Mr. Chairman, Ranking Member Lamborn, distinguished Members of the Committee, thank you for the opportunity to testify before you today regarding the use of technology to improve the efficiency of the Department of Veterans Affairs claims process.  My name is John Roberts, and I am the National Service Director for the Wounded Warrior Project (WWP), a non-profit, non-partisan organization dedicated to assisting the men and women of the United States Armed Forces who have been injured during the current conflicts around the world. As a result of our direct, daily contact with these wounded warriors, we have a unique perspective on their needs and the obstacles they face as they attempt to transition and reintegrate into their communities. 

In addition to my experience with WWP in general and the Cleveland’s specifically, I am a service-connected veteran, a former veterans service officer, and was most recently a supervisor with the Houston VA Regional Office where I reviewed claims and became familiar with a number of significant deficiencies within the system.

In order to fully appreciate the problem, it is important to understand how the system currently operates.  Despite recent advances in technology common to most businesses, the Veterans Benefits Administration (VBA) claims processing system is still dependent on a paper system.  Although the VBA can now view electronic health records transmitted from the Veterans Health Administration (VHA), the ratings team is still required to print the records and place them in the veteran claims folder, which are then reviewed page by page by a Rating Veterans Service Representative. 

The current model of the VBA claims processing system has a total of six separate teams and often, but not always, includes another team that is dedicated to processing only the OIF/OEF cases.  The six main teams are as follows:

• Triage which handles the incoming claims, evidence, and is charged with maintaining the outdated file cabinet system, which stores the hard copy paper claims files

• Pre-Determination which is charged with the initial development of all claims for service connected disability.

• Rating is responsible for reviewing all available evidence and determining if disabilities are service related.  If so, the percentage of disability assigned.

• Post Determination is responsible for inputting awards and generating notification letters to the claimants.

• Appeals maintains all pending appeals submitted by the claimants.

• Public Contact is charged with the general phone calls and questions and conducting one-on-one interviews with the veterans, dependents and survivors.

Files must be hand carried to each of the teams, and any member of these teams has access to the records at any given time.

Despite the number of people with access and the ease with which a file may be misplaced, VBA has only one way to locate a claim file once it is removed from the filing cabinet. An electronic system called COVERS is available, but is only effective if utilized by the individual employee.  Rather than having access to the file through electronic means, COVERS requires manual input to identify a specific location or individual.  If this is not done, it is a very time consuming task to locate one file among all the files that are in the processing system.   For example, in the Houston Regional Office (RO), there are approximately 200 employees and each person could have up to 30 files or more on his/her desk. 

Another challenge is the outdated filing system used to store the thousands of active files warehoused either at or near each Regional Office.  If a File Clerk or any employee for that matter is not paying attention and misfiles a claims folder into the wrong cabinet or drawer, it again becomes a very time consuming and difficult task to check each and every drawer to locate the missing file.

The Triage team at each RO is also responsible for the intake of all new claims and all evidence submitted by each and every claimant.  If the file is not easily located, it is placed on search within the Covers system, until the file can be located.  Because there are so many teams within the claims processing system, a particular file could be located within any of the teams at given time.  This allows for the human error factor, which is often why the numerous pieces of vital evidence are often lost or misplaced and cannot be associated with the appropriate claim folder.  

If a file cannot be located and all avenues have been exhausted to locate the file, the RO will then take action to rebuild the folder from scratch.  This means that all prior evidence and claims submitted by the claimant are also lost.  The responsibility to replace the missing evidence or claims is placed on the claimant.  The VA will ask the claimant to submit any copies that he/she may have in their possession.

In addition, due to the current war on terrorism, VBA is faced with another challenge.  The new challenge is trying to obtain records from National Guard and Reserve units.  Active duty forces obviously do not file a claim until released from service.  Once demobilized a member of the Reserve or National Guard component is eligible to file such a claim.  If reactivated, however, the Reservist’s claim is halted and he/she takes the medical file with them to the theater. 

There is also the large backlog of records requests to the Records Management Center which houses not only claim folders, but now receives all service medical records for recently discharged servicemen.  Think of this as a large warehouse of nothing but paper files and an inadequate staff to locate each and every file or record that has been requested by Regional Offices across the country. 

Another significant issue which can be identified at every Regional Office around the country is the varying levels of experience with the Rating Veterans Service Representatives (RVSR).  In any given case, you could take five individual RVSR’s and give them the same file and come up with five different opinions on how the case should be rated.  Although there have been improvements with the implementation of RBA 2000, the current electronic system utilized to rate compensation claims, the system is far from perfect.  The overall ratings decision including service connection and actual percentage is left up to the interpretation of the individual RVSR.  The gap in varying decisions nation wide can also be attributed to local policy at each individual Regional Office.  While this has been the case for many years, the issue has come to a head due to the increased frequency with which this generation of veterans speak to each other and compare their individual situations. 

Mr. Chairman, unfortunately, these are only a few of the issues that surround a paper-based system, and situations like that of the Cleveland’s are not unique.  Many working groups, Government Accountability Office reports, and commissions have made recommendations on this topic.  Most recently, the Veterans Disability Benefits Commission suggested that claims cycle times and accuracy could be improved by “establishing a simplified and expedited process for well-documented claims, using best business practices and maximum feasible use of information technology.” While the availability of well-trained, customer service minded employees cannot be overvalued,  the implementation of recommendations such as these can help to greatly reduce the complexity of the claims processing system and result in timely results. 

WWP looks forward to working with you and the VA to try to resolve these problems.  Thank you again for the opportunity to testify today, and I will be happy to answer any questions you may have.