Apr112013
Hearing Transcript on Implementation and Status Update on the Veterans’ Benefits Improvement Act, P.L. 110-389.
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IMPLEMENTATION AND STATUS UPDATE ON THE VETERANS' BENEFITS IMPROVEMENT ACT, P.L. 110-389
HEARING BEFORE THE SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS OF THE COMMITTEE ON VETERANS' AFFAIRS U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED ELEVENTH CONGRESS SECOND SESSION FEBRUARY 3, 2010 SERIAL No. 111-58 Printed for the use of the Committee on Veterans' Affairs
U.S. GOVERNMENT PRINTING OFFICE For sale by the Superintendent of Documents, U.S. Government Printing Office
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CORRINE BROWN, Florida |
STEVE BUYER, Indiana, Ranking |
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Malcom A. Shorter, Staff Director SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans' Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined. |
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C O N T E N T S
February 3, 2010
Implementation and Status Update on the Veterans' Benefits Improvement Act, P.L. 110-389
OPENING STATEMENTS
Chairman John J. Hall
Prepared statement of Chairman Hall
Hon. Doug Lamborn, Ranking Republican Member
Prepared statement of Congressman Lamborn
Hon. Jeff Miller, prepared statement of
WITNESSES
U.S. Department of Veterans Affairs, Bradley G. Mayes, Director, Compensation and Pension Service, Veterans Benefits Administration
Prepared statement of Mr. Mayes
American Federation of Government Employees, AFL-CIO, John McCray, Rating Specialist, Los Angeles, CA, Regional Office, Veterans Benefits Administration, U.S. Department of Veterans Affairs
Prepared statement of Mr. McCray
American Legion, Ian C. de Planque, Assistant Director, Veterans Affairs and Rehabilitation Commission
Prepared statement of Mr. de Planque
Disabled American Veterans, John L. Wilson, Assistant National Legislative Director
Prepared statement of Mr. Wilson
National Organization of Veterans' Advocates, Inc., Richard Paul Cohen, Executive Director
Prepared statement of Mr. Cohen
Vietnam Veterans of America, Richard F. Weidman, Executive Director for Policy and Government Affairs
Prepared statement of Mr. Weidman
SUBMISSION FOR THE RECORD
Veterans for Common Sense, Thomas Bandzul, Associate Counsel, statement
IMPLEMENTATION AND STATUS UPDATE ON THE VETERANS' BENEFITS IMPROVEMENT ACT, P.L. 110-389
Wednesday, February 3, 2010
U. S. House of Representatives,
Subcommittee on Disability Assistance and Memorial Affairs,
Committee on Veterans' Affairs,
Washington, DC.
The Subcommittee met, pursuant to notice, at 2:06 p.m., in Room 334, Cannon House Office Building, Hon. John J. Hall [Chairman of the Subcommittee] presiding.
Present: Representatives Hall, Halvorson, Rodriguez, Lamborn, and Miller.
OPENING STATEMENT OF CHAIRMAN HALL
Mr. HALL. Good Afternoon. Welcome to the House Committee on Veterans' Affairs, Subcommittee on Disability Assistance and Memorial Affairs, hearing on the Implementation and Status Update of Veterans' Benefits Improvement Act of 2008, Public Law 110-389.
This meeting will now come to order and I will ask us all to rise for the Pledge of Allegiance.
[Pledge of Allegiance.]
Thank you all for being here today to receive an update on the status and implementation of the Veterans' Benefits Improvement Act of 2008 (VBIA 2008), Public Law 110-389.
At the time of its enactment, this law was embraced by many stakeholders as a way forward for the VA to revamp and modernize its claims processing system to bring relief to those veterans, their families and survivors who were languishing in an antiquated system in dire need of reform. I was proud to lead that effort for the Committee. I am proud of the bipartisan cooperation of the Committee in unanimously voting for Public Law 110-389, which also received the unanimous support of both houses of Congress before being signed into law by President Bush.
Under this law we created the Office of Survivors Assistance. This measure also made it possible for survivors to step into the shoes of deceased claimants. We also put critical pilot programs in place to expedite ready-to-rate claims and to provide a checklist with Veterans Claims Assistance Act (VCAA) notices so veterans are less confused about what they actually need to substantiate their claims.
In addition, we created the Disability Advisory Commission to provide ongoing expert input on the claims processing system, particularly with updating the VA Schedule for Ratings Disabilities (VASRD), and we created additional checks and balances with required studies of VA's work credit system and its Work Management system, currently known as the Claims Processing Initiative (CPI).
On a separate note, I wish we could have included Section 101 of H.R. 5892 in Public Law 110-389 to help the many combat veterans who are still forced to prove stressor exposure for post-traumatic stress disorders (PTSDs). While this fix was not included in Public Law 110-389, it is now a separate bill, which I have introduced, H.R. 952.
However, I am heartened by the the U.S. Department of Veterans Affairs' (VA's) separate executive rule making efforts concerning PTSD claims and look forward to issuance of a final rule soon so that veterans suffering from PTSD can get the benefits that they have earned and deserve in a more timely fashion.
I am pleased that Public Law 110-389 also laid the foundation for a number of initiatives that VA is currently undertaking, particularly its Veterans Benefits Management System and Veteran Relationship Management initiatives, as well as the Business Transformation Lab in Providence, Rhode Island, the Claims Processing Pilot in Little Rock, Arkansas, and the Virtual Regional Office (RO) in nearby Baltimore, Maryland.
You clearly have listened to the clarion call from this Committee and many veteran stakeholders that the current system is broken and in need of a major overhaul. These efforts hopefully will result in a system that reflects improved accountability, accuracy, quality assurance and timeliness of claims processing for our veterans, their families and survivors.
I applaud VA's more deliberative approach on these fronts and welcome the opportunity to support the VA in the upcoming budget cycles in the VA's efforts to transform the Veterans Benefits Administration (VBA) claims processing model.
I look forward to hearing about how all of these forward-thinking pilots and laboratory initiatives will put VA on a track to processing its compensation and pension (C&P) claims in a virtual environment using a 21st century processing platform. I also look forward to hearing how VA plans to move to an electronic rules-based processing environment by the year 2012.
While electronic claims processing is not the panacea for eliminating the backlog, coupled with business reformation efforts, it will transform the claims processing system in a manner that will improve accuracy, consistency and quality and accountability, and we all hope, at long last, reduce the backlog of claims. We owe our Veterans nothing less.
I now would like to welcome and recognize Ranking Member Lamborn for an opening statement.
[The prepared statement of Chairman Hall appears in the Appendix.]
OPENING STATEMENT OF HON. DOUG LAMBORN
Mr. LAMBORN. Thank you, Mr. Chairman. And I also welcome everyone to this hearing, which is the first of our 2nd session, and I look forward to continuing the progress that we have made so far in the 111th Congress.
We are at the midpoint and there are a lot of good provisions that we have passed. Perhaps most notably among them, the measures that we have worked on to help VA gain control over the claims process. The backlog is a major concern for everyone who is a stakeholder in veterans' issues, and I believe that through a bipartisan, collaborative effort, we will begin to resolve the issues that have hampered VA for so many years.
Of course, along with following through on pending legislation, we must take a close look at the implementation of earlier provisions that became Public Law. That is the purpose of our hearing this afternoon, and I am eager to discuss the progress that has been made regarding the implementation of the Veterans' Benefits Improvement Act of 2008.
I also look forward to how it is progressing with other measures which would increase the accuracy and timeliness of benefits' claims decisions and the use of information technology, also, of the assessment of disability compensation and the efforts to ensure due consideration is afforded to veterans for their loss of earnings and quality of life.
I am interested, as well, if the authority to allow substitution upon death of a claimant for purposes of acquiring accrued benefits has had a noticeable impact. It is my hope that this will relieve survivors of the arduous and time-consuming process of starting the entire claims process over from square one. I expect the VA to discuss the implementation of this provision.
Mr. Chairman, it is a pleasure to be seated with you here once again, and I look forward to working with you and all of our veterans' advocates in the months ahead.
Thank you, and I yield back.
[The prepared statement of Congressman Lamborn appears in the Appendix.]
Mr. HALL. Thank you, Mr. Lamborn. The pleasure is mutual.
And Mrs. Halvorson, would you like to make an opening statement?
OPENING STATEMENT OF HON. DEBORAH L. HALVORSON
Mrs. HALVORSON. Thank you, Mr. Chairman. I just wanted to say thank you for having this and I look forward to working and making sure that we can get to the bottom of making sure that we can fully implement the Veterans' Benefits Improvement Act of 2008.
One of the most important things that I hear everyday is the backlog. It is about the benefits. It is about everything that is due to our veterans and that we are not doing, so I want to make sure that whatever it is that comes of this, that we do a better job. So thank you, Mr. Chairman for this hearing.
Mr. HALL. Thank you, Mrs. Halvorson.
Mr. Miller, would you like to make an opening statement?
Mr. MILLER. I would just like to submit my statement for the record, Mr. Chair.
Mr. HALL. Okay. Without objection, it will be included.
[The prepared statement of Congressman Miller appears in the Appendix.]
Mr. HALL. Once again, I remind all panelists that your complete written statements have been made a part of the hearing record so that if you wish, you can limit your remarks to the 5 minutes allotted time, so that we have sufficient time to follow up with questions.
Thank you all, again, for coming here to share your vision or your observations with us.
On our first panel is Mr. Richard F. Weidman, Executive Director for Policy and Government Affairs, Vietnam Veterans of America (VVA); Mr. John L. Wilson, Assistant National Legislative Director for the Disabled American Veterans (DAV); Mr. Ian C. de Planque, Assistant Director for Veterans Affairs and Rehabilitation Commission for the American Legion; Mr. Richard Paul Cohen, Executive Director for the National Organization of Veterans' Advocates, Inc. (NOVA); and Mr. John McCray, Rating Specialist in the Los Angeles Regional Office on behalf of the American Federation of Government Employees (AFGE) with AFL-CIO.
Thank you all for the work that you do. Thank you for being here today.
Mr. Weidman. You are now recognized for your statement.
STATEMENTS OF RICHARD F. WEIDMAN, EXECUTIVE DIRECTOR FOR POLICY AND GOVERNMENT AFFAIRS, VIETNAM VETERANS OF AMERICA; JOHN L. WILSON, ASSISTANT NATIONAL LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS; IAN C. DE PLANQUE, ASSISTANT DIRECTOR, VETERANS AFFAIRS AND REHABILITATION COMMISSION, AMERICAN LEGION; RICHARD PAUL COHEN, EXECUTIVE DIRECTOR, NATIONAL ORGANIZATION OF VETERANS' ADVOCATES, INC.; AND JOHN MCCRAY, RATING SPECIALIST, LOS ANGELES, CA, REGIONAL OFFICE, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS, ON BEHALF OF THE AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES, AFL-CIO
STATEMENT OF RICHARD F. WEIDMAN
Mr. WEIDMAN. Mr. Chairman, Ranking Member Lamborn, thank you. I want to echo the earlier sentiments. Thank you for having this hearing and for keeping the dialogue going.
The statute that we are under discussion today really happened after a series of round tables last year where people were trying to figure out is there, in fact, common ground. The real problem there was that the VA officials at that time were talking about processes and how long it took to do various administrative processes to a paper packet and everybody else in the room was talking about what happens to an individual veteran who is going through that process and the impact that it has on him or her.
Until we get a common nomenclature, we are going to struggle. Among the things mandated by this statute was an Advisory Committee which seems to be starting to work well, mandated several other things, including putting on a checklist, and that is going in four offices. We have read the Center for Naval Analyses (CNA) assisted evaluation of that. I am not sure that it is particularly helpful.
The key thing is, are the veterans clearer about it than they were before, and in many cases I suspect they are, although that didn't come out yet and it remains to be seen whether it actually speeds up claims.
The second half of that is in offices where they are supposed to be working on fully developed claims and that is an ongoing problem that we have had throughout the Nation.
The Little Rock, Arkansas, pilot is really almost back to the future. The New York Regional Office at 252 7th Avenue, back when I was still a young man, used to operate on that model of groups where they broke down into small groups and worked it as a team and then they got away from that over the years. But certainly after about 1979 or 1980, and that is essentially what they are going back to with the help of a facilitator and it's working well, so that is a plus.
The paperless office in Providence, I haven't been there, so I can't?nor have any of our folks?so I can't really comment, although I hear secondhand that both Providence and Baltimore seem to be moving along, but it is taking longer than one would think.
The Veterans Benefits Management System (VBMS) system we had a briefing on about 2 weeks ago and I am not sure that it makes sense to a lot of us that you are going to automate a system to track paper claims. It makes no sense to us. You ought to be automating the paper claims and that would make a great deal more sense.
There is, however, a new attitude in VBA that has started to evidence itself this spring, or excuse me, this winter since last spring when we had those discussions, and just last week there was a joint meeting between VBA and the VHA, the Veterans Benefits Administration and the Veterans Health Administration, Mental Health Specialists, to work on the ratings schedule for PTSD claims, and there also was Congressional staff there. There were advocates there and it was one of the most useful exchanges in coming to a common viewpoint that we have seen in a long time on these issues about how can you speed it up and how can you quickly come to an accurate diagnosis and what has to happen.
Many of the things that are detailed in this statute and that need to be done in order to, quote/unquote, "fix the Veterans' Benefit System" are really just common sense.
Number one is common training for VA, the veterans service organizations (VSOs), the State and local government employees in veterans claims law. Second is a common competency-based exam for all who touch a claim; three, organizing the claims files so that the documents in every single claimant's file is in the same order with the most salient documents up front; number four along that is a decision template at the beginning of every claim that has to be put together for every claimant that summarizes the key elements of the claim; and five, express lines for presumptive and other ready-to-rate claims; and last but not least, a systematic effort to put all the information into electronic form.
There is another that I would add is we would encourage this distinguished Subcommittee to work with the Armed Services Committee with a view towards digitizing the unit records and the individual records in St. Louis, in College Park, and elsewhere, which would greatly speed one of the things that really bogs down the claims now because it's all paper and then VA is not really in control of the process of getting those claims.
My time is up, and once again, let me thank you and your distinguished colleagues for having this hearing this afternoon and I would be happy to answer any questions. Thank you.
[The prepared statement of Mr. Weidman appears in the Appendix.]
Mr. HALL. Thank you, Mr. Weidman.
Mr. Wilson, welcome. You are now recognized.
Mr. WILSON. Thank you very much, Mr. Chairman.
Mr. Chairman, Members of the Committee, I am glad to be here today on behalf of the DAV to address implementation and status of the Veterans' Benefits Improvement Act of 2008.
Like my colleagues, I was hoping to come to today's hearing and comment upon the many studies and pilot programs related to improving the Benefits' Claims Process Approval System which the law required VA to complete last year. However, since this information was not available until we arrived at today's hearing, my testimony will focus on other aspects of the law.
I would ask, however, that the Committee allow additional comments that my colleagues and I may wish to make after having a chance to review VA's testimony as part of today's hearing.
Having said that, let me now comment upon a few provisions of the law that have already been implemented. First, Section 101 sought to make VA correspondence to veterans' ratings, substantiation of claims, more understandable, uniform and useful. A very good idea.
On December 11th, VA published a proposed regulation that we do not believe, however, meets the intent of Congress as expressed in Public Law 110-389. In the Federal Register of December 2009, VA states in part that they, "will not provide any specific notice in increased rating claims regarding the relevant rating criteria under diagnostic codes that are applicable to rating the current extent of the claimant's disability." We believe the intention of Congress was for VBA to be case specific.
When I read Public Law 110-389, that's what it says. We do not agree with VA's statements that providing case-specific information to veterans would, "divert resources from the development and adjudication of claims and generally would not make VA's notices more helpful to claimants."
It has been, and continues to be, DAV's view that well informed veterans are in the best position to make educated decisions regarding their claims. We do not support VA's efforts to only develop a generic letter.
Rather, we instead recommend that it make every effort to provide clarity of content and organization of information?that is key?in every letter on matters of notice to veterans.
Section 214 established the Advisory Committee on Disability Compensation which, among other matters, focused on updating the VASRD.
We agree with the importance of a systematic review and update of the VASRD, the source of all disability compensation ratings. This rating scheme addresses illnesses and conditions running into the hundreds and should reflect the most recent medical findings in every case. The Advisory Committee has made a number of strong recommendations to strengthen the VASRD with which we agree.
One, the Deputy Secretary of the VA should provide oversight of the VASRD process, with VHA and Office of the General Counsel fully integrated into this VBA process. Two, VHA should establish a permanent administrative staff of nine for this VASRD review. At least one permanent party medical expert must be on this team and have authority to liaise with VBA, assign VHA and medical staff to participate in VBA body-system reviews and to coordinate with other medical experts.
The expertise that VHA clinical professionals can bring to the discussion should prove invaluable and well worth the additional staffing provided.
For example, a recent VBA/VHA Mental Health Summit, which Mr. Weidman referenced, conducted here in Washington just last week, demonstrated over a 2-day period that VHA mental health professionals outside academics and veteran service organizations can serve as effective resources for VBA, that VBA reviews changes that are needed in the VBA rating schedule for mental health disabilities in particular.
That simplistic rating schedule on mental health disabilities built primarily on diagnosis and subject to interpretations by examiners has far too much discretion and has been criticized by the Institute of Medicine.
Also, as indicated in the Independent Budget for 2011, which was released today, two other outside reviews have found that veterans rated with service-connected psychiatric disabilities suffer greater lifetime earnings loss than do veterans with physical disabilities.
We strongly believe VA should update its mental health rating criteria to make them fairer, more reliable and ensure that those veterans with service-connected psychiatric disabilities are equitably and appropriately evaluated and compensated.
We also agree with the Committee's body system prioritization, beginning with mental health disorders. Under the current system, for example, one veteran service-connected for schizophrenia, and another veteran service-connected for an eating disorder are evaluated using the same general criteria.
It is essential that new criteria be formulated to evaluate mental health disorders. A number of possible new approaches can be found in the VBA/VHA Mental Health Summit results. We look forward to participating in their future development, as well as continue working with the Advisory Committee as they continue their vital work.
I thank you for the opportunity to speak to you today regarding this particular bill and I look forward to any questions that you may have.
[The prepared statement of Mr. Wilson appears in the Appendix.]
Mr. HALL. Thank you, Mr. Wilson.
Mr. de Planque, you are now recognized.
STATEMENT OF IAN C. DE PLANQUE
Mr. DE PLANQUE. Good afternoon, Mr. Chairman, and Members of the Committee. On behalf of the American Legion, I would like to thank you for the opportunity to testify today.
VA has done several things to begin with the implementation, but we have several major concerns and I would like to state and emphasize two of those points?timeliness and implementation.
Timeliness can be exemplified by the speed with which the VA proposes and implements the new regulation. Public Law 110-389 provided a much needed alteration, for example, to the manner in which survivors are allowed to substitute as claimant in the case of veterans who pass away before final adjudication of their pending claims.
To the credit of VA, they did publish an initial Fast Letter in March in response to this requirement and some of the claims affected have been adjudicated under the informal guidance of the Fast Letter.
VA has already helped some families to receive the compensation they're entitled to, however, a Fast Letter is not a formal regulation change. The law established procedures to change regulations, which require the VA to publish a proposed regulation so the public may comment and raise questions or concerns. After such a proposed regulation has been proposed and the period for public comment has expired, final regulation can be considered.
Talking recently with the expectation of proposed regulations showing up for the three new presumptive Agent Orange conditions, we are looking at the absolute earliest is sometime this summer to see a final regulation, so this is a lengthy process and we haven't even begun the process of the proposed regulation for this provision 16 months after the passage of the law. It has been a year almost since the Fast Letter. That is too much time.
The implementation is the other concern that we have and one of the points that was brought up that this Public Law addressed was to look at the earning capacity and quality of life issues. That was stated again by Members of the Committee.
VA has focused largely on the earning capacity and they stubbornly cling to focusing on that, however, there have been some signs that some of these studies, the Econsys Study, the Advisory Committee on Disability Compensation, some of those that are raising concerns about quality of life and whether it is adequately represented are starting to come to the forefront.
I will reiterate that the very, very recent Mental Health Summit with the VA's attempt to reexamine the mental health rating criteria was an extremely great step forward on behalf of VA, that as a veterans service organization, we are excited to be participating in. When we think dialogue such as that is essential, is essential if we are going to see veterans properly compensated.
The aspects of traditionally looking at things in terms of earning capacity are very, very difficult to measure in cases, particularly with mental health issues. And so seeing this as a first priority of getting fixed is a great step forward and we hope to have continued input on that.
Other than that, we want to summarize to pay attention to those two main points, that the VA must be held to timeliness standards for the implementations of laws and that if all these studies are going to point out information and nothing is going to be acted on, then there is no purpose in having the studies. You can have all the studies in the world, but without action, they don't serve the veterans of America.
We would like to thank you for giving us the opportunity to testify today and we will, of course, answer any question you or the Committee may have.
[The prepared statement of Mr. de Planque appears in the Appendix.]
Mr. HALL. Thank you, Mr. de Planque.
Mr. Cohen, welcome, and you are recognized.
STATEMENT OF RICHARD PAUL COHEN
Mr. COHEN. Thank you, Mr. Chairman, and thank you to, the Committee, for allowing the National Organization of Veterans Advocates to testify here today.
We have read in great detail, not only the VBIA 2008, but the Booz Allen Cycle Study as well. Although the Cycle Study seems to have some good recommendations, we are concerned about two problems with the VA, which are not addressed in the Cycle Study. The first one is that the VA misunderstands its mission, and the second one is that the VA does not function as an effective business.
Looking at the mission first, NOVA agrees with Mr. Weidman and the VVA that the issue for the Veterans Benefits Administration, is that VBA's mission is veterans' lives and the sacrifices that were made by veterans. The mission is not about dealing with inventory. It is dealing with people's lives. The mission could be to determine how a claim should be granted, not to determine how to protect the public fisc.
The mission should be how to validate the claims of a combat veteran, not how to deny them. The fact that the VA has missed the point about its mission can be seen by the example referenced by Mr. Lamborn, Ranking Member Lamborn, the importance of the survivor's benefits. That has not been implemented as my colleague over here mentioned. Yet it is very important to have those regulations. That is something that is top priority, yet the VA has not acted on it.
Similarly as Mr. Wilson from the DAV mentioned, the proposed VCAA regs are inadequate and the VA has taken the opportunity, based on the Vasquez case, to propose to use a generic notice, rather than the case-specific notice. The fact pattern mentioned in the Federal Circuit's decision in Vasquez showed that both the claimants, Vasquez and Schultz, were given generic notices and did not know what they needed to introduce in order to get benefits for increased disabilities.
So the VA has decided to go to the least possible help they can give veterans rather than the most. In addition, I will point to the failure to issue permanent regs on the Agent Orange presumptions for B-Cell leukemias, Parkinson's disease and ischemic heart disease.
People are dying of those conditions today, yet no regs have been issued. If veterans go for priority healthcare and they are not service-connected for any other condition, they are not going to get health care. This needs to be taken care of right away.
Our members know of instances where combat veterans are being denied PTSD benefits because they are told that they lack a stressor, and that their Purple Heart is insufficient. This shows a lack of understanding of the VA's mission.
The VA is also an inefficient business. As recognized by yourself, Chairman Hall, the amount of paper that the VA needs to track mandates that there be an electronic system. The VA seems to be unable to figure out how to do this, yet NOVA members every day scan their files with optical character recognition programs and manage their cases with case management programs that are available and are out there.
The VA does not have reliable data and doesn't know how to get it. The processing times are not adequately tracked. The backlogs, as recognized by Representative Halvorson, are important and they have not been tracked adequately. And accuracy is totally a myth in the VA. They refuse to do what they need to do, that is, track a claim from beginning to end and find out if they got it right. They should not say that a claim is right based on the Systemic Technical Accuracy Review (STAR) system because internally they think it is right.
That would help with training, too. If they would take these claims and give them to raters and say, "This is what you did, but this is what the court said you should have done." And I think that the tracking of accuracy would solve a number of their problems if they did it correctly.
I want to thank you for the opportunity to testify and I'm prepared to answer your questions.
[The prepared statement of Mr. Cohen appears in the Appendix.]
Mr. HALL. Thank you, Mr. Cohen.
Mr. McCray, you are now recognized.
Mr. MCCRAY. Chairman Hall and Members of the Subcommittee, thank you for the opportunity to testify today on behalf of AFGE and to share my experiences as a rating specialist with the Los Angeles Regional Office.
Since coming to the VA 9 years ago, I have worked in every aspect of the claims processing, public contact, claims development, adjudication, the rating board and as acting team supervisor. The one thing I am certain of is the respect and commitment my coworkers have for veterans. Everyone is extremely aware of the duty we owe to our clients and the responsibility we have to them and their families.
However, the individual obstacles, flaws and idiosyncrasies of our job often impede us from fulfilling that duty. That is why AFGE urges this Subcommittee to expedite implementation of Public Law 110-389. This critical law has the potential to significantly reduce barriers to accurate efficient claims processing if the VA implements urgently needed changes in training, supervisory skills certification and systems for measuring and managing case production.
The VA is one of the most data-saturated work environments I have ever encountered. To successfully perform your job, you must have a thorough knowledge of the Code of Federal Regulations, the VA Manual of Operations, Medical Terminology and Ideology, Board of Veterans' Appeals decisions, Department of Defense procedures, current events, military history and veterans legal rights.
At the same time you must have the agility of mind to immediately learn and adapt to a constantly changing set of laws, regulations, procedures, technology, duties and priorities, all while maintaining the professionalism and compassion that our clients deserve and expect.
Productive adjudicators and rating specialists do not happen overnight. You cannot simply hire more bodies, give them a computer and a disc and reduce the backlog.
It takes time and commitment from both the employee and management. Employees must apply themselves to learning the written materials and commit the time it takes to effectively learn the job.
From my experience, it takes 2 years of on-the-job training to begin making a significant contribution and production. I have seen people with master's degrees and law degrees, people who have succeeded in other careers, medical professionals and ex-military personnel who have thrown in the towel in frustration because they did not receive the proper training and mentoring to learn this complex job.
Again, management must commit the time it takes to develop a good employee. After new employee classroom training, which is effective because it is developed by VA's Central Office (VACO), employees fail to receive consistent, sufficient quality on-the-job training. Too often, our own management fails to provide adequate training time or clear coherent learning materials that convey the correct way of processing claims and making decisions.
Therefore, AFGE urges VA to make all VBA training programs standardized throughout the country and sustained throughout a person's career to keep everyone on track and eliminate variation among regional offices.
Employees must be allowed time to develop the VA's unique job skills without fear of demotion or dismissal for not making daily production standards. As for the standards, they must accurately reflect everything that we do in our jobs, not just the number of cases that are produced.
If people are rushing to make points at the VA, it is not for wanted promotion. It is for fear of losing their jobs. I feel we do a disservice to American veterans if we reduce their needs to a simple tally of numbers that are calculated at the end of the day.
By failing to credit all aspects of our job, we discourage employees from taking the time necessary to provide compassionate thorough service for our veterans. I cannot emphasize enough the anxiety employees feel by attempting to meet minimum production standards.
Unable to keep up with the current standards, employees with years of valuable VA experience are forced into lower responsibility jobs, and in some cases, forced to retire. By allowing these seasoned employees to fail, VA risks losing years of accumulated knowledge and expertise that could best be used to mentor the thousands of new hires at VBA.
There is no silver bullet to claims processing. We try ways of tracking the files, arranging them on the shelves, color coding them and scanning them with the computer. Ultimately a human being still has to open the file, analyze the evidence and come to a decision and there are so many who are essential to the VBA claims process, from Clerks to veteran service representatives (VSRs), to rating specialists and Decision Review Officers. If any one of these people is poorly trained or so filled without anxiety about losing his or her job due to production standards that they cannot even perform their duties, the entire process is delayed indefinitely.
In short, we need less finger pointing and more training and mentoring by knowledgeable supervisors with proven teaching skills. We also need revised work credit and measurement systems that value judgment and action over fear and avoidance of errors. Only then will we truly be able to fulfill our duty to America's veterans. Thank you.
[The prepared statement of Mr. McCray appears in the Appendix.]
Mr. HALL. Thank you, Mr. McCray.
I will start off the question and answer session by asking you, since you are working in an RO, if you could summarize any changes that you have seen in the approach or the attitude of the VA since the change at the top, the change in administration and the new Secretary?
Mr. MCCRAY. I believe that we have actually?there are a lot more cases that are being labeled as priority cases. For example, the seriously injured or the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). However, without coming in and giving more resources to the cases that are not priorities, you are essentially just moving your manpower into a different field and changing which cases are rated first.
So I will say that there has been a response, different priorities, but yet, I feel like we need to refill the resources behind those priorities.
Mr. HALL. What would AFGE recommend changing so that there could be a culture change and a stigma change within the VBA?
Mr. MCCRAY. I honestly believe that everyone that works there is trying to do the best for veterans. But you know, we have been given this enormous convoluted system that has been kind of cobbled together over the last 90 years. And I kind of always describe the VA as being, it is like an old car that, you know, you have to turn on the blinker and then stick in the cigarette lighter and jiggle the steering wheel, and even still it only goes 10 miles an hour.
And you know, we get new people in and we try to teach them, well, you have to turn on the, you know, jiggle the steering wheel and stick in the cigarette lighter. And it is still, no matter what you do, there is only so much that you can get out of the machine the way it is now.
So I think to?ultimately you have to really train the people. You have to encourage the people. You have to encourage them to be proactive. You have to encourage your employees to make decisions and to have confidence to make decisions because if people are afraid to make decisions or step out of the box or afraid to stick their heads up, you will never have anything accomplished at the VA.
Mr. HALL. And one last thing, Mr. McCray. You talk about the lack of national uniformity in training programs. Do you feel that if there was a national standard, perhaps a manual that was given to all of our directors in every region, that this would eliminate some of the deficiencies and lack of uniformity training?
Mr. MCCRAY. I think it would. A couple of weeks ago the Central Office did come up with a Fast Letter that indicated that they were going to start standardizing some of the continued training, which I think is a step in the right direction. I am still waiting to see how it is implemented before I can, you know, actually comment on it personally.
But, you know, it is kind of like a judge across the country. We all have the same laws, but each judge will see, will interpret it subtly himself, and yet we ask every rating specialist or every VSR to have the same laws and then come up with exactly the same decision every time, and it is just impossible, I think.
So the clearer you can make it, as far as the procedures, the clearer you can make it as far as the criteria and trying to standardize it throughout, yeah, that would greatly help the job that we do.
Mr. HALL. Thank you.
Mr. de Planque, in your testimony you refer to flaws in the VA's work credit system. Could you elaborate on this point in terms of what you see as the major flaws and how you propose VA could improve upon the Work Credit System?
Mr. DE PLANQUE. Well, the Work Credit System, and I believe this was alluded to by my colleague over here, counts production solely based on numbers. It does not take into any account whether or not the work is done correctly or not.
And as you stated very clearly, there is a tremendous pressure that is felt by the workers. I go out as part of Regional Office reviews that the American Legion conducts on various ROs. I talk to employees within the system. These are people who believe they are going to work to help veterans. They want to help veterans. These are good employees that they have in there, but they feel tremendous pressure on the numbers that they have to turn out, and the ability to properly do their job within the time constraints allotted.
I had a rater from one of the offices who was a veteran himself from Afghanistan and we discussed Afghanistan for a while and he said, I have a case, it is this thick, I have 2 hours to get through that case, how do I give that veteran justice. And you know, to hear that, that is heartrending to hear from them. They want to be given the time to do the job right and so that if you look at a system that is only putting credit on the numbers and not whether or not they are done correctly, we are never going to make any progress that way.
So then you have to look at counting it in a different sort of fashion. The American Legion has a resolution that it supported for a long time, only counting a claim as done when it has been properly and finally adjudicated. That obviously would be a major shock to the system and different in any way that it has been done before.
But there are other ideas. We don't necessarily endorse the ideas but we have heard ideas recently mentioned where you could look at it like a checkbook. When you do something right, you get a credit to the account of an RO or the account of something. And when you are dinged for doing things improperly, when they are remanded over things that could easily have been corrected, then a debit would go against it and you could look at whether an office was operating in the black or in the red on whether or they are properly doing the claims.
All of the sudden you look at it that way, then you are measuring your cases by how many you are getting done right and you are going to give people the time they need to get it done right. If it takes you 2 hours to do a claim wrong and you have to do it three times because it keeps getting remanded and 3 hours to do it right, that is 6 hours to do a case or 3 hours to do it right. Do it right the first time, and that is what we are advocating.
Mr. HALL. Thank you very much.
Mr. Lamborn, you are now recognized.
Mr. LAMBORN. Thank you, Mr. Chairman. And to some extent, the following question you all have been addressing this, that sort of to clarify for me and condense what you are saying, what would be your top recommendation for the VA? And I would like each one of you to take a stab at this, on how they could improve the quality of their decisions. And I know, you have just addressed that?but what would be, and this might vary a little bit?what would be your top recommendation? And we can start with you, Mr. Weidman and just go down the table.
Mr. WEIDMAN. No guts, no glory.
They can only do one thing. It is the organization of the C-file itself, Mr. Lamborn. You literally, I mean that was no exaggeration by Mr. McCray, they have them thicker than 12, 18, 20 inches thick. And to just find the salient documents can burn up a good part of that 2-hour time frame that we are talking about.
To have a template in a set order, which you put things into a C-file, so if you go to my C-file to Brian Lawrence's C-file, to John Wilson's C-file, you will find the same documents in the same location within the C file and you start there and then, as you automate it, if you don't set that business process, get that straightened out, even using OCR/ICR scanning techniques, you get people used to a doing business process in a set way. Then you can concentrate on what those documents say, as opposed to trying to find a document in the first place.
Mr. WILSON. It is a good question, Mr. Lamborn, and we are talking about that among ourselves as veterans service organizations. We had a meeting off of campus, if you will, to talk about how we could best advise VA to move more effectively towards a better way of providing a better product. And one of those tough points we believe is that VA take an approach of quality first in their work and all the other issues will fall into place and the timeliness and appeals issues will be resolved substantially.
VBA employees need a robust digital electronic system so they can develop claims. They need to be able to retrieve data electronically from the National Archives, the military services, et cetera. That is essential.
This development phase is the most time-consuming phase in the claims process. So efforts need to be made in the development area first to get your biggest bang for the buck.
So a quality initiative focusing on a digitized development process and a revised the Work Credit System is essential. To get all these development tools off the rater's desk, out of binders, books and archaic data bases with little interoperability and into their laptop computers would help immensely.
Ten years ago while on active duty, we used Lean Six Sigma. To improve the quality of certain programs. We found it very effective. We are heartened to see VA finds it to be a viable program to help them with their processes as well, as is being done down in Little Rock.
Mr. LAMBORN. Thank you.
Mr. WILSON. Yes, sir.
Mr. DE PLANQUE. One of the things that I think, in terms of looking for consistency, is to achieve consistency with the training and to centralize and standardize the training. You mentioned there is an increase in hours from 80 to 85 hours, but it has also got to be the right training. And to use another example from an RO visit, we went into a particular Regional Office that had been having a lot of trouble rating PTSD claims, and we brought this up to them and we said, we have seen this ahead of time.
And they said, well, we just delivered a training on this.
And we said, oh, do you have it?
And they brought the PowerPoint out that they received from Central Office and delivered to their employees. We went through it. There are three errors in the PowerPoint that were factually incorrect on how to interpret the regulations.
To Central Office's credit, we brought it up to them and they immediately changed it and distributed the information out to the Regional Offices. They corrected it very quickly when they were made aware it, but the point it that was bad training that was out there and so they need to be getting the right training. It needs to be across the board and they need to make sure that that is also a priority.
And we understand that they are under a lot of pressure to get cases done, too. The service organizations and Congress are breathing down VA's necks to take care of the backlog, but getting the people trained to do it right will help them do the claims faster and get them right.
Mr. LAMBORN. Thank you.
Mr. COHEN. I would likewise agree that the accuracy is crucial and that is dependent on the training. And I see the training as needing to be case specific so that someone who works on a claim should know how what they did affects the end product and whether they did the right thing, and they can only know that if they can track the claim through the BVA and through the Court and back down again and then, in addition to that, once they know the right thing to do, they need standardized materials. This was mentioned by the Booz Allen Cycle Study, that some people have some great checklists that they have put together and materials that they use, but others don't. That needs to be standardized so everyone has a checklist that helps them deal with a particular type of claim.
Then, the final thing is, they need allotted time to be able to do it right because again, as was noted before, it saves time and cuts backlog to do it right the first time, but they can't do that if the time limits prohibit them from adequately developing or adequately reviewing the file.
Mr. LAMBORN. Thank you, and we have run out of time, but can you very quickly?
Mr. MCCRAY. Yeah, I would say, also, just consistent and ongoing, on-the-job training because, you know, this isn't like just moving boxes somewhere, like, we aren't saying, well, we have a million boxes that we have to move. I mean, each one of these cases is unique and individual in its own right. It is a person's life.
And as a rating specialist or as a VSR, you have to observe that. And you know, you get the training that kind of tells you how to deal with cases like that, but every case is unique, and so you need training and mentoring that goes on to kind of teach people who to think and how to judge cases rather than just process them.
Mr. LAMBORN. Okay. I thank each one of you.
Mr. HALL. Mr. Miller?
Mr. MILLER. Mr. Weidman, in your testimony, you suggested a common training platform for VA, VSOs, State, Federal or local government employees. Can you talk a little bit about how you would envision that being structured?
Mr. WEIDMAN. Literally, meet, call all the players together from the National Association of State Directors of Veterans Affairs to the county veterans service officers (CVSO) to the veterans service organizations with VA and come up with a set piece.
Training manuals are great, but today they should be done in webinars so that people can go back and back again until they get whatever section it is of the training. And you can standardize it across the country that way much more easily as well. With standardized exams based on competency that everyone has to pass, including attorneys by the way?just because somebody's an attorney doesn't mean they know Veterans' law at all.
So if you do that, I mean the astonishing thing is, we get so many complicated claims right as we do the first time through, given the lack of expertise, if you will, that impinges at so many points in that process.
So it would be, instead of doing it in the legalistic way, you sit down and negotiate, if you will, the VSOs, NOVA and with VA, and come up with a common training program and with tests that make sense.
Incidentally, on that training, somebody mentioned it here and I will say it more specifically. VA's training is all too often showing slides and exposing people to training as opposed to doing case studies. Case studies, people actually have to do and then they learn what it is, what the impact is of doing things right, the right way is on the end product, and a lot of that can be worked out.
I can't tell you how heartened many of us were by last week in that session and that it was a different attitude that we hadn't seen before. All that was missing from that was we should have had Voc Rehab and claims specialists like Mr. McCray there, and next time I think they will get it, but the point is, the attitude that we can figure this out together. And once we have that attitude, we can, in fact, collegially get the darn thing done.
Mr. MILLER. Anybody else got anything they would like to add to that?
Mr. DE PLANQUE. In terms of the platform and getting everyone together on the same page, whether you are a service officer or whether you are rating a claim, you are doing the same thing. You are going through a case file start to finish, trying to put together a picture of the veteran's life and why they are entitled to the benefits.
Everybody's doing the same job and if we are all working together on the same page, it helps a lot. And I just also wanted to reiterate that when we do get together with VA, whether it is for a mental conference or when VA's compensation and pension holds quarterly meetings with the service organizations, great things do come out of those. A lot of improvements that have been made towards recognizing Brownwater Navy boats came out of the meetings with quarterlies and the VSOs working with VA and VA doing things of its own initiative by listening to the stakeholders in it.
So when we do work together, good things happen for veterans and that is an essential component that needs to go forward and they seem willing to do.
Mr. MILLER. Thank you. I yield back.
Mr. HALL. Thank you, Mr. Miller. I'll just recognize myself for a couple more questions before we excuse you.
First of all, Mr. Cohen, I just wanted to ask you? there has been mention of the Vasquez-Flores v. Peake case today, and I was wondering if you could speculate as to what effects that will have on the aims of the Veterans' Benefits Improvement Act of 2008. Are there any other rulings because of Vasquez that have analyzed other provisions of this law that you are aware of, and if so, what has been the impact of these rulings?
Mr. COHEN. Well, the Vasquez case is very detrimental to the whole idea of the Veterans' Claims Assistance Act providing notice to veterans because the decision of the Federal Circuit overturned a Veterans' Court decision requiring case-specific notice in a situation where a veteran applied for increased benefits.
And, as I said, in the fact pattern of the case, it was very clear that the veterans who complained about not getting adequate notice, in fact, did not get notice that would tell them what they needed to do to get increased ratings.
So if the VA proceeds with their proposed regulation saying that only generic notices would be given, they are going to be doing a great disservice to VBIA 2008 and to the veterans that that legislation sought to help. These generic notices, rather than assist the veteran, just tie up the system because they consume time to get them out and get a reply back.
But since veterans can't understand them and aren't benefitted from them, the question is why even submit a generic notice? That just consumes time.
Mr. HALL. Mr. Wilson, do you have a comment on that? Or perhaps what this Committee or Subcommittee might do or Congress might do to clear up the situation that is caused by Vasquez?
Mr. WILSON. It was interesting to read in the Federal Register what the VA's contention was. It would be useful, if Congress could articulate its wishes that, in fact, the VA must be specific, not generic, in its notices to veterans.
It was more than just a whim, on a particular sunny day that it would be a thing for the VA to do for veterans if they wish was Congressional intent. We believe it is absolutely essential that veterans be well informed and, therefore, request Congress mandate, in fact that VA carry out the wishes of Congress and make these notices specific, not generic.
Mr. HALL. Thank you. Back to Mr. Cohen. I just wanted to refer to your testimony that there has been no action by the VA on substitution by survivor's regulations as required by the Act. In fact, you assert that the VA is attempting to subvert the intention of this provision of the Act by trying to administer a regulation, 38 CFR 20.1302, which requires an appeal to be dismissed upon the death of the claimant.
The intention of the Act, as we all know, was to allow the survivor to step into the veteran's shoes and continue to the completion of the claim.
What do you believe are the legal consequence of this action by the VA and what steps you believe we should take here in Congress to address this action?
Mr. COHEN. Well, I think part of the oversight of Congress is to require the VA to explain why this particular regulation has not issued. This is not something that is compl
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