Lawmakers tell VA 'no more hollow promises' to fix the claims backlog

Thursday - 7/19/2012, 5:54am EDT

Jared Serbu, DoD reporter, Federal News Radio

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House lawmakers grilled the Department of Veterans Affairs Wednesday over a backlog in payments to veterans that has outpaced the agency's ability to speed up its claims process. Department officials say they're in the midst of an ambitious effort to transform their entire claims process, but the fixes won't happen overnight.

VA has made progress during the past several years in its ability to process disability claims. The Veterans Benefits Administration processed 900,000 claims in 2009 and moved the needle forward to more than 1 million claims in both 2010 and 2011.

Ordinarily, that would be good news. But the number of new claims coming in from veterans is growing much faster. The department received 1 million new claims in 2009, 1.2 million in 2010 and 1.3 million in 2011, part of a 48 percent workload growth for claims processors over the past four years, driven by the return of Iraq and Afghanistan soldiers and the department's decision to make it much easier for Vietnam-era vets to demonstrate that they were disabled by Agent Orange.

Rep. Darrell Issa (R-Calif.)

As of this week, the VA has 843,000 compensation claims pending in its system, compared to 768,000 one year ago. Almost 68 percent of the claims fall under the VA's definition of a "backlogged" case, in which a veteran has been waiting for 125 days or longer.

"It's unacceptable that the federal government is continuing to promise what it was promising before," said Rep. Darrell Issa (R-Calif.), chairman of the Oversight and Government Reform Committee. "The system was broken during the Vietnam War when I enlisted, and the system has never been fixed. We're going to concentrate on hearing what you're going to do, but understand, we've heard it before. You will be judged by what you do. You will no longer be allowed to come back again with promises of reforms that are a year away."

IT is not the only answer

Allison Hickey, who took over in 2011 as the VA's undersecretary for benefits, said the biggest hang-up for claims has been the mountains of paper records that claims adjudicators have to sift through in order to make their determinations. She said the VA realizes it can't dig out of the backlog with that paper-based system. But she vowed that system is going away and soon.

"Our transformation plan, our new organizational model, our new processes, our new technology will be implemented at 16 of our regional offices by this Sept. 30, and all the rest of them by the end of next calendar year," she told the committee. "We're not computerized right now, but our task is to eliminate this antiquated, paper-bound process that does not serve our veterans, and who are frustrated by its lack of speed and transparency."

Allison Hickey, under secretary for benefits, VA

The VA's paperless Veterans Benefits Management System (VBMS) is in a pilot phase at four of the agency's regional offices. The system already has proved to be faster than the paper-based processes, Hickey said.

"I literally have raters sitting with little rubber fingertips going through the 18 inches of paper in a veteran's record to find the one time it says 'back' in that record. They're working really hard to find that," she said. "But I also have raters today, in VBMS, who are putting the word 'back' into a search box and it's finding it in all of those 18 inches that used to be paper and is now electronic. It's solving all that time and effort."

Gerald Manar, deputy director of the Veterans of Foreign Wars' National Veterans Service, said electronic records are ideal, but there's no silver bullet to fix the claims system. He said the VA needs to make sure it fixes problems that veterans service organizations have identified with VBMS before rolling it out nationwide.

"There can be no misunderstanding. VBA must see this through to conclusion. VA has no alternatives, no fallback position. It must succeed in creating a fully-functioning, veteran-centric, interactive, user-friendly and highly agile claims processing system," he said. "Failure to do this will have dire consequences for VBA and veterans benefits programs."

Paper from DoD hinders the process

Hickey said while VBMS will help VA speed up the claims process, it will only digitize the VA's own records, not the vast amount of data on military service members' medical history that comes from the Defense Department when they separate from the military.

Despite ongoing efforts to integrate the two departments' data systems, she said virtually all the data the VA receives from the DoD still arrives on printed pages.

"On average, it takes us 250 days to complete a claim, but 175 of those days (are) spent by the VA waiting to get evidence we don't own," said Hickey, a retired Air Force brigadier general. "That's a significant reason why we need to get data, not paper. We need to get access to systems, not wait for a monthly report that rolls out to us with the information we need."

Rep. Jackie Speier (D-Calif.)

The VFW and other veterans groups say it is important to speed up the claims process. But they worry that the VA is under so much pressure to get claims out the door that the quality of its decisions is suffering. Over the past year, the VA reported it processed 14 percent of its claims inaccurately.

Rep. Jackie Speier (D-Calif.) said the problem is even worse on the West Coast. She said the Los Angeles, Seattle and Oakland offices have backlogs that are at "crisis" levels. She told several stories of cases in which she and other local lawmakers had to intervene on behalf of veterans after holding "fix-it" town hall meetings with VA claimants.

"They were angry, they were hostile, and they had every right to be," Speier said.

In one case, VA staff in the Oakland regional office required a disabled Iraq war veteran who could not work and was facing eviction proceedings to wait more than a year before making a determination that he was entitled to benefits. Staff later lost track of him after sending him to one of the VA's own hospitals, Speier said.

She said she arranged and attended a meeting between the Oakland office's leadership and the Iraq veteran's wife and mother. Until that point, the claims office was unaware that he was hospitalized. The veteran later told a "fix-it" gathering that he nearly committed suicide during that limbo period.

"The good news is he's had his surgeries and he's had his treatment for PTSD and he has his disability benefits. But if a congressional office hadn't intervened, he would probably be dead today," Speier said.

Oakland office tested new approach

Hickey said VA officials recognized the problems at the Oakland office and have since acted to fix them, using a recently overhauled training program for claims raters called "challenge training." The VA barred the entire office from handling new claims and put all staff members through the training program.

"That's the very first time anyone in VA has done this," she said. "We stood down the entire office. We took every single employee and ran them through challenge training. We were done with that in June, and they're back to work. Before, their quality was at about 69 percent. After the course, their post-training results were at 93 percent and I'm going to use that model to go after others who are in that same challenged environment."

Hickey said VA also has had success with providing veterans access to their benefits information and letting them file claims online. The department's new eBenefits website now has 1.7 million users, which is up 500 percent from January, she said.

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