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Witness Testimony of Ms. Diana Rubens, Deputy Under Secretary for Field Operations, Veterans Benefits Administration, U.S. Department of Veterans Affairs

Good morning Chairman Runyan, Ranking Member McNerney, and Members of the Subcommittee.  Thank you for the opportunity to discuss the Veterans Benefits Administration’s (VBA’s) work with the Texas Veterans Commission (TVC) to expedite claims processing for Texas Veterans.  I am accompanied today by Mr. John Limpose, Director of VBA’s Waco Regional Office (RO).  VA is committed to achieving our goal of processing all claims within 125 days with 98 percent accuracy in 2015, and assistance from stakeholders like TVC is critical to our success in improving the timeliness and accuracy of the claims process. 

VBA Transformation

VBA is in the midst of implementing its Transformation Plan and is relying on support from stakeholders to better serve our Veterans, Servicemembers, and their families.  This transformation changes interactions with our employees, other Federal agencies, Veterans Service Organizations (VSOs), and state and county service officers, such as TVC.

VBA’s transformation is demanded by a new era, emerging technologies, the latest demographic realities, and our renewed commitment to today’s Veterans, family members, and survivors.  In the face of dramatically increasing workloads, VBA must deliver first-rate and timely benefits and services – and they must be delivered with greater efficiency.  VBA is aggressively pursuing its Transformation Plan, a series of tightly integrated people, process, and technology initiatives designed to eliminate the claims backlog and achieve our goal of processing all claims within 125 days with 98 percent quality in 2015. 

VBA is working to simplify processes and reduce the burden of paperwork for both Veterans and our workforce.  Many of our transformation initiatives will improve efficiency and customer service.  While stakeholder engagement is important to nearly all of VBA’s transformation initiatives, I would like to highlight three initiatives, the eBenefits web portal, disability benefit questionnaires (DBQs) and the fully developed claims (FDC) program, in which Veterans service officers play a vital role. 

eBenefits:  Veterans now have access to benefit information from multiple channels – on the phone, online, or through the Department of Defense (DoD) and Department of Veterans Affairs (VA) shared portal called eBenefits.  The eBenefits portal provides over 45 self-service features to check the status of a claim or appeal; review the history of VA payments; request and download military personnel records; secure a certificate of eligibility for a VA home loan; and numerous other benefit actions.  eBenefits enrollment now exceeds 1.8 million users, and VA expects enrollment to exceed 2.5 million by the end of 2013.  VA is engaging our VSO, state and county partners in registering Veterans for eBenefits accounts.

DBQs:  DBQs are templates that solicit the medical information necessary to evaluate Veterans’ medical conditions.  VA has made 71 DBQs available to the public, so that Veterans can take them to their private physicians for completion.  Ten additional DBQs for specialized medical examinations and opinions are used by VA physicians, bringing the total number of DBQs to 81.  DBQs facilitate submission of a fully developed claim, the fastest means of getting a claim processed.  VBA is informing stakeholders, particularly VSOs and state and county partners, about DBQs so they can encourage Veterans to utilize these templates and receive more timely and accurate rating decisions. 

FDC:  A Fully- Developed Claim (FDC) is a Veterans disability benefit claim that consists of a complete application, all Military and civilian medical treatment records, and relevant Military personnel records to include the DD 214.  Veterans participating in the FDC program, often supported by their VSO representatives, send all the required evidence with their claims and certify that they have nothing further to provide.  By doing this, they dramatically reduce the processing time of their claim.  The more claims we receive that are fully developed, the faster we can make decisions.  Currently, claims submitted under the FDC program are processed in an average of 115 days.  However, only three percent of claims from VSOs and state and county service officers are currently submitted through the FDC Program.  VBA’s target for FY 2013 is to increase this percentage to 20 percent – meaning VBA will have the ability, if this goal is reached, to complete 153,000 more claims before they can become backlogged.  VBA is exploring both monetary and nonmonetary incentives for its VSO partners to increase FDC submission because of the impact this would have on claims-decision timeliness. 

Initial TVC Pilots

The Waco RO first conducted a pilot, the Development Assistant Pilot Project (DAPP), from June 2008 through January 2009.  In this partnership, four TVC employees assisted with the review and development of cases needing rating decisions.  VA gave TVC counselors 32 hours of training in claims processing.  Follow-up training was also given to counselors on an “as needed” basis.  A VBA first-line supervisor was assigned to provide subject matter expertise, oversight, guidance, and review of the work each counselor completed.  TVC touched over 1,600 claims, 33 percent of those claims were made ready for decision.  Evidence was received in an average of 11 days during our initial partnership with TVC. 

An additional pilot, the Claims Processing Assistance Team (CPAT), was conducted with TVC and the Waco and Houston ROs from November 2009 through July 2011.  TVC had funding available to support CPAT.  TVC dedicated 12 full-time counselors to contact claimants by telephone, e-mail, or other means to facilitate completion of required development.  CPAT members also worked with health care providers and DoD to expedite receipt of requested information needed to complete claims.

TVC’s review was limited to claims where TVC was designated as the claimant’s accredited representative.  They were and are unable to assist with the entirety of the Waco and Houston ROs’ workload.  Claims determined to be ready-for-decision were forwarded to the ROs’ decision makers for expedited action. 

TVC Strike Force Teams

The Texas State Legislature’s 2012-2013 biennial budget includes $1.5 million to create TVC Strike Force Teams to work side-by-side with the Houston and Waco ROs to reduce the number of pending claims and appeals.  On August 15, 2012, a planning meeting was conducted between leadership of TVC and the Houston and Waco ROs.  At the meeting, TVC committed to assign 34 counselors to the Strike Force Team.  Thirteen TVC counselors will be stationed at each RO, five of whom will concentrate on gathering evidence and working with Veterans to submit FDCs, and the other eight will focus on pending claims and appeals.  The remaining eight counselors will be stationed at key field locations around the state.

Similar to the previous pilots, TVC counselors on the Strike Force Teams will assist by gathering evidence from Veterans and securing health-care records to expedite claims processing.  However, the new partnership will do much more than the CPAT pilot to support submission of FDCs as well as DBQs.  VBA hopes that with the assistance of TVC’s Strike Force Team, we will far exceed our goal of receiving 20 percent of claims from Veterans represented by TVC through the FDC program by the end of fiscal year 2013. 

As of September 11, 2012, the Houston RO’s inventory of pending disability claims included 38,088 claims, of which 27,981 or 75 percent were pending longer than 125 days and are considered to be part of VA’s backlog.  The Waco RO’s inventory included 50,039 claims, of which 38,217 or 76 percent were pending over 125 days.  The ultimate goal of our partnership with TVC is to impact these numbers in a positive manner, and provide the Veterans in Texas with fast and accurate service. 

In addition to FDC claims, TVC will also assist the Houston and Waco ROs with their appeals inventory by working with appellants to identify cases in which appealed issues may be resolved through written submissions or informal conferences without the need for a hearing and to determine whether a partial grant of benefits by VA resolved the appeal to the appellant’s satisfaction.

VBA has provided desk space in the in both Houston and Waco ROs for all TVC employees.  They will be provided training with a special focus on FDC.  The TVC Strike Force Teams will also have VBA tools and training materials at their disposal and may consult with members of the ROs’ Quality Review and Training Teams on an as-needed basis.  RO staff will provide regular feedback regarding the quality of the cases deemed ready-for-decision by TVC. 

FDC Partnerships in Other States

Since our last partnership with TVC, VA has been reviewing and reengineering our business processes in collaboration with both internal and external stakeholders, including VSOs, state and county service officers, and Congress, to constantly improve our claims process using best practices and ideas.  There are approximately 8,000 Veterans service officers nationwide, and they are an integral part of our transformation initiatives, particularly the FDC program.

In December 2009, the Chicago RO was selected to pilot the FDC initiative.  Since the beginning of the FDC program, open and continual communication has occurred between the Chicago RO and the collocated VSOs.  Through this pilot, VBA confirmed that the FDCs allow employees to spend less time developing and gathering evidence for claims and spend more time rating claims and reducing the backlog. 

The Togus Regional Office has also established a robust FDC program by forming a strong relationship with VSOs in the Maine.  VBA especially recognizes the Maine Department of Veterans Services for the outstanding assistance they are providing to the Veterans they represent, submitting 42 percent of their claims as FDCs.

On July 31, 2012, an FDC workshop was held in Washington, DC, for representatives from 10 VSOs.  The goal of the workshop was to emphasize the positive impact of filing FDCs, and VBA emphasized that the receipt of DBQs with FDCs would further improve processing time.  A presentation on the technical process of submitting a FDC was provided, and the Director of the Chicago Regional Office led a discussion on how ROs and VSOs can work together to increase participation in the FDC program. 

Conclusion

VSOs and state and county service officers, such as TVC, are important partners in VBA’s transformation to better serve Veterans, their families, and survivors.  In our pilot projects with TVC, VBA experienced positive outcomes; we believe there are greater opportunities to improve service and productivity in the new partnership with TVC.  The broader scope from the new Strike Force Teams can assist VBA in decreasing the backlog in the Houston and Waco RO’s.  VA is working on a standard operating procedure that will clearly outline the responsibilities of both VA and TVC and assist the agencies in ensuring a smooth process.  VA will carefully track and monitor the Strike Force Teams and assess the potential for future partnerships or pilots to be expanded to other ROs. 

Mr. Chairman, this concludes my statement.  I would be pleased to answer any questions you or other Members of the Subcommittee may have.