged in battle off the coast of Beirut.

"I brought it to the attention of the supervisor because I was new and I didn't know what to do," she said.

Fox never saw Roundtree's file again. Five months later, she was forced out.

"It was devastating. I was in shock. I was confused," Fox said.

Fox filed a wrongful termination suit against the VA. The agency declined several requests to discuss her case, but in Fox's termination letter, the VA said she failed to follow instructions by not sending Roundtree a letter denying his claim. And in a deposition, the former director of the VA's Oakland office, Lynn Flint, said it didn't matter if the agency's decision in Roundtree's case was "right or wrong."

"They're not interested in quality. They are interested in production and getting the decisions done, regardless of whether they are right or wrong," said Gordon Erspamer.

Attorney Gordon Erspamer has successfully sued the VA on behalf of veterans. He doesn't represent Roundtree or Fox, but he's not surprised by what happened to them.

"The system is simply broke, and we can do a lot better for our veterans," said Erspamer.

The VA says its error rate on disability claims is 14 percent. The Center for Investigative Reporting analyzed VA audits of a subset of those claims and found an error rate of 38 percent. The VA's Board of Veterans' Appeals found the agency made mistakes in 73 percent of the nearly 50,000 appeals the board decided last year.

Erspamer says errors are often the result of a well-known practice at the VA.

"There's a practice called topsheeting, a very famous term in the VA. And that is basically you take a look at the file, you look at the top pages of the file and you write a decision," said Erspamer.

In a statement, the VA said it is "retooling procedures and deploying paperless data systems" to limit mistakes. The VA promises to reduce its error rate to 2 percent by 2015. But that's not soon enough for one congresswoman.

"I want to see dramatic changes taking place now," said United States Rep. Jackie Speier. Speier says errors are contributing to the VA's huge backlog of disability claims.

"There is no benefit in pushing a determination out that is wrong because, in the end, it will be appealed, and it, it's going to make the record look even worse," she said.

Appeals represent 31 percent of the agency's 819,000 pending disability claims. By the time Hosea Roundtree filed his first claim, he had spent 17 years in the Navy, and more than a decade on the streets addicted to drugs.

"I lost it. I had a major breakdown," said Roundtree.

The same day he received his denial letter, Roundtree got a job offer from the VA's health care division. He now works as a cook at the agency's medical center in Sacramento. Fox now works for the same division of the VA that hired Roundtree, assisting veterans at a clinic in Santa Rosa. Her lawsuit is still pending.

This spring, Fox found Roundtree on Facebook.

"I was so nervous calling. I didn't know how he was going to respond," she said.

She heard what happened to his claim, and he heard what happened to her job.

"I felt her pain. I felt her anger. I felt everything about her, because she and I connected," said Roundtree.

A few weeks later, they met, and Fox persuaded him to file a new disability claim.

"It's not just for me. It's for me and every other vet that's out there that's suffering. It's for every other vet that's coming back home, that they're going to see a difference. I want these vets coming back from overseas to get fair, better treatment," he said.

Roundtree is waiting to hear if the VA will approve his new claim. On average, veterans who submit claims to the Oakland office will wait a year for a decision.


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