Quality Rating Decisions
Solution to Backlog
Congressional oversight is necessary to ensure that the VBA shows progress in reducing or eliminating the claims backlog instead of short-term gains at the expense of long-term reform.
DAV has cautioned the House Veterans’ Affairs Committee that accelerating the disability claims process is less of a solution to the mounting backlog than deciding claims correctly the first time, avoiding lengthy appeals.
“In order to achieve real and lasting success, the Veterans Benefits Administration (VBA) must instead remain focused on creating a claims processing system that is carefully designed to get each claim done right the first time,” Assistant National Legislative Director Jeffrey Hall said in written testimony.
“Eliminating the backlog is not necessarily the same goal as reforming the claims processing system, nor does it guarantee that veterans are better served,” he explained. “While accuracy has been and remains one of the performance standards that must be met by all [VBA] employees, new performance standards adopted over the past two years appear to have done little to create sufficient incentives to elevate quality above production.”
Hall urged Congress to keep the VBA focused on improved training, testing and quality control as the foundations for claims reform. “We believe it is essential that all VBA employees, coaches and managers undergo regular testing to measure job skills and knowledge, as well as to measure the effectiveness of the training,” he said.
“By catching errors at the regional office level, where they can more easily and quickly be corrected, we not only serve [veterans], we also save the VBA time and resources they would otherwise have expended on lengthy and burdensome appeals,” Hall said.
Using DAV’s training programs as an example, he explained that our National Service Officers (NSOs) have “a lifelong commitment to achieving excellence.” They initially receive 16 months of training in developing claims, followed by a comprehensive Structured and Continuing Training program to keep current on changes to laws and regulations affecting veterans benefits. “They then start the entire training cycle again from the beginning, but the changes, updates and new information that is provided by DAV’s national training staff are constantly monitored and updated in the course material,” said Hall.
“The VBA training program for its employees, particularly Veterans Service Representatives and Rating Veterans Service Representatives is shorter, less rigorous and has fewer testing requirements,” he said. “There is substantial evidence demonstrating that represented veterans receive better and more accurate outcomes than those without representation.
“Our NSOs improve the quality of the claims filed, thereby reducing the workload on VBA,” said Hall. “We also reduce the burden on VBA’s contact offices by interacting with veterans seeking routine information or updates on the status of their claims.”
He praised new VBA initiatives that are streamlining the claims review, such as the Fully Developed Claims process, which encourages the veteran to gather as much evidence as possible to support the claim, and the new Disability Benefits Questionnaires, which can substitute private medical evidence for a VA medical examination, cutting months off processing a claim. (See March/April issue of DAV Magazine
Addressing the Veterans Benefits Management System (VBMS), Hall noted DAV has helped the VBA improve and redesign its claims process. “We have and will continue to work with VBA as it completes the redesign of the new operating model so that claims are accurately processed and [decided] right the first time,” he said.
The VBMS is an information technology system to provide a comprehensive, paperless, rules-based method of processing and deciding claims for VA benefits. Hall urged the committee to fully fund the program. “Over the next year, Congress must ensure that the funding required and designated for the VBMS is protected from cuts or reprogramming and spent as Congress intended,” he said.
“The openness and candor of the VBA leadership in keeping us and others informed of what they are doing are very welcomed,” said Washington Headquarters Executive Director Barry Jesinoski. “The VBA and DAV have worked in cooperation on the VBMS development to ensure that it accomplishes the goals of both organizations timeliness and accuracy. It is to the credit of the VBA that they are working diligently and cooperatively to initiate a program that brings the maximum benefits to veterans.”
Next, it is up to Congress to play a crucial role in the
process by providing “careful and continuing oversight … to help ensure that the VBA achieves true reform and not just arithmetic milestones,” said Hall.
Most important, he said, is the congressional oversight necessary to ensure that the VBA shows progress in reducing or eliminating the claims backlog instead of short-term gains at the expense of long-term reform.
“VBA must transition as quickly as feasible to a fully digital processing system, which may require significant upfront investment, but will pay long-term dividends for veterans,” Hall said.