Mr. Bruce Hollinger
Las Vegas, NV November 7, 2013
MADAM CHAIRMAN AND MEMBERS OF THE SUBCOMMITTEE:
On behalf of the men and women of the Veterans of Foreign Wars of the U.S. (VFW) and our Auxiliaries, I would like to thank you for the opportunity to offer the VFW’s perspective on how VA is meeting the needs of veterans living in Nevada.
First, I would like to take a moment to discuss the new VA medical center here in Las Vegas. Veterans like the new facility. It has allowed VA to begin seeing more patients and provide more of the specialty care that in the past was conducted through an MOU with Nellis Air Force Base, at a VA hospital in either Arizona or California, or was provided under contract in the community. Even with a new facility, veterans still experience long wait times for appointments. Primary care appointments can take up to 90 days and specialty care appointments can take even longer. The VFW is hopeful the new Patient-Centered Community Care (PCCC) program will assist in reducing these wait times. The House Veterans Affairs Committee must use its oversight role to ensure our facility has the resources to hire needed medical staff to provide timely access for Nevada’s veterans, to go along with the quality care provided by VA.
The VFW has a full time service officer who works at the medical center; he has a good relationship with the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) care coordinator. When an OEF/OIF veteran walks into the medical center to take advantage of the five year access to medical care, the OEF/OIF Coordinator checks to see if a claim for benefits was previously filed. If it hasn’t been, the coordinator refers the veteran to a Veteran Service Organization (VSO) service officer, who is co-located in the medical facility for help in filing a claim.
One request local veterans have that would make finding the new facility easier is to have road signs identifying the exits that lead to the facility from the highway.
Scheduling for Compensation and Pension (C&P) exams continues to be an issue. Exams are often scheduled with only one or two days of notice to the veteran. This does not provide veterans time to rearrange their schedule to make the exam. If exams are missed, VA then adjudicates the claim without the exam, to the determent of the veteran. This was a larger problem while VA was working to eliminate all claims over two years old, but continues to be an issue across the country. At this time the only recourse for veterans when this happens is to file a Notice of Disagreement (NOD) in an effort to have the exam rescheduled.
VFW knows of a veteran being called by scheduling, who told the veteran that his exam would take place the next day. The veteran was out of town and could not make the exam. The veteran was told by the scheduler, “if the appointment wasn’t important, then why did you file a claim.” There are other reports that a VA employee would tell veterans that she would reschedule the C&P exam if they stated they were unable to make the appointment. Unfortunately, she would not reschedule and the next letter the veteran would receive would be a notice of denial of benefits. These are not the practices or policies VA has in place for scheduling appointments, but unfortunately, here in Nevada these are not isolated incidents.
It is difficult to determine if these practices are widespread, because the Veteran Service Representatives (VSR) orders the exam, then goes through scheduling to make the appointment. The doctor who is scheduled to give the exam and the VSR would not be aware of when, or under what conditions the exam was scheduled. If the appointment is missed, the doctor notates the veteran failed to make the appointment, which is cause for the VSR to adjudicate the claim with the evidence at hand. VA must work to ensure that customer service standards are upheld and that proper scheduling practices are conducted so veterans are afforded the fullest opportunity to complete their C&P exams, and have all evidence necessary to adjudicate their claim.
The VFW is pleased with the Reno VA Regional Office (RO) program that allows VSR and Decision Review Officers (DRO) to contact veterans directly and ask for clarification on an issue that is preventing VA from successfully adjudicating the claim. This program gives VA the ability to gather that missing piece of evidence or clarify an issue, eliminating the need to send a letter requesting the information, and then wait sixty days for a response. This is a much more efficient process, effectively reducing the claims processing time by more than two months in many cases.
Unfortunately, many veterans have told us that they are not provided a call-back number when VA leaves a message. Consequently, working veterans cannot respond to VA with the necessary information in a timely manner. There are reports from veterans who received two or three of these types of calls, but they were not able to respond, only later to have their claim decided without the opportunity to provide the missing evidence or clarification. VA must ensure veterans have the ability to respond to these calls, and if contact is not made via phone, VA must continue to send the letter requesting the information. This new policy will only work if veterans are afforded the opportunity to respond.
Fortunately, many VA employees will contact the representing service officers when VA fails to reach the veteran themselves. In these cases, the service officer can work with the veteran to answer the questions that are preventing VA from accurately adjudicating the veteran’s claim. While this practice is very positive, it isn’t required, so not all VA employees take the time to contact the service officer for assistance, nor does it provide a safety net for the thousands of unrepresented veterans. VA must mandate that VSOs are notified when the veterans they represent are called to make this process work.
Our service officers report that paper claims continue to be misplaced or lost, and the likelihood of loss is increased when claims are brokered to other regional offices. This is adding months and years to veterans’ claims, often requiring veterans to resubmit some or all of their evidence. Our service officers have started making copies of all documentation for the veterans they represent as a safety net for when files are lost, allowing them to protect effective dates and quickly resubmit the claim.
VFW services officers must have a Personal Identification Verification (PIV) card to access files within the VA database. However, VA has struggled in granting these cards to our service officers. This is not just a local issue, it is a national problem that prevents service officers from accessing the Stakeholder Enterprise Portal (SEP). In Nevada specifically, VFW service officers have waited eight months to a year to receive their PIV cards. Recently, a new manager of Change Management in the Reno RO has begun working with the VSO community to ensure a more expedited process for issuing the PIV cards. We are hopeful this issue can be quickly resolved.
The lack of access to SEP also prevents our service officers from filing original paperless claims. Service officers want to file claims electronically, knowing the likelihood of a lost file is decreased and that claims can move though the system much quicker. With access being limited and our service officers are forced to file paper claims. While VA has recently released a nationwide protocol for issuance of PIV cards, our service officers report problems with the procedure and continue working without this essential tool. This is a source of frustration for our service officers that prevents them from assisting in VA’s move to an all paperless claim process.
VA is making strides in areas of care and outreach to veterans, however, these strides are overshadowed by lost documentation and poor customer service. All the issues mentioned in this testimony are fixable. We want to work with VA to remedy all of these issues.
Thank you again for the opportunity to testify before you today. The VFW looks forward to working with Congress and VA in identifying issues and suggesting solutions to ensure our veterans receive the care and services their selfless sacrifice has entitled them to.
This concludes my testimony, and I am happy to answer any questions the Committee may have.