I would like to thank Chairman John Hall and members of the subcommittee for inviting Veterans for Common Sense to offer testimony regarding regional office solutions to eliminate the enormous backlog of 650,000 claims at the Veterans Benefits Administration.  VCS is a non-profit organization based in Washington, DC, founded in 2002, providing advocacy for service members and veterans.

At a recent VCS meeting with veterans, one Iraq war combat veteran asked us, “What would a smooth running VBA regional office look like?”  We said it should be where veterans come first and where claims are decided accurately within 30 days.

VCS fully supports the superb recommendations already made by Harvard Professor Linda Bilmes, Morrison & Foerster’s Gordon Erspamer, and the Veterans Disability Benefits Commission.  In addition, we recognize the tremendous efforts by VBA rank-and-file staff, many of whom are veterans, for their work assisting veterans every day.

Backlog Causes

VCS believes there are five major reasons why VBA remains foundering in an ocean of incomplete claims, doubling from 325,000 claims in 2002 to 650,000 claims today.  Veterans now wait more than six months for an answer from VBA.   Most of the reasons are beyond the control of rank-and-file VBA employees working at regional offices:

1. Staffing: VBA lacks the money to hire enough staff to handle the increased volume or to adequately train existing staff to make accurate, complete and timely decisions.
2. Process: VBA’s complex and adversarial rules, VBA’s 26-page claim form, and VBA’s lack of due process make deciding claims unreasonably complicated.
3. Volume: More claims – with an increase of 17 percent more issues per claim over the past six years – keep flooding into VBA, such as Vietnam War veterans seeking benefits for Agent Orange poisoning and PTSD, as well as other veterans seeking a financial safety net due to a weak economy.
4. The Iraq and Afghanistan Wars: The two wars generated 245,000 unanticipated VBA claims – again, with more issues per claim – with high rates of traumatic brain injury (TBI), post traumatic stress disorder (PTSD), and hearing loss.
5. Poor Leadership: VBA’s political leadership lacked the vision to become proactive and resolve VBA’s severe claims crisis.

When combined, these five factors created a perfect storm at VBA.  Compounded by institutional inertia and draconian budget restrictions from the Office of Management and Budget and the White House, the result is a catastrophic failure where the backlog and the length of time to process claims continues to grow.   Now hundreds of thousands of veterans go without disability payments and access to VA medical care because VBA remains rudderless, sinking, and far out to sea in a raging hurricane.

Future Challenges

Here are four significant additional challenges VBA faces:

1. The VBA capacity crisis is expected to worsen in the foreseeable future, as VA expects to process nearly one million new and re-opened claims next year.
2. VA regional offices received 245,000 unanticipated disability claims, yet 16 percent, or 39,000 veterans, are still waiting, on average six months, for a VA claim decision.
3. DoD already reports 68,000 non-fatal battlefield casualties from the two wars, and VA expects to treat 333,000 veteran patients during 2009, most of whom can be expected to file VBA disability claims, based on the activity of Gulf War veterans.
4. Veterans who served in the National Guard and Reserves are nearly three times as likely to have their claim denied than veterans from regular Active Duty (14% v. 5%).  VCS believes this discrepancy warrants an investigation by VA, the Department of Justice, and Congress because last year the difference was only two times as likely.

Solutions

VBA should use two avenues to fix problems: an incremental approach and an overhaul approach.  VBA must make immediate reforms while keeping its eyes focused on creating a robust system where VA can, in fact, produce prompt, complete, and accurate VA disability claim decisions with 30 days.  In the long-term, VCS suggests using the recommendations provided by the Veterans Disability Benefits Commission as a blueprint for the start of a desperately needed overhaul of VA, especially VBA.

In the short term, in addition to recommendations made by Bilmes, Erspamer, and the VDBC, we ask Congress to change the law and thus provide VBA regional office employees the tools to put our veterans first:

1. 1.      Automatically approve disability claims for TBI.  Congress should pass legislation to automatically approve disability benefits for deployed veterans who are diagnosed with TBI.  Such a law would simplify and expedite claims processing at regional offices.  According to the Defense and Veterans Brain Injury Center at Walter Reed Army Medical Center, up to 20 percent of Iraq and Afghanistan war veterans are at risk for TBI due to roadside bomb blasts.  One VA physician estimates up to 30 percent, or between 320,000 and 500,000 TBI cases.  However, the military does not document all bomb blasts, thus making it hard for VA to verify and to process TBI claims.  This new law would establish that a deployment to the Iraq and Afghanistan war zones means VBA concedes there was a concussive blast incident strong enough to cause the TBI, unless there is evidence to the contrary. Coupled with this recommendation is a requirement for mandatory full funding for VA to provide proper TBI screening for all 1.6 million of our service members sent to war zones since September 11, 2001.
2. Automatically approve disability claims for PTSD.  In July 2007, VCS asked Congress to pass legislation designed to automatically approve disability claims for veterans who are diagnosed with PTSD.  VCS believes such a law would simplify and expedite claims processing at regional offices.  Estimates range from 20 percent to 36 percent for Iraq and Afghanistan war veterans returning home with PTSD, or between 320,000 and 600,000 PTSD cases.  In a July 2004 Army study, the military documented 93 percent of soldiers and 97 percent of Marines experienced "being shot at or receiving small arms fire," indicating that nearly all soldiers are now involved in combat.  Congress should investigate why VA diagnosed 56,246 veterans with PTSD, yet approved only 34,138 PTSD disability claims, or only 61 percent.  Are the 22,000+ claims pending, denied, or under appeal?  Do veterans receiving free VHA healthcare know about VBA?  A major problem facing veterans and regional office staff is the military’s lack of records for all combat engagements.  PTSD claims should be automatically approved with the understanding that deployment to Iraq and Afghanistan means VBA concedes there was at least one stressor sufficient enough to cause PTSD, unless there is evidence to the contrary.
3. Expand Benefits Delivery at Discharge.  One of VBA’s biggest hurdles at regional offices is obtaining military service and medical records.  With a complete forward deployment of VBA staff at military bases, including all National Guard and Reserve armory and demobilization sites, VBA would have immediate and full access to records before they are shipped off to storage, misplaced, or destroyed.  Congress should change the law so that all service members can file claims while still in the military.  Currently, this is not available at all military installations, and is noticeably absent for our Reserve and National Guard.  Congress should require any VBA employee stationed at a military facility to be trained and authorized to assist with both military and VA healthcare and claims paperwork.  Coupled with this suggestion is the need for DoD to comply with 38 USC Section 5106 and provide military service records and military medical records to VA and to the veteran at discharge and for VHA to automatically enroll all new service members upon enlistment.
4. Hold VBA Accountable.  In the end, VCS believes there must be accountability at VBA.  At present, VCS is aware of only a very small number of VBA employees who have faced adverse consequences for incomplete, incorrect, negligent, or criminal activities involving veterans’ claims.  VCS asks Congress to request statistics from VBA that show the number of VBA employees who faced personnel actions (counseling, reprimands, demotion, transfer, or termination) as a result of a poor performance evaluation associated with developing or approving claims – and this should include all VBA staff, from rating specialists to supervisors to executives.

VCS believes accountability for VBA must rest with the highest official at VBA, the Under Secretary for Benefits, Daniel Cooper.  After six years, he provided only small incremental changes rather than both incremental change and a massive overhaul.  Congress must hold the entire Administration – VBA, VA, OMB, and the White House – accountable for this systemic failure to assist our disabled veterans, lest this problem continue indefinitely even if a new Under Secretary were confirmed.

Here is a chronology showing the Under Secretary was fully aware of VBA’s crisis before he became Under Secretary, yet he failed to deliver for our veterans:

• In early 2001, then-Secretary Anthony Principi recognized challenges at VBA, and he created the “Claims Processing Task Force,” naming Cooper to lead it, even though he had no experience with VA.  He was a retired Navy Vice Admiral who served on the board of directors for Exelon, a nuclear power company, and USAA, an insurance and banking company.
• In October 2001, Cooper issued his Task Force report, which made dozens of thoughtful incremental recommendations, including holding VBA employees accountable.  In November 2001, the full Committee held a hearing to discuss the work of the Task Force.  After 9/11 and after the invasion of Afghanistan, Cooper told the full Committee, “In my opinion, today, there are enough resources in VBA to do the job that has to be done” (page 16).
• In December 2001, with more troops pouring into Afghanistan and with plans on the table to invade Iraq, Cooper provided additional written answers to the full Committee’s questions about staffing resources.  Cooper wrote, “At the hearing, I specifically stated that new resources (i.e., FTE) should not be provided” (page 166).  Given that there were hundreds of thousands of claims from half of our Gulf War conflict veterans, why did he not plan for nor act on the needs of a new generation of war veterans when he became Under Secretary in 2002?

Conclusion

A failure to address VBA’s claims catastrophe has needlessly increased suffering among our veterans and their families.  According to published government and news reports, the number of broken homes, unemployed veterans, drug and alcohol abuse, suicides, and homelessness all rose – problems expected to worsen without immediate action to resolve VBA’s claims crisis.  VCS believes VA, VBA, and Congressional leaders should work closely with VBA employees and advocates to find solutions.  VCS respectfully requests our ethics complaint against the Under Secretary for Benefits sent to DoJ on September 4, 2007, be entered into the hearing record.