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Witness Testimony of Heather Ansley, Esq., MSW, Vice President of Veterans Policy VetsFirst, a program of United Spinal Association

World War II Merchant Mariner Service Act (H.R. 1288)
We urge swift passage of this legislation.
Blue Water Navy Ship Accountability Act (H.R. 1494)
We support this legislation because it would provide information that will facilitate processing disability claims related to Agent Orange.
VA Claims Efficiency Through Information Act of 2013 (H.R. 1623)
We support this legislation but believe that it would be strengthened by focusing on the top 10 medical conditions for which veterans file for compensation as opposed to all conditions.
To direct the Secretary to provide notice of average times for processing claims and percentage of claims approved (H.R. 1809)
We support this legislation, but are concerned about the need for applicants to sign a notice acknowledging receipt of the information due to possible delays in claims processing resulting from failure to submit it.
Pay As You Rate Act (H.R. 2086)
We support swift passage of this legislation.
Ending VA Claims Disability Backlog and Accountability Act (H.R. 2138)
We support the intent of this legislation but believe that reporting requirements would need to be monitored to ensure that the information being collected is needed to facilitate ending the backlog.
To establish a commission or task force to evaluate the backlog of disability claims of VA (H.R. 2189)
We believe that a task force or commission should focus either on the backlog or the broader claims process, including appeals, but not both.
Veterans Pension Protection Act (H.R. 2341)
We do not have an official position on this legislation but believe that any efforts to penalize transfer of assets must provide for appropriate exemptions for transfers to special needs trusts.
Prioritizing Urgent Claims for Veterans Act (H.R. 2382)
We support passage of this legislation but believe that additional prioritization categories would be beneficial for our most vulnerable veterans.
Disabled Veterans’ Access to Medical Exams Improvement Act (H.R. 2423)
We support passage of this legislation

Chairman Runyan, Ranking Member Titus, and other distinguished members of the Subcommittee, thank you for the opportunity to testify regarding VetsFirst’s views on the bills under consideration today.
VetsFirst, a program of United Spinal Association, represents the culmination of over 60 years of service to veterans and their families. We provide representation for veterans, their dependents and survivors in their pursuit of Department of Veterans Affairs (VA) benefits and health care before VA and in the federal courts. Today, we are not only a VA-recognized national veterans service organization, but also a leader in advocacy for all people with disabilities.
World War II Merchant Mariner Service Act (H.R. 1288)
This legislation would provide individuals who served as coastwise merchant seamen during World War II with additional ways to prove their service. According to the GI Bill Improvement Act of 1977 (Public Law 95-202) and the Veterans Programs Enhancement Act of 1998 (Public Law 105-368), merchant mariners may use the following documentation to prove their eligibility for VA benefits: certificate of shipping and discharge forms, continuous discharge books, and company letters showing vessel names and dates of voyages. However, these forms of documentation are not always available.
For individuals without applicable Coast Guard shipping or discharge forms, a ship logbook, a merchant mariner’s document or Z-card, or other official employment record, Social Security Administration records in conjunction with validated testimony given by the individual or his or her primary next of kin that the individual performed such service will be acceptable proof. In the case of documentation that has been destroyed or is unavailable, other official documentation shall be accepted. Providing such proof would allow these individuals to be eligible for burial benefits; medals, ribbons, and decorations; and the ability to identify as a veteran.
We support this bipartisan legislation and urge its swift passage.
Blue Water Navy Ship Accountability Act (H.R. 1494)
Veterans who served on vessels in and around the waters of Vietnam often face difficulties in proving they were exposed to Agent Orange. In order to benefit from presumed exposure to Agent Orange in filing a claim for disability benefits, veterans must prove that the vessels on which they served traveled on Vietnam’s inland waterways or that the ship was docked to the shore or pierside and they disembarked (“boots on the ground”). Otherwise, veterans must actually prove that they were exposed to Agent Orange, which can be very difficult.
Although being able to obtain official information regarding the area in which you served is critical for proving exposure to Agent Orange, VA does not have a full accounting of the locations of all vessels that served in the waters near Vietnam. Instead, VA must continue to work with the Department of Defense (DOD) to develop the information as individual claims are received. This delay contributes to the backlog and delays benefits for many Vietnam veterans who have disabilities due to their exposure to Agent Orange.
This legislation would require DOD’s Army and Joint Services Records Research Center (JSRRC) to perform a comprehensive review of the logs of all ships that served in waters near Vietnam to determine if the vessels served within the territorial waters of Vietnam. Specifically, the JSRRC must determine

whether a vessel operated in the territorial waters of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, and where the ship was located in relation to the shore. Proactively researching this information will ensure that veterans’ claims for service connection are not delayed due to lack of information under the custody and control of the federal government.
We urge swift passage of this legislation.
VA Claims Efficiency Through Information Act of 2013 (H.R. 1623)
The backlog in processing initial claims for disability compensation is well known. Despite numerous efforts to address the backlog, the difficulty in processing claims in an efficient and timely manner has continued to elude VA. Addressing the backlog will require many solutions because the reasons for the backlog are not only found in the overall claims processing system but also in the customs and culture of each regional office.
This legislation would require VA to make transparent information regarding the processing times of claims by regional office and by each medical condition for which a veteran seeks service connection or an increased rating. Specifically, VA will be required to post, by regional office, the average number of days between the date of the submittal of a claim and the date of the decision, the average number of days each claim is pending, the quality and accuracy rating of the claims adjudication process, the number of claims pending, those pending beyond 125 days and the number of claims completed by current month, the preceding month, current calendar year, and the preceding calendar year. This same information is also required by medical condition.
Although we support this legislation, we believe that the information collected by medical condition would be more useful if the following requirements were included. First, we believe that it would be helpful to consider evaluating processing times for individual medical conditions by regional office. Reviewing information by regional office may highlight problems in processing certain claims that are nationwide in nature versus regional. In addition, instead of requesting information for each medical condition filed, it would be more useful to look at the top 10 conditions for which veterans file for compensation. Otherwise, VA would be forced to provide data for numerous medical conditions, including those for which very few veterans actually seek compensation.
With these changes, we believe that this important legislation would be able to provide data that will not only help to address the backlog but also serve as an indicator moving forward about resource allocation and potential problem areas.
To direct the Secretary to provide notice of average times for processing claims and percentage of claims approved (H.R. 1809)
Veterans now have more options than ever for filing claims for veterans benefits. In addition to filing claims using traditional paper forms, veterans are also able to file claims electronically. For veterans who have identified all of the information needed to prove their claim, the opportunity to submit a fully developed claim promises faster processing times and will as of August 6, 2013, allow the veteran the opportunity to receive up

to one year of additional retroactive benefits. In filing claims, veterans also have the opportunity to seek the assistance of a veterans service officer or other individual or to file a claim on their own.
To ensure that veterans are able to make the best educated decisions regarding their benefits claims, this legislation would require VA to post information in regional offices, claims intake facilities and on the Internet regarding processing times and claims for which benefits are awarded. Specifically, VA will be required to provide information regarding the average processing time for claims, whether fully developed or not, and the percentage of claims that were awarded benefits. VA will also be required to provide information regarding claims granted by those in which a veteran was represented by a veterans service organization, those who used the assistance of another individual under a durable power of attorney, and those in which the veteran acted on his or her own behalf. Veterans would also be required to sign a notice when submitting a claim for benefits that acknowledges that they are aware of this information.
We believe that veterans should have the information they need to make informed decisions regarding their benefits claims. However, we are concerned about the requirement for applicants to sign a notice stating that they are aware of this information. We are not opposed to ensuring that veterans have information regarding processing times and claims approved. But we believe that unless the notice is incorporated into all application forms for VA benefits, the need to receive and sign a separate form could add another layer to the claims process that would further delay it.
If our concerns regarding the need to acknowledge receipt of the notice can be addressed, we think that this legislation would be very beneficial to veterans and other claimants.
Pay As You Rate Act (H.R. 2086)
Veterans today are filing increasingly complex claims for disability compensation. For veterans who file claims with multiple issues, final resolution of all issues in a claim may require a significant amount of time. Once VA has reached a decision on each issue in a veteran’s claim, the veteran should begin receiving any owed disability compensation without having to wait for a final adjudication of all issues raised in his or her claim.
This legislation would require VA to make interim payments of disability benefits when an issue is favorably decided for the veteran, as those decisions are made. VA would be required to pay veterans as they rate individual issues for those claims that require VA to make decisions with respect to two or more disabilities. We hope that each decision on an issue will be considered a final decision so that if a veteran wishes to appeal his or her rating that process will be able to begin immediately.
We support this legislation and urge is swift passage.
Ending VA Claims Disability Backlog and Accountability Act (H.R. 2138)
VetsFirst believes that VA Secretary Eric Shinseki is personally committed to eliminating the backlog for veterans benefits. VA’s current goal is in 2015 to process initial claims within 125 days of receipt at 98 percent

accuracy. In recent years, however, the backlog has only continued to grow despite a variety of efforts to stem the tide.
On January 25, 2013, VA published a strategic plan to accomplish this goal. The Strategic Plan to Eliminate the Compensation Claims Backlog addresses the Veterans Benefits Administration’s (VBA) transformation plan which focuses on using people, process, and technology to end the backlog. Despite indications that VA may finally be turning the tide on the backlog, many members of Congress and veterans remain concerned that VA will not be able to finally address its processing delays. Furthermore, even if processing timelines are met, it is unclear whether quality will ultimately be sacrificed by those seeking to ensure that claims are completed within 125 days.
This legislation would require VA to fully implement its strategic plan to ensure elimination of the claims backlog by Memorial Day 2015. At that time, all claims should meet VA’s goal of processing claims for disability compensation within 125 days of receipt at 98 percent accuracy. VA would also be required to provide a supplemental report that provides metrics and timelines for implementing the plan. To ensure progress on the plan, the Government Accountability Office would be required to provide 90 day progress reports to Congress on VA’s implementation.
VetsFirst believes that VA must be held accountable for reaching the goal of processing initial claims within 125 days of receipt at 98 percent accuracy. No single action will eliminate the claims backlog. Thus, we believe that requiring a continuing evaluation of the metrics that will show if progress is being made will be helpful in ensuring that VA is pursuing the correct policies and procedures and making any needed course corrections that will help them to succeed. We also believe, however, that reporting requirements must be carefully monitored to ensure that the information being collected is needed to facilitate ending the backlog and not diverting critical resources from the mission.
In addition, the legislation would also require the expedited transfer of records under the purview of the Social Security Administration and DOD. It would also require the development of a plan to decrease to 30 days that amount of time needed to provide members of the National Guard and VA with needed medical records. The legislation would also require a training program to ensure that all newly hired claims processors receive at least three years of training and partnering with mentor processors who can assist in the training.
We support the intent of this legislation but believe that implementation will be key to ensuring success.
To establish a commission or task force to evaluate the backlog of disability claims of VA (H.R. 2189)
This legislation would create a commission or task force to study the claims backlog, including the policies and procedures VA uses to evaluate claims and appeals for veterans benefits. The resulting study will be a comprehensive evaluation and assessment of the backlog of claims, an analysis of possible improvements and related issues. As part of the study, the commission or task force will be required to consider the interests of veterans, procedural and substantive due process issues, the responsible use of resources, and the importance of a veteran friendly claims process. The task force or commission will also address the backlog of claims and possible improvements to the claims process, along with a review of the appellate process.

While we believe that VA must act to ensure that the goal of processing claims within 125 days at 98 percent accuracy is met, we are concerned that a commission or task force might hinder VA’s current efforts by diverting resources from the overall push to address the backlog. However, VA must be held accountable for effectively implementing its Strategic Plan to Eliminate the Compensation Claims Backlog. A commission or task force that is narrowly focused on VA’s current efforts related to the backlog might have benefit for veterans and the claims process.
We also believe, however, that there is a need for a more broad-based commission or task force that will thoroughly evaluate the entire claims process, including the appeals process. The work of such a commission or task force should begin with a review of the most recent commission and task force recommendations, including those of the Veteran’s Disability Benefits Commission and the VA Claims Processing Task Force. This would allow the task force or commission to evaluate previous recommendations, and determine whether unimplemented recommendations would be beneficial in improving the claims process, and what additional recommendations are needed. The commission or task force would also need to evaluate the role of technology in claims processing, the effectiveness of veterans service organizations, agents, and attorneys in assisting veterans in prosecuting their claims, and whether the current claims processing system meets the goals and spirit of actually assisting veterans with their claims.
Any broad-based commission or task force would also need to be forward thinking and consider claims processing beyond 2015. Although ending the backlog and increasing claims quality are top priorities, we must also anticipate the needs of claims processing beyond the next couple of years. Thus, it should also consider how to maximize efficiencies that may be afforded through technology and the changing needs of veterans. Otherwise, we may exchange the backlog or another set of equally daunting concerns.
We also believe that any broad-based commission or task force should include a focus on the appeals process. The VA’s Office of Inspector General (OIG) reported in a May 2012 report  that the inventory of appeals had increased more than 30 percent between fiscal year 2008 and fiscal year 2010. The OIG’s report concluded that, “VBA’s management of appeals was ineffective in providing timely resolution of veterans’ appeals.” Clearly, a focused review of the appellate process is needed.
Thus, we believe that a task force or commission should focus either on the backlog of initial claims or the broader claims process, including appeals, but not both. We would ask that either the task force proposed by this legislation be limited in scope or that the focus and timeframes be broadened to include all areas of concern.
Veterans Pension Protection Act (H.R. 2341)
VA’s pension program provides benefits for veterans who are low-income and are either permanently and totally disabled, or age 65 and older, if they served during a period of war. These benefits are critical for veterans who have few other resources available to them.

Because these benefits are very important to low-income and/or disabled veterans, we believe that these benefits must be protected to ensure that they are fully available when needed. As a result, we do not condone fraudulent efforts to benefit from the VA’s pension program. We also believe, however, that people should not have to impoverish themselves just to receive the services that they need whether in VA’s program or any other similar government benefits program.
The look-back proposed in this legislation seeks to preempt efforts to transfer assets to make veterans eligible for pension benefits. Without commenting further on the specific merits of this proposal, we are concerned that the legislation does not exempt transfer of assets to special needs trusts. Special needs trusts are designed to supplement the services and supports received by people with disabilities through Social Security and Medicaid. The funds in a special needs trust may be used for expenses such as modifying a home for accessibility, paying for recreational activities, or purchasing tickets to visit family. If the funds were made directly available to the individual, then he or she may lose eligibility for Supplemental Security Income (SSI) benefits and Medicaid services and supports, which are income dependent. By placing the funds in a special needs trust, parents can ensure, for instance, that their disabled children retain eligibility for these crucial benefits and services.
A good example illustrating the importance of special needs trusts is found in the current quandary with DOD’s survivor benefit plan (SBP). An SBP annuity allows for retiring servicemembers to make a portion of their retired pay available to their survivors. However, federal law requires that these benefits must be paid to a “natural person.” Thus, if a child with a disability is in receipt of income dependent services and supports, then the child may lose these benefits and services because SBP funds cannot be paid to a special needs trust. Unfortunately, the amount received from the annuity may not be sufficient to pay for the services lost. Thus, the child not only loses eligibility for the services but then is unable to pay for them privately.
In the November 2011 edition of Exceptional Parent Magazine, Kelly A. Thompson, an attorney, relayed how this dilemma played out for one adult child with a disability.
“A recent example concerns a 52 year-old man with an intellectual disability who had lived in a group home for 18 years and attended a day program for individuals with disabilities. His only income was SSI of $674 per month. His SSI benefits and Medicaid paid for his programs and services. However, when his father, a retired Navy officer, died, his adult son began to receive military SBP in the amount of $2,030 per month. This SBP payment made him ineligible for Medicaid waiver services. The private pay cost of the programs and services he was receiving prior to his father’s death is $8,600 per month, more than four times his SBP payment. He lost his group home placement, as well as his day program, and was transferred to a state “training center”—a large institutional setting isolated from the community.”
People with disabilities greatly benefit from access to special needs trusts. In the Omnibus Budget Reconciliation Act of 1993, Congress exempted the transfer of assets for the benefit of a person with a disability under the age of 65 from the look-back provisions of the Medicaid program. Thus, not only is a person with a disability able to benefit greatly from a special needs trust but the transfer of assets to the trust for the benefit of

another does not count against the transferor in the event that he or she subsequently needs Medicaid assistance. In light of the importance of special needs trust, it is clear that these benefits should be available for the disabled children of veterans, without disadvantaging the veteran in receiving VA pension benefits if needed.
It should also be noted that a person with a disability who is under the age of 65 may have his or her own assets transferred into a special needs trust that directly benefits him or her. These types of trusts may only be established by a parent, grandparent, legal guardian, or a court and allow the individual to remain eligible for Medicaid services and supports. Any remaining funds available at death must be used to pay-back the Medicaid program for services provided.
Any efforts to penalize transfer of assets under the VA’s pension program must provide for appropriate exemptions for transfers to special needs trusts similar to those available through other federal programs also based on financial need.
Prioritizing Urgent Claims for Veterans Act (H.R. 2382)
In cases pending before the Board of Veterans’ Appeals, veterans who are of advanced age (75 years of age or older), suffering severe financial hardship, or seriously ill may under regulation advance on the docket. VBA has recently testified that initial claims filed by veterans who are homeless, terminally ill, or Medal of Honor recipients or were Prisoners of Wars are processed as expeditiously as possible. However, there are no similar regulatory or statutory protections for initial claims.
This legislation would require the Secretary to provide priority for veterans who are age 70, terminally ill, or who have life-threatening illnesses. We strongly believe that statutory protections for our most vulnerable veterans are necessary to ensure that benefits are available to those who are in the most need. However, we suggest that this legislation be amended to also include those veterans who are homeless and those who are suffering severe financial hardship.
We believe ensuring that those veterans who have dire need for benefits should have priority in claims processing. We hope that this legislation will be expanded to include other vulnerable veterans and urge its subsequent passage.
Disabled Veterans’ Access to Medical Exams Improvement Act (H.R. 2423)
Veterans who file claims for disability benefits are often scheduled for medical examinations that will provide VA with the information needed to evaluate their claims. To ensure that veterans’ claims are not unduly delayed due to the need for medical information, Congress gave VA the temporary authority to use contract examiners in the Veterans’ Benefits Improvement Act of 1996 (Public Law 104-275). Congress has continued to extend this authority, which currently expires on December 31, 2013.
This legislation would extend VA’s authorization to use contract physicians to perform examinations required for disability benefits claims. The authority, which would be extended to December 31, 2016, would also allow for licensed physicians to travel to other jurisdictions to perform exams as long as they were conducted pursuant to VA’s contract. Use of the authority would be limited to 15 or fewer regional offices that will be selected

based on the number of backlogged claims, the total pending case workload, the length of time cases have been pending, the accuracy of completed claims and the overall timeliness of completed cases in each region.
We support this legislation because it will not only extend VA’s authority to use contract physicians to perform medical examinations for compensation purposes but because it will also allow VA to move resources to the areas with the most need. Veterans who are served by regional offices that experience high volume and delays should not be further delayed in receiving an examination if VA already has contract resources available. We believe that this legislation would provide VA with another important tool in addressing the backlog.
Thank you for the opportunity to testify concerning VetsFirst’s views on these important pieces of legislation. We remain committed to working in partnership to ensure that all veterans are able to reintegrate in to their communities and remain valued, contributing members of society.