Chairman Hall, Ranking Member Lamborn and members of the Subcommittee, thank you for inviting Veterans for Common Sense (VCS) to present our comments about “The State of the Veterans Benefits Administration” (VBA).

VCS appreciates the many hearings and round table discussions this Subcommittee has held in the past few years on this topic of vital interest to our veterans and families.

We seek a broader relationship between VBA and VBA’s many stakeholders.  For example, we support additional hearings devoted to individual veterans offering their views about their challenges with VBA as well as their ideas for improving VBA.  In another example, we support a greater dialog with the private sector to find innovative ideas to kick-start VBA into the 21st Century.  All of this can easily be accomplished with a White House – Congressional – Veteran Advocate conference open to the public so we can cast a wide net for short-term and long-term solutions.

Progress reforming VBA begins by listening to veterans and advocates.  Allow us to begin today by stating our goal is to work closely with VBA so our veterans receive both prompt and high-quality healthcare and disability benefits.  In many instances, an approved VBA claim is required before a veteran receives medical care. 

Our testimony contains four parts.  Our first part highlights promising news about the current state of VBA.  Our second part lists troubling challenges needing prompt attention.  Our third part, from our web site, www.FixVA.org, describes VBA’s systemic problems.  And our fourth part offers a few pragmatic and progressive VCS solutions for the consideration of Congress and VA leaders also posted at www.FixVA.org.

Part One: Recent Promising News About VBA

On February 4, 2010, VCS listened to VA Secretary Eric Shinseki testify before Congress and announce that fixing VBA was his top priority for this year.  We commend him for addressing this serious issue.  VCS wants him and all of VBA to succeed, as this is in the best interest of our veterans and our families.

On March 18, 2010, VCS listened as VA’s top information technology advisor, Peter Levin, told Chairman Bob Filner and dozens of veterans’ advocates, “In my judgment, [VBA] cannot be fixed.  We need to build a new [claims] system, and that is exactly what we are going to do."  This admission of the scope and severity of VBA’s crisis of poor quality combined with long delays was a critical first step toward reforming VBA.

On May 7, 2010, VA announced VBA would contract to build a simplified processing system for Vietnam War veterans’ claims for disabilities.  Scientists linked exposure to Agent Orange (dioxin) poisoning in Southeast Asia to several serious health conditions.  VCS supports VA’s decision, and we will be monitoring this public-private effort.

On June 2, 2010, the Office of Management and Budget approved VBA’s new Form 21-526EZ, an express disability compensation claim.  VCS hopes a new form may reduce the burdensome and frustrating 26-page claim obstacle course our veterans now face.  We believe, when implemented, the new form may make it easier for veterans to file claims, easier for advocates to assist veterans, and easier for VBA staff to process accurate claims.

On June 10, 2010, VCS reviewed briefing materials concerning VBA’s pilot programs intended to improve claim processing quality and timeliness.  Overall, VCS supports these endeavors, so long as they actually improve accuracy and speed.  The pilots must also be scalable: meaning VBA must be able to apply the pilot (or successful parts of it) to the entire VBA system within a short time frame.  VBA’s pilots adopt a veteran-centered approach, and VCS salutes this culture change.  VCS reserves judgment on the pilots until VBA releases final reports about the completed pilot programs.    

Part Two: Troubling News About VBA

While tackling some of VBA’s systemic challenges, VBA continues to face serious obstacles stalling VA Secretary Shinseki’s vision of transforming VBA.

Leadership Vacancies.  As of June 8, 2010, VBA remains leaderless. There is no permanent Under Secretary or Deputy Under Secretary.  VCS urges VA Secretary Eric Shinseki to fill the positions as quickly as possible with qualified veteran advocates who will continue his efforts to transform VBA.  We strongly encourage VBA’s soon-to-be-selected leaders to bring on board a team of dozens of subject matter experts focused on two goals.  The first goal should be to improve both the quality and timeliness of claim decisions.  The second goal should be to develop and implement a long-range plan to overhaul VBA’s information technology, training, regulations, and leadership.

Unacceptably High Error Rate.  VBA’s error rate processing claims hovers at more than 25 percent, according to VA’s Office of the Inspector General (OIG).  Of particular concern are high error rates for PTSD and Agent Orange claims.  We refer the Subcommittee to a hearing held earlier this month regarding VBA’s inability to implement recommendations made by OIG and agreed to by VBA.  VCS urges VA to instituted total quality management controls as well as auditing to reduce the error rate.  VCS has posted VA OIG audits at our program web site, www.FixVA.org.

Tidal Wave of Claims.  VA estimates the number of claims flooding into VBA may reach one million this year, creating additional burdens on VBA to process more claims.  VCS urges VBA to closely monitor claims filed, granted, and denied by period of service, gender, age, and condition in order to have a more robust picture of emerging trends.  VA currently receives one million new claims each year, and the total of all pending claims, appeals, and other claim-related work is in excess of one million.  Demand for VBA benefits may remain at a high rate for many years due to:

• Iraq and Afghanistan claims.  The two wars already caused nearly 500,000 new claims, with 500,000 more expected in the next five years.
• Vietnam War claims.  Scientific evidence linking Agent Orange poisoning to medical conditions may result in hundreds of thousands of new claims.
• PTSD claims.  Scientific evidence linking deployment to a war zones with PTSD may result in tens of thousands of new and re-opened claims.
• Gulf War claims.  Scientific evidence linking toxic exposures during the 1991 war may result in tens of thousands of additional claims. 
• Economic Recession.  The economic recession and high unemployment causes some veterans to file more claims against VBA in order to obtain care.

Education Benefits Debacle.  VBA’s failure to implement the Post-9/11 GI Bill education benefits could have easily been prevented if VA, Congress, and veterans’ groups cooperated on the design, construction, and implementation starting in 2007.  If there was greater communication and cooperation among legislators, VA, and veteran stakeholders, then the crisis may have been mitigated or prevented.

VA’s Anti-Veteran Legislative Proposal.  On May 25, 2010, VA sent a letter to Speaker of the House Nancy Pelosi containing draft legislation focusing on VBA.  VCS objects to VA’s efforts to restrict veterans’ due process rights to retain counsel for claim appeals.  VCS provided VA and Chairman Filner with a letter detailing some of our major objections.  

Unfinished Gulf War Issues.  On May 3, 2010, VCS submitted comments regarding VA’s draft Gulf War Veterans’ Illness Task Force report.  VCS awaits VA Secretary Shinseki’s response to our comments, especially those about improving disability compensation benefits for Gulf War veterans.  The 20th anniversary of the start of the conflict, now the longest in U.S. history, represents an opportunity for VA to conduct outreach for research, healthcare, and benefits for our Gulf War veterans.

PTSD Claim Regulations.  On October 14, 2009, VCS submitted comments regarding VA’s proposed regulations granting a presumption of service connection for PTSD for veterans diagnosed with PTSD who deployed to a war zone.  VCS supports VA Secretary Shinseki’s bold initiative, and we hope VA publishes the final regulations soon so veterans may receive care and benefits.  We urge VA to work transparently with veterans’ advocates and Congress so we can monitor the implementation of the new regulations.

Historical Pattern of Neglect.  The press coverage about VBA remains unflattering, due in part to what appears to be a lack of media outreach by VBA.  We hope this can change soon, with more news in the press about fewer VA errors and shorter wait times for veterans. 

• On August 13, 2003, the Wall Street Journal reported on the tragic plight of Afghanistan War veteran Jason Stiffler.  While deployed, Stiffler was injured and suffered psychological trauma, leading him to have both traumatic brain injury (TBI) and post traumatic stress disorder (PTSD).  Nearly seven years ago, the estimate of Iraq and Afghanistan claims was only 50,000.  Today, VBA has received nearly 500,000 claims from current war veterans.  Seven years ago, the number of claims sitting at the Board of Veterans appeals was just over 100,000.   Today, the Board has 200,000 pending appeals.   VCS asks the Subcommittee to read the article: http://www.veteransforcommonsense.org/index.php/veterans-category-articles/1766-wall-street-journal
• On June 7 and again on June 9, 2010, National Public Radio (NPR) aired two lengthy investigative reports about TBI.  The two NPR articles describe significant problems for soldiers caused by the military due the lack of awareness, exams, and treatment for TBI.  VCS urges VBA to be aware of the military’s lack of exams and treatment when it comes to reviewing veterans’ claims for TBI. VCS asks the Subcommittee to read the NPR articles.

NPR Part One:  http://www.veteransforcommonsense.org/index.php/whats-new/1754-npr

NPR Part Two:  http://www.veteransforcommonsense.org/index.php/whats-new/1763-npr 

Conclusion for Parts One and Two

While many challenges persist at VBA, significant progress toward reform is being made by VA Secretary Shinseki.  However, simply recognizing a catastrophe exists and promising to transform VBA is not enough.  VCS and our collective constituency want to see results.  Measurable results will be observed when a new team is brought in to lead VBA with a broad mandate from Secretary Shinseki and President Obama.  Results will be celebrated when VBA’s error rate is reduced significantly, and claims are processed quickly (with an exception for serious cases with multiple conditions).

In order to reach our long-term goal to transform VBA for the 21st Century, VCS asks Congress to pass a new law mandating the creation of an entirely new VBA system from the ground up.  A new law should fund the creation of a new, streamlined VBA, based on VBA pilots.  The new law and new VBA must set requirements for quality and timely decisions so our veterans don’t wait for healthcare or benefit payments.

Part Three: VCS Identifies Nine Major Problems at VBA

Parts three and four contain information from our new program web site, www.FixVA.org.  On Friday, April 9, 2010, Veterans for Common Sense held a press conference in San Diego, attended by the Honorable Bob Filner, Chairman of the House Veterans’ Affairs Committee.  At our new web site, VCS listed the nine major problems in Part Three as well as the nine practical solutions shown in Part Four: 

1. Stagnant System.  For decades, leaders at VBA failed to upgrade VBA information technology, regulations, training, and oversight.  This led to a backlog of one million claims (of all types), hundreds of thousands of appeals, and a high error rate.  Veterans wait, on average, six months for an initial claim decision from VBA.  Veterans who appeal a VBA decision can wait an additional four or five years for a decision from the Board of Veterans Appeals (BVA).  Instead of reforming VBA, leaders tinkered with a few rules, declared victory, and hoped Congress and veterans would walk away.
2. Different Locations.  VBA leaders work at 1800 G Street, NW in a separate building a half-mile away from VA Secretary’s Eric Shinseki’s headquarters at 810 Vermont Avenue, NW, in Washington, DC.  Out of sight means out of mind when it comes to reforming VBA.
3. Obsolete Computers.  VBA uses several different computer systems, some dating back decades.  They don’t work.  Mail is stacked, claims are shredded, and claims are lost because VBA is not digitized.  VBA’s obsolete computers mean VBA leaders don’t know why Guard and Reserve veterans from the Iraq and Afghanistan war are half as likely to file claims, yet twice as likely to have their claim denied.  The current system computer is not friendly for VBA staff or for veterans.
4. 26-Page VBA Application.  VBA forces veterans to complete a 26-page claim form.  Imagine being a veteran with post traumatic stress disorder – PTSD – or traumatic brain injury – TBI – and trying to fill out VBA’s complex, overwhelming, and burdensome paperwork all alone.  
5. No Military Records.  VBA doesn’t have automatic access to computerized military service records and military medical records.   That means VBA must request paper records one at a time for each veteran.  VBA and military searches for paper records often take years and often are the root cause for denials for benefits and healthcare due to veterans’ lack evidence for their claim.
6. Two Separate Agencies.  Except in a few locations, VBA and VHA don’t share office space, and that means they might as well be on different continents.  Most veterans file their VBA claims at a VHA medical facility, where there are few, if any VBA staff to review the claim, set up claim exams, or make claim decisions.  VHA then mails the claim form to VBA.  In some cases, veterans incorrectly confused a VBA claim denial as a VHA healthcare denial – with devastating consequences.
7. VBA Vacancies.  VBA recently began advertising for new positions to process the tidal wave of claims.  For example, in Waco, Texas, VBA is hiring 100 new claims processors.
8. Attorney Restrictions.  Veterans are prohibited from hiring an attorney until after VBA has denied their claim.   Enemy prisoners of war can have attorneys at Guantanamo, yet our veterans fight VBA alone.
9. VA Audits Prove Serious Problem Exists.  In the past seven months, more than 10 VA Office of the Inspector General (VA OIG) reports have found very serious systemic problems within VBA.  Examples include unacceptably high VBA error rates at eight VBA regional offices.  VBA’s reports about the backlog of claims are incomplete and difficult to understand.   A recent study also found VA remains unable to determine the full human and financial costs of the Iraq and Afghanistan wars.  After nearly nine years of war, that’s unacceptable.

Part Four: VCS Offers Nine Practical and Progressive Solutions  

1. New Leaders.  The Under Secretary for Benefits position is vacant. VCS urges VA Secretary Eric Shinseki to hire new, pro-veteran leaders at VBA dedicated to fixing VBA within the next two years.  The new leaders will also need additional support staff to oversee a massive overhaul of the beleaguered agency. 
2. Move Leaders.  VCS urges Secretary Shinseki to relocate VBA leaders from 1800 G Street in Washington to inside VA’s national headquarters located at 810 Vermont Avenue, where they will be co-located with his other VA leaders.  This sends the signal to veterans, Congress, and the public that fixing VBA is a top priority.
3. Presumptive Conditions.  VCS urges Secretary Shinseki to create an automated, veteran-friendly system that takes advantage of laws creating more presumptions in favor of the veterans, such as VA’s new regulations expanding healthcare and disability benefits for Vietnam War veterans suffering serious and adverse medical problems associated with their exposure to Agent Orange poisoning.  VA’s goal should be to process claims in one month, not the current five to six months.  Two examples under consideration now supported by VCS would streamline PTSD and Gulf War claims.
4. Single Page Claim Form.  VCS urges Secretary Shinseki to adopt a one-page claim form to replace VBA’s current 23-page form.  This would cut burdensome red tape and remove a significant barrier, especially for veterans with mental health conditions and/or brain injuries.  This will also make it easier for VBA employees to process claims.  VHA currently uses a one-page healthcare enrollment form, and VBA should follow suit.
5. Joint DoD-VA Record.  VCS urges Secretary Shinseki to work closely with Defense Secretary Robert Gates and begin using the new, robust lifetime electronic military medical record proposed by President Barack Obama.  VCS urges the military to complete the mandatory pre- and post-deployment medical exams as part of the new record.  This will end VBA’s current lengthy practice of reconstructing medical records, a process that takes years and delays veterans’ timely access to healthcare and benefits.
6. VBA Staff at VHA Facilities.  VCS urges Secretary Shinseki to bring VBA to where our veterans are by restructuring VBA and placing VBA claims processing staff at VHA medical facilities to meet face-to-face with veterans.  Veterans hope and expect to see friendly VBA experts who can quickly and accurately process claim forms, set medical appointments, and decide veterans’ claim.  Completing a veteran’s claim correctly the first time reduces appeals that clog up VBA.
7. Hire More Veterans. Veterans returning from Iraq and Afghanistan have an unemployment rate of nearly 15 percent, according to a recent CNN broadcast. VCS urges VA Secretary Shinseki to place personnel offices at military discharge locations so veterans have faster access to VA jobs, including VBA positions.  We urge VA to hire veterans.
8. Veterans Need Attorneys.  VCS urges Secretary Shinseki to work with Congress so our veterans can hire an attorney before they file a claim.  This is especially vital for our veterans suffering from PTSD, TBI, or other mental health conditions.  Completing a fully developed quality claim correctly the first time with expert legal advice reduces appeals that often clog up VBA for years.
9. Greater Transparency.  VCS urges Secretary Shinseki to release more information about the agency’s work as well as conduct more outreach to inform our veterans about their benefits.  VCS urges the Secretary to hire the appropriate staff to conduct oversight so there is more accountability within the new VBA system, especially staff to oversee quality as a high priority.  VCS also urges VA to begin tabulating the current cost of the wars as well the estimating the future costs of the war so VA is well positioned with staff and facilities to meet the increases in demand.

Conclusion

VCS presents Congress with our bold agenda listing VBA’s systemic challenges and pragmatic solutions.

At the top of our list of critical VA actions: VA must fill top VBA leadership vacancies.   

VCS constantly encourages veterans to seek care and benefits from VA.  VCS also advocates for systemic improvements so our veterans receive the prompt and high-quality medical care and benefits they earned.

Our final message to VA and Congress is for VBA to work with veterans’ advocates and focus on quality claim decisions, timely claim decisions, and improving VA’s culture.