House Subcommittee Reviews Claims Process for Veterans

Washington, D.C. – On Thursday, June 18, 2009, the House Veterans’ Affairs Disability Assistance and Memorial Affairs Subcommittee, led by Chairman John Hall (D-NY), conducted a hearing to address concerns regarding the growing backlog at the Veterans Benefits Administration (VBA) and to explore the manner in which VBA has begun implementing new laws designed to improve the disability claims processing system for veterans.

Chairman Hall offered the following comments during his opening statement: “Members of this Subcommittee convene today to conduct a hearing on the record number of claims facing the VA, now approaching one million.  This is a problem that has plagued the VA and the veterans it is intended to serve for years.  Veterans applying for the very benefits they have earned through sacrifice for our country have been stuck languishing in a growing backlog.  Many veterans have been waiting months and years – and in some mind boggling cases, even decades for finality in their disability claims.  Is this how America fulfills its promise to our veterans?  When men and women sign up to put on the uniform and defend our country, they sign a contract.  We need to make sure that America is living up to our part of that contract.  We must have a VA that is an advocate for veterans not an obstacle, a VA that smoothes the way, not puts up roadblocks.”

Witnesses recommended against piecemeal solutions, instead discussing wholesale changes to managing the VBA’s claims workload and ways to deal with the overly burdensome evidentiary burdens placed on many veterans filing claims for compensation.  A veteran, David Bohan, summed up his experience maneuvering through the claims processing system:

  “The VA system is confusing, overwhelming and is not at all friendly to veterans.  So many of the people at VA are not veterans and don’t understand what we are going through. You end up feeling like some of them care more about their rules and regulations and paperwork than they care about the veterans.

  “We veterans don’t have any idea where this piece of paper or that record is after all of this time.  Regarding military records we veterans don’t have any idea were our records are kept and apparently the military doesn’t know either. I was up late at night, digging through boxes, looking for records to prove I was in the Army, that I was in the Gulf War, and that I had been in combat and that I had all of the necessary stressors to qualify for VA assistance. The memories that going through all of those materials from my Army days was very painful.”

VA Deputy Under Secretary for Benefits Michael Walcoff explained that the steady and sizable increase in workload presents a major challenge in improving service delivery of compensation and pension benefits to veterans.  VBA’s pending inventory includes the rating and non-rating workload.  The rating workload includes original and reopened claims for disability compensation and pension.  Non-rating workload includes dependency adjustments on active compensation and income adjustments on pension awards, among other things.

  “During FY08, VBA received 888,000 rating claims and 755,000 non-rating claims for a total of more than 1.6 million, or 4,501 per day.  Through May 2009, rating-related claims received are up 13.5% during FY09 compared to the same period in FY08.  Despite a 9.3% increase in claims completed, the rating-related inventory has increased from 379,842 at the end of FY08 to 402,047 at the end of May 2009.
Although the inventory of rating claims has increased by approximately 22,000 this year, we have made progress in improving the timeliness of our decisions.  During FY09, VBA has improved average days to complete on rating claims from 178.9 days at the end of FY08 to 161.8 days at the end of May 2009.  We have made similar progress in improving non-rating timeliness from 109.4 days at the end of FY08 to 88 days at the end of May 2009.  The combined FY09 timeliness for all rating and non-rating claims completed through May 2009 is 120.9 days.  VBA’s entire inventory of pending disability claims is frequently – and incorrectly – referred to as the ‘claims backlog.’  While we currently have approximately 400,000 claims in our inventory, the majority of these claims are not
‘backlogged.’    The inventory is dynamic rather than static.  It
includes all claims received, whether pending for just a few hours or as long as six months.  Completed claims are continuously removed from the inventory while new claims are added.  This year we are averaging over 80,000 new claims added to the inventory each month.” 

Complicating the concern of increase in workload is the number of days it takes to process a claim under VA’s current Claims Processing Improvement model (CPI).  Currently, VA has over 20.8 percent of its cases pending for over 180 days.  Although this figure is down from last year’s 25.1 percent, there is still a great deal of fluctuation and variances in the system regarding the number of days a claim is pending or those on appeal.  According to the Appeals Management Center Director (AMC), it recently finished its last 2003 case and is still working about 40 cases from 2004.  It takes the AMC and the Board of Veterans Appeals an average of at least a year and a half to complete a case.
Remarkably, these figures represent an improvement over the last fiscal year’s performance.

“These problems are not new and this issue affects far too many veterans,” said Bob Filner, Chairman of the House Committee on Veterans’
Affairs.  “Our brave service men and women are fighting to defend this nation, only to return to an uncompassionate system that neither remembers nor rewards their service.  Action must be taken to empower our veterans as they heal from war, as they reconnect with their families, and as they transition into civilian life.”

The 110th Congress voted to enact the Veterans Benefits Improvement Act (P.L. 110-389), which aimed to modernize the VA’s disability benefits claims processing system by, among other things, authorizing temporary ratings and claimant substitution, studying veterans’ loss of earnings and quality of life, piloting programs to expedite fully developed claims and a claims checklist, certifying and training VBA employees, and evaluating performance measures for claims adjudication.  Congress set several implementation due dates that VA must meet over the course
of this coming year, and implementation of the law is in process.   

On April 9, 2009, President Obama, along with VA Secretary Shinseki and Defense Secretary Gates, announced that VA and the DoD will create a Joint Virtual Lifetime Electronic Record, which is to be a comprehensive system that will streamline transition of health care records between the Departments.  It will eventually contain administrative and medical information from the day individuals enter military service, throughout their careers, and during the remainder of their lives as veterans if they should enter the VA system.

Chairman Hall concluded: “These veterans do not deserve to have their requests for assistance languish in the VA’s bureaucracy.  There must be a way to stem this tide.  Veterans cannot wait any longer. The VA requires a cultural and management change that can only manifest itself if it embraces the very reason it was enacted in the first place – to serve veterans.  As Chairman of this Subcommittee, I believe we have given VA the tools and the authority it needs to take the necessary steps to bring about the transformation Secretary Shinseki has evoked since stepping into the leadership of the VA – to become a veteran’s advocate, not an adversary.”

Witnesses:

Panel 1

* Ian DePlanque, Assistant Director, Veterans Affairs and
Rehabilitation Commission, The American Legion
* David Bohan, Gladstone, OR, Veteran
* Robert Jackson, Assistant Director, National Legislative
Service, Veterans of Foreign Wars of the United States
* Kerry Baker, Assistant National Legislative Director, Disabled
American Veterans
* Rachel Natelson, Esq., National Legal Advisor, Service Women’s
Action Network

 Panel 2

* LTG James “Terry” Scott, USA (Ret.), Chairman, Advisory
Committee on Disability Compensation, U.S. Department of Veterans Affairs
* Michael Ratajczak, Decision Review Officer, Veterans Affairs
Cleveland Regional Office
 on behalf of American Federation of Government Employees, AFL-CIO

 Panel 3

* Michael Walcoff, Deputy Under Secretary for Benefits, Veterans
Benefits Administration, U.S. Department of Veterans Affairs

Accompanied by

*       Bradley Mayes, Director, Compensation and Pension Service,
Veterans Benefit Administration, U.S. Department of Veterans Affairs

*       Scott Cragg, Executive Director and Program Manager, Virtual
Lifetime Electronic Record Program, Office of Policy and Planning, U.S.
Department of Veterans Affairs

*       Paul Tibbits, M.D., Deputy Chief Information Officer, Office of
Enterprise Development, Office of Information and Technology, U.S.
Department of Veterans Affairs

* RADM Gregory Timberlake, SHCE, USN, Acting Director, DoD/VA
Interagency Program Office

Prepared testimony for the hearing and a link to the webcast from the hearing is available on the internet at this link:
http://veterans.house.gov/hearings/hearing.aspx?newsid=426