Dear Chairman and Members of the Subcommittee:

The American Federation of Government Employees, AFL-CIO, which represents more than 600,000 federal employees who serve the American people across the nation and around the world, including roughly 160,000 employees in the Department of Veterans Affairs (VA), is honored to testify today regarding the Veterans Benefits Administration (VBA) claims processing system and the current claims backlog.

The current backlog and waiting times for pending claims are unprecedented and unacceptable. Our veterans served our country when they were needed. It is imperative that we serve them when they are in need.  

AFGE is the sole employee representative of Veterans Service Representatives (VSRs), Rating Specialists (RVSRs), Decision Review Officers (DROs) and other VBA employees. A large number of these employees are veterans, and many are service connected themselves. (We hope that VBA will increase its hiring of preference eligibles to ensure that the valuable perspective of the veteran remains part of the claims process, but that is a subject for another hearing.) Therefore, AFGE is in a unique position to convey the sense of mounting pressure, frustration and demoralization at the front lines in the face of this backlog.

AFGE is also in a unique position to identify approaches to improving the quality and timeliness of the process. The input of the VBA workforce is essential to any claims reform process because the skills of a VBA claims processor are unique. Unlike skills such as medical care and information technology that are largely transferable from one workplace to another, VBA claims processing is learned entirely on the job.  Consequently, the employees who have been developing and rating cases for much of their career are extremely valuable sources of guidance. 

Sadly, the VA does not recognize what these employees have to offer. In recent years, management has increasingly excluded AFGE from national level efforts to improve the claims process, VSR Certification testing and training.  At the local level, our members report that they are regularly rebuffed by management when they attempt to make suggestions for process improvement. These days, management wants one thing, and only one thing from the VBA workforce: produce claims as fast as possible.

Employee representatives and veterans’ service organizations (VSO) are the eyes and ears on the ground, and we engage in a regular dialogue about different reform approaches. Both are key stakeholders who should be included in VBA policy setting groups.

RECOMMENDATION: Congress should establish a Joint VSO-AFGE Advisory Committee to make recommendations on needed improvements to the claims process, and related issues of training, skills certification and production standards. 

The unrelenting pressure “to make the numbers” starts at the top with VA Central Office (VACO) where individual station goals are set.  The RO director’s performance is measured by the total number of claims produced, not the quality of completed work or quality of the training provided to the employees who perform the work.  As a result, new employees lose critical on-the-job training because supervisors who are trying to meet their own production goals assign cases to them before they are fully trained.  Similarly, managers frequently cut short training for experienced employees who rely on continuing education to become familiar with the steady stream of new laws, court cases, and benefits programs that directly impact claims determinations.   It is also common for rating specialists who have recently been promoted from VSR positions to have their critical on-the-job training interrupted so they can perform VSR duties. All these training gaps contribute to the backlog.

Issuing new mandates without accountability leaves the VBA with just that: more mandates. VBA is not held accountable for the quality and consistency of training at each RO.  VBA’s national training program operates more as a guideline, rather than a requirement to follow a mandatory curriculum and training schedule. VBA now mandates training, and proudly points out that each RO is required  to provide employees with 80 hours of training per year.  However, VBA never explained how it determined that 80 hours, not more, not less, was adequate.

Recommendation: The Joint VSO-AFGE Advisory Committee should oversee the VBA training process and make recommendations to Congress about ways to improve current training programs.  Training and accuracy of claims determinations should be included in management performance measures.

Persistent problems with the VSR Skills Certification test also adversely impact VBA’s ability to reduce the claims backlog. Pursuant to an agreement between VBA and AFGE, qualified GS-10 VSRs who pass a skills certification test can receive a noncompetitive promotion to a GS-11. Contrary to assurances from VBA and the terms of our agreement, the training is not always sufficiently aligned with the scope of the exam, and trainers are often confused about which training materials are relevant to the test.  In addition, extremely low passage rates (that also raise questions about the test’s validity) are demoralizing to competent VSRs with years of experience.  At the same time, management refuses to provide employees with useful feedback on the questions they missed.

AFGE was not allowed to collaborate in the process of refining the test and working out test administration problems.  We were also denied access to raw test data to help address low passage rates.   

Recommendation: Congress should require VBA to release to AFGE  complete demographics on skill certification test results.  VSRs should be provided with adequate feedback on their test scores to allow them to strengthen their understanding of all relevant concepts.

Our members desperately want to reduce the backlog, and when a new proposal to accomplish that emerges, they feel a sense of renewed hope.  Yet time and again, those proposals fall victim to the same forces: poor implementation, lack of accountability and inadequate training. 

AFGE initially worked with VBA on the development of the Claims Process Improvement Initiative (CPI) Model, and reached an agreement on the recommendations of the CPI Task Force. Even though VBA has since made a number of revisions to the CPI model, such as centralizing the Public Contact Unit, employee representatives were excluded from recent Task Force meetings. When CPI was implemented in 2002, it was supposed to provide a uniform national model for all ROs. Instead, six years later, we have “57 varieties”, that is, 57 different ways of applying the CPI model to the claims process.  The Program Director for the Compensation and Pension (C&P) Service is not being held accountable for consistent implementation of this model.

Similarly, VBA welcomes each new set of Government Accountability Office (GAO) recommendations, but fails to implement them.  Again, accountability is the key. . 

Recommendation: AFGE supports the recommendation in the veterans’ 2008 Independent Budget (IB) to hold the Compensation and Disability Program Director more accountable for the performance of RO directors, including the quality and consistency of training provided to claims processors. 

VBA claims process reform adds new meaning to the familiar quote, “Those who don't know history are destined to repeat it.”   Before Congress embarks on a search for a new approach to improving this process, we urge you to consider the reasons why previous attempts to reform the claims process have failed.

We see a renewed interest is using Artificial Intelligence (AI) to expedite the claims process. AI may have some utility in helping a veteran file a claim, but our members see much less utility in AI’s ability to help a VSR or RVSR work a claim. Certainly in its current stage of development, AI is not advanced enough to replace the individual experience-based judgment of a VSR or Rating Specialist who is adept at “reading between the lines” of a claimant’s record.   

 VBA also mandates production standards, but we fear they are based more on politics and bonuses rather than the requirements of the many complex, multiple claims being filed by veterans at the current time. Again, mandates without accountability or scientific basis will not bring about meaningful claims process reform. One member explains flawed production standards as follows: “Like an engine, when an employee is run too long at too high an RPM without fresh oil, it will inevitably begin to perform poorly and eventually quit.”

Currently, VBA managers, many of whom have not adjudicated a claim for many years (or never), define performance solely in terms of inventory and days pending completion of a decision. In addition, employees and their representatives are never invited to participate on teams that develop employee performance standards. 

Production standards and staffing should be based on scientific methodology, not politics. VBA has never done a time - motion study of the claims process, to determine how many hours are required to process claims of different categories and complexity. This should be the first step in any reform process.

AFGE is aware of only one extremely limited attempt to conduct a study along these lines but it failed to produce any useful findings. Management placed a software program on a sampling of employees' computers in an undetermined number of ROs, with no explanation of how they selected the sample. The data was collected by a program appearing on the screen every few hours to ask what the employee was doing. The program did not differentiate between employees working on a single claim and multiple claims.  Again, with input from VSOs and employee representatives, the findings of a more meaningful study can be used to establish and regularly update production standards and set appropriate staffing.

Recommendation: VBA should conduct a scientific time-motion study of the resources and skills required to do the current mix of increasingly complex claims.

We also caution the Subcommittee about further centralization of VBA functions.  VBA regularly touts centralization as synonymous with management efficiencies. In addition to extensive centralization of VBA functions outside of Compensation and Pensions (C&P), VBA has centralized its 57 Call Centers down to 9 centers in operation today, and is planning to centralize the Fiduciary Program.  Yet, VBA has never been held accountable for proving that centralization improved its operations.  Centralization puts a greater distance between the veteran and the claims process. The taxpayer and the veteran deserve a careful assessment of the costs and benefits of centralization before we centralize more functions or continue centralized operations already in place.  

Recommendation: The impact of centralization on VBA functions should be assessed and compared with alternative, more decentralized approaches to delivering services.  

Our members have identified a number of specific fixes for expediting and improving the claims adjudication process. However, AFGE continues to have great difficulty in obtaining information from management, and as noted, is increasingly left out of key policy setting groups. Therefore, this list is somewhat limited.

Vetsnet: Problems Remain

Although VBA started to phase in the Vetsnet program to replace the Benefits Delivery Network (BDN) nearly twenty years ago, significant glitches remain. For example, there remains a redundancy in the process of inputting information, more specifically, employees have to have multiple applications open at the same time and enter duplicative information because these programs do not "talk to one another."  It would be more efficient if the system automatically made the updates when employees enter new veteran information.  VBA made a commitment to address this defect but has not done so to date.

Recommendation:  AFGE supports the recommendation of the 2008 veterans’ Independent Budget to complete the phase-in of Vetsnet. VBA should be required to consult with the Joint VSO-AFGE Advisory Committee on a regular basis to identify future problems that emerge as the transition from BDN to Vetsnet proceeds. VBA should develop an online “suggestion box” to which employees can submit reports of problems associated with Vetsnet.

 “Benefits Delivery and Discharge“Authority

VBA already has the authority under current regulations to award benefits for one year payable immediately upon discharge from active duty.  Known as Benefits Delivery at Discharge (BDD), this allows VBA to give seriously injured new veterans immediate compensation during their recovery through a 50% or 100% rating. Their claims are reevaluated a year later to see if their conditions have worsened or improved. 

Recommendation: VBA should expand the use of Benefits Delivery and Discharge authority to expedite processing of appropriate claims.

Paperless Records:  AFGE also supports the recommendation of the 2008 Independent Budget to further develop and enhance a paperless records system.  VBA employees already have limited access to electronic medical records from VA medical centers, which enables them to conduct an effective online search for needed medical evidence. However, military records are still only available in hard copy.  As VBA moves toward an electronic records system, we urge them to take steps to ensure that these files are readable and that the system has a strong online search capability so evidence can be efficiently located.

Recommendation: The Subcommittee should move towards a fully paperless records system, and should examine similar efforts already in place for VBA education claims for lessons learned.

Assembly lines and widgets: the wrong approach to veterans’ disability claims

In the words of another member, CPI takes an assembly line approach to claim processing, i.e. CPI divides up the tasks, so that one employee installs the headlights, another the tires.  Whereas in the past, employees did everything from taking the claim to issuing the final decision, now, once the employee “installs the headlights”, he or she has no knowledge of or investment in the outcome of the claim.  When a case is remanded from the Board of Veterans Appeals or the courts, a new employee has to learn the claim all over again.  The same employee should handle a claim at all stages.

Another practice from the past that should be revived are regular (usually weekly) meetings among claims adjudication staff to review new cases, changes in the law and share best practices, This practice seems to have disappeared along with the case management approach that CPI replaced.

Recommendation: VBA and the Joint VSO-AFGE Advisory Committee should reexamine the case management model to determine whether some of its features should be brought back to the claims process, including regular case meetings in each RO and having the same employee handle cases from application to appeal.

We look forward to working with Chairman Hall and members of the Subcommittee to identifying approaches to improving the VBA claims process and ensuring that VBA considers regular input from employees, their representatives, and the veterans’ community.  Thank you.