Jessica McGoldrick - RATING VETERANS SERVICE REPRESENTATIVE - U.S. Department of Veterans Affairs

Summary

Experienced with evaluating and adjudicating veteran claims. Utilizes regulatory knowledge and analytical skills to ensure fair and timely decisions. Track record of effective communication and teamwork, fostering positive relationships with veterans and colleagues.

Overview

16

years of professional experience

1

Certification

Work History

RATING VETERANS SERVICE REPRESENTATIVE

U.S. Department of Veterans Affairs

Waco, TX

08.2010 - Current

As an RVSR, I have more than 16 years of experience in claims processing. I am a subject matter expert in claims involving Military Sexual Trauma, Traumatic Brain Injury, and Blue Water Navy Veterans. Additionally, I have supported VBA’s special mission to adjudicate claims eligible under the Nehmer Court Orders from 2010- 2013 and from 2022-2026. I have also served as a mentor to other RVSRs to support Waco's Quality Review Team.
REASONING: My role requires that I analyze claims to determine if diseases and/or injuries were incurred or aggravated by military service in the line of duty for purposes of compensation, treatment, or hospitalization. I identify regulations, laws, rules, principles, or relationships that explain facts, data, or other information; I analyze information and make the correct inferences or draw accurate conclusions. I confidently exercise independent judgment in applying claims determinations. By possessing highly expert knowledge, well-developed skills, and ability to evaluate disabilities, a practical knowledge of adjudication and authorization functions in compensation and pension programs. I have served as a subject matter expert (SME) for claims involving combat PTSD, military sexual trauma (MST), traumatic brain injury (TBI), and readjudication under the Nehmer court orders. I have performed second signature reviews while assigned to work as an SME in 2022 for Waco Blue Water Navy Teams on a special project handling cases readjudicated under the Nehmer court order. Additionally, I have had the opportunity to provide feedback and advised supervisors on technical issues related to rating and case flow management. I am enrolled in the M-21 updates to stay current on all regulation and manual changes.
DECISION MAKING: I am authorized to make formal decisions and take other actions that required a rating decision on specialty claimed issues including Military Sexual Trauma, Traumatic Brain Injury, and Seriously Injured, Very Injured (SI/VSI) Veterans. I determine service-connection, percentage of disability, permanent and total disability, and entitlement to compensation, pension, burial, dependency indemnity compensation, special monthly compensation and vocational training, medical and dental treatment, automobiles, or other conveyances, insurance, specially adapted housing, dependent education allowances, and other ancillary benefits. I make sound, well-informed, and objective decisions; perceiving the impact and implications of my decisions; committing to action even in uncertain situations in order to assist customers and meet organizational goals. I work closely with Veterans Service Representatives (VSRs) to ensure all development actions were completed prior to finalizing a decision for claimants. I am accountable for proper application of the Rating Schedule and other applicable instructions for proper analysis and development of final rating determinations.
PROBLEM SOLVING: Whether I am working on an individual case or assisting in workload management at the station level, I have practiced identifying and analyzing problems, using sound reasoning to arrive at conclusions, provided multiple alternative solutions to complex problems, and learned to distinguish between relevant and irrelevant information to make logical judgments. On the case level, this includes evidence review, identifying and correcting outstanding development, evaluating disabilities by utilizing all relevant sources of data, and providing a timely and accurate decision. On a larger scale, I helped identify a backlog in complex issue cases (such as MST and TBI) in the Regional Office and worked as a mentor to trainees until they were competent in working those claims. This resulted in an increase in claims processing for MST and TBI claims at the RO. By evaluating the claims development process and operations, I was able to determine a breakdown in the effectiveness in meeting established goals and objectives and assist in shortening the pending claim time on this special issue cases. I participate in sharing rating quality trend information with trainee coaches, the Rating Quality Review Specialist (RQRS), and Rating Veterans Service Representatives trainees (RVSR). I evaluate and identify deficiencies in the rating decision spanning all elements of a claim from evidence development to adjudication. I have extensive experience retrieving, reviewing, and completing rating quality reviews using the Quality Management System (QMS).
WRITTEN AND ORAL COMMUNICATION: I contact claimants and or their representatives to clarify or explain any benefit programs and entitlement criteria, if needed. When assigned to training of employees in claims involving Military Sexual Trauma, Posttraumatic Stress Disorder, Traumatic Brain Injury, Gulf War, and Blue Water Navy Herbicide Exposure, I am required to articulate and communicate to the team the assignment, project, problems to be solved, actionable events, milestones, program issues under review, and deadlines/time frames for completion. I am able to conduct interviews or hearings in person or by telephone with Veterans, eligible individuals, representatives, and advocates to obtain or clarify information. I conducted informal conferences and hearings for claimants who disagreed with decisions involving proposed adverse actions specified in the rating decisions. I communicate with VSRs and other employees in the regional office, employees of VA medical centers, and other regional offices, using correct English grammar, punctuation, and spelling; I communicate information in brief, clear, and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience. I actively participate in meetings, assist with training, and am expected to lend my expertise in developing VSRs and RVSR's skills as they relate to evidence gathering for rating decisions. I participate in outreach programs speaking to groups of Veterans in detail about available benefits. I complete individual quality reviews to determine the rating quality level of RVSR trainees. Successfully communicating verbally and in writing, the review feedback with the training Rating Veteran Service Representatives (RVSR). I exercise effective training techniques and claims processing knowledge to provide authoritative consultation and troubleshooting services.
SELF MANAGEMENT: I have a high level of initiative, effort, and commitment towards completing claims and other assignments in a timely manner; I work independently with minimal supervision; I am motivated to achieve; sets well-defined and realistic goals that are in alignment with organizational goals and objectives. I am currently supporting VBA mission by processing BWN Nehmer Claims. I have a strong background in written communication and have been highly successful these past sixteen years. I maintain a 98 percent quality score and always exceed production standards. I have excellent organizational and time management skills which have allowed me to continuously participate in the work at home (WAH) program.

Education

Master of Art in Teaching - Education

University of The Incarnate Word

San Antonio, TX

05-2009

Bachelor of Arts - History

University of Texas Pan American

Edinburg, TX

05-2002

Skills

As an RVSR, I have utilized the following data systems/subsystems to collect and analyze data of key performance measures, goals, and objectives:
Veterans Benefits Management System (VBMS)
Veterans Benefits Management System- Rating (VBMS-R)
Microsoft Teams, Outlook, Word, Excel, PowerPoint
SHARE databases
Individual Longitudinal Exposure Record (ILER)

Workforce And Time Reporting System (WATRS/EPR)
Veteran Information Solutions (VIS)
Centralized Administrative Accounting Transactions System (CAATS)
Talent Management System (TMS)
Compensation and Pension Record Interchange (CAPRI)

Certification

Nehmer Subject Matter Expert (SME)

Military Sexual Trauma Subject Matter Expert (SME)

TBI Subject Matter Expert (SME)

Timeline