DAV Sees Progress, Concerns in Claims System
VA Secretary Eric K. Shinseki toured the Salt Lake City Regional Office and received a demonstration of the Veterans Benefits Management System (VBMS).
DAV has endorsed the VA’s programs to resolve the claims backlog in testimony during hearings before two House panels, but pointed out to lawmakers that problems in the Veterans Benefits Management System (VBMS) could jeopardize its ability to achieve success.
National Legislative Director Joseph A. Violante told the July 18 hearing of the House Oversight and Government Reform’s Subcommittee on National Security, Homeland Defense and Foreign Operations that there are “some reasons to be optimistic” that VA’s changes in the claims processing system could succeed.
“These problems have persisted for decades,” Violante said. “The Veterans Benefits Administration (VBA) has taken important steps toward comprehensively transforming the claims processing system.”
“The backlog is a symptom, not the root cause, of the problem,” he said. “In order to achieve real and lasting success, the VBA must instead remain focused on creating a claims processing system that is carefully designed to get each claim done right the first time.”
Violante credited recent improvements in claims processing to VA Under Secretary for Benefits Allison Hickey’s direction. “The open and candid attitude of the VBA’s leadership, particularly Under Secretary Hickey, led toward developing a true partnership with DAV and other veterans service organizations which assist veterans in filing claims.”
Assistant National Legislative Director Jeffrey Hall testified at a June 19 House Veterans’ Affairs Committee hearing that “DAV is extremely pleased with the continuing partnership between the VBA and VSOs.”
“There is indeed positive change and significant progress being made,” Hall said. “There are also some troubling problems related to the VBMS and other automation initiatives that raise serious questions about whether VBA’s transformation efforts will ultimately be successful.”
Violante testified that one of the most promising developments has been the VBA’s new initiative of creating Quality Review Teams (QRTs) in regional offices. “The QRT program will assign full-time dedicated employees whose sole function is to seek out and correct errors in claims processing,” he said. “QRTs will also work to develop in-process quality control measures to prevent errors before decisions are made.
“It is the VA’s responsibility to arrive at a quality decision, not a claims decision that will involve a lengthy appeal,” said National Adjutant Arthur H. Wilson. “The absence of quafrom receiving their earned benefits in a timely fashion. Justice delayed is justice denied.”
“DAV has closely participated in the VA’s development of the VBMS and other initiatives to not only reduce the claims backlog, but also to improve the decision-making process for the benefit of veterans,” said Washington Headquarters Executive Director Barry Jesinoski.
“The recent reassignment of nearly one-third of VA’s veterans service representatives from Agent Orange claims to backlogged claims and other streamlining measures will make a difference,” Jesinoski said. Meanwhile, more than 919,000 claims were undecided as of July 18, including 66 percent pending longer than the 125-day goal set by VA.
Hall said that as the VA nears implementation this year of some major initiatives, VSOs representing veteran claimants do not have access to the VBMS electronic IT programs used, and the scanning of claims files is far from complete.
“VSOs have neither the logistical capability nor IT expertise to comprehensively evaluate the complicated programming, software and hardware that make up the VBMS,” Hall said. He also cited limited access to documents scanned from paper claims files. “It is not yet clear whether the lack of a scanning vendor will delay the rollout of the VBMS at selected VA regional offices,” Hall testified. “The failure to properly plan for such an essential feature of the VBMS system troubles us and once again raises questions in our minds about whether there are other gaps or problems in their claims processing transformation strategy.”
Hall also voiced concerns about the quality of recently implemented Simplified Notification Letters (SNLs). In one example, he said that one of the automated letters denied a veteran’s claim, but it was filled with confusing and somewhat contradictory explanations “that even an experienced service officer would have difficulty understanding.”
“Clearly the SNLs are intended to streamline the rating and notification part of the process and help reduce the backlog of claims,” he said. “This should not be at the expense of the veteran or quality of the rating and notification.”
“The issues we have found in SNLs lead us to question the legal validity of these ratings and whether the VBA has cut other corners within the VBMS in order to meet self-imposed deadlines for reducing the backlog,” Hall said.
DAV has long advocated that quality and accuracy in claims decisions should be the goal of the VBA. “It is not enough to simply reduce the backlog,” said Hall. “Moreover, it doesn’t matter how quickly a claim is completed if it is not done correctly.”
“The VBA must not use the technological automation to eliminate essential manual steps...that are crucially important to the veteran,” Violante warned. “We believe that requiring raters to provide detailed, plain English explanations of their decisions will not only better inform veterans, but will also lead to better reasoned and more accurate decisions by the raters themselves.”
An incorrect claim only leads to lengthy appeals, which would shift the burden to other areas of the VBA. To avoid that, DAV urged Congress to continue oversight of VBMS and to support the VBA as it implements the program.
“It is imperative that we finally and truly reform VBA’s claims processing system, and a successful VBMS must be a central component of that change,” Wilson said. “We have advocates in the VA and in Congress who want the backlog eliminated, and we’ve seen years of work expended with little success.”
“We have an opportunity to make substantive changes, if the VA is willing to find new ways to complete old tasks,” he said. “DAV remains cautiously optimistic that the VA can resolve the problems and create a state-of-the-art system that will return pride to the VA’s duties.”