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Submission For The Record of The American Legion

In 2010, when Secretary Eric Shinseki laid out the laudable goal of achieving 98% accuracy on veterans’ disability claims with no claim pending over 125 days, the Veterans Benefits Administration (VBA) had 509,423 claims pending with 39 percent of those claims pending over 125 days.  Just this week, on March 18, 2013, VBA’s figures show 895,838 claims pending, with a full 70.3 percent of those claims pending over the 125 day deadline.  The Department of Veterans Affairs (VA) is moving backward, and veterans across America are deeply concerned.

On behalf of National Commander James Koutz and the 2.4 million veterans of The American Legion, we would like to thank this Committee for the opportunity to address the critical issue of the claims backlog affecting veterans across the nation.

The disability claims backlog affects millions of American veterans.  The VA has been aggressively pursuing technological solutions to attack the backlog and deliver decisions in a timely manner through the Veterans Benefits Management System (VBMS).  However, technological solutions will not be the sole key to reducing the backlog.  The American Legion believes there are other important, transformative steps VA must take to fix the system.  Three of the most important changes are:

1.    Fix a broken work credit system that currently gives the same credit for work whether or not it is performed correctly.
2.    Develop a system to aggregate common errors in processing and use this to create a training plan for employees.
3.    Hire more veterans to process claims to increase understanding of the military in those who are interpreting the claims files.

The Work Credit System:

Under the current work credit system, a VA employee gets credit when a file moves off their desk on to the next station in the chain.  Unfortunately, this system doesn’t take into account whether or not the claim was processed correctly.  Error rate continues to be a problem among VA claims adjudicators.  When an error is made processing a claim, that claim must be appealed.  The lengthy appeals process means a claim that should have been decided in a few months now will take years to be resolved for the veteran.  This keeps the system clogged with work that could have been removed from the work flow if it had been done correctly the first time.

Employees are only human.  Pressure to move a claim off the desk is evident because raw volume is the standard VA uses to set productivity goals.  To fix the system would not necessarily require a major overhaul.  It could be as simple as giving credit for when a claim is finished, but also applying a negative credit or debit when it is determined work was done in error.  If an office finishes 5,000 claims, but only at an 80 percent accuracy rate, then they would get credit for 4,000 claims.  

This is a simple step which would help mold the operational climate in VA offices.  The ability to work hard and accomplish a high work volume would still be prized; however the ability to work carefully and achieve high accuracy would then be equally prized.  This incentive structure would help raise VA’s accuracy rate to achieve Secretary Shinseki’s goal of 98 percent accuracy.

Common Error Training:

Another factor towards increasing accuracy is improving the quality of VA’s training for claims adjudicators.  Software and operating system solutions such as VBMS are important, but the vast amount of information VA possesses about veterans’ claims should be harnessed for the purposes of training.  With everything shifting to an entirely electronic operating environment, VA should have unprecedented ability to track common errors in their claims processing work.  

By aggregating common errors found by the Board of Veterans Appeals (BVA), the Court of Appeals for Veterans Claims (CAVC), and the internal Systemic Technical Accuracy Review (STAR) VA should be able to develop effective computer models of where their employees are making the most mistakes and adjust training accordingly.  If the BVA is consistently finding that Regional Offices (ROs) are not applying DeLuca factors in rating skeletal-muscular disorders, then VA Central Office (VACO) should develop training modules for dissemination to correct the problem.  Similarly, if the CAVC finds a consistent pattern of failure to apply proper evidence standards for Posttraumatic Stress Disorder (PTSD) cases involving combat zones, refresher material can be developed and delivered to the ROs to get everyone back on track.

As VA moves towards such a powerful electronic model for the office environment, they must utilize those tools to be a support to their employees’ decision making skills.  Training is already inconsistent from RO to RO, and developing a centralized plan based on real time data about where VA can best use their training resources.

Hiring Veterans:

At any given time, less than one percent of the population is serving in the military.  Far fewer people in the population at large truly understand the sacrifices and day to day realities of military service.  The average person on the street doesn’t know the difference between a Battalion and a Battery, or even that a Battery in a military context can mean a Company of Artillery soldiers and not the thing that powers your Smart Phone.

In terms of the claims backlog, military experience is a plus for claims adjudicators because it enables easy familiarity with the military records in the claims files.  Veterans don’t have to spend extensive time looking up the myriad military acronyms, they just know that the initials CIB mean a service member has seen combat and thus the provisions of 38 USC § 1154b apply to their claim.

Veterans have seen unemployment rates two thirds higher than their civilian counterparts in past years.  Boosting the number of veteran employees at VBA would serve a dual purpose.  It would both increase the institutional knowledge within VBA of the military, and it would reduce veteran unemployment.  To this end, greater work can be done through vocational rehabilitation programs to encourage veterans to work for VBA and to ensure they have the skills necessary to be successful there.

Conclusion:

These three simple steps are by no means an exhaustive solution to taming the claims backlog.  However, they do represent three simple actions, with a specific scope, which can improve the operational environment and help VA achieve their goals of accuracy and timeliness.  Nobody, not VA, not Congress, and certainly not the veterans’ community, is satisfied with the current state of the claims system.  It will take work to reduce the claims backlog, but not all of the work needs to be overly complicated.  The American Legion believes that with a couple of simple initiatives, VA could move forward with their transformation and help the human side of their offices as their tech people work diligently on the electronic side of the process.

The American Legion again thanks the Committee for its diligent attention to the claims process.  For additional information regarding this testimony, please contact Mr. Ian de Planque at The American Legion’s Legislative Division, (202) 861-2700 or ideplanque@legion.org .