VA's disability claims backlog down by 44 percent, but problems remain

Wednesday - 4/2/2014, 4:53am EDT

Jared Serbu reports.

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The Department of Veterans Affairs says it has reached a tipping point in its ongoing effort to eliminate its backlog of disability claims: The backlog is 44 percent smaller than it was a year ago.

VA observers and overseers say there are several problems with the way VA is measuring success.

More than half of the cases in the department's current queue of claims still fall under the department's current definition of "backlogged," and the time veterans are waiting for appeals of claims that were previously denied has increased significantly within the past year.

But those numbers are, in part, an artifact of decisions VA made several years ago, said Eric Shinseki, the secretary of Veterans Affairs. At the same time it committed to ending the backlog, VA also decided to make policy changes that opened benefits to hundreds of thousands more veterans, including those who were exposed to Agent Orange in Vietnam and service members from multiple conflicts whose combat experiences caused post-traumatic stress effects later in their lives.

When VA officials announced in 2010 that the department would end the backlog by 2015, they always knew the backlog would get bigger before it got smaller, Shinseki said.

VA officials now know that the peak was March 2013, when the backlog stood at 611,000 claims, and are confident that the tide of new claims has receded.

"We couldn't exactly predict when in 2013 it would occur, but we were pretty sure that we were going to hit a high water mark. We also knew that it gave us three years to develop an automation tool that we did not have three years ago," Shinseki told the House Appropriations Committee last week. "It took us three years to design, develop, test, pilot and then field the Veterans Benefits Management System (VBMS), and we committed to fielding that automation tool before the end of 2013, and we finished it six months ahead of schedule. All 56 of our regional offices are now outfitted with this program."

Lawmakers not confident in VA

But VA still has a long way to go. As of this week, it still has nearly 344,000 compensation claims that meet the department's own definition of backlogged-those that have been awaiting attention for more than 125 days.

Rep. John Culberson (R-Texas), the chairman of the Appropriations subcommittee on veterans affairs, said he is skeptical that VA will meet its own goal of eliminating the backlog sometime during calendar year 2015.

"It's difficult to see how you're going to meet your targets," he said. "Last September there were 59 percent of the disability claims in backlog status. Six months have gone by, and it's still about 59 percent. It just seems unrealistic."

Shinseki said he still is confident VA will meet its goals of processing all claims within 125 days and at an accuracy level of 98 percent because of the progress VA has made on disability claims over the last several years. The changes included not just the transition to the paperless VBMS system, which now handles 85 percent of the department's current claims, but also mandatory overtime for VA claims staff as part of a "surge" to prioritize the claims of veterans who have been waiting the longest. It also began letting claims processors award partial payments to veterans on a provisional basis while the department waits for more medical evidence.

But even as VA has steadily chipped away at its backlog of newer claims, it has seen a staggering increase in wait times for veterans who are appealing claims they believe were wrongly decided.

In 2012, the average delay for a veteran to have an appeal decided was 675 days. By the end of 2013, it was 923 days.

"Those numbers are startling," said Zachary Hearn, the deputy director for benefits at the American Legion, in a separate interview with Federal News Radio.

Of the appeals the Legion helps veterans to navigate through the process, roughly three quarters are ultimately remanded back to VA by the Board of Veterans Appeals, Hearn said. While only about one percent of all claims decisions are appealed, he said the high rate pointed to potential problems with training and education at the regional office level, where initial decisions are made.

Appeals board hiring aggressively

But he said there are other reasons for the appeals backlog.

"If you look at the number of claims they adjudicated over the last year, any time you're adjudicating more cases, you're going to have more appeals," Hearn said. "The second reason is that, at least in the case of the American Legion, we have 2,900 well-trained representatives out there, and if they tell one veteran that their case didn't consider a regulation or a piece of case law, it's going to encourage other veterans to appeal."