VA hacks away at claims backlog, increases accuracy

Wednesday - 5/28/2014, 4:49am EDT

Jason Miller, executive editor, Federal News Radio

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The Veterans Affairs Department says its claims backlog is at its lowest point today than at any time in the last three years. Officials credit its progress to several changes under its Veterans Benefits Management System (VBMS).

Allison Hickey, VA's undersecretary for benefits, who spoke last week at the ACT- IAC's Management of Change conference in Cambridge, Maryland, said VBMS has transformed the agency from a paper system to one that mostly relies on electronic data.

"We have taken more than 52 percent in a single year out of backlog and completed those claims," she said. "Some might say, 'Well, yeah, but maybe you are just doing them fast and therefore not paying attention to quality.' When I arrived in June of 2011, our quality was at 83 percent and our accuracy level was at 83 percent nationally. Today, our accuracy is at 91 percent at the claim level and at 96 percent at each of the issue levels inside of the claim. So no, we aren't just doing them faster, but we are doing them faster and better."

Hickey said VA's disability and benefits claims backlog is down by more than 300,000 over the last year alone. It was at 611,000 in March 2013 and now it's down to 291,000 as of May 26.

The claims backlog is one of two numbers VA, Congress and veterans organizations pay close attention to, the other being the number of pending claims. These are two different, but related numbers.

The number of pending claims is much higher than the total backlog. VA says there are more than 572,000 claims in its inventory, down from more than 883,000 in July 2012.

The claims backlog shows any veteran who has been waiting for more than 125 days since VA received their paperwork and data.

The claims inventory includes both those under and those in the system for more than 125 days.

System troubles a thing of the past?

At Management of Change 2014 (MOC), Hickey highlighted several successes by VA including completing 1.17 million claims last year. She said in 2014 VA already is 170,000 claims ahead of its efforts last year.

It has not been a smooth electronic transition for VA. VBMS has suffered from periodic but serious latency issues as well as full-blown outages, sometimes several times per day. VA took three years to develop and roll out the paperless system, and lawmakers often question how the agency measures progress.

"We have fundamentally overhauled a complete claims process. We moved from human beings with rubber tips on their fingers going through 5,000 tons of paper in a single year into an environment where we have 88 percent of all of our claims being processed online," Hickey said in an exclusive interview with Federal News Radio. "In any large scale change like that in the early days, you will have bumps in the system, and we did and we experienced them. But the positive thing is we reacted quickly to them. I can tell you of late we are not seeing some of those issues happening. In fact, I can tell you we've had record-breaking production months of late."

She added VA expects to process no less than 1.3 million claims this year.

"We now have rules-based calculator and capability built into the system that's helping us to make sure that our answers are accurate so our accuracy has gone up too," Hickey said. "I do feel like [VBMS] is stabilized now, and I think we even in the last month added the last final piece of baseline functionality for those employees who actually review and award the claim and make sure it gets paid. That is taking about 15 minutes per claim off the process. Now we are fully from end-to-end completely from all the way to the beginning of having a veteran come online through eBenefits, file their claim online, upload their medical evidence, or have a veteran service organization do the same, and it can go completely paperless through the process and not generate an ounce of paper."

Metrics are too limited

Despite this progress, some members of Congress remain concerned over VA's efforts.

"To date, the VA has made progress on tackling their backlog and focusing on the oldest claims, as the VA is, is a good thing to do," said a spokesperson for Rep. Mike Michaud (D-Maine), the ranking member of the Veterans Affairs Committee. "While we have seen good progress on those older claims considered to be a substantial part of the backlog, other claims that are not considered in this distinct workload related to veterans 'disability entitlement claims' have unfortunately risen — such as wait times associated with appeals or injured service members waiting on the VA for a rating to get their medical discharge."