[House Hearing, 113 Congress]
[From the U.S. Government Publishing Office]
BEYOND TRANSFORMATION: REVIEWING
CURRENT STATUS AND SECONDARY EFFECTS OF VBA TECHNOLOGY
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
of the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED THIRTEENTH CONGRESS
SECOND SESSION
__________
WEDNESDAY, FEBRUARY 5, 2014
__________
Serial No. 113-51
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.fdsys.gov
______
U.S. GOVERNMENT PUBLISHING OFFICE
86-727 PDF WASHINGTON : 2015
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COMMITTEE ON VETERANS' AFFAIRS
JEFF MILLER, Florida, Chairman
DOUG LAMBORN, Colorado MICHAEL H. MICHAUD, Maine, Ranking
GUS M. BILIRAKIS, Florida, Vice- Minority Member
Chairman MARK TAKANO, California
DAVID P. ROE, Tennessee JULIA BROWNLEY, California
BILL FLORES, Texas DINA TITUS, Nevada
JEFF DENHAM, California ANN KIRKPATRICK, Arizona
JON RUNYAN, New Jersey RAUL RUIZ, California
DAN BENISHEK, Michigan GLORIA NEGRETE McLEOD, California
TIM HUELSKAMP, Kansas ANN M. KUSTER, New Hampshire
MIKE COFFMAN, Colorado BETO O'ROURKE, Texas
BRAD R. WENSTRUP, Ohio TIMOTHY J. WALZ, Minnesota
PAUL COOK, California
JACKIE WALORSKI, Indiana
DAVID JOLLY, Florida
Jon Towers, Staff Director
Nancy Dolan, Democratic Staff Director
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
JON RUNYAN, New Jersey, Chairman
DOUG LAMBORN, Colorado DINA TITUS, Nevada, Ranking
GUS M. BILIRAKIS, Florida Minority Member
MARK AMODEI, Nevada BETO O'ROURKE, Texas
PAUL COOK, California RAUL RUIZ, California
DAVID JOLLY, Florida GLORIA NEGRETE McLEOD, California
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
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Page
Wednesday, February 5, 2014
Beyond Transformation: Reviewing Current Status and Secondary
Effects of VBA Technology...................................... 1
OPENING STATEMENT
Hon. Jon Runyan, Chairman........................................ 1
WITNESSES
Statement of Mr. Gerald T. Manar, Deputy Director, National
Veterans Service, Veterans of Foreign Wars of the United States 5
Prepared Statement........................................... 37
Statement of Mr. Jeffrey C. Hall, Assistant National Legislative
Director, Disable American Veterans............................ 7
Prepared Statement........................................... 41
Statement of Mr. Zachary Hearn, Deputy Director for Claims,
Veterans Affairs and Rehabilitation Division, The American
Legion......................................................... 9
Prepared Statement........................................... 46
Statement of Mr. Frank Logalbo, National Service Director,
Wounded Warrior Project........................................ 10
Prepared Statement........................................... 49
Statement of Mr. Eric Jenkins, Rating Veterans Service
Representative, Winston Salem Regional Office, American
Federation of Government Employees, AFL-CIO and the AFGE
National VA Council............................................ 12
Prepared Statement........................................... 53
Statement of Ms. Diana Rubens, Deputy Under Secretary for Field
Operations, U.S. Department of Veterans Affairs................ 24
Prepared Statement........................................... 57
Accompanied by:
Mr. Richard Hipolit, Assistant General Counsel, U.S.
Department of Veterans Affairs
Accompanied by:
Ms. Lorraine Landfried, Deputy Chief Information Officer
for Product Development, Office of Information
Technology, U.S. Department of Veterans Affairs
Statement of Richard W. Thomas, Director, Healthcare Operations,
Defense Health Agency.......................................... 26
Prepared Statement........................................... 61
Accompanied by:
Mr. Dave Bowen, Director, Health Information Technology,
Defense Health Agency
MATERIALS SUBMITTED FOR THE RECORD
Paralyzed Veterans of America.................................... 63
Vietnam Veterans of America...................................... 64
Letter From: Hon. Dina Titus, Ranking Minority Member to Hon.
Eric K. Shinseki............................................... 69
QUESTIONS AND RESPONSES FOR THE RECORD
Questions For the Record......................................... 69
Questions From: Dina Titus and Responses From: VA................ 71
BEYOND TRANSFORMATION: REVIEWING CURRENT STATUS AND SECONDARY EFFECTS
OF VBA TECHNOLOGY
----------
Wednesday, February 5, 2014
U.S. House of Representatives,
Committee on Veterans' Affairs,
Subcommittee on Disability Assistance and Memorial
Affairs,
Washington, D.C.
The subcommittee met, pursuant to notice, at 3:30 p.m., in
Room 334, Cannon House Office Building, Hon. Jon Runyan
[chairman of the subcommittee] presiding.
Present: Representatives Runyan, Lamborn, Bilirakis, Cook,
Titus, O'Rourke, Ruiz, Negrete-McLeod.
OPENING STATEMENT OF JON RUNYAN, CHAIRMAN
Mr. Runyan. Good afternoon, and welcome, everyone. This
oversight hearing of the Subcommittee on Disability Assistance
and Memorial Affairs will now come to order.
Today's hearing will focus upon technological initiatives
of the Veterans Benefits Administration as well as the
secondary effects of those initiatives.
Specifically we will hear information on the status of the
Veterans Benefits Management System 6.0 release and the
Veterans Relationship Management System including e-benefits.
We will also address the recently implemented secure
electronic transmission of service treatment records between
healthcare artifacts the image management solution of the
Department of Defense and VA's VBMS.
Additionally, the subcommittee will seek information on
VA's work credit system within the new electronic framework of
their regional offices, the national work queue, and the
proposed rule of VA as to standardized forms.
Many of these new technology solutions will reduce reliance
on paper-based processes and were designed to simplify and
streamline the VA's services to veterans, their families, and
survivors.
To the extent that they increase efficiency, they lead to
faster and more accurate outputs to beneficiaries. I remain
eager to work alongside the VA to implement this reasonable
path forward.
I am optimistic that many of the efforts the VA has
employed to date have made a positive change. However, I
caution that in the department's efforts to reach the numeric
goal of the 125 days pending for claims in 2015, VA must not
prioritize an appearance of success above actual qualitative
improvement.
And I assure you that this subcommittee will labor to hold
focus upon the quality of both VBA's process and outcomes.
We will hear today that there have been both progress and
problems. VBMS consistently experiences serious latency
problems with regular weekly, sometimes daily outages. Why do
these latency issues continue and how are the regional offices
dealing with this complication?
VA indicates that VBMS has been successfully deployed the
Board of Veterans' Appeals. I believe that to be true at a
superficial level, but I am aware of the functional quagmire of
VBMS at BVA.
If we take your statements at face value, it would appear
that BVA is productively chugging along with no problems.
However, we know that BVA does not have the necessary
functionality in VBMS for indexing and file maintenance and
continues to experience issues with load time, misplaced
documents, and, again, latency.
Additionally, VA's obligation to properly safeguard
personal information is paramount. VA represents that the
technology tools are accredited and secured under VA's strict
security standards to combat evolving cyber security threats.
Yet, in recent weeks, e-benefits was compromised to an unknown
extent.
The personal information of thousands of veterans was
revealed and this simply was unacceptable. It would go without
saying, but I will say it nonetheless, this lack of security is
of tremendous concern.
One other area that we will hear about today is VA's
proposed rule that would require claims to be filed on a
standard form and would also require appeals to be initiated
using a standard form.
Finally, we will be examining VA's transition to what it
refers to as a national work queue, meaning that claims are
processed by the next available VA employee, not necessarily
the next local VA employee, and in particular examining the
effects that such model has on local representation.
I look forward to hearing both the department's explanation
of the desired change as well as the comments of the various
interested organizations that are seated in our first panel
this afternoon.
And with that, I will begin the introductions. Will the
first panel be seated at the witness table.
Our first panel today will include Mr. Gerald Manar, deputy
director of National Veterans Service with the Veterans of
Foreign Wars of the United States; Mr. Jeffrey Hall, assistant
national legislative director with Disabled American Veterans;
Mr. Zachary Hearn, the deputy director for Claims, Veterans
Affairs and Rehabilitation Division with The American Legion;
Mr. Frank Logalbo, the national service director with the
Wounded Warrior Project; and Mr. Eric Jenkins who is here in
representation of the American Federation of Government
Employees, AFL-CIO, and the AFGE National VA Council.
Once we conclude with panel one, we will move on to panel
two which consists of representatives from the Department of
Veterans Affairs and the Department of Defense.
For VA, we will hear from Ms. Diana Rubens, deputy under
secretary of Field Operations, accompanied by Richard Hipolit,
the assistant general counsel, and by Ms. Lorraine Landfried,
deputy chief information officer for Product Development,
Office of Information Technology.
And from the Department of Defense, we will hear from Major
General Richard Thomas, director of Healthcare Operations,
Defense Health Agency, who is accompanied by Mr. Dave Bowen,
director of Health Information Technology, Defense Health
Agency.
With those introductions complete, I thank you all for
being with us today and now yield to the ranking member, Ms.
Titus, for her opening statement.
Ms. Titus. Thank you very much, Mr. Chairman.
I think some of the things I am going to say in the opening
statement echo some of the points that you have already made,
but sometimes it does not hurt to hear them twice. This is a
very important hearing and I appreciate your calling it.
I want to commend the VA for its efforts to address the
claims backlog. I know last fiscal year, the VA completed a
record 1.7 million claims. You reduced the time veterans have
to wait for their claims and you cut the backlog by 35 percent.
So if you continue along these lines, I suspect that at
this rate, you'll reach the secretary's ambitious goal by next
year.
But I also want to thank the stakeholders who have joined
us today because we would not be where we are in reducing the
backlog if it were not for the help that you have been giving
our veterans and the advice that you gave us and the VA on how
to tackle this challenge. Your help is very much appreciated by
both the veterans and by us.
We are confident that the VA has seen an increase in
production due to some of the mandatory overtime and the
implementation of provisional ratings, but results of the new
electronic claims system, the VBMS, are unfortunately mixed
reviews and despite the promises that we heard of how they were
going to make the system more efficient and effective.
According to the strategic transformation plan, the VA
expected to reduce the backlog by 345,000 claims based on the
efficiencies from utilizing this system alone, just because of
that. We're hopeful that that occurs.
However, we remain concerned about that because as VBA
staff and stakeholders continue to question the efficiencies
that have been gained during this system, there have been
excessive down times, latency, lack of access to the system for
the VSOs via that stakeholder enterprise portal, and these are
all problems that we hope will be able to be addressed.
And as the chairman pointed out, just last week we learned
of yet another VBMS outage and then a few days later the media
reported that a data breach in e-benefits had led to the
release of personal information for some 1,400 veterans.
So needless to say we are not overly impressed by the
system's security, efficiency, or effectiveness at this point
and we are looking to see some improvements as we move forward.
Adding to this challenge has been the VA's continued lack
of transparency regarding the performance of specific VA
regional offices. For months, the VA has shuffled claims among
the ROs and then reported that the struggling offices have been
improving.
Now, I have dealt with this firsthand with the performance
of the Reno regional office which serves all the veterans in
Nevada and some in California. It was one of the worst in the
country, had one of the longest delays and one of the biggest
backlogs.
Well, now I have learned that half of their workload was
brokered to other stations around the country. That work was
actually completed in those other stations, but the Reno RO was
given credit for reducing its backlog.
Now, because of that, I wonder, and it remains unclear, if
the poor performers have really gotten any better or if they
are going to improve in the future or if we are addressing the
real cause of the problem and not just the symptoms.
While veterans might be served in a timelier fashion
through brokering, and it is a good thing in the short term, it
is not a solution in the long term. It is imperative that we
know not only how well our veterans are being serviced but how
well the VA regional offices that are serving them are really
performing.
This is particularly important as you move towards this
national work queue where many veterans' claims will be sent to
other states or other parts of the country to be worked on.
Just in closing, I would like to state that earlier this
year, our subcommittee worked on a bipartisan package of bills
that was designed to speed up the benefits process for
veterans. The House has passed most of these bills, and I hope
that the Senate will soon address them and send them to the
President for his signature.
Some of these will be very important as you move towards
that national work queue including my bill, Pay As You Rate. So
I hope that we can work on those to provide a more timely
delivery of payments.
Additionally, I hope that the VA is looking towards the
national work queue as a way not just to moving cases from the
under performing to places where they can be addressed more
quickly but as a way to specialize in medical conditions in
certain offices that are especially challenging like military
sexual trauma and traumatic brain injury. That could be a
potential game changer if you focus on specializing and not
just on shuffling the chairs around.
So with that, I would like to restate and emphasize our
commitment to the VA, proud of the good work that you do. I
know VA employees work hard and this is not an easy process.
This committee wants to be your partner. We want you to tell us
if something works, help us understand if something is not
working, and then be forthright when there are problems so that
we can try to address it.
So thank you all for being here, and thank you, Mr.
Chairman.
Mr. Runyan. Thank you, Ms. Titus.
And with that, I know Mr. O'Rourke does have an opening
statement, but protocol says I ask Mr. Cook first.
Mr. Cook. [Nonverbal response.]
Mr. Runyan. Mr. O'Rourke is recognized.
Mr. O'Rourke. Mr. Chairman, I just ask unanimous consent to
submit my opening statement for the record.
Mr. Runyan. Without objection, so ordered.
Mr. O'Rourke. Thank you.
Mr. Runyan. Ms. Negrete-McLeod, anything?
Mrs. Negrete-McLeod. [Nonverbal response].
Mr. Runyan. We welcome our first panel, and, Mr. Manar, you
are now recognized for five minutes for your oral testimony.
STATEMENTS OF GERALD T. MANAR, DEPUTY DIRECTOR, NATIONAL
VETERANS SERVICE, VETERANS OF FOREIGN WARS OF THE UNITED
STATES; JEFFREY C. HALL, ASSISTANT NATIONAL LEGISLATIVE
DIRECTOR, DISABLED AMERICAN VETERANS; ZACHARY HEARN, DEPUTY
DIRECTOR FOR CLAIMS, VETERANS AFFAIRS AND REHABILITATION
DIVISION, THE AMERICAN LEGION; FRANK LOGALBO, NATIONAL
SERVICE DIRECTOR, WOUNDED WARRIOR PROJECT; ERIC JENKINS,
RATING VETERANS SERVICE REPRESENTATIVE, WINSTON-SALEM
REGIONAL OFFICE, AMERICAN FEDERATION OF GOVERNMENT
EMPLOYEES, AFL-CIO AND THE AFGE NATIONAL VA COUNCIL
STATEMENT OF GERALD T. MANAR
Mr. Manar. Chairman Runyan, Ranking Member Titus, and
Members of the subcommittee, thank you for the opportunity to
present to you the views of the members of the Veterans of
Foreign Wars of the United States and its auxiliaries on these
important topics.
While workload remains near historic highs and quality
remains problematic for VA, these are not VA's biggest problems
in our view. What confronts VBA is a problem in leadership,
leaders at the top so intent on meeting arbitrary goals by 2015
that they have systematically suborned the legal, regulatory,
and policy protections granted veterans over the last 75 years.
I say this today with the full knowledge that the Veterans
of Foreign Wars has largely supported this leadership as they
move to transform the claims processing system. However, VBA
policies and practices in claims processing have increasingly
become hostile to the interests of veterans.
Secretary Shinseki established aggressive goals for VBA in
both claims processing and timeliness by declaring 125 days as
the maximum time in which to process a claim with 98 percent
quality by 2015. It appears that VA leadership long ago
realized that they could not process all claims within 125
days.
In the past few years, the true workload has reached over
two million claims and appeals. Today there are over 1.7
million compensation, pension, and education claims and
appeals.
Instead of fully fixing its problems, VA leaders redefine
them. Since VA could not reduce the entire 1.7 million workload
of claims and appeals to a reasonable level by 2015, they
decided to define the workload as only disability claims
requiring rating action.
Like a mantra, they have repeated that redefinition over
and over until the media and Members of Congress use it when
talking about the backlog.
Seven hundred thousand disability claims are pending today,
just 41 percent of all the claims and appeals VA has to work in
its regional offices.
Next VA decided to focus its entire workforce on reducing
pending disability claims, leaving nearly 60 percent of the
workload nearly untouched. The cost of this neglect is found in
two examples.
In the past three and a half years, dependency claims,
perhaps the simplest of claims that VA can process, have grown
from about 40,000 to nearly 235,000.
Because appeals do not fall within the definition of
backlog, VBA has consistently diverted appeals' staff to work
disability claims. As a consequence, appeals have grown from
252,000 to over 268,000 in just the past year.
The definition of quality has also changed in several ways.
VA's central office directives have relaxed development
requirements to allow rating specialists to make decisions
using evidence considered inadequate just a few years ago.
Claims are decided faster but often less favorably to veterans.
In addition, VA is moving to an issues-based method for
determining quality levels. This is significantly different
than the case-based method used when Secretary Shinseki set his
goal of 98 percent quality. The new method makes VA look better
while making the same number of mistakes.
What you see here is a cold-blooded assessment by VA
officials that if they cannot achieve their goals under the
current standards, they will change the rules to meet their
goals. VA is proclaiming vast improvements when, in fact, they
have only changed the way they look at quality.
Proposed regulation AO81 styled standard claims and appeals
forms is another attempt by VA to change the playing field. We
discuss this at length in our written testimony. This
regulation change is not about requiring standardized forms. VA
has had standardized forms since at least the 1930s. It is
about reducing incoming claims and depriving thousands of
veterans each year of millions of dollars in earned benefits.
There will be a profound and negative effect on veterans
seeking benefits if VA implements these changes.
Congress has spent 75 years or more working to construct a
benefit system which is veteran friendly, a system which
recognizes the contribution of the men and women who have worn
the uniform of the United States.
VA proposed to make rigid a claims processing system which
was constructed with the purpose of helping veterans who may
not know every rule and policy. VA leaders have apparently
decided to ignore the injunction of Omar Bradley, administrator
of the Veterans Administration following World War II, who
stated we are dealing with veterans, not procedures, with their
problems, not ours.
And, finally, we ask this committee to examine what VA
leadership is doing. Examine the methods they are using to
redefine problems so they can reach their self-created
artificial goals.
We ask Congress to block any attempt by VA to reduce rights
that veterans and other claimants currently have to submit
informal claims to VA and we ask this committee to force VA to
address all pending issues and appeals, not just disability
claims.
America's veterans did not sacrifice their time, their
bodies, or their lives to be run over by a bureaucratic train
racing to declare victory by 2015. They deserve more respect
than that for their service to our great Nation.
Thank you for the opportunity of speaking to you today, and
I will be happy to answer any questions you may have.
[The prepared statement of Gerald T. Manar appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Manar.
With that, I will recognize Mr. Hall for five minutes for
his testimony.
STATEMENT OF JEFFREY C. HALL
Mr. Hall. Thank you.
Chairman Runyan, Ranking Member Titus, and Members of the
subcommittee, on behalf of DAV and our 1.2 million members, we
appreciate the opportunity to testify today regarding VBA's
technology initiatives.
Let me begin today by sharing some insights from a recent
unannounced visit to the Newark VA regional office which is the
only fully electronic regional office within the VA.
All claims processing performed in Newark today is for all
intents and purposes completely paperless. During my visit to
Newark, I was able to see virtually every step of the process
from the intake processing center through the steps of the
development in the core lane concluding with a fully digital
claim file being reviewed in the VBMS and a final rating being
prepared in the VBMSR program.
Not having seen more than a demonstration of VBMS prior to
my Newark visit, I now have greater confidence in the overall
performance of VBMS and I am reassured that it actually works
as promised.
In speaking with many of the employees at the Newark VA
regional office, morale was much higher than it was in the past
and it is growing every day. Employees I visited with feel VBMS
and the new organizational model while not perfected allow for
greater productivity, speed, accuracy, and accountability in
completing their work, albeit they do realize there will be
routine improvements in the VBMS system and not without
problem. Yet, they are optimistic that as their proficiency
using the new system escalates, they will be able to
demonstrate the increases in all measurable activities.
Recognizing the fact that no modern IT system or software
is ever truly finished, it is vitally important. So in addition
to the funding required for maintenance of the VBMS system, VBA
must continue to make significant investments in the VBMS
development for as long as this system is capable of meeting
VBA needs.
Like VBMS, the e-benefits system has been in place for more
than a year and while the e-benefits system is working and
claims are being submitted and received electronically as
intended, it is certainly not without obstacles which must be
overcome as they arise and without delay.
One of the first obstacles encountered within the e-
benefits system was veterans not being able to set up their
account due to problems with the inaccurate information
maintained by the Defense Enrollment Eligibility Reporting
System or DEERS. This remains a major problem for many
veterans, especially older veterans, and must be resolved.
Mr. Chairman, clearly VBA would like to see more veterans
file their claims electronically and DAV has been the leader
amongst VSOs in increasing the number of claims filed
electronically. However, more than a lack of interest from a
veteran is the problem of gaining access which the veteran
cannot resolve on his or her own.
Simply put, if more veterans filing claims electronically
is desired by VBA, then their system needs to be capable of
basic matters such as access.
Certainly there are some ongoing issues with the
technology. However, DAV remains supportive of VBA's
transformation efforts and veterans being able to submit claims
electronically through the e-benefits system or on their behalf
through the stakeholder enterprise portal with the assistance
of our national service officers.
However, the SEP is dependent upon a veteran being required
to have an e-benefits account which means without e-benefits
access, we cannot file electronic claims for our clients. We
are hopeful that changes will occur in the near future so that
we can file electronic claims directly with the VBA through the
SEP system without the need of going through the e-benefits.
With new technology in place, VBA is now looking at the
prospect of a national workload management model which we
believe falls in line with similar VBA strategies such as
centers of excellence and centralized mail centers.
When considering a major change to the claims process such
as a national workload management model or anything of a
centralizing nature, thoughtful deliberation must be given to
the impact of removing the benefit of face-to-face interaction
with VBA which at the very least could be hindered.
As we have done for nearly 100 years, DAV will continue to
evolve and adapt to any changes in the claims process. However,
any change to the claims process must include VSOs from the
earliest planning stages possible.
And, finally, Mr. Chairman, with respect to VA's proposal
to require all claims and appeals to be filed on standard VA
forms, DAV understands the stated intent of VA's proposed
amendments to promote submission of claims and appeals in
standard formats in order to capture data for a paperless
claims and appeals system. However, we have concerns about the
proposed rule and the consequential adverse effect upon
veterans.
To be clear, DAV takes no issue with the veterans being
required to submit their claims and appeals on standardized
forms. It is not new. We do, however, take exception to
eliminating the informal claims processing which is also
contained within the proposal, thereby causing veterans to lose
their rightful entitlements such as retroactive monetary
benefits just so the VBA can speed the process.
Mr. Chairman, this concludes my statement. I would be happy
to answer any questions.
[The prepared statement of Jeffrey C. Hall appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Hall.
With that, I will recognize Mr. Hearn for five minutes for
his testimony.
STATEMENT OF ZACHARY HEARN
Mr. Hearn. Good afternoon, Chairman Runyan, Ranking Member
Titus, and Members of the committee. On behalf of our national
commander, Dan Dellinger, and the 2.4 million proud veterans
serving veterans in The American Legion, I want to take a
moment to thank you for bringing us here to share our views and
insights about VA's technological transformation.
Really this is not a pro forma thank you, but we generally
want to say thank you for listening. You treat us as partners.
This committee recognizes that we are in a unique position to
speak for what the veterans in America want. We are the voice
of those veterans and you listen to us. You think about what we
have to say and you consider our experience.
You are working together with us to try to make this work
for the veterans because that is what we are all here for. We
are trying to make the system work for the veterans. This is a
partnership and partnership includes dialogue.
You have received our testimony, the testimony of all my
colleagues, and VA's testimony. The way technology impacts the
office environment for VA is going to change a lot of things.
Some of those changes are going to be good. Some of those
changes may not be so good. We know we are all probably going
to see changes that nobody saw coming.
But I have talked to veterans. I have talked to many of the
over 2,900 American Legion accredited representatives
throughout the country. I have talked to my colleagues here and
we can see a lot of flags that come up when we think about how
some of these things will affect veterans' claims. Our voice is
important.
We stated in our testimony the most important factor going
forward is what changes are going to make the system better for
veterans, not easier for VA, better for veterans.
Is it better for veterans to force them to use an
electronic process when according to the Census Bureau roughly
half of elderly Americans, a large and vulnerable portion of
the veterans' population do not have regular Internet access?
Does that make things better for veterans or easier for VA?
The American Legion is honored to help bring veterans to VA
in a manner that makes things easier for VA. We are partners
serving veterans. VA and The American Legion are partners
designed to advocate on behalf of the 21 million veterans.
The American Legion took the lead in promoting the fully
developed claims process with veterans and enabled VA to report
a reduction in how long it takes to process claims. We do the
work up front and hand it off to VA. VA turns things around
faster for veterans and the veterans get their results faster.
That is the ultimate win. That is why we do this.
But the choice has to stay with the veteran. First and
foremost, we have to make sure that any changes implemented are
there to serve the veteran. VA can assure they are making the
right decisions to serve veterans by expanding the inclusion of
The American Legion and other VSOs as full partners in this
process.
Very early on in the planning of what would later become
VBMS, VA used to regularly work with the VSOs and we were able
to point out things like that early versions did not include an
integrated power of attorney to ensure veterans'
representatives were seeing the information needed to help
veterans with their claims. We worked together and helped to
keep the focus on what was going to help the veteran.
You have reviewed the written testimonies. You have seen
some specific issues we have raised. We recognize the
importance of technological advances to improve the VA claims
process. However, any process implemented must be advantageous
to the veteran. We appreciate VA's efforts to expedite the
claims process, but it cannot be on the backs of veterans.
The most important thing I want everyone here to take away
from this is how important it is to recognize all of us as
fully participating partners, veterans, VSOs, VA, Congress, and
to keep the goal as what is the best way to deliver benefits to
veterans who have been disabled serving their country. That
more than any number or metric needs to be the target.
Again, I offer my sincere thanks for recognizing the
importance of the voices of 2.4 million veterans and the
greater community of veterans they serve and for giving us a
share in the dialogue at this table, and I will be happy to
answer any questions. Thank you.
[The prepared statement of Zachary Hearn appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Hearn.
With that, I will recognize Mr. Logalbo for five minutes
for his testimony.
STATEMENT OF FRANK LOGALBO
Mr. Logalbo. Chairman Runyan, Ranking Member Titus, and
Members of the subcommittee, thank you for holding this hearing
and for inviting Wounded Warrior Project to testify today.
In working daily with wounded warriors, we appreciate what
advanced technology can bring to claims and adjudication, but
the efficiency that technology delivers is not an end in
itself. Fundamentally this system must serve our veterans.
Let me provide some context by reference from our most
recent annual survey. With almost 14,000 responses, nearly all
the warriors we surveyed were injured during post 9/11 service.
Almost 60 percent of those injured resulted from IEDs, other
blasts, and more than 44 percent reported traumatic brain
injury. Seventy-five percent of the respondents had PTSD, the
most commonly reported condition.
While many of our warriors rely on computers, many do not.
Some with invisible wounds like PTSD, anxiety, TBI have
comprehension difficulties or experience anxiety, frustration
with computer technology. Many have high anxiety relating to
information security. The recent data breach on VA's e-benefits
Web site will very likely heighten that concern, maybe even
irreversibly.
VBA must meet the veterans where they are. Technology may
be the way to reach optimal efficiency, but VA's highest
obligation must be to the veteran and it must accommodate the
veteran, not the other way around, even at modest cost to peak
efficiency.
The principle would seem beyond question and a system long
celebrated as for its pro-claimant, veteran-friendly policy,
but a recent rule making proposal would abandon the core tenet
of that policy.
Under that proposal, VA would throw out current rules that
aim to minimize the burden initiating a claim and allow
benefits to be paid at the earliest possible date. It would
abolish rules that permit a veteran to file an informal claim
and receive benefits paid from the date of informal claim that
is filed. Instead, it would push the veterans to file claims
electronically and penalize those who do not.
VA would levy that penalty by setting new effective date
rules on benefit awards with one rule for electronic filers and
a different harsh rule for filing claims via paper.
Here is how it would work. A warrior who suffers from
multiple injuries from an IED would have to list specific
disabilities on a claims form. If the veteran could not
identify all the disabilities and simply wrote multiple
injuries, VA could not consider that, they would consider it as
an incomplete claim.
If the veteran had filed electronically, VA would preserve
the effective date of filing as that date. If the veteran had
submitted that same incomplete claim on paper, the veteran
would be penalized by deferring establishment of an effective
date until the claim becomes complete. The difference could
mean a loss of thousands of dollars for that veteran.
In essence, pro-claimant VBA policies would abandon any
attempt to achieve efficiency and speed. We certainly do not
oppose VA's becoming more efficient and timely, but it must
comply with the laws centered on serving a veteran.
If new policy is that efficiencies trump veterans' rights,
then Congress must make the judgment, not the secretary. VA's
proposal would also undermine that safeguard to appellate
rights.
Regulations that now permit any expression of disagreement
to be taken as a notice of disagreement would be discarded.
Instead, veterans would have to use specific forms to file a
notice of disagreement. Omitting any required information would
render the veteran's notice incomplete.
And a veteran who is unable to complete a form successfully
within 60 days would forfeit the right to appeal. Individually
and collectively, these changes go much too far.
Moreover, the department's single-minded pursuit of
efficiency fails even to acknowledge that applicants for
veterans' benefits have a constitutionally protected property
interest in their application for benefits and are entitled to
due process.
Rather than protecting that property interest, VA aims to
establish procedures that would shrink it. And for the first
time, it would create a substantial distinction between
electronic and non-electronic claims. We see no basis in law to
establish this two-tiered discriminatory system.
In striving for efficiency, the proposed rule would create
barriers that would deny veterans benefits to which they are
entitled. While Congress may elect to take steps to streamline
claims and appeals processes, a department charged with
administering the law may not unilaterally block statutory
pathways to veterans' benefits.
VA describes the effect of the rules it wants to abolish as
time consuming, but Title 38, the laws VA administers say
nothing about speed.
VA's statutory authority to establish online tools to
facilitate claims and processing is not in doubt. Its authority
to develop standard forms is not questioned. Many veterans may
find online tools helpful, but VA goes too far in trying to
establish procedures that will result in veterans losing
benefits to which they are entitled.
In the final analysis, the secretary's duty is to
administer the law, not to rewrite it. Several important
interests are at stake here. The first is adherence to the law.
The second is preserving pro-claimant adjudication system.
The third is protecting veterans who for a reason including
disability, hardship, remoteness, or fear, they do not have
online access to a computer cannot reasonably be expected to
communicate through that modality, and, finally, preserving
congressional prerogatives.
Given the importance of each of those interests, we ask the
subcommittee to press the VA to withdraw its proposed rule
making.
Thank you, Mr. Chairman.
[The prepared statement of Frank Logalbo appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Logalbo.
With that, I will recognize Mr. Jenkins for five minutes
for his testimony.
STATEMENT OF ERIC JENKINS
Mr. Jenkins. Chairman Runyan, Ranking Member Titus, and
Members of the subcommittee, thank you for the opportunity to
share views, discuss our concerns, and provide recommendations
regarding the VBMS implementation on behalf of AFGE members
working daily processing these claims.
I am a rating specialist at the Winston-Salem regional
office where I worked for the past nine years. I am a disabled
marine and a combat veteran who served during Operation Desert
Storm, Enduring Freedom, and Iraqi Freedom. I have a deep
personal and loyal commitment to serving veterans.
I work with VBMS and VBMSR on a daily basis. The constant
latency, technical issues, and frequent VBMS shutdowns make it
difficult for me and others to serve veterans accurately and
effectively.
In the last week, the VBMS system was shut down for more
than a day and VBMS was restarted four other times during the
week. Because I work in a completely paperless system, all of
the work I had completed during the day was now inaccessible
until the system restarted.
AFGE recommends the formation of an ongoing stakeholder
work group to allow AFGE and veteran service organizations to
work with management to address these serious implementation
issues.
VBA employees, many of whom are veterans themselves, are
deeply committed to completing claims as quickly and accurately
as possible for our brothers and sisters who served so
honorably. But during these shutdowns, the employees I speak
of, many managers do not give them excluded time needed even
though they are already facing intense production quotas,
performance improvement plans, and possible termination.
Excluded time is a longstanding policy in VBA that not only
protects employees but also ensures that they have the
sufficient time to focus on their work serving veterans.
AFGE recommends that VBA work with all the stakeholders to
develop an effective contingency plan for VBMS shutdowns.
Improvements to VBMS go hand in hand with fixing VBA's
currently work credit system.
I am a current member of the National RVSR Performance
Standards Work Group which is a joint venture with both
management and labor that created the most recent RVSR
standards.
The current work credit system creates performance
standards that are arbitrary, inconsistent, and focus too much
on quantity over quality. VBA has never had a formal work
credit system based on actual data that reflects the amount of
time required to process specific types of claims and their
components.
Given VBA's current transformation strategy, AFGE believes
that the timing is ideal for a time motion study to be created,
a formal work credit system. AFGE recommends that the committee
adopt an approach similar to the one proposed by S. 1982 to
form a stakeholder work group to overhaul the current system.
AFGE also should have a more meaningful role in the
implementation of veterans' relationship management initiative.
It is always good policy to include employees' perspectives in
any new initiatives. AFGE has not been given the opportunity to
contribute to this implementation.
We also recommend better integration of DoD's file system
named HAIMS for greater ease in transmitting medical evidence
between DoD and VA for claims processing.
AFGE remains cautious regarding VBA's national work queue
strategy including the methods VBA will use to assign work. If
an office is considered under performing by VBA, there are
concerns that they will now be starved for cases.
Employees in these offices might lose certain essential
skill sets if they are deprived of special issue cases.
We were pleased to hear of Under Secretary Hickey's
commitment to improving VBA's current resource allocation model
so that struggling ROs are not arbitrarily deprived of
resources. Therefore, we urge the committee to review the
current resource allocation model and encourage VBA to expedite
reforms, especially in light of the rollout of any national
work queue strategy.
Finally, AFGE is very troubled by a recent announcement
that VBA is considering the use of outside contractors for
dependency claims instead of continuing to use the experienced
VBA employees.
VBA intends to begin the program in March. AFGE strongly
urges Congress to prohibit this counterproductive and illegal
solution to the claims backlog. Past evidence with other
contracts such as the ACS contract demonstrates that contracts
can actually add to the backlog.
The ACS contract was cancelled after only nine months. It
wasted VA resources and taxpayer money and forced veterans to
wait longer for their benefits.
Once again, I would like to thank the committee for
providing AFGE the opportunity to share our views, and I will
be happy to answer any questions.
[The prepared statement of Eric Jenkins appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Jenkins.
And with that, I will start a round of questions, giving
each Member five minutes.
And my first question is actually for you, Mr. Jenkins.
Just asking you to elaborate a little bit on HAIMS and VBMS and
how you indicate that the integration is not working that well.
Mr. Jenkins. I do not work with it directly. It usually is
on the hospital side, VHA side. But dealing with VSRs who
actually process the pre-development side say that some of the
information they are getting or some of the STRs, which are
servicemen's treatment records, are not being uploaded properly
and sometimes they are mixed with one veteran or veteran's
information.
Mr. Runyan. Okay. I know the problems we have been having.
Obviously, those continue with your experience there.
Next question, Mr. Manar, in your written testimony, you
state your concern that over the past year, the focus of
achieving the secretary's goals of ending the backlog by 2015
and achieving 98 percent accuracy in the claims processing has
taken on a life of its own and that the goal is no longer to
help all veterans but create appearance of success by changing
the playing field.
I think this is a concern shared by me and this whole
committee and not just in the context which arose in your
written testimony.
Would you please comment, in your organization's experience
how VA loses its sight of its mission to help veterans in favor
of trying to present favorable image of the department. Please
provide specific examples of how as you noted that the VA has
changed the playing field in order to effect the appearance of
success towards its goal of eliminating the backlog.
Mr. Manar. Thank you, Mr. Chairman.
Let me start with the second question first, examples of
how VA has changed the playing field. There have been many
court cases as well as VA regulations and I believe statute
that requires the VA to provide reasons and bases for the
decisions that they make, especially when they are negative
decisions.
However, starting with a project that VA initiated two and
a half or three years ago, they removed a substantial part of
reasons and bases out of rating decisions. And in the letters
that are sent to claimants, they tell claimants basically
conclusions. They do not explain the analysis or reasons why
certain evidence was found to be wanting or substandard. They
simply conclude that it was not sufficient to grant the
benefit.
This is an example of depriving veterans of the information
they need in which to determine whether they should appeal a
case. And as I mentioned earlier, appeals are now at 268,000
controlled by VA. The lack of information that veterans receive
when they have received decisions may very well account for
some of those appeals.
In addition, we have a recent example, the over two-year-
old case review project, VA letter 201305 issued in April of
last year directed rating specialists to rate on the evidence
of record.
Now, two-year-old claims and many one-year-old claims are
old. Many of them were old because they were difficult cases.
They were not able to get all the evidence that was necessary
and, yet, the VA blatantly told their rating specialists to
rate based on the evidence of record.
In some cases, they issued what they called provisional
ratings and left it up to the veteran to decide whether or not
they would submit additional evidence throughout the year. If
they failed to submit any more evidence, the decision became
final.
Many of these decisions were negative or, if not negative,
not at the full benefit level that the individual might have
obtained had they completed development.
So these are just two examples of how VA has moved in
addition to all the things that we said about their proposal to
change regulations to eliminate informal claims, to change the
appeals process in this AO81 that we talked about earlier.
Mr. Runyan. So in your opinion, VA is less helpful to the
veteran in changing the policy on how they respond?
Mr. Manar. They have decided or so it appears that it is
much better for them if they can move cases quickly. They will
take less flack than if they continue the process of
deliberately developing and acquiring the evidence necessary to
make reasoned and substantial decisions.
And it appears, as one of my colleagues pointed out, that
VA is more and more moving to make changes not by improving
their performance but by eliminating policies or procedures
that affect rights of veterans so that they are making these
changes seeking to make improvement on the backs of veterans.
Mr. Runyan. Thank you, Mr. Manar.
With that, I will recognize the ranking member, Ms. Titus.
Ms. Titus. Thank you, Mr. Chairman.
I appreciate all of your concerns about the standardized
form, and I know that Beto has some legislation that would
address it. So I would just like to turn my attention to the
problem of transparency.
I wonder if you all would address the fact that as we move
towards this national queue, and as cases are moved from one
regional office to another. What kinds of problems are you
having tracking things, getting updates, getting information
about the case for the veterans that you serve and what
recommendations do you have for making that better because it
looks like that is the way it is all moving?
We can start at this end maybe.
Mr. Jenkins. It is my understanding, ma'am, that it has not
taken place yet. They are moving towards it, but the work queue
has not formally----
Ms. Titus. That part is true, but they are already
brokering claims
Mr. Jenkins. Yes, ma'am.
Ms. Titus [continuing]. From one regional office to
another.
Mr. Jenkins. Yes, ma'am.
Ms. Titus. That is kind of a similar problem, I think.
Maybe I am wrong about that.
Mr. Jenkins. Yes, ma'am. Well, during the two-year
initiative, our regional office brokered quite a few claims. I
started off in what was called Quick Start which was a national
mission. It was similar to benefits on delivery, BDD, if you
might have heard of that.
So many of the claims we were working, the two-year-old
claims were brokered to other regional offices to speed up the
process to help veterans get the benefits quicker. But in doing
so, it left a void at our regional office once the two-year-old
initiative was finished. So that left individuals not having an
amount of work to work.
So then we started working cases that are in a service
center which we are still brokering cases to this day. And it
leaves people wondering. We have many people saying I do not
have work today, I do not have any. Although there is a
backlog, you are still having individuals saying I do not have
enough work for the day.
Personally I have emailed my manager saying I need work, I
need something to do.
Ms. Titus. That is interesting. That is the opposite
problem----
Mr. Jenkins. Yes. It is not an every-day thing, but it does
happen.
Ms. Titus. Okay. What about from the veteran standpoint
when his or her case is brokered to some other place, what is
your ability to help track it or get information?
Mr. Hall. Well, I will start. I do not know if anybody
wants to answer that. But, you know, with brokering claims just
looking at it from that aspect is not inherently a bad thing.
It is much worse in the paper form than it is in the electronic
form it would seem.
Now, that would be because when you are taking a file and
you are transferring the whole file, then I do not have access
to that file if it is sitting in your VA regional office.
Ms. Titus. Uh-huh.
Mr. Hall. So that is something that may be better in this
particular, you know, electronic system that they are using.
To answer your question from a veteran's standpoint, sure,
you know, veterans, they contact us as a representative to find
out answers. They contact the VA for the same answers whether
they have representation or they are calling, you know,
without.
And they would like to speak to somebody in the RO which
they filed the claim or which they thought they filed the
claim, but they may get somebody on the call center that is
sitting in Cleveland when they filed their claim from New York
City.
So that was something that was very difficult to overcome
and assist a veteran and let them know when you call, you are
not going to be speaking to somebody in this particular RO
unless you call our office as a representative. But when you
call VA, you are going to be talking to somebody in another RO.
That was a big problem for quite a while because, and it
may be not that it resolved, but more along the lines that
veterans just gave up, you know. I am not going to call there
because I am going to be talking to somebody from somewhere
else and I want to talk to somebody in the RO that is making my
decision. That is what veterans like. That is something that is
at risk with the national work, you know, management model.
And, again, DAV, we would like to know more about what
their plan is. And I understand that it may have been something
that they used, you know, in the process of completing all of
the oldest claims first, using kind of a brokering style.
So whether the person is sitting in Reno, you know, when
the claim was filed on the East Coast, it is really not going
to matter much on the VA end of it. But, again, as my testimony
points out, you know, this is going to be at the risk of face-
to-face service to veterans. And it seems like the more
technology we have, the more fragmented that service to a
veteran becomes.
Ms. Titus. Any additional comments?
Mr. Manar. If I might, one of the problems, one of the big
problems that we see is that whenever VA develops a new
software program, VBMS is the most recent example of this,
their focus is on getting a system up and running for VA claims
processors and developers and all the people who are going to
use it on the VA side. And it is almost as if service
organizations are an afterthought.
With this Administration, certainly give them credit, they
have certainly given us more access. We have more interaction
almost on a weekly basis than we have had under previous
administrations. But still what we lack today is a really
functional work queue that we can manage our own work, look at
cases that may have been brokered either electronically or in
paper. Finding information or being given notice of decisions
that have been made at other offices on cases that originated
in our office is lacking.
So VA has a long way to go, I think, before we can have
this true partnership where we are working in sync together to
help veterans with their claims.
Mr. Hearn. Yeah. Some of the problem, I think, is when you
start talking about brokering claims out, you have got several
issues. People who reside in states or locations where their
regional office is managed effectively and things go on
relatively smoothly, they almost feel like they are being
punished because they are doing things well.
But the other thing, too, is a lot of the work and
effective service with an effective regional office is the
relationship is what the important part is between the service
officer and VA. If you have a claim now that has gone out to a
different location clear across the country, that relationship
is severed.
When they went to this type of setup with pension and they
had consolidation models that occurred in Philadelphia and
Minnesota and other places, that is one of the problems that
our service officers felt was that this relationship where I
could go up a flight of steps, talk to a rater, and try to work
something out that we differed about just at the local level
there, that is severed.
And the other thing, too, when you are talking about
national work queue, and this is something that we have talked
about internally that we have specific concerns about, is that
if you have a situation where a veteran is--let's say he is
trying to get service connected or she is trying to get service
connected for four or five conditions and there is a way to
maybe have these conditions interrelate with each other and you
are just looking at it and you are saying this rater over here,
you need to work on the feet, this rater over here, you are
working on the ankles, this rater over here, you are working on
the knees, and they are going to look on it as a direct service
connection, but you can grant service connection for one of
those conditions that could have caused or aggravated the other
two conditions, if you have got this separated process, who is
going to go back and look at this and say, well, these things
could have either manifested secondary or have been aggravated
by the service-connected condition that somebody at a different
regional office granted.
Ms. Titus. My time is out, so I will ask you to be brief.
Mr. Logalbo. Yes, very brief. One of the direct points I
would like to make when you look at VA in controlling workload
and shifting resources to different ROs to manage that
workload, one thing I would like to point out is making sure a
training initiative is set out.
Like as you discussed, PTSD, MST, TBI, if there are
specialized areas or areas of concern, make sure that there are
training initiatives, quality review process to make sure that
the veteran or family member is getting the correct decision
the first time.
Ms. Titus. Thank you.
Thank you, Mr. Chairman.
Mr. Runyan. Thank the gentle lady.
With that, I will recognize Mr. Cook.
Mr. Cook. Thank you, Mr. Chairman.
I wonder if you could do me a favor, the whole panel. And,
you know, by the way, I want to thank you all for your service.
The young marine there, he will kind of realize with me I
always boil it down to the KISS principle. Keep it simple
stupid.
Now, what we have been talking about, if you can bear with
this dumb marine up here right now, based upon what you say,
and each one of you I'm going to ask and we'll put it in terms
of combat ready or non-combat ready, what we are talking about,
I'm getting the feeling that in most instances, this whole
evolution, what we have been talking about is non-combat ready.
And I use that phrase because we are talking about so many
people. So if you could kind of bear with me and just I am
putting you on the spot, but--and, by the way, you guys are
right there with the troops. You know, you hear what is going
on, everything, and you are our eyes and ears. And so that is
why I am asking you to do it.
So if you feel comfortable with making that rating or you
can do the old A, B, C, D, F or what.
Sir.
Mr. Jenkins. Well, as a marine, I would like to take this
first. As you may be able to relate to, a battalion commander
does not do anything without talking to his sergeant major.
Mr. Cook. Absolutely.
Mr. Jenkins. And the way VBMS has been implemented,
management saw this, but they did not speak to the people who
are actually implementing it. And you cannot go to war unless
your troops are ready. You can send somebody out there, but you
are going to have a lot of body bags to fill.
Mr. Cook. Not combat ready?
Mr. Jenkins. Not combat ready.
Mr. Cook. Thank you.
Sir.
Mr. Logalbo. And, yes, I do agree with Mr. Jenkins as well,
is you need to speak to the folks on the ground. You need to
speak to the RVSRs. You need to speak to the VSRs. You need to
speak to the folks on the ground to get the input not only to
go through some of the challenges with the system but also make
the system that much better. So I agree in the same analogy.
Mr. Cook. Thank you.
Yes, sir.
Mr. Hearn. The American Legion conducts regional office
review visits periodically throughout the year and we have
heard similar concerns by service officers and also by
employees within VA. So, I mean, as far as recent months, I
cannot say for certain if that shift has changed opinion. But
over the last year, I would not say that it is combat ready at
all, no.
Mr. Cook. Thank you.
Mr. Hearn. Thank you.
Mr. Cook. Yes, sir.
Mr. Hall. Well, as you know, especially in combat, if you
do not have effective communication, somebody is going to die.
So from a combat ready perspective, I would say this. There is
a lot of positives going on in VA as my testimony points out,
but combat ready and putting it in that terms, I would not send
it.
Mr. Cook. Thank you, sir.
Yes, sir.
Mr. Manar. I have to agree with my colleagues. VA is doing,
despite the negative nature of my oral testimony, VA is doing
many things simultaneously and they are working hard. They are
doing a lot more than any of their predecessors ever did, but
we are not ready for prime time.
Mr. Cook. And, by the way, I appreciate your candor. And to
do this, that is a tough question to respond to. And as I said,
I appreciate that.
What I would also like in the remaining time, not right
now, but if your organizations that you represent, I do not
want a five, ten-page analysis of this, I basically want
something very, very simple, five things that are working
correctly, five things that are not working correctly, and five
recommendations.
Now, as I said, no acronyms. If you can put it in military
jargon. You are dealing with Paul Cook here. I am not a rocket
scientist. But by doing that, and I try to do this when I talk
to veterans and what have you, and it is like you got to talk
to the troops and you got to put it in the language of the
troops, and then you can do something in the language of the
troops.
Thank you.
Mr. Runyan. I thank the gentleman.
With that, I recognize Mr. O'Rourke.
Mr. O'Rourke. Thank you, Mr. Chairman.
I first want to thank you and the ranking member for your
leadership on this committee. The fact that we are hearing from
all the folks who are in the front lines on these issues, the
VSOs who are helping out, their members and other veterans to
make sure that they have the advocacy necessary to complete
their claims, get a reasonable response in a reasonable amount
of time including coming up to Congress to testify is greatly
appreciated.
Hearing from those who are actually working within the VA
on the front lines is also appreciated, and then to have that
followed up by our representatives from the VBA is great. So I
really appreciate the format and the content of this hearing.
And I want to follow-up on Mr. Cook's request and just ask
that as you respond to him, you respond to everyone on this
committee. We could all benefit from the response and the
experience and wisdom that you can share with us. So I look
forward to getting that.
I wanted to thank you for the very critical but I think
very constructive feedback on where we are with the VBA right
now.
And to Mr. Manar, I think you essentially made the point in
your testimony that we are dealing within the confines of a
zero sum game. And so if we prioritize resources to resolving
the disability claims that are in need of a rating, we suffer
in other key areas that VBA is working on. And we can put more
resources into that system, but ultimately we are going to have
to prioritize, decide what is important and what we are going
to follow and look at.
And you gave some examples of, I believe, if I am quoting
you correctly, dependency claims going from 40 to 235 thousand
outstanding.
Mr. Manar. That is correct.
Mr. O'Rourke. I am looking at the IDES backlog for soldiers
who are transitioning out and I especially think of those who
are at Fort Bliss in El Paso, Texas at the WTU who are
languishing when we have, I believe, a 15-day goal that is now
averaging 143 days before we can get a response. So those are
some other examples.
But given that system, how would you better prioritize the
work that VBA is doing? If it is not correct to prioritize
disability claims awaiting ratings over these other areas, what
is the best way to do this?
Mr. Manar. Thank you.
First of all, it is important to recognize that until the
last five or six years, seven years, VBA was chronically short
changed over decades in terms of staffing it needs to process
claims. One of the reasons why the workload and backlog grew in
the 1990s and then accelerated after the turn of this century
is because of staffing levels that existed at least back into
the 1970s. I hate to be a historian about that, but that is
what brought us to this point in time, I think.
Congress has done an awful lot to up the staffing of VA and
they have made a lot of progress because of the additional
people, FTE that you have given them. And all of us are
grateful for that. More veterans have been served because of
your actions than would have been without it.
But that does not mean that VBA is staffed at the
appropriate levels even now. Now we live in a world where there
are tight budgets and I doubt that you all can scrape together
a whole lot more people to give to VA to process claims.
So to your question, what can VA do? It is a question of
managing the workload. They have in terms of appeals, they have
designated decision review officers and support staff in each
regional office and, yet, because of their drive to work over
two-year-old cases and then over one-year-old cases, many of
those people have not worked a significant number of appeals
in, well, it is going on a year, more or less.
The Board of Veterans' Appeals is running out of appeals
work to work as are staffed at the board because work is not
flowing to the board. VA needs to release those people and let
them get back to work.
A business practice that has been ongoing which caused this
drastic increase in dependency claims, VA for decades had this
policy that you could not close out an end product on a rating
decision until you not only notified the veteran about what
they were going to get, but you worked every issue that was
related to that including dependency.
Well, what has been going on for the last three years is,
and it may have started in the regional offices, but it has
never been corrected by central office, to the best of my
knowledge, and that what has been going on is that people have
got to the point where they are notifying the veteran about the
decision and they just roll that dependency issue over into a
separate end product.
And they do not deal with it. They have got the evidence.
In most cases, they have got, you know, the marriage dates and
birth certificates and all the rest of the stuff that they need
to pay benefits, but they just roll over for another day. And
that accounts for a large number of those things.
But the problem is that managers are not managing their
work. They are being driven by the directives of central
office. This is what you are going to do and these are the
goals that you are going to reach, and they are not allowed to
do the things that they should have been trained to do and many
of them want to do and that is to manage the work.
In Reno, as an example, I learned just the other day fully
developed claims which are supposed to be fast tracked average
263 days in Reno to be completed and that if it is one or two
issues, they will put them in a fast track lane. If it is three
or more issues, then it just gets mixed in with the regular
work.
Well, what is the point of all of that? How does that help
veterans? How does it help VA? You have got claims that are in
many instances ready to rate at that point, to resolve, and,
yet, you just throw them in the mix where they get older and
older.
Mr. O'Rourke. Mr. Manar, let me interrupt for just a
minute----
Mr. Manar. Sure.
Mr. O'Rourke [continuing]. Only because my time is expired
and it is obviously a question that deserves a longer answer
than we have time to give today. And I would love ultimately to
hear from everyone. If there is a second round of questioning,
I will pose that same question to everyone else.
But I really would like to know whether there, because you
spoke a lot about process improvements, whether there is any
wisdom to prioritizing certain workload over other workload
within the VBA as it appears that we are doing to the point
that you made earlier or whether it can be handled through
other means.
And so look forward to getting that back from the other
panelists and also your recommendations per Mr. Cook's request.
With that, I will yield back to the chair. Thank you.
Mr. Runyan. Thank the gentleman.
With that, I will recognize Mr. Ruiz.
Mr. Ruiz. I would like first of all to thank you all for
coming here and for being so honest in your assessment and
willing to roll up your sleeves and get this fixed.
At this point, I can yield my time to Beto O'Rourke so that
you can get your answers from the other members.
Mr. O'Rourke. I appreciate that. Thank you.
If the other members of the panel would like to answer that
question about prioritization of certain claims or work
activities within the VBA over others, I would love to get your
answer. Thank you.
Mr. Hearn. Last year, The American Legion started working
pretty heavily with VA and the White House on this FDC process.
And one of the things that we discovered when we would go out
to these different regional offices, and it was a common line
that was used whether it was in Indianapolis or Oakland or
Nashville, was if everything is a priority, then nothing is a
priority.
That was a line from the employees. That was not a line
from a VSO. It was not a line from a department service
officer. So there appears to be some consternation, and maybe
Mr. Jenkins can explain that a little bit further, too, that
even internally that there is not a recognition.
We believe and we have bought in on this fully developed
claim process. However, if, like what Mr. Manar said, if it is
going to go into a 235-day chute to get the claim done, then it
serves nobody any good.
I mean, as far as we are concerned, if the veteran is
giving everything to VA to rate the claim and it is ready to
go, go ahead and make that a priority. I mean, I am really kind
of surprised that it has expanded to that point in roughly 12,
14 months.
Thank you.
Mr. Hall. Could I just elaborate on one thing that Zach had
said and that is, you know, the FDC program, it is probably one
of the more exciting things happening that is making a positive
difference.
And you can look directly at the Chicago VA regional office
and see the time lines and how long it takes for a claim.
At the same time, you know, I think VA's overall is
somewhere near 25 percent of all claims are fully developed.
But let's not forget they are fully developed because of the
veteran and because of the VSOs. So we are doing a lot of the
legwork, the majority of it, and presenting it to the VA where
it makes their job much easier. We are happy to do that. We
hope to gain even more of that.
In DAV, our number of FDC claims is increasing more. I
mean, that is what we do. Educate the client or the veteran to
make sure that they know the most advantageous way to help them
navigate the system, number one, but also tell them, listen, if
you can do all of this, you are not going to have a year to
wait. You will be much quicker in your decision, maybe 120
days, depending on that RO.
So that is something that needs to be constantly promoted
not just through the VSOs to the people that we serve, but VA
needs to do a much better job in getting that message out.
Mr. O'Rourke. I do not know if anyone else would like to
comment. I do want to follow-up on your remarks by saying that
we had hoped that the VA would elect to administratively
implement the Faster Filing Act, which recently passed the
House of Representatives, which would require them to notify
veterans and VSOs that are assisting them in filing their
claims of the fastest response time based on the different kind
of claims you choose.
So I do not like the new rule making from the VBA and I do
not like this forcing veterans and VSOs to use these
standardized forms. I believe in empowering the VSOs and the
veterans with the information being perfectly transparent and
allowing them to make the decision that is in their best
interest given what they are willing to do, realizing the
average wait times.
In El Paso where we recently had wait times up to 470 days
to hear back from the Waco Regional Office, it is now down much
lower than that. We wanted to be able to tell veterans if you
file a fully developed claim and you file it online, you can
get that back in under a hundred days on average and you are
eligible for a full year's retroactive--retroactive benefits.
I would love the VA to do a much better, more aggressive
job of pushing that information out there. If we cannot get
them to do it administratively, we hope that will become law
soon and do exactly what you are asking us to do.
I have got about 30 seconds left on Mr. Ruiz's time for
anyone who would like to add.
Mr. Logalbo. Yes, I would like to.
And what we are discussing is how we are empowering and
embracing the warriors and the veterans as we look forward face
and helping them with claims. When you are actually out there
as helping a warrior with a fully developed claim or guiding
him through the process and teaching him how to navigate and
understand the process, that is where you are going to get more
buy-in and the claims are going to be done a lot quicker.
When folks, as you see in Houston, when they reached out to
a number of folks regarding appeals to clarify issues to be
that forward-facing, veteran-centric focus, they were able to
reduce time lines because now the veteran understands the
process, the evidence needed. They work hand-in-hand not
creating a process that is separate and distinct.
Mr. O'Rourke. Thank you, and thank you for the responses.
It looks like the time has elapsed. I guess parliamentarily
speaking, I yield back to Mr. Ruiz.
Mr. Ruiz. Thank you very much.
Mr. Chairman.
Mr. Runyan. The gentleman yields back.
In the essence of time in getting to the next panel, I am
going to ask all members to submit any additional questions for
the record and we will ask the gentlemen to please respond in a
timely manner and also please respond to the subcommittee with
Mr. Cook's request. We would like to get that to all of our
members here.
So with that, thank you all for your testimony and your
service, and you are now excused, and we welcome the second
panel to the table.
At this time, I welcome panel two including Ms. Diana
Rubens, deputy under secretary for Field Operations, U.S.
Department of Veterans Affairs, accompanied by both Mr. Richard
Hipolit, assistant general counsel, and Ms. Lorraine Landfried,
deputy chief information officer for Product Development.
I also welcome Major General Richard Thomas, director of
Healthcare Operations of the Department of Defense Agency or
Department of Health Agency who is accompanied by Mr. David
Bowen, director of Health Information Technology.
We appreciate all of your attendance here today. Your
complete and written statements will be entered into the
hearing record.
And, Ms. Rubens, you are now recognized for five minutes
for your oral testimony.
STATEMENTS OF DIANA RUBENS, DEPUTY UNDER SECRETARY FOR FIELD
OPERATIONS, U.S. DEPARTMENT OF VETERANS AFFAIRS
STATEMENT OF DIANE RUBENS
Ms. Rubens. Good afternoon, Chairman Runyan, Ranking Member
Titus, members of the subcommittee. Thank you for the
opportunity to discuss VA's transformation initiatives.
I would like to start by providing an update on our
progress in eliminating the backlog. During fiscal year 2013,
VA completed a record 1.17 million claims with a 90 percent
accuracy at the claim level and 96 percent accuracy at the
medical-issue level. Since its peak in March of 2013, the
backlog has been reduced by 35 percent and the overall
inventory has been reduced by 22 percent.
Also important, the average number of days rating claims
have been pending has also been reduced, meaning that today,
veterans are waiting 111 days fewer than they were last year at
this time for a decision.
None of this progress would be possible without the
tremendous support from our partners, including this
subcommittee, the remainder of Congress, our veteran service
organizations, and, of course, our unprecedented effort and
dedication of the VBA employees, 52 percent of whom are
veterans themselves.
I would like to update you on a few key initiatives. Our
veterans relationship management initiative is providing
veterans with seamless, secure, and on-demand access to
benefits, information, and services. Veterans now have improved
access to benefits information from multiple channels, on the
phone, online, and through our shared VA DoD portal called e-
benefits.
From fiscal year 2009 to 2013, the number of contacts with
VA through these channels increased from 9.1 million to 56.3
million. Currently VA has over 3.3 million e-benefits users
representing a 51 percent increase from fiscal year 2012.
Our stakeholder enterprise portal is a secure Web-based
entry point that complements e-benefits and gives VSOs access
to assist veterans with electronic claims submissions. Over
1,200 registered users across 75 organizations can check the
status of claims, review payment history, and upload
documentation on behalf of the veterans they represent all
within a digital environment.
Our digits-to-digits initiative scheduled for
implementation this fiscal year will enable VSOs to submit
claims directly using their own claims management systems.
Our Veterans Benefits Management System was deployed six
months ahead of schedule in June of 2013. After development
over the course of 18 months with side-by-side end users and
our SMEs with programmers, we continue to monitor and solicit
feedback from partners as well as end users.
In December of 2013, VBMS entered generation three of our
system development increasing system functionality, adding more
complex automation capabilities, reducing dependency on legacy
systems, and enabling the capability to accept veterans'
electronic service treatment records from DoD through HAIMS so
that STRs will be available for servicemembers separated after
January 1st, 2014 when they file their claims.
VBA also established our Veterans Claims Intake Program to
streamline the process for receiving paper records and data in
VBMS. As of January 10th of this year, VCIP had converted from
paper and uploaded into VBMS more than 430 million images.
As I turn to our national work queue, VA transitioning into
a paperless process, we are in a better position to adopt a
national workload strategy that is boundary-free and improve
our capacity to serve veterans.
In April of 2013, VBA's oldest claims initiative aimed at
expediting decisions for veterans who had waited the longest,
we redistributed claims across the Nation to best utilize
resources of all regional offices. The success of this
initiative demonstrates the potential for a national workload
management strategy by optimizing every member of our VBA
workforce.
Our national work queue is being developed in a two-phase
approach. In phase one, claims will be managed from a central
location and routed, based on individual station capacity, with
the first filter for a claim being the one in which the state
where the veteran resides, as well as other national
priorities. In phase two, claims can be routed to individual
employees based on the nature of the claim and the skill set of
the claims processor.
Our employee performance standards are routinely evaluated
and revised to keep pace with changes in process and
technology. With VBA's transition to electronic claims
processing, it is more important than ever to consider the
impact of technology on employee performance and ensure that
the expectations of our workforce align with the tools
employees have to complete their work.
Revised standards were most recently implemented in 2013
and a further revision to VSR and rating VSR standards were
last week presented to our national labor partners and is in
the final stages prior to implementation.
A recently proposed rule is intended to get benefits to
veterans quickly with the most accurate decision possible. The
rule would require claims to be filed on a standard form and
would require appeals to be initiated using a standard form
whenever one is provided for that purpose. The proposed rule
does not require veterans file electronic claims in order to
receive benefits.
VA gave interested members of the public the opportunity to
comment on the proposed rule from October 30th through December
30th. We are currently carefully reviewing the 53 comments that
we received from stakeholders and will be responding to them in
accordance with the Administrative Procedures Act.
While we know there is more work to be done to reach our
goals, we know that the gains we are making in information
technology and automation of our processes are critical. In
going forward, we will need to sustain the resources for
programs like VBMS in order to eliminate our backlog in 2015
and achieve our quality goals.
This concludes my statement, Mr. Chairman. I would be happy
to entertain any questions you or other members may have.
[The prepared statement of Diana M. Rubens appears in the
Appendix]
Mr. Runyan. Thank you, Ms. Rubens.
With that, I recognize Major General Thomas for his
testimony.
STATEMENT OF RICHARD W. THOMAS
Major General Thomas. Well, good afternoon.
Chairman Runyan, Ranking Member Titus, distinguished
members of the subcommittee, thank you for the opportunity to
discuss the department's successful implementation of a new
capability which claims adjudicators may electronically request
and receive complete electronic DoD service treatment records,
or STRs, for newly separated servicemembers.
I would also like to recognize and thank the previous panel
members, the VSO members for their continuing service to our
country.
I am accompanied today by Mr. Dave Bowen to my left, the
chief information officer for the military health system, and
this oral statement is provided on behalf of both Mr. Bowen and
myself.
Just last month, the DoD delivered on our commitment to
make certified, complete, electronic STRs available in support
of the Veterans Benefits Administration's transition to a fully
digital environment for claims processing.
We are now providing the VA with access to electronic STRs
for servicemembers who separated or were discharged after
January 1st, 2014 in our Health Artifact and Image Management
Solution, or the HAIMS, repository.
Now, to achieve this goal, the DoD significantly revised
our HAIMS deployment strategy. Working closely with our VA
partners, the DoD established a tiger team of experts to plan
and develop the required secure system interface needed to
allow the VA to query the HAIMS repository for relevant STRs.
Now, this tiger team is critical to ensure that the resulting
solution would align with the disability benefits claims
adjudication workflow.
Now, the process for digitizing a servicemember's STR and
making it retrievable by the VBA begins with the DoD personnel
scanning any paper-based elements of a newly separating
servicemember's service treatment record. The digitized STR
comprised of both scanned information and existing digital
content from the servicemember's DoD electronic health record
is then submitted into the HAIMS repository and made available
to the VA as a single record.
When a separated servicemember or a veteran files a claim,
a VBA claims adjudicator then establishes a claim in the
Veterans Benefits Management System. The system initiates an
automated request for the STR and when the requested record has
been located and retrieved, the system alerts the claims
adjudicator that the STR is available to support the claims
process.
The process I just described supports probably the most
important contribution the DoD makes to the VA's effort to
expedite the claims processing for our veterans. By providing
the VA with the complete, certified, electronic STRs at the
point of a servicemember's separation, the DoD helps to ensure
the claims adjudicators have the military service-related
healthcare evidence needed to adjudicate a VA disability claim.
Now, we are quite pleased with the successful and ongoing
collaboration with our VA colleagues to deliver this needed
service to our veterans.
Chairman Runyan, Ranking Member Titus, and distinguished
subcommittee Members, this concludes my oral statement. Mr.
Bowen and I would be happy to answer any questions that you or
the subcommittee members may have. Thank you.
[The prepared statement of Richard W. Thomas appears in the
Appendix]
Mr. Runyan. Thank you, Major General Thomas.
And with that, I will start a round of questioning, and my
first question is for Mrs. Rubens.
Although in your introduction to testimony you note that
veterans may submit claims electronically through e-benefits'
Web site, you glossed over the recent e-benefits system defect
in which thousands of veterans may have had their personal
information broadcast to other users.
Have there been any other problems such as outages,
glitches, or information compromises associated with the VA's
e-benefits portal since the most recent breach of the veterans'
personal information on January 15th of 2014?
And I know for a fact yesterday there was actually an
outage of e-benefits because I received it about 4:40, 4:45
last night. So I would like to hear your response to that
question.
Ms. Rubens. Mr. Chairman, thank you.
Obviously we take very seriously the security of our
personally identifiable information of our veterans. Ms.
Landfried is prepared to speak to the specifics of last week,
but I will tell you that we continue to work very closely from
a business and OIT side as we identify these kinds of issues.
Ms. Landfried.
Ms. Landfried. Thank you.
First, before I start, I would like to apologize to any
servicemember, any veteran, or their family member who may have
had their information viewed by another veteran who was on the
system on the evening of January 15th. We hold ourselves to a
very high standard in the Office of Information Technology and
during that incident, we did not meet that standard.
The specifics of what happened, we were doing an update to
a system that feeds into e-benefits. We completed the update.
After an install, we verify to see if it is working. During
that verification, we discovered that users on the system were
able to see information about other users.
As soon as we found out that the newly installed software
was the cause, we removed that software from the system and
verified that the potential to see another person's information
while you were viewing your own no longer existed.
Then as a further precaution, we took the e-benefits system
offline so that we could do a review end-to-end to make sure
that there were not any other vulnerabilities. We waited until
that Sunday morning to bring the system back online working
with our VBA colleagues to make sure that when we did bring the
system online that the VBA call center was staffed. Even though
it was on a weekend, we did this just in case any of the
veterans using the system coming back online had any questions
or concerns or saw anything out of the ordinary.
Mr. Runyan. Have there been any other issues? The committee
received notification of an outage as of last night, so what
are the other issues?
Ms. Landfried. The incident last night, although e-benefits
was impacted, it was actually an issue at the Austin data
center with domain controllers. If users were able to refresh
their browser a few times, the issue cleared. The duration of
the impact really was dependent on how long it took for that to
reset.
So the issue was not with the e-benefits system, but to an
end user that does not really matter because they were not able
to get to the system at the exact time that they needed it.
Mr. Runyan. A department official also stated that up to
5,351 people may have been affected by this defect. How was
this number determined and is VA confident that this number is
accurate?
Ms. Landfried. Sure, I will take that. Yes I am confident
that that number is accurate. Whenever there is an incident, as
I explained the first thing we look at is, what was the cause,
so that we can get systems back and operational for VBA and our
veterans.
As soon as we did that and determined that we had stopped
the problem, we then examined all of our audit logs so that we
could determine exactly who was on the system at the time that
the incident occurred and what functions they were using. The
problem was contained to four or five functions on the system,
so it was not every system or every function that you could get
to on the e-benefits portal.
I am confident in that number because that is the maximum
number of people who were on the system at that time. They were
the maximum number of people who could have potentially viewed
another veteran's information.
According to, all of the logs that have been examined at
this point, the actual number of veterans whose information was
potentially seen by another veteran on the system was 1,362.
I failed to mention before that, whenever there is a
potential Pll loss there are two things that we do at the
department. One is, we communicate it. We notify Congress. We
work with our VSO partners to get the message out to them. I
put out a blog post.
And then in parallel, we have a data breach core team that
looks to make sure that all of the material is complete and
then determines what the remediation should be for the people
that were potentially impacted.
Mr. Runyan. Thank you.
With that, I will recognize the Ranking Member, Ms. Titus.
Ms. Titus. Thank you.
I would like to continue that, Ms. Landfried, if you do not
mind. I appreciate what you do when a problem like that
happens, but I would ask you two things. One is, has that data
breach team completed its investigation and made any
recommendations, and what safety provisions have you put in
place to keep this from happening again?
Ms. Landfried. Sure. First of all, the data breach core
team is wrapping up their review and they have begun the
notification process. Letters have started going out to the
impacted people, and part of the remediation that has been
offered is how to get free credit monitoring in the event that
any of the information that was viewed by other people on the
system falls into the wrong hands.
In terms of how we respond to the event, as Ms. Ruben said,
we take very seriously our obligation to protect veterans and
their personal information as if it were our own. So we have a
multilayered defense in place to combat, you know, whatever the
issue might be.
That includes monitoring outside the VA network by external
partners; monitoring internally of the VA network; monitoring
of our servers, our applications, as well as desktop devices.
It is sort of a defense in-depth type of strategy to make sure
that information is protected to the best of our ability.
Ms. Titus. So is it just back to business as usual or are
you putting in place something new to keep this problem from
recurring?
Ms. Landfried. With this particular problem it was a
combination of events that happened. There was the software
that we put in that did not behave which caused e-benefits to
expose information that it shouldn't have. We have put
additional error handling in e-benefits to make sure that
should it ever see that same error condition, that we won't
have that same condition.
We have also reviewed all of our other applications that
have similar features to make sure that they also have
appropriate error handling in case they ever encounter this
problem.
Ms. Titus. Thank you.
Now, I will go back to my previous problem which is the
brokering of cases. I know in Reno 5,000 cases have been
brokered to other places around the country. And my question
is, that is kind of lipstick on a pig. I mean, you are dealing
with the symptoms, but not the causes of the problem. Now, in
the short term, those 5,000 cases may get decided quicker, but
still there is a problem at the Reno office if they couldn't
handle it.
Also, I wonder, does a case have to get to be stale or get
to sit around for a long time or almost be at the status of
being part of the backlog before it is brokered? You know Reno
is not going to be able to do it. Why don't you just broker
those cases up front and then figure out some way to fix the
Reno office? Would you answer that for me.
Ms. Rubens. Sure. Thank you, ma'am.
I understand your concern that brokering them out is not
necessarily addressing the issues that we have got in Reno and
I want to assure you that we are doing two things.
First and foremost, obviously, is working to get veterans
who have been waiting the longest their decisions, and at the
same time, working with the Reno regional office to ensure that
we are maximizing the efficiency and ensuring the
accountability throughout the chain so that the work being done
in Reno continues to work. They have got great quality today,
but also work to improve timeliness and output to ensure that
they are capable to providing the service to the veterans of
Nevada.
We will continue to use that approach so that we are, one,
taking care of veterans, and, two, ensuring that the systems
that are in place in Reno are working the way that they should
to improve the output in the performance of the Reno regional
office itself.
Ms. Titus. Thank you, Mr. Chairman.
Mr. Runyan. I thank the gentle lady.
With that, I recognize Mr. O'Rourke.
Mr. O'Rourke. Thank you, Mr. Chairman.
Ms. Rubens, thank you for your answers so far and for being
responsive to me and to our office, accompanying us to the Waco
regional office to look at the backlog issue there, which, as I
noted earlier, has gone from something like 470 days on average
to, I guess, close to 250, which is not yet near where it
should be, but much better than where it was. And so we hope
that it continues to move in that direction.
I have three questions that I hope to be able to get you to
answer today. There are so many issues brought up by the
representatives from the VSOs and the gentleman from the AFGE,
but one that I want to focus on is the assertion made by Mr.
Manar that in prioritizing disability claims that need to be
rated, we are not committing the necessary resources to take
care of other critical VBA responsibilities. He mentioned a
few. I mentioned a few in my response to him.
Could you comment on that and let us know whether or not
that is the case?
Ms. Rubens. Thank you, sir.
And I would tell you that as we are prioritizing not only
the aging claims, I will remind us all that we also
established, of course, those priorities for the Congressional
Medal of Honor recipients, our former POWs, homeless, terminal,
extreme financial hardship, as well as our fully developed
claims, in an effort to ensure that we were addressing all of
those.
When you talk about the fact that we had a record year for
claims processed in the rating bundle, I would draw to your
attention that we have also had a record year for the number of
non-rating claims that we completed, and so I would tell you
that we are continuing to work, whether it is across non-rating
or appeals work to ensure we are accomplishing work across the
spectrum.
I know we talked at some length about where we are at with
our IDES work. I would tell you that VBA has also worked to
improve the outcomes on behalf of those servicemembers going
through the IDES program. Our Seattle regional office is
processing for the army. We have added resources, 180 folks
last year, and, of those, we recently promoted and sent to
training another 36 rating specialists who are going to make
those decisions on the claims on both preliminary and final
ratings in the decisions, working with the army to agree on our
approach as to how we work towards those claims. And so we are
taking a holistic approach and working all of the veterans'
claims.
Mr. O'Rourke. So if I could just summarize it to a one-word
answer, it would be, no, we are not suffering in other areas
for prioritizing the disability claims and the other issues
that you raised?
Ms. Rubens. Correct.
Mr. O'Rourke. Okay. How would you then explain how far off
the mark we are when it comes to IDES, and I realize the steps
that you just outlined that you are going to take to rectify
the problem, but if our goal is 15 days and we are at 143 days,
how did that happen and how soon or can you make a commitment
to the date on which we will be back to 15 days or get to 15
days in the first place?
Ms. Rubens. So I would tell you that the outcome of being
as far behind as we are is a number of issues to include our
inability to keep up with the surges in work that we began to
receive through the IDES program. As we made those adjustments,
our ability to turn claims processors from other work and into
the IDES work and get them trained up is something that has
taken us some time. We are very much engaged in doing that.
We have plans in place that will get us for both pre-lim
and final decisions caught up by March and October of this year
in conjunction with the agreement that we have got with the
army. I have continued to have regular and ongoing calls with
our folks in Seattle to ensure that we are working to those
goals and we continue to anticipate meeting them. We have also
used some resources from our Providence IDES processing center
to help back down that time and age for our army participants
in the IDES program.
Mr. O'Rourke. And to put a point to it, we will be at 15
days at what point?
Ms. Rubens. So I guess the 15 days, if I recall, really is
the up-front component and there are pieces of the IDES program
that start with the claims intake, the getting the exam
accomplished. And I would like to make sure that I am referring
to the right target of 15 days with you so that I am not
misleading you.
Mr. O'Rourke. The VA has two parts of this; the Department
of Defense has the rest. I am looking at the VA rating which is
one of those parts which--the first VA rating which has a goal
of 15 days. The actual in the case that we are looking at is
191 days. The Army average is 143 days. That is the one I want
to know when we are going to be able to get to our goal.
Ms. Rubens. So as we work to the agreement with the army
about which we would, I will say tackle first, we determined
that we would complete the final rating initially. Those are
the servicemembers who have gotten not only the preliminary
from us, but finished the work with the army on the MEB/BEB
process. That target is March and it is August of this year
that we are targeting the preliminary rating in 15 days.
Mr. O'Rourke. Okay. And then we won't have time for your
response because I have run out of time, so I will just pose my
third question as an appeal. You heard from the VSOs in terms
of their feelings about the standardized form, and I understand
the logic behind implementing that and the rule, but I think
you have heard about the discomfort and distress and the
disservice that we might end up doing to our veterans with that
rule. So I would appeal to you to use something like the Faster
Filing Act to allow veterans, VSOs to file a claim in whichever
way they think is best.
But make sure that we are very transparent with the
information about how soon that claim is likely to be resolved
based on current trends, which, again, you can elect to
implement administratively. The VA has chosen not to, so the
legislation has passed the House. Before that becomes mandated
by law, we just appeal to you to implement that
administratively. I think that could do a world of good given
how much harm we fear this rule may do.
So, with that, I will yield back to the chairman.
Mr. Runyan. I thank the gentleman.
With that, I recognize Mr. Ruiz.
Mr. Ruiz. Thank you all for coming today and thank you for
your efforts in trying to fix this problem. I am interested in
the e-benefits program and initiative and I am assuming that
this program will allow users to file and follow their claims
from their own home, correct, Ms. Rubens?
Ms. Rubens. Yes, sir.
Mr. Ruiz. Okay. So the whole purpose is to have our
veterans log on so they can have an easier way to file and
follow their claims.
So what are you doing to train and educate our veterans and
our volunteer veteran service officers and those in the
community who work with veterans to utilize this e-benefits,
and how is it getting all the way into the community at the
grassroots level?
Ms. Rubens. Terrific. Thank you very much.
And, yes, in fact, we believe that e-benefits is going to
give us that, and our veterans, frankly, that simpler process
for them to come in online, upload documents, check their
status of claims, as well as 58 other self-service initiatives.
As we work to get the word out, frankly, it has been an
across-the-board push educating--starting here with members of
the committee and staff, with our VSO partners, and press
releases, as well as information that we regularly post up
online.
Any outreach event, frankly, sir, that we go to, we also
have members, whether it is from our benefits assistance
service here in Washington or our regional offices across the
country, out at those outreach events with an e-benefits site
working to get folks informed about e-benefits, and for those
that are not registered for a premium account so that they can,
in fact, make use of all of those online services.
Mr. Ruiz. A lot of our veterans are more senior and not
very computer savvy, so they would require some hands-on
training walking through with computers. Do you have those
training workshops, not just lectures or panels or flyers, but
actual training for veterans?
Ms. Rubens. So I would refer back to the veterans who
participate in our outreach events. If they come in, we will
work with them to show them, whether that is in our outreach
event or in our regional office, to show them how to get into
e-benefits and use it. I would tell you we are very much
engaged and our VSO partners have been awesome in helping to
ensure knowledge about e-benefits and utilizing e-benefits is
there.
Also, for our veterans who are not computer literate, as we
continue to build that functionality for our stakeholder
enterprise portal, it will allow our VSO partners who hold
power of attorney for those veterans to come in and submit
claims online on behalf of those veterans who are not computer
friendly.
Mr. Ruiz. Now, we are starting a veterans university in our
district where we are going to train and educate a lot of our
veterans and our veteran service officers in the area to really
help them learn the system and learn what they qualify for and
train them on how to help other veterans.
I would like to invite your experts into the district to do
a series of these for our VFWs, our American Legion, and our
other VSOs, and our veterans in my district so that we can help
them access their claims better.
Ms. Rubens. Wonderful. We would like to be at any outreach
event you might hold.
Mr. Ruiz. Okay.
Ms. Rubens. Great.
Mr. Ruiz. Thank you.
I yield back my time.
Mr. Runyan. I thank the gentleman.
With that, I am actually going to have another round of
questions. We are going to have votes here pending in the next
five, ten minutes maybe.
I have two questions, one for Ms. Rubens and one for Major
General Thomas, and I will start with Ms. Rubens because some
of the VSO testimony contradicts some of the things you
actually said in your opening statement. All of the VSOs had
testimony that contained some negative feedback on the proposed
rule to require the use of standardized claims forms.
In part, some of these concerns include the elimination of
all informal claims, the creation of a new, arbitrary--burden
on claimants to submit a completed claim suggesting that the VA
will not work a claim until the veteran complies with certain
bureaucratic hurdles.
Can you explain from the department's perspective how this
new rule would benefit the veteran?
Ms. Rubens. Thank you, Mr. Chairman.
And I will start and if Mr. Hipolit has something to add, I
will turn to him. I will tell you that organizationally VBA
continues to look at how do we gain efficiencies in processing
claims because we think that will help us process claims more
quickly and to a higher degree of quality for our veterans if
we can readily identify the veteran and the issues claimed in
evidence that is either available or attached.
To that end, we have gone through the regulation proposal.
We have gathered 53 sets of comments, many from our VSO
partners, and many with great, thoughtful information that we
are going to cull through very closely. And as we work to
publish the final rule, obviously, we will work to address
every one of those comments.
Mr. Hipolit, is there something that you might add to that?
Mr. Hipolit. I would just like to add that although the
proposed regulation would do away with the term informal claim,
there are still certain aspects of the old system that would be
preserved in the rule to the benefit of veterans, particularly
in the electronic filing environment. If a veteran comes in and
starts to develop a claim and has what we would call an
incomplete claim under the rule, that would still serve to
preserve their effective date.
We have also made it clear that in cases where there is
medical evidence that would allow an increase in benefits, a VA
exam or whatever that could be the date of a placeholder that
could then be the basis for an effective date if the veteran
came in and filed a claim within a year there after.
So some aspects of the old system are still preserved, even
though the term informal claim is no longer used. As was
mentioned, though, a lot of the VSOs did have concerns about
the impact of the rule, and there may be changes to what has
been proposed in a final rule.
We have greatly appreciated receiving those comments. We
are in the process of analyzing those in depth now and we are
going to certainly take those into account moving forward.
Mr. Runyan. Every single VSO that sat up there had a
concern about it.
I think, Mr. Hipolit, you have addressed it, and, Ms.
Rubens, you have addressed it a little bit, but it is a concern
that they all have. And just make sure when you go through the
process that you are weighing concerns the way they should be
weighed.
My next question is for Major General Thomas.
Both DoD and VA state in written testimony, the deadline
for implementing HAIMS transfer of digital STRs to the VA was
met, but at a the recent oversight visit, subcommittee staff
was informed that there had been some complications with the
rollout.
Can you detail these complications and then state what has
been done to fix those problems?
Major General Thomas. Yes, sir, absolutely.
You know, I think the initial rollout here is really to get
the system to IOC or initial operating capability. They have
goals and milestones to get to the FOC and there is a targeted
date for that.
And I know that, specifically, there were some issues
working with the VA here to address a certain timeout issue
affecting subscription service to obtain the--or to retrieve
the full service treatment record.
And I will defer to Mr. Bowen, if you want to give any more
specific details about complications?
Mr. Bowen. Yes, sir.
Mr. Chairman, we do have some issues we are working
through. They are involved around some of our workflow
processes on the DoD side still needing to be refined. I know
we have had one instance where a document was misclassified and
so it showed up in the wrong section of the service record that
transferred over to the VA, but, nonetheless, was there. The
system worked as planned. We just put the document into the
wrong section. So we are working on that.
We have some issues around duplicate records showing up on
the VA side. We are working through those issues. We believe
that may be a user education issue on the VA, where the
claimant has actually requested multiple times, so working
through that.
Teams are looking at the details of all of these issues. We
are logging them. We are tracking them, and the teams are
meeting every single day to work through these issues, research
the problems, and get them resolved.
Mr. Runyan. Thank you.
Ms. Titus.
Ms. Titus. Thank you, Mr. Chairman.
I would just ask Ms. Rubens how station targets are set for
VA regional offices? We have discovered, of course, especially
in Reno, that they are not being met. I wonder if those targets
are realistic and what happens to hold offices accountable that
do not meet those targets?
Ms. Rubens. Yes, ma'am. Thank you.
Targets are based on the resources within each regional
office. The expectation that a resource from one office will be
equivalent to the resources in another office, and so from one
RO to another, it is based on how many individuals they have
working within the service center to make decisions. And I
would tell you that in any instance where a regional office is
not meeting its targets, feedback is ongoing and appropriate
accountability measures are taken.
Mr. Runyan. I thank the gentle lady, and thank all of you
for being here with us today.
The panel is excused. I appreciate the time and attention
that went into preparing your remarks for today.
VBA is moving forward in a positive direction with
technological updates to its processes, but it is obvious that
there will be continuing growing pangs along the way. It is
frustrating when the department delivers a message that
everything is going as planned when we know that is not always
the case.
Accordingly, I would ask you all to, again, keep
communication open with this subcommittee.
I would also ask unanimous consent that all members have
five legislative days to revise and extend their remarks and
include any extraneous material. Hearing no objection, so
ordered.
I thank the Members for their attendance today, and this
hearing is now adjourned.
[The Statement of Paralyzed Veterans of America appears in
Appendix]
[Whereupon, at 6:26 p.m., the subcommittee was adjourned.]
APPENDIX
Prepared Statement of Gerald T. Manar
Deputy Director, National Veterans Service Veterans of Foreign Wars of
the United States
On behalf of the men and women of the Veterans of Foreign Wars of
the United States (VFW) and our Auxiliaries, I would like to thank you
for the opportunity to present our views on the current status of
Veterans Benefits Administration (VBA) transformation and secondary
effects of VBA technology.
The wide ranging focus of today's hearing on the status of VBA's
transformation and intended and unintended consequences of these
changes is both apt and timely. VBA is moving forward so quickly and on
so many fronts to modernize its claims processing tools that it is only
appropriate that all of us pause from time to time, and determine where
the Department of Veterans Affairs (VA) is at in the process and
examine the effects of this massive effort.
While the VFW is both an observer of these changes and a
participant in many of them, and we have some knowledge and
understanding of all the topics you are interested in today, we will
confine our comments to three issues which concern us the most: VA's
national work-queue strategy within Veterans Benefits Management System
(VBMS); how that strategy will affect VFW representational activities;
and the recently proposed rule mandating electronic forms and its
potential impact on veterans and veterans' rights.
VA's National Work-Queue Strategy
VA has one of the most geographically diverse claims adjudication
operations of any federal agency or department in the federal
government. Claims processing occurs in VA regional offices found in
every state. Several states have two regional offices; California has
three. Regional offices also exist in Puerto Rico and the Philippines.
In addition, claims processing has been further dispersed to other
locations, including Sacramento and Orlando. Claims intake sites, and
some claims processing personnel, are also located on scores of
military bases around the nation.
Even with this widespread diffusion of personnel, claims processing
is still largely worked on by staff in the office with jurisdiction
over the geographic area in which the veteran lives. Except for several
counties in the southern part of the state, for instance, New Jersey
claims are processed in Newark; claims submitted by residents of Nevada
are processed in Reno; and claims from veterans living in California
are adjudicated in San Diego, Los Angeles or Oakland. However, for at
least 30 years, VBA has increasingly transferred cases from offices
with high workloads to those more capable of processing the work more
quickly--a process called brokering. VBA has developed tools to assess
the capacity of offices to handle more work and moved the work to those
locations.
The VFW has often been critical of the practice of brokering work.
All too often, VBA has chosen to move work around rather than address
the problems extant in overburdened offices with overworked staff.
Inadequate training, poor management and other factors have not always
been addressed in a timely manner in order to fix known problems and
ameliorate the need to transfer work to another office.
Further, the practice of brokering work has the unintended
consequence of undermining the ``ownership'' of claims that many VA
employees feel, which has a subtle but real effect on the quality of
development and decisions in cases not from their state. Poor quality
of decisions in brokered claims has been a common complaint of veteran
service officers and VA employees alike. While VBA claims that quality
of brokered work is no different than work that is not brokered, the
near constant cacophony of reports to the contrary makes us question
VBA's claims.
We are in the midst of a great and long overdue renaissance in
claims processing technology. While we may still talk about the
electronic transfer of claims from one office to another, the reality
is that the only thing transferred is the authority to work a claim, or
pieces of that claim, to an office other than the one with jurisdiction
over it. For the first time in its history, VBA has the capability to
develop a claim in Phoenix, rate a claim for PTSD in Pittsburgh and
evaluate the other claimed conditions in Jackson. The question is not
whether they can do this. It is, rather, how they can do this while
ensuring that veterans receive quality correspondence from Phoenix and
legally correct decisions from Pittsburgh and Jackson.
The VFW generally supports VBA's modernization efforts, recognizing
full well that in order to be effective, it must take advantage of all
the resources and assets it has available to it. The VFW has worked
with VBA administrators, innovators and contractors over the past three
years, often on a daily basis. The VFW, along with other major Veteran
Service Organizations (VSOs), have cooperated with VBA by providing not
just our time, ideas and observations, but also by providing personnel
to work side by side on specific projects.
Even though we are living through an unprecedented period of
cooperation and transparency, we find that significant gaps exist in
what we are allowed to see and comment on. For instance, other that
talking to us about the vision of developing a national work-queue, of
truly nationalizing the work to more effectively deal with workload
peaks and valleys, VBA leadership has not yet presented us with a
coherent picture of their vision nor have they sat down to explore with
us how representatives from veterans service organizations fit into
that plan.
Impact of A National Work-Queue Strategy on Service Organization
Representation
Over the past few years, as the major VSOs sat with VBA personnel
and contractors to discuss how accredited service officers will access
and use VBMS, SEP, D2D and other programs, they often seem confounded
and occasionally confused by the divergent business models that exist
between VSOs. There are two basic business models between the major
VSOs. The VFW and the American Legion service programs generally follow
a federal model: most representational activity is performed at the
local regional office level by service officers employed by the
respective organizational Departments or states. For instance, the VFW
Department of Michigan employs the VFW service officers who work in
Detroit. While the national VFW contributes to Michigan's service
program, the employees do not work for the national organization.\1\
---------------------------------------------------------------------------
\1\ The national VFW employs service officers at the Board of
Veterans Appeals supporting claimants who have appealed to the BVA.
Other national service officers work at over 16 military installations
helping service members understand VA benefit programs and, where
appropriate, file a claim for compensation.
---------------------------------------------------------------------------
This business model works best when local service officers work
with and support local veterans and other claimants. The claims are
worked in the regional office where they are collocated which allows
them to develop professional relationships with local VA personnel.
This close proximity allows them to get problems corrected quickly and
informally, helping veterans receive the benefits to which they are
legally entitled and avoiding unnecessary appeals.
Other VSOs, such as the Disabled American Veterans and the Military
Order of the Purple Heart, employ a cadre of national service officers.
While these service officers may be stationed in the various regional
offices, they work for the national organization. The national
organization in this business model may find it easier to repurpose or
redirect their service officers and can tell them which cases they are
to review regardless of geographical boundaries. While there are
significant differences in these two business models, under the current
work processing system employed by VA, both models work similarly. In
both, local service officers assist claimants, review decisions made by
VA and work to get mistakes corrected without the need to appeal.
Today the work queue provided to service officers only shows the
work in the office where they are situated. While the service officer
can search for a specific claim and view whatever information is
available in VBMS and Virtual VA for any case in the VA system, they
must do this on a case by case bases since the current work queue does
not show work outside the geographical boundaries of the office in
which they work.
There are over 4,000 Illinois cases brokered from the Chicago
regional office to other offices around the United States. Our service
officer currently has no way to obtain a list of all Illinois VFW cases
being worked in another VA office. Although he may have helped many of
these claimants file a claim with VA, he is unable to identify which
cases have been brokered or what is being done with them unless he
searches these cases one by one. VA can and should do better.
Under a national work-queue plan, VA must accommodate the service
organizations which have represented veterans for decades. It is not
enough to allow service officers in Detroit to review a file and rating
for a claim brokered to Detroit from Fargo. VA must allow the service
officer in Detroit to review a Michigan claim which was developed three
states away and rated in Utah. VA is developing this capability for its
claims personnel. It is critical that VSO service officers are not left
behind.
This, then, comes full circle to our previous comments about VBA's
failure to sit down with VSOs, discuss the needs of each service
organization, explore in a robust and frank manner how VBA systems can
be modified to allow for the various business models employed by the
various VSO's and then commit to making these system changes concurrent
with developing a national work-queue.
VA Proposed Rule AO81-Standard Claims and Appeals Forms
VA published a proposed rule on October 3, 2013, which caught the
attention of the veteran community. Disguised as a proposal to require
claimants to complete standardized forms, it actually proposed to:
Eliminate all informal claims----
Create a new and arbitrary burden on all claimants to
submit a ``complete claim'' before VA is required to take any
notice of a claim.
Advance the concept that VA will work no claim until a
veteran first complies with every arcane bureaucratic
requirement it creates.
The comments of the VFW, along with over 60 other responses, were
submitted by the December 30, 2013, deadline. Every major veteran
service organization, and virtually all of the other respondents,
opposed these changes.
Over the past five years, the VFW has been generally supportive,
both publicly and privately, of the focus and vision of both Secretary
Shinseki and Under Secretary for Benefits Hickey. Together they have
accomplished more, and advanced VBA further than all of their
predecessors for at least the previous decade combined. However, we
have become increasingly concerned over the past year that the focus on
achieving the Secretary's goals of ending the ``backlog'' by 2015 and
achieving 98 percent accuracy in claims processing has taken on a life
of its own; that the goal is no longer to help all veterans but to
create the appearance of success by changing the playing field.
These regulatory proposals change the playing field for veterans.
In order to force them to use specifically designated forms, VA makes
it demonstrably harder for veterans to begin a claim. Under current
law, a claimant need only submit a communication to VA indicating his
or her intent to file a claim for one or more benefits. If a formal
application is not of record, VA is obligated to send the claimant an
application to complete. The claimant has one year in which to return
the completed application. If benefits are awarded, benefits may start
as early as the date of receipt of that first communication.\2\
---------------------------------------------------------------------------
\2\ ``Any communication or action, indicating an intent to apply
for one or more benefits under the laws administered by the Department
of Veterans Affairs, from a claimant, his or her duly authorized
representative, a Member of Congress, or some person acting as next
friend of a claimant who is not sui juris may be considered an informal
claim. Such informal claim must identify the benefit sought. Upon
receipt of an informal claim, if a formal claim has not been filed, an
application form will be forwarded to the claimant for execution. If
received within 1 year from the date it was sent to the claimant, it
will be considered filed as of the date of receipt of the informal
claim.'' 38 CFR 3.155(a)
---------------------------------------------------------------------------
If these changes go into effect, that first communication can no
longer act as an effective date, nor does it compel VA to respond to
the veteran. VA may eventually send a letter to the veteran stating the
communication was received. However, VA will not take any action until
the veteran fully completes and returns a required form. Omission of a
single required entry means that the veteran has not submitted a
``complete claim'' and VA will continue to do nothing.
While surely not intended by Secretary Shinseki, the implementation
of these changes will result in substantial delays in veterans being
able to file a ``complete claim'' and a substantial reduction of
benefits because the date of claim is delayed by months while veterans
are forced to comply with arbitrary administrative requirements. The
backlog will be reduced, not because VA is more efficient, but because
it tells thousands of veterans that they have not filled out VA forms
to its satisfaction. Because a date of claim is not established until
VA accepts an application as ``complete,'' veterans will lose months of
benefits. These proposed changes are not in keeping with the veteran
friendly laws enacted by Congress over the last four score years.
The VFW believes that there is an alternative to this draconian and
heavy handed approach. The acceptance of an informal claim in the
absence of a ``complete claim'' does not harm VA. It is nothing more
than a place holder. If a claimant submits a ``complete claim'' within
one year, then VA can use the date of receipt of the informal claim as
a possible effective date as is currently allowed by law and
regulation, allowing VA to obtain the data it wants from claimants in
the form it wishes to receive it, regardless of the initial informal
claim. However, claimants are not harmed because, under current law,
they have one year in which to submit a claim form satisfactory to VA.
The authors of these proposed changes must believe themselves to be
clever, because while doing away with informal claims they create the
concept of an ``incomplete claim'' only for claims started
electronically. Incomplete electronic claims can be completed at any
time within a year after they are started, and VA may use the date the
claim was started electronically as the date of claim. They create a
special incentive for claimants who are aware of, and comfortable with
the online application process. VA elects to penalize claimants who do
not have a computer, access to the Internet, an e-Benefits account, or
just like to sit at the kitchen table and complete a paper form.
It is strange that VA chooses to not just incentivize the filing of
an electronic claim; instead they have decided to penalize veterans who
write a letter or fill out most of a prescribed form by delaying the
start of any earned benefits by many months. The Internal Revenue
Service incentivize Americans to file electronically by processing
refunds with lightning speed. However, they do not reduce a refund
simply because the filer chooses to send in a paper form 1040.
VA has proven that it can process claims submitted electronically
much faster than those received on paper. Many dependency claims filed
electronically today can be worked in minutes while over 235,000
previously filed paper claims continue to wait.\3\ What more incentive
do people need? It is VFW's contention that these draconian measures
are unneeded to encourage many thousands of veterans to file
electronically.
---------------------------------------------------------------------------
\3\ Monday Morning Workload Report, http://www.vba.va.gov/reports/
mmwr/, January 27, 2014. VA reported that dependency claims, controlled
by End Product (EP) 130 totaled 235,189; 74.2 percent were pending over
125 days. In the last 42 months the number of dependency claims has
grown 474 percent from 40,990 in June 2010.
---------------------------------------------------------------------------
There is one other consequence of the elimination of the informal
claim. The Fully Developed Claim (FDC) program, created by VA to
encourage veterans to accomplish all required development before
submitting a claim to VA in exchange for expedited claims processing,
will be dealt a severe and likely fatal blow. In Fast Letter 10-22,
Fully Developed Claim Program (June 15, 2010), specifically addresses
and endorses the use of informal claims in FDC claims. Veterans may
notify VA that they intend to file a claim under the FDC program. VA
acknowledges that notification and tells the veteran that they have one
year in which to submit a complete FDC.\4\
---------------------------------------------------------------------------
\4\ Fast Letter 10-22, Fully Developed Claim Program, June 15,
2010, states in part: Consider any communication or action that shows
intent to apply for benefits under the FDC Program as an informal FDC.
[emphasis supplied] Upon receipt of an informal FDC: Advise the
claimant to complete and return a formal claim within one year to
receive benefits from the date of receipt of the informal claim.
---------------------------------------------------------------------------
Implementation of the changes proposed by VA to eliminate informal
claims will take away a major incentive offered to veterans for
accomplishing their own development. Without the ability to file an
informal claim, veterans stand to lose months of retroactive benefits
if they chose to submit an FDC. We fully anticipate that veterans will
decide that the cost of delay in filing a claim is too great. Without
the ability to file an informal claim they will elect to file a
standard claim and forgo the FDC program. Currently, over 27 percent of
disability claims submitted to VA are accepted as Fully Developed
Claims. Implementation of this rule will eliminate this vast savings of
VA manpower overnight.
The VFW does not oppose the use of standardized forms, nor do we
oppose the required use of such forms in order to complete a claim for
benefits. However, the proposed elimination of the ability to file an
informal claim will have a profound impact on every veteran who does
not or cannot use a computer to start a claim.
This proposed rule will take away a basic and fundamental right
that has existed for many decades. It unnecessarily increases the
complexity of starting a claim with VA, and will substantially reduce
the amount of compensation awarded to veterans and other claimants.
Further, because VA will not count any attempt to file a claim until
the veteran has filled out every form to VA's satisfaction, it will
have the effect of reducing pending claims, making VA appear to be more
efficient than it really is.
The VFW opposes these proposed changes. We believe them to be
unnecessary to accomplish VA's stated objectives and harmful to
veterans and other claimants. We have talked to VA leadership about
these proposed changes with little apparent result. We ask Congress to
take action to protect the ability of claimants to file an informal
claim, whether electronically or on paper.
Mr. Chairman, this concludes my testimony. I will be happy to
answer any questions you or the committee may have.
Information Required by Rule XI2(g)(4) of the House of Representatives
Pursuant to Rule XI2(g)(4) of the House of Representatives, VFW has
not received any federal grants in Fiscal Year 2013, nor has it
received any federal grants in the two previous Fiscal Years.
Prepared Statement of Jeffery C. Hall
DAV Assistant National Legislative Director
Chairman Runyan, Ranking Member Titus and Members of the
Subcommittee:
On behalf of the DAV (Disabled American Veterans) and our 1.2
million members, all of whom are wartime wounded and injured veterans,
thank you for asking DAV to testify before the Subcommittee today
regarding the current status of the many technological initiatives
occurring in the Veterans Benefits Administration (VBA), including the
Veterans Benefits Management System (VBMS) 6.0, Veterans Relationship
Management (VRM), e-Benefits, Stakeholder Enterprise Portal (SEP), the
work-credit system in an electronic environment, national work-queue
strategy, and the potential impact of the proposed rule mandating the
use of standardized forms within the Department of Veterans Affairs
(VA). As the nation's leading veterans service organization (VSO)
assisting veterans seeking disability compensation and other benefits,
DAV has tremendous experience and expertise relating to the processing
of claims as well as the various ways veterans may appeal adverse
actions and decisions.
Mr. Chairman, I recently had the opportunity to accompany DAV
National Service Director Jim Marszalek on a visit to the Newark, New
Jersey, VA regional office (VARO). As you may know, the Newark VARO is
the only fully electronic regional office within the VA, also known as
an ``e-VARO.'' All claims processing performed in Newark today is fully
electronic and for all intents and purposes, completely paperless.
Upon receipt of a claim for benefits on a standard VA Form 21-526
by the Intake Processing Center (IPC), employees first check the system
to determine if an electronic record already exists. If no electronic
record exists, the IPC begins building the veteran's electronic file
(e-File) by first establishing where the paper file is currently
located and then requesting the file be sent to the scanning facility
where it will be converted digitally and become the base of the e-File.
IPC employees then input the basic information from the paper claim
into a newly created VBMS record, including the specific contentions or
issues being claimed. Based upon the number and/or complexity of the
issues being claimed, IPC employees then assign the claim to one of the
corresponding processing lanes: Express for one or two issue simple
claims, Core for most standard claims with less than eight issues, and
Special Ops claims with more than eight issues or complex claims, such
as post traumatic stress disorder (PTSD), military sexual trauma (MST),
or traumatic brain injury (TBI). After the IPC has created the VBMS
record, the paper claim is sent to the centralized scanning facility to
be converted digitally in the same manner as the paper claims file.
For veterans who visit the Newark VARO wishing to file a claim,
computers are available so the individual can create an e-Benefits
account and file their claim electronically. Help is available if
needed. Should that individual have paper evidence to submit along with
the claim, it can be scanned and uploaded in Newark or it may follow
the same path as above, being sent to the scanning facility, depending
on the amount of the paper evidence. Clearly, for those submitting
claims electronically via e-Benefits, the less cumbersome initial
processing is for VBA. For veterans who want DAV to represent them and
file their claim through SEP, we also begin that process by having them
establish an e-Benefits account.
Once the now electronic claim has been received in the
corresponding lane by an assigned Veterans Service Representative
(VSR), development can begin. Each day, the VSR opens his or her work
queue, selects a case, and begins undertaking the necessary
development. The VSR may be requesting service or private treatment
records, a VA physical examination and Disability Benefits
Questionnaire (DBQ), or other necessary development. Not only does this
assist greatly with organization during claims development and working
with the veteran's information, it provides tremendous benefit in
productivity and output, having everything electronic and at a person's
fingertips.
Being able to actually watch a working demonstration from a Rating
Veterans Service Representative (RVSR) proved to be invaluable during
the visit to Newark. When RVSRs come in each day, they are greeted with
a much more harmonious working environment, with neat work spaces
instead of the customary mountains of paper and files that used to be
there waiting for them. Now all of a veteran's claims and related
information has been converted electronically within the VBMS system to
be process or searched; and by more than one user at a time if
necessary. When the RVSR opens the work queue, he or she is able to
quickly ascertain what has been done and what needs to be done in each
respective case. The RVSR is able to review the veteran's e-File and
see all of the development as it relates to the claim, tab certain
information and make notes. When the case is ready for rating, the RVSR
opens the VBMS rating program (VBMS-R) on a second screen program to
prepare the actual rating. Gone are the stacks of paper and cumbersome
files laid in front of an RVSR, replaced with two computer screens, one
for the VBMS showing the veteran's e-File with tabbed notes to review
for quick reference, and the other opened to the actual VBMS-Ready for
the RVSR to input pertinent information and produce a final rating with
much greater ease than in the past.
In speaking with many employees at the Newark VARO, including the
leadership, they uniformly told us that employee morale is higher than
in the past and growing every day. Employees feel VBMS and the new
organizational model, while not perfected, allow for greater
productivity, speed, accuracy and accountability in completing their
work. Employees realize there will be continuous upgrades and
improvements to the VBMS system, but they believe that as their
proficiency using the new system rises, they will be able to
demonstrate further increases in all measurable activities.
It is important to note that no modern IT system or software is
ever truly ``finished'' and therefore it is vitally important to
continue making significant investments in VBMS development in order to
allow this system to be capable of meeting VBA's needs. For example,
the coding and embedding of rating calculators inside the VBMS remains
a labor-intensive, time-consuming process and one that needs to
continue as the VA Schedule for Rating Disabilities (VASRD) is
continually updated in the future. Furthermore, as new IT technologies
emerge, and new requirements for the VBA are identified, the VBMS must
evolve to address those needs and opportunities, requiring an
aggressive development program that has sufficient resources, in
addition to funding just required to maintain the current IT hardware
and software.
Mr. Chairman, while a backlog of claims pending longer than 125
days still exists in Newark and nationally, there are measurable signs
of progress resulting from VBA's transformation efforts. The number of
claims in the backlog is down by about one-third, the total number of
pending claims has been reduced by about one-fifth and the average days
pending continues to drop as the oldest claims are now being processed
first. Questions remain as to whether this progress can be sustained
two, five or 10 years from now, and based only on the currently
available data and information from the VBA, it is not certain whether
this level of progress will be sufficient to meet the Secretary's
ambitious 2015 goals. Nonetheless, DAV continues to support VBA's
transformation efforts through our working partnership and we remain
optimistic that the documented progress is not simply short-term
progress that will stall; rather, it is progress that must be sustained
and accelerated if VBA is to finally eliminate the backlog.
Veterans Relationship Management (e-Benefits & SEP)
Although not as well known as VBMS, the VRM systems are equally
important to the current transformation. The VRM system provides both
veterans and VSOs the ability to file claims electronically. Like VBMS,
the e-Benefits system with VONAPPS Direct Connect (VDC) has been in
place for more than a year. While VBMS is the paperless, rules-based
system VBA uses to create electronic files, manage workflow, and
determine ratings, the e-Benefits and SEP systems were created to allow
veterans to file claims electronically and manage benefits online.
Notwithstanding the recent problems related to the security of the
e-Benefits system, in general over the past two years it has been
working as intended. More and more claims are being submitted and
received electronically; however, there have been obstacles to be
overcome, some of which still remain. One of the first obstacles
veterans encountered in e-Benefits was problems with inaccurate
information maintained by the Department of Defense in the Defense
Enrollment Eligibility Reporting System (DEERS). When a veteran's
personal information is inaccurate in the DEERS system, such as one
incorrect digit in a birth date, the veteran is unable to set up an e-
Benefits account until that information is corrected. The system does
not provide adequate support and correction. Such a problem can be a
daunting task that causes some veterans to become frustrated, abandon
the process and possibly not file a claim at all. Although this seems
to occur more frequently with older veterans less familiar with
computers and the Internet, it is nonetheless a major obstacle that
must be corrected immediately.
Many of our DAV clients have reported problems trying create an
account and file a claim electronically. DAV service officers work
diligently with our clients to find solutions, but it can take a great
deal of time to resolve these issues with DEERS before the e-Benefits
system will allow a veteran to create an e-Benefits account and file a
claim electronically.
Mr. Chairman, VBA wants more veterans to file claims electronically
and DAV has been the leader among VSOs in increasing the number of
claims filed electronically. However, regardless of the level of
interest from veterans for electronic filing, if access continues to be
a problem for many veterans, particularly when they are not given
information or tools to resolve those problems, there will be too many
veterans who walk away from e-Benefits. Nonetheless, DAV is fully
committed to promoting electronic filing of claims through e-Benefits,
or on their behalf through the SEP with the assistance of our National
Service Officers (NSOs). Even SEP, however, is dependent upon a veteran
having an e-Benefits account in order to receive official information
from VBA, thus heightening the need for VBA to resolve the issue with
VSOs' ability to file claims directly in SEP without the need to do so
through e-Benefits.
The SEP is a crucial IT component for reforming the claims process
because it allows our NSOs the ability to file a veteran's claim
electronically, accept a power of attorney (POA), and upload evidence,
while being fully integrated with VBMS. The SEP allows DAV and other
VSOs to do for veterans what the VDC and e-Benefits allows veterans to
do for themselves, but with the benefit of assistance and expertise of
an experienced representative. Early problems with the SEP development
were encountered with access as well. Essentially, VSOs were not able
to access any information about a claimant they represented through
VBMS unless the POA box was properly checked. Although this issue has
been addressed and resolved to a degree, the problem still persists in
certain locations and leaves our VSOs unable to assist a client even
with simple matters such as obtaining the status of a claim in VBMS.
Like e-Benefits, the VBA must continue to address and resolve these
types of problems in VBMS with immediacy to ensure that DAV and other
VSOs are able to fully represent veterans in this electronic
environment.
Work Credit in an Electronic Format
DAV has long said that the only real solution to the claims backlog
is the development of a new claims processing system that focuses on
quality and accuracy, not just production and timeliness. While
accuracy has been and remains one of the performance standards that
must be met by all employees, current performance standards adopted in
recent years have done little to create new incentives to promote
quality above production. As new processes and technologies come
online, such as VBMS and the new organizational model, it is vital for
the VBA to make timely adjustments to outdated performance standards to
ensure that production pressures not outweigh the goals of accuracy and
quality, while creating a systematic accountability for work-credit
that would function with the new organizational model and within the
electronic environment. Implementation of the new organizational model
has changed the roles and workloads of VSRs and RVSRs, which requires
consistent adjustments to be made to performance standards. For
instance, employees handling complex Special Ops claims should not be
held to the same performance levels in terms of claims completed per
day as those handling simpler Express claims. Although VBA revised its
performance standards and work credit system, further refinement is
needed to create the proper system of work incentives.
DAV believes it to be absolutely imperative for the VBA to develop
a scientific methodology for measuring the resources (primarily
personnel) required to accurately and timely process the current and
future anticipated workload as well as develop a new data-driven model
for allocating those resources among VAROs. Crucial data needed to
establish a sound performance plan or work-credit system is readily
available in the VBMS and includes such information as specific
development or rating actions, workload management, quality, accuracy,
output, as well as the correct application of pertinent laws and
regulations.
Mr. Chairman, as the transformation to a completely paperless
system changes the dynamics of the daily business of assembling,
developing and processing claims, VBA must also change VBA's work-
credit strategy to ensure each employee is properly credited for the
work they complete. DAV believes VBA must take the time now to ensure
development of a new performance plan and work-credit system within an
electronic environment , not only to hold management and employees
accountable, but perhaps more importantly to ensure proper resources
and staffing can be calculated and provided. It is also essential for
the proper allocation of those resources and staffing in the most
prudent and forward-thinking manner. Additionally, it is absolutely
crucial for VBA to look back at claims accuracy rates using STAR and
other reviews to continually adjust these standards so that they have
sufficient resources not just to process the workload of claims, but to
make sure that they are doing them right the first time.
National Workload Management Model
Another top priority for VBA, VSOs and veterans is the timeliness
of processing claims. While demonstrated progress was achieved last
year in reducing the backlog of claims, other VBA initiatives such as a
national workload management model, Centers of Excellence and
centralized mail centers, are being proposed, developed and tested.
Although we have not yet seen detailed information of any national
workload management model, our understanding is that this will allow
all claims to be processed nationally by VSRs and RVSRs, regardless of
their physical location or the origin of the claim. This is essentially
the same approach VBA took last year when they processed all claims
pending more than two years within a short period. With all claims now
being submitted and/or converted electronically, claims processing can
be done by any fully trained VSR or RVSR regardless of their location.
This approach is not unlike the process of brokering claims from one
VARO to another when assistance is needed, which VBA has relied heavily
upon over the years. So taking the basic concept of brokering claims
and VBA's ``all hands'' strategy they used last year to process the
oldest claims and applying it to national workload may have the
potential for success; however, we would like to know more details of
how this type of model would work.
For the past several years, VBA has discussed the general concept
of establishing Centers of Excellence, wherein specific VAROs would be
designated to process specific types of claims for the entire country.
For example, a particular VARO would be designated as a Center of
Excellence for claims involving PTSD, MST, and TBI, and all claims
containing such conditions would be processed by that facility for the
entire country.
While Centers of Excellence could relieve the majority of VAROs
from processing some of the more time consuming, complex claims, it
must be done properly, with certain principles guiding such a model.
One key question is whether claims split by issues and processed by
multiple centers. What would happen when a VARO receives a claim for
PTSD and an orthopedic condition - would the origin VARO process the
orthopedic condition or would a PTSD Center of Excellence process all
issues? Such questions are crucial and we believe that VBA must move in
a deliberate and thoughtful manner to ensure that Centers of Excellence
are truly ``excellent,'' not just ``centers.''
VBA has already begun progress towards testing centralized mail
centers, each designated to perform all initial intake processing for a
designated group of VAROs. For instance, there may be one such mail
center located in Wisconsin to receive all incoming mail from five or
six VAROs, wherein all initial intake processing will be accomplished
in the same manner as each respective VARO does at present. Eventually,
claimants may no longer send paper documents to their respective VAROs,
instead sending all documents directly to the mail center, as is done
for some other government agencies, such as for passports.
As we have done for nearly 100 years, DAV will continue to evolve
and adapt to any changes in the claims process; however, such
fundamental, structural change to the claims process should include
VSOs in the planning process from the earliest planning stage possible.
When considering a major change to the claims process such as a
national workload management model or anything of a centralizing
nature, thoughtful deliberation must be given to the impact of removing
the benefit of face-to-face interaction between highly-trained VSO
service officers and VBA, which at the very least would be hindered.
Mr. Chairman, the process of veterans submitting claims and
receiving personal assistance from VBA has been around much longer than
computers and automation. Many wounded, ill and injured veterans have
relied heavily upon personal assistance to help them navigate the
complexity of the claims process. While a national workload management
model may be a potentially important strategy for VBA's goal of
reducing the backlog, equal consideration must be given to the effect
it will have on individual veterans. We know that many veterans rely
heavily on personal interaction and assistance to help navigate VBA's
complex system; how will service be affected when a claim is filed by a
veteran residing in one state but processed by a VBA employee in
another state?
We have already seen the challenges of creating the national call
center, wherein veterans often call and end up speaking with someone
far removed from the VARO of original jurisdiction. DAV NSOs routinely
receive complaints from veterans who are unable to speak to a person in
the call center or if they are able to get through, someone who is
unable to answer basic status questions. Such problems with VBA's call
centers have caused many veterans to lose some confidence in VA and the
claims process.
Would a national workload management model, centralized mail
center, or Centers of Excellence further fragment personal contact for
veterans? DAV understands the need for and embraces change; however,
these changes must be done thoughtfully to ensure that they are equally
positive for veterans and VBA alike. Some of the changes, like e-
Benefits, involve ``self-service,'' wherein veterans, especially those
without representation, can be much more immersed in the claims
process; however, there are and will always be many who cannot and must
rely heavily upon personal contact with their local VARO. This is not
to say a national workload management model or anything of a
centralizing nature will not work, but we believe every effort must be
made to preserve the benefit of local claims processing first, and then
perhaps allowing all claims over a designated amount for each VARO to
be processed within a national workload management model.
Standardized Forms
Finally Mr. Chairman, VA is proposing to amend its adjudication
regulations and the appeals regulations and rules of practice of the
Board of Veterans' Appeals (Board), in order to require all claims to
be filed on standard forms prescribed by the Secretary, regardless of
the type of claim or posture in which the claim arises; and, to require
that VA would only accept an expression of dissatisfaction or
disagreement with an adjudicative determination by the agency of
original jurisdiction as a Notice of Disagreement if it is submitted on
a standardized form provided by VA for the purpose of appealing the
decision, in cases where such a form is provided.
DAV understands the stated intent of VA's proposed amendments as an
effort to improve the quality and timeliness of processing claims and
appeals. The purpose of the regulatory change is to promote submission
of claims and appeals in standard formats in order to capture data for
a paperless claims and appeals system. Nonetheless, we have concerns
about the proposed rulemaking and the consequential adverse effect upon
veterans.
First, requiring a veteran to submit a claim on a standardized form
is not a new concept. In fact, claim for disability benefits is defined
under title 38, Code of Federal Regulations, section 3.151(a) as ``[a]
specific claim in the form prescribed by the Secretary must be filed in
order for benefits to be paid.'' So requiring a veteran to file a claim
on a standardized form is the current practice; however, the real
question is how the new proposal would impact the effective date of a
claim received.
Currently, when a claim is received on a form not prescribed by the
Secretary, it is an informal claim, which, by definition under title
38, Code of Federal Regulations, section 3.155 is ``[a]ny communication
or action, indicating an intent to apply for one or more benefits . .
.'' provided the informal claim identify the benefit sought. Upon
receipt of an informal claim, if a formal claim on a prescribed form
has not been submitted, VA will then provide the veteran the proper
application for execution and the veteran would have one year to
complete then submit the required form(s). Should the veteran submit
the required form(s) seven months later, benefits would be payable
retroactively to the date the informal claim was received by VBA. This
proposal goes much further than requiring a standardized form to be
used; it effectively removes the preservation of date of claim by
eliminating the informal claim from the process. Under this proposed
rule, if a veteran does not submit a claim in the standardized format,
they too will be provided the form; however, if that same veteran does
not submit the proper forms until seven months later, that will be the
effective date of the claim--not the actual date the veteran submitted
his or her non-standard form claim, thereby losing entitlement to seven
months of benefits.
DAV takes no issue with veterans being required to submit their
claims on standardized forms, because that is not the root of what is
being changed. This proposed rule will cause many veterans, who may
have needed that seven months due to illness or other reasons, to lose
the benefit of the informal claims process, unless they file their
claim electronically; for those individuals their effective date will
be preserved. Whether this is meant to entice veterans to file their
claims electronically, clearly there will be veterans who stand to lose
their rightful benefits. We have submitted our comments to the proposed
rule and call upon Congress to further examine this matter, as it will
have a major adverse impact on veterans and the benefits they need and
earned.
This proposed rule also seeks to require veterans to submit their
notice of disagreement on a standard form. As we have stated, DAV does
not have an issue with requiring the use of a standard form, which may
make it easier for VA to extract pertinent information as to what the
veteran disagrees with; however, this proposal will cause many veterans
to lose their appeal rights. Quite simply, under this proposal if a
veteran does not use the standard form and complete exactly as
directed, no additional time period will be provided to the veteran for
correction. The appeal period will simply end. Currently, veterans are
allowed one year to appeal any VBA decision. If a veteran submits his
notice of disagreement on day 365, he or she will still have 60 days
from the date of the Statement of Case to submit the actual appeals
form, VA Form 9, Appeal to Board of Veterans' Appeals. We have
submitted our comments to this proposal as well; however, this is
another example of making this non-adversarial process adversarial and
unnecessarily complicated, especially for veterans.
Mr. Chairman, there is a distinction being created between those
who possess the resources and capabilities to meet the electronic
claims filing requirements, and those who are not able to do so. VA
serves veterans and claimants of all diverse backgrounds, with varying
physical and mental capabilities, education, and financial resources.
Some claimants, particularly those of limited financial means and those
with severe mental or physical impairment, will be penalized by not
retaining some measure of accommodation for allowing an effective date
for entitlement to benefits to be based upon the receipt of
communication expressing such belief.
Setting aside special consideration for claimants capable of filing
electronically, and excluding those who cannot, will cause a certain
portion of the eligible claimant population to be treated differently.
Based on resources, electronic access and capabilities, one group of
claimants will receive special consideration for the effective date of
a claim, while the other group, of limited resources, will be penalized
with a later date based on receipt of a complete application.
Because of this disparity, and its effect on a claimant population
that may require extra assistance, we recommend that an incomplete
electronic or non-electronic claim, to be considered a request for an
application of benefits under the proposed provisions of title 38, Code
of Federal Regulations, section 3.155(c), be established as the
effective date of entitlement if an appropriate complete application is
received within one year of the date the Secretary notifies the
claimant and the claimant's representative, if any, of the information
necessary to complete the application.
Mr. Chairman, this concludes my testimony and I would be happy to
answer any questions from you or members of the Subcommittee.
Prepared Statement of Zachary Hearn
Deputy Director for Claims Veterans Affairs and Rehabilitation
Division, The American Legion
The Department of Veterans Affairs (VA) is in the midst of a
massive transformation of the manner in which they do business, the
business of processing disabled veterans' claims for benefits. In an
attempt to move beyond the legacy system of paper files that threatened
the physical integrity of their own buildings under the massive weight
of backlogged disability claims, \1\ VA has promised an electronic
operating environment, the Veterans Benefits Management System (VBMS)
that will move the agency into the 21st century and eliminate many
problems that have caused the current backlog of claims.
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\1\ VA Office of the Inspector General (VAOIG) Report 12-00244-241
``Claims Folder Storage at the VA Regional Office, Winston-Salem, North
Carolina'' August 9, 2012
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While The American Legion has long maintained no electronic system
can be a complete panacea for the myriad problems that plague the
disability claims system, VBMS will offer some improvements and does
offer opportunities to help alleviate some problems that contribute to
lengthy delays for disabled veterans. However, the change to the new
system also presents new concerns, new challenges, and without careful
consideration of the impact of these changes, veterans could be
negatively affected by the changes. The most important consideration
moving forward is that VA must include veterans as stakeholders in the
decision making process about how to proceed into this brave new world
of electronic claims processing. Nobody is better placed to see the
impact on veterans than Veterans Service Organizations (VSOs) such as
The American Legion, who provides accreditation to over 2,900 service
officers across the nation to serve the needs of veterans navigating
the complex disability claims process. Our American Legion service
officers have already helped nearly 11,000 veterans file new claims
this fiscal year, and are proud to serve and represent over 720,000
veterans nationwide.
It goes without saying that any changes to the process need to
focus, not on what makes things easier for VA, but on what makes the
process best able to serve veterans. After all, the entire purpose of
the VA is to serve those who have borne the battle for this nation, and
their surviving spouses and orphans.
While there are many areas potentially affected by the changes to
the new electronic system, The American Legion would like to focus on
three areas for the purposes of this testimony. The American Legion is
concerned about recent attempts by VA to force veterans into options
which may not be in their best interest; about how a move to divide
work hinted at in testimony from VA may impact the claims process; and
how splitting claims and opening up the processing to a cloud network
may negatively impact the ability to communicate between VA and the
VSOs who represent veterans, to the detriment of those veterans'
claims.
Veterans Losing the Ability to Choose
Recently, in the Federal Register, VA promulgated a proposed rule
change \2\ which, though potentially innocuous on the surface, could
negatively impact veterans. The change, insisting that all initial
claims must be filed on a specific VA form, effectively eliminates the
current ``informal claim'' which has been important for protecting the
effective dates of veterans' claims.
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\2\ ``RIN 2900-AO81-Standard Claims and Appeals Forms''-78 Fed.
Reg. 65,490 (October 31, 2013).
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Through the elimination of the traditional informal claim, VA
eliminates the opportunity to create an effective date at the point
where the veteran opts to pursue a disability claim. Our understanding
of the proposed regulation affects only the veterans seeking disability
compensation through non-electronic means. If a veteran applies for
disability compensation through electronic means through the submission
of an ``incomplete application'', VA will establish an effective date
at the time of the incomplete application submission as long as the
veteran submits a complete application within one year.
Through adoption of these changes, VA will essentially create a
division between veterans with Internet access and those without
Internet access. According to the National Center for Veterans Analysis
and Statistics, the average age of male veterans was 64 years old in
2011; \3\ the United States Census Bureau reported that only 45.5
percent of Americans (veteran and non-veteran) age 65 and older have
access to the Internet from any location. \4\ Assuming these
statistics are similar in the veteran community as the non-veteran
community regarding Internet accessibility, VA could be potentially
eliminating for millions of veterans an appropriate effective date
simply by virtue of whether the veteran has access to the Internet.
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\3\ http://www.va.gov/vetdata/docs/SpecialReports/Profile-of-
Veterans-2011.pdf
\4\ http://www.census.gov/prod/2013pubs/p20-569.pdf
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Beyond the issue surrounding informal claims is the status of
inferred claims. The proposed regulation suggests that the veteran
would no longer be permitted to receive a grant for service connection
based upon an inferred claim as the veteran never filed for the claim.
Frequently, a veteran may have secondary or aggravated conditions by a
service connected condition the veteran is seeking. If the veteran
receives the appropriate nexus statement supporting this relationship
either from a VA medical professional or an outside medical
professional, the veteran under current regulations is entitled to
receive these benefits; however under this proposal, this would not
occur.
Ultimately, The American Legion is concerned VA is sacrificing
veterans' choices and options in the interest of making the claims
system easier for VA to work with. However, the disability claims
system does not exist to serve VA; it exists to serve the veterans
disabled through service to their country.
While it may be beneficial, both for veterans and the VA, to have
veterans submit claims in a certain fashion, such as through the Fully
Developed Claims (FDC) process or through the e-Benefits portal, not
every veteran is going to find that choice in their best interest or
find that choice to be the one that meets their particular set of
needs. There are better ways to approach channeling veterans towards
the proper path for receiving benefits. Legislation such as the
``Veterans Benefits Claims Faster Filing Act'' (HR 1809/S 1148)
provides information to veterans and allows them to make the choice
that best suits their needs. Through this information, many veterans
will see the benefits of applying through the FDC program, or of filing
electronically. Veterans will still be encouraged and channeled towards
the better options, but only if that's the option that works best for
that veteran. We cannot take away veterans' rights to choose the
options for their claims that best suit their needs.
Splitting The Issues
In his testimony before this committee on December 4, 2013, VA's
Director of Compensation Service Tom Murphy edged toward the notion in
his responses to questioning that VA may soon be able to split multi-
issue claims and send the individual issues to those best able to
process that medical concern. This sort of proposal, seemingly simple
at the outset, has potential ripple effects both good and for ill.
In his testimony, Director Murphy notes VA's concern about the
rising complexity of VA claims. According to Murphy the average VA
claim now contains 7.2 medical issues for consideration.\5\ In
conversations with claims raters, many American Legion Department
Service Officers (DSOs) report they are told VA employees are expected
to process five claims per day to meet their work product goals. Even
simple math means a VA employee is expected to read, analyze and apply
all existing rules and regulations to 36 distinct medical issues in a
single day, or 180 medical issues per week. Clearly, it's worth looking
at how work credit is counted if this is the workload raters are
expected to accomplish.
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\5\ Witness Testimony of Mr. Tom Murphy, Director, Compensation
Service, Veterans Benefits Administration, U.S. Department of Veterans
Affairs--December 4, 2013
---------------------------------------------------------------------------
However, the solution cannot be as simple as merely splitting the
issues off into individual chunks and distributing the work amongst
many. In addition to the more traditionally understood method of
service connection for a disability--that the injury or disease had its
onset during the veteran's period of active service--veterans are also
entitled to service connection for a disability `` . . . which is
proximately due to or the result of a service-connected disease or
injury.'' \6\ If a veteran's multi-issue claims are to be split up,
with the individual issues farmed out to multiple VA employees, there
must be a mechanism in place that will still look at the whole picture
of the veteran and determine the possibility of secondary service
connection. Exactly what this means or how it could be best implemented
still requires consideration.
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\6\ 6 38 CFR Sec. 3.310(a)
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It may be as simple as providing each overall claim with an
overseer to ensure the entirety of the veteran's claim remains in
focus. It may be more complicated, such as issuing instructions to the
physicians who examine the veterans and provide opinions, as well as
the raters who render the final determination along the lines of:
This veteran is being evaluated for service connection for [X]
condition. Service connection is allowed through direct linkage
to an event or disease occurring during active duty service
and/or through secondary service connection, wherein the
current disability is caused or aggravated by a service
connected condition. The veteran is ALSO being evaluated for
service connection for [Y] and [Z] conditions. In your opinion/
decision, please address whether those conditions, individually
or in concert, are as likely as not contributory to the cause
or aggravation of [X] condition.
In essence, such a divided process would likely need to expand the
reliance on hypothetical consideration within the claims system.
Whether this would be effective or not, or whether it would ultimately
be in the best interest of veterans will require a good deal of further
discussion. Suffice to say, while there may be some benefit to ensuring
that VA's 100 best evaluators of mental health disorders work on the
lion's share of mental health claims, the implementation of such a plan
is unlikely to be a simple or smooth transition process. There are
going to be many questions raised, and the needs of veterans must be
considered at every step along the way. The VSOs must be included in VA
and congressional decision making along this road.
Processing In The Cloud
One of the other concerns raised by VBMS's ability to split claims
into individual issues and redirect them throughout the entire cloud of
the nationwide system is the breakdown in communication between VA
employees and the VSOs that represent veterans, as well as the
communication factor for veterans themselves. Past VA experiments in
moving claims out of the Regional Offices (ROs) in which they are filed
have caused problems.
In 2008 and 2009 respectively, VA's Pension Management Centers
(PMCs) took on the additional task of processing responsibilities for
death pension applications and Dependency and Indemnity Compensation
(DIC) claims.\7\ In addition to the problems caused increasing the
backlog on these death pension and DIC claims because the PMCs were not
equipped to adequately process the volume directed to them,\8\ The
American Legion Department Service Officers (DSOs) reported an even
greater problem. Whereas when these claims were still located in the
ROs, the DSOs were able to communicate regularly with the VA staff
processing the claims and ease the process along for the widows and
widowers, in the PMCs communication was next to impossible. When the
delays started piling up, DSOs, working on behalf of the recently
widowed surviving spouses, some of the most vulnerable clients,
couldn't even get basic information about the claims.
---------------------------------------------------------------------------
\7\ VAOIG Report 10-00639-135 ``Veterans Benefits Administration
Review of Pension Management Centers'' March 30, 2011
\8\ VAOIG Report 10-00639-135 ``Veterans Benefits Administration
Review of Pension Management Centers'' March 30, 2011
---------------------------------------------------------------------------
In a successful RO, the relationship between the VA staff and the
VSOs working for veterans in that office is one of open communication.
Often, the people involved can talk together and solve a lot of
problems quickly and without extra bureaucratic red tape. When people
work together as partners it is a lot easier to get things done, to the
benefit of veterans. It's a mutually beneficial relationship.
An American Legion DSO can spot a situation where a veteran's claim
was denied because VA failed to consider important evidence and raise
that issue with the rater and coach before the decision is promulgated.
Often times VA and the VSOs agree and can save a lot of time for the
veterans, who otherwise would have to submit to a lengthy appeals
process that can add years, not months to the total claim time.
Furthermore, this helps keep claims off of VA's active inventory if the
situation can be resolved reasonably. Similarly, sometimes a VA
employee working on rating a claim will notice a veteran, despite being
prompted by a letter, has failed to submit critical evidence. Many
employees will pick up the phone, or jog down a flight of stairs or two
to find the veteran's service officer and see if they can rapidly
acquire the evidence and help move the process along. They can speak to
each other in short hand because they both know exactly what's needed
in the complicated claims system. It helps the VSOs and it helps VA,
but most importantly, it helps the veterans get timely, accurate
decisions.
What The American Legion found in the consolidation of death
pension and DIC claims to the PMCs was that this easy communication was
shut down. Even though VA intended to help the claims process by
consolidating, when they ran into trouble, the communication with the
key partner--the VSOs--was hindered by geography and lack of
infrastructure to address this vital back and forth between rater and
DSO.
The American Legion believes this would not happen if VSOs were a
vital part of the planning stages of any consolidation or workflow
change plans.\9\ Currently, the VSOs are not as included in that
process as we would like them to be. Before VA lunges forward with
another scheme to alter the manner in which they process claims, it
would behoove them to ensure they have on board all the partners who
could help them to be successful and fully supportive.
---------------------------------------------------------------------------
\9\ American Legion Resolution No. 25: ``The American Legion Policy
on Department of Veterans Affairs (VA) Consolidation Efforts''--MAY
2009
---------------------------------------------------------------------------
On behalf of National Commander Dan Dellinger and our 2.4 million
members, The American Legion would like to thank the Committee for
their consideration of the many ramifications of VA's electronic
transformation. The American Legion looks forward to working with the
Committee, as well as VA, to ensure the new electronic system is
effectively implemented to fulfill the most important goal: getting
veterans the benefits they deserve in a timely manner. For additional
information regarding this testimony, please contact Mr. Ian de Planque
at The American Legion's Legislative Division, (202) 861-2700 or
[email protected].
Prepared Statement of Frank Logalbo
National Service Director, Wounded Warrior Project
Chairman Runyan, Ranking Member Titus, and Members of the
Subcommittee:
Thank you for holding this hearing relating to VBA technology, and
for inviting Wounded Warrior Project (WWP) to provide testimony.
As an organization that works daily with wounded warriors, to
include advising and assisting them in securing VA benefits to which
they are entitled, we believe we can provide a helpful perspective to
your inquiry this morning.
WWP recognizes and appreciates the advances technology can bring to
claims adjudication. All of our benefits staff gained adjudication and
advocacy experience in an era of paper-filled claims files and manual
processes. Yesterday's development and adjudication processes are not a
model for the 21st century, and it would be foolish for us to insist
that VBA roll back the changes it has instituted and cling to last
century's processes and systems. But as VBA continues to build out
streamlined, technologically-based systems and capabilities, it must
also be mindful of those it serves.
VA's troubled experience with a longstanding claims backlog is an
inescapable reminder of the need for changes. The backlog has certainly
highlighted both inefficiencies in the system and opportunities for
shrinking that backlog through smart use of technology and
streamlining. Certainly the system should become much more efficient.
But efficiency is not an end in itself. Fundamentally, this system must
serve veterans who have incurred disability in service. And even as the
computer and internet-based tools have largely become the predominant
mode of communication and commerce, they are not necessarily the means
by which each of our veterans communicate or transact business. Some
wounded warriors do not have ready access to this technology, some may
not be computer-literate, and some may be anxious about or otherwise
uncomfortable with using these technologies. It may not ``optimize
efficiency,'' but VBA must accommodate those warriors, not the other
way around.
Let me provide some context to amplify the point, by reference to
our most recent annual survey, which is based on almost 14 thousand
responses (more than 50% of the nearly 27 thousand wounded warriors we
surveyed).\1\ Nearly all respondents (98.7%) reported that they
experienced at least one injury during their post 9/11 service. Almost
60% of these warriors' injuries resulted from blasts, including IEDs,
mortar, grenades, and bombs. The survey showed that the most commonly
reported injuries were PTSD (75%), anxiety (74%) and depression (69%).
More than 44% reported traumatic brain injury (TBI). Among those
reporting multiple injuries or health problems, more than two-thirds
reported between three and seven injuries or health problems.\2\
---------------------------------------------------------------------------
\1\ Franklin, et al, 2013 Wounded Warrior Project Survey Report,
July 2013.
\2\ Id.
---------------------------------------------------------------------------
My staff and I have found that some warriors who have sustained
invisible wounds, like PTSD, anxiety, and TBI have comprehension-
difficulty with, or experience anxiety or a high degree of frustration
with computer technology. It is also not unusual for warriors with
these conditions to have higher levels of concern with, or even serious
anxiety relating to, information-security. The recent data-breach on
VA's e-Benefits Web site \3\ will very likely heighten that concern,
perhaps irreversibly.
---------------------------------------------------------------------------
\3\ See J. Hicks, ``VA software glitch exposed veterans' personal
information,'' Washington Post (Jan. 22, 2014), accessed at http://
www.washingtonpost.com/blogs/federal-eye/wp/2014/01/22/va-software-
glitch-exposed-veterans-personal-information/.
---------------------------------------------------------------------------
We raise these examples to highlight a point. This system must meet
these veterans where they are. Even as technology provides VBA the
means to do its work with greater efficiency, its highest obligation
must be to the veteran. It would follow that VA must accommodate those
who, for whatever reason, cannot or choose not to, employ that
technology in filing or appealing claims, even at some modest cost to
peak ``efficiency.''
Such a principle would seem beyond question in a system long
celebrated for its pro-claimant, veteran-friendly policy. But a recent
VA notice of proposed rulemaking, ``Standard Claims and Appeals
Forms,'' \4\ (hereinafter, ``the NPMR'') would abandon a core tenet of
that policy.
---------------------------------------------------------------------------
\4\ 78 Fed. Reg. 65,490 (Oct. 31, 2013).
---------------------------------------------------------------------------
VA would eviscerate ``current rules [which] are meant to minimize
the burden associated with initiating a claim, and allow benefits to be
paid from the earliest possible date if the claim is ultimately
granted.'' \5\ At the heart of the current system is VA's longstanding
acceptance of an ``informal claim'' for benefits, that is, ``[a]ny
communication or action, indicating an intent to apply for one or more
benefits.'' \6\ VA now proposes to redefine what is meant by a claim
for benefits. While 38 C.F.R. sec. 3.1(p) currently defines the term
``Claim-Application'' to include an ``informal communication in writing
. . . '', that ``informal communication'' would no longer be recognized
as a ``claim,'' under VA's proposal. Instead, VA would require all
claims to be filed on standard forms. It proposes to ``incentivize''
submission of claims to facilitate efficient processing by establishing
new rules governing effective dates of awards that for the first time
would draw a distinction between ``electronic'' and ``non-electronic''
claims. VA's rule changes would actually penalize veterans who do not
submit claims online.
---------------------------------------------------------------------------
\5\ Id.
\6\ 38 C.F.R. sec. 3.155(a).
---------------------------------------------------------------------------
We offer an illustration of how these proposed rules would work. A
warrior who suffered multiple injuries from an IED explosion might have
difficulty with the question on VA's application for compensation, Form
21-526, that asks for a listing of specific disabilities, and might
instead simply answer ``multiple injuries.'' VA would likely deem that
an ``incomplete claim.'' Under the proposed regulation, if the veteran
had submitted that claim electronically, VA would allow the veteran to
preserve the filing date as the effective date for an award of
benefits. But if the veteran had submitted that same incomplete claim
on paper, he or she would be penalized. Instead of allowing the veteran
that early effective date, VA would defer the effective date until the
claim had become ``complete,'' with the result that the veteran could
lose thousands of dollars.
Under the VA's NPRM, what has long been hailed as ``the pro-
claimant policy'' \7\ underlying the veterans' benefits system would
give way to an overriding emphasis on achieving ``efficiency,''
``speed,'' and a ``modernized process.'' WWP does not contest the
challenges facing the Department in managing a claims backlog, nor are
we opposed to achieving greater efficiency and timeliness of claims
processing and appellate review. We certainly appreciate as well that
the Department has statutory authority to prescribe rules and
regulations and to prescribe forms of application for benefits. But the
Department's exercise of that authority must remain faithful to a
statutory scheme that is centered on serving the veteran. In our view,
if efficiency and modernization are to be given primacy over
longstanding rights that have been afforded veterans under the
Department's benefits system, Congress must make those changes.
Consistent with that view, our comments to the NPRM urged that the
Secretary withdraw the proposed rulemaking.\8\
---------------------------------------------------------------------------
\7\ See, R. Riley, ``The Importance of Preserving the Pro-Claimant
Policy Underlying the Veterans' Benefits Scheme: A Comparative Analysis
of the Administrative Structure of the Department of Veterans Affairs
Disability Benefits System,'' 2 Veterans L. Rev. 77 (2010).
\8\ Wounded Warrior Project, Comments on RIN 2900-AO81--Standard
Claims and Appeals Forms (Dec. 24, 2013) at http://www.regulations.gov/
#!documentDetail;D=VA-2013-VBA-0022-0027.
---------------------------------------------------------------------------
In essence, the proposed rule would upend important principles
cemented in law and regulation. Among them, it would abolish a
principle and practice that permits a veteran to file an informal claim
and receive benefits paid from the date that informal claim is filed.
The proposed rule would also for the first time effectively create a
two-tier system that distinguishes substantively between veterans who
have the capability of interacting with VBA online and those who do
not, rewarding one and penalizing the other. (Under the NPRM, a
claimant who by reason of disability, lack of computer access, or
otherwise is unable to file a claim online would forfeit a statutory
entitlement to an early effective date under circumstances where that
initial claim was incomplete.) Procedural rules critical to
safeguarding appellate rights would also fall under the NPRM.
Regulations that now permit any expression of disagreement to be taken
as a notice of disagreement would be discarded, to be overtaken by a
first-time requirement that a veteran must file any notice of
disagreement on a specified form. Moreover, omitting required
information would render the veteran's NOD ``incomplete,'' and were the
veteran unable to complete the form (or unsuccessful in doing so)
within a 60-day ``grace period,'' the veteran would forfeit the right
to appeal.
In our view, these changes go much too far, and cannot be squared
with the statutory framework the Secretary is charged to administer.
Moreover, with the Department's seemingly single minded pursuit of
speed and ``efficiency,'' its rulemaking pays insufficient attention to
other critical interests here at stake. Of great concern, the NPRM
fails even to acknowledge that applicants for veterans' benefits have a
constitutionally protected property interest in their application for
benefits and are entitled to constitutionally prescribed procedures in
connection with their claims for benefits under the Due Process clause.
\9\ Rather than protecting that property interest, the NPRM proposes
to establish procedures that would literally shrink it.
---------------------------------------------------------------------------
\9\ Cushman v. Shinseki, 576 F. 3d 1290 (Fed. Cir. 2009).
---------------------------------------------------------------------------
In striving for efficiency, the proposed rule would create real
barriers that risk denying veterans benefits to which they are
entitled. While Congress may elect to take steps to streamline claims'
and appellate processes, a Department charged with administering the
laws providing benefits and other services to veterans \10\ may not
unilaterally block statutory pathways to veterans' benefits. While the
Secretary has authority to prescribe rules and regulations necessary or
appropriate to carry out the laws administered by the Department, those
rules must be ``consistent with those laws.'' \11\
---------------------------------------------------------------------------
\10\ 10 38 U.S.C. sec. 301(b).
\11\ 11 38 U.S.C. sec. 501(a).
---------------------------------------------------------------------------
Those laws are clear. Section 5102 of title 38 codifies the
principle of an informal claim, namely a ``request made by any person
claiming or applying for, or expressing an intent to claim or apply
for, a benefit . . .'' \12\ (Emphasis added.) Such an expression of
intent to apply for or claim a benefit triggers an obligation on the
Secretary's part to ``notify the claimant and the claimant's
representative, if any, of the information necessary to complete the
application.'' \13\ Under section 5102(c), the veteran has one year
within which to complete that application. Where that veteran
ultimately submits a fully developed claim within that year, section
5110(b)(2)(A), (as amended by Public Law 112-154) allows the veteran to
preserve the date of submittal of that application as the effective
date of an award of benefits. (``The effective date of an award of
disability compensation to a veteran who submits an application
therefor that sets forth an original claim that is fully-developed (as
determined by the Secretary) as of the date of submittal shall be fixed
in accordance with the facts found, but shall not be earlier than the
date that is one year before the date of receipt of the application.'')
\14\
---------------------------------------------------------------------------
\12\ 38 U.S.C. sec. 5102(a).
\13\ 38 U.S.C. sec. 5102(b).
\14\ 38 U.S.C. sec. 5110(b)(2)(A).
---------------------------------------------------------------------------
The Department's proposal is tantamount to a plan to graft onto
this statutory framework an utterly novel distinction between claimants
who file completed electronic claims--who would gain the benefit of
such earlier effective date--and non-electronic filers who would not.
We see no basis in law for such a two-tiered system, or any reasonable
basis to discriminate between these two classes of claimants.
The NPRM runs similarly afoul of the law in proposing to limit
substantially the manner in which a claimant may initiate appellate
review. The statutory provisions governing the initiation of appellate
review are prescriptive only insofar they impose a time limit within
which a notice of disagreement (NOD) must be filed, \15\ and provide
that the NOD ``must be in writing.'' \16\ The Department, by
administrative fiat, would effectively rewrite that clear statutory
provision to redefine the phrase ``in writing'' to mean a completed and
timely submitted copy of a mandatory form where (under proposed new
section 38 C.F.R. sec. 19.24(c)) ``a form may be considered incomplete
if any of the information requested is not provided, including . . .
for compensation claims . . . if it does note enumerate the issues or
conditions for which appellate review is sought, or does not provide
other information required on the form to identify the claimant, the
date of the VA action the claimant seeks to appeal, and the nature of
the disagreement . . .'' \17\ The NPRM would convert what is a
permissive statutory pathway to appellate consideration into a closed-
door policy under which the ``VA would not accept as an NOD any other
submission expressing disagreement with an adjudicative determination''
\18\ than the fully completed form.
---------------------------------------------------------------------------
\15\ 15 38 U.S.C. sec. 7105(b).
\16\ 16 Id.
\17\ 78 Fed. Reg at 65495 (October 31, 2013).
\18\ 18 Id.
---------------------------------------------------------------------------
As with other changes it seeks to institute through the NPRM, VA
characterizes the regulations it seeks to revise or abolish entirely as
involving time-consuming processes or as barriers to processing cases
more expeditiously. We see nothing in the statutory fabric to suggest
that speed is an end in itself. While WWP would welcome greater
timeliness of claims processing and appellate review, those objectives
should not be achieved at the expense of longstanding, statutorily-
based procedural safeguards.
VA's statutory authority to establish online tools to facilitate
claims-filing and processing is not in doubt. Its authority to develop
standard forms is not questioned. Many veterans may see benefit to
employing such tools-at their option. But VA goes much too far in
seeking to impose procedural requirements under which some veterans
will lose benefits to which they are entitled. It runs that grave risk
under circumstances where its rationale is at odds with the very
statutes the Secretary is to carry out as well as with a longstanding
pro-claimant regulatory framework that it proposes to abandon in
significant part in the name of ``modernization'' and efficiency.
In the final analysis, the Department's determination to
effectively reinvent some of the most fundamental elements of the
claims-filing and appellate-review-initiation to achieve greater speed
and efficiency are, in our view, simply beyond the Secretary's powers.
Mr. Chairman, we trust you would agree that the Secretary's duty is to
administer the law, not to rewrite it.
Many interests are at stake here: adherence to law; preserving a
pro-claimant adjudication system; protecting veterans who--for reasons
including disability, hardship, remoteness, or fear--do not have
effective online computer access or cannot reasonably be expected to
communicate through that modality; and preserving congressional
prerogatives. Given the importance of each of those interests, we ask
the Subcommittee to press VA to withdraw its proposed rulemaking.
Prepared Statement of Eric Jenkins
American Federation of Government Employees, AFL-CIO and the AFGE
National VA Council
Executive Summary
The American Federation of Government Employees and the AFGE
National VA Council (hereinafter ``AFGE''), the exclusive
representative of employees processing disability claims at the
Department of Veterans Affairs (Department) Veterans Benefits
Administration (VBA) Regional Offices (ROs) supports the Department's
transformation efforts and appreciates the opportunity to share views
on behalf of our members working on the frontline processing claims.
AFGE appreciates the opportunity to share our views on the
implementation problems associated with VBMS.
Our greatest concern with transformation is VBMS' regular shut
downs. AFGE urges the Committee to require VBA to create a national
plan in conjunction with AFGE when VBMS is inoperable as well as
provide employees with excluded time. AFGE also urges the Committee to
address VBA's broken work credit system that is currently not based on
data. AFGE also urges the Committee to ensure that AFGE has a more
active role in discussions related to new initiatives.
VBMS Updates
AFGE consistently receives reports from members at ROs nationwide
regarding shutdowns and technical problems with VBMS. AFGE would like
to remain a strong partner with VBA to improve VBMS to better process
claims and to make the system more user friendly. AFGE requests the
establishment of a working group to improve VBMS, which would include
AFGE, management, and VSO stakeholders.
Since the program's expansion, the additional users have
exacerbated existing latency problems with VBMS. Employees on the east
coast report that the system experiences latency as more users log on
to VBMS (as the other time zones begin arriving to work). AFGE has
reported the latency issue to VBA management consistently throughout
VBMS' rollout.
AFGE members also report that VBMS shuts down on roughly a weekly
basis. AFGE regularly receives reports from ROs nationwide of VBMS shut
downs. For example, during the last month, VBMS shut down on roughly a
weekly basis. The shut downs varied from just over an hour to spanning
multiple days.
During each of these shutdowns, the majority of employees were not
provided with excluded time. Excluded time protects employees from
missing performance standards based on situations beyond their control.
Inoperable software should qualify for excluded time since employees
are being judged during shut downs on their performance within VBMS.
When VBMS shuts down, employees are directed to use VBA's legacy
software (RBA 2000) that does not use electronic files. However, newer
employees have no training in RBA 2000, meaning they cannot be
productive during shutdowns. New employees must be trained in RBA 2000
in the event of a VBMS shut down. Employees also receive far lower work
credit when completing work in RBA 2000 (or any other work that is not
completed in VBMS), meaning their performance standard will be even
more difficult to achieve when VBMS is experiencing shut downs and
technical problems. There is also limited work to complete in RBA 2000
since most claims are now paperless. AFGE fully agrees with VBA that
when system shut downs threaten the service we provide to our veterans,
every effort must be made to remain productive during the work day.
AFGE urges the Committee to require VBA to develop a plan for when VBMS
is inoperable, and AFGE must be at the table when creating this plan.
Offices also report inconsistencies in how managers deal with
completing work when VBMS is shut down. As mentioned above, some
managers direct their employees to begin work in RBA 2000 or other non-
electronic work. We also urge other ROs to follow the lead of the San
Diego RO where employees received training when VBMS is not
functioning, which is a productive use of time.
Beyond shut downs, AFGE members reported other issues with VBMS.
Claim authorization is not yet completed in VBMS, so VSRs cannot
complete promulgation of claims. For development and rating, VBMS
separates these two tasks in different programs, meaning employees must
exit the program and reenter in order to switch from development to
rating. This extra step inhibits efficiency, slows down employees, and
hurts veterans.
Another malfunction reported by VSRs and RVSRs occurs when
additional paperwork enters the system from a claim that is being
processed; sometimes, the information disappears for several days. The
employee's performance is impacted by this malfunction and the veteran
may receive a claim decision with an error. If information is not
present when an employee completes a claim due to a system malfunction,
VBA should not punish the employee for that error.
AFGE remains frustrated with the lack of success of VBMS. Our
members are all motivated to serve veterans as quickly and effectively
as possible. AFGE believes that when VBMS is shutdown, VBA must make
all efforts to ensure that any production slowdown is avoided while not
punishing employees for any inadequacies of the system.
Undersecretary Hickey has mentioned the opportunity for employees
to provide feedback to her regarding VBMS' functionality through weekly
conference calls. While AFGE applauds Undersecretary Hickey for stating
her interest in hearing directly from front line bargaining unit
employees (BUEs), this phone call does not include sufficient input or
participation from AFGE, resulting in too few BUEs on the calls. The
phone calls should include AFGE as the exclusive representative of
these employees. Without the union present, many employees fear
retaliation from management for any negative feedback related to VBMS.
Undersecretary Hickey has stated clearly that she would like to hear
any negative feedback related to VBMS so that we can all continue to
improve the system. With active, ongoing union involvement, this
information sharing can be accomplished. We urge VBA to work directly
with AFGE to ensure sufficient participation of BUEs on these calls.
AFGE Recommendations
AFGE urges the Committee to require VBA to provide
employees with excluded time when VBMS is not operational.
The Committee should require VBA to develop a
contingency plan for operations when VBMS is shutdown to
maintain productivity and not negatively impact employees'
performance ratings. AFGE should have a seat at the table when
creating this plan.
AFGE should have an ongoing, meaningful role in
providing feedback to VBA and the Committee must involve AFGE
in the feedback loop for improving VBMS.
Current Work Credit System Problems
VBA has never had a formal work credit system based on actual data
that reflects the amount of time required to process specific types of
claims and their components. VBS should not deprive employees of the
proper credit for critical work needed to process claims accurately and
timely the first time. The broken work credit system creates
performance standards that are arbitrary, inconsistent, and focus too
much on quantity over quality.
The agency has made a few perfunctory efforts to establish a more
reliable set of measures over the years. However, AFGE has not seen any
work credit study or work credit system based on actual data. Given
VBA's current transformation and the national rollout of VBMS, AFGE
believes the timing is ideal for a scientific based time motion study
to create a formal work credit system.
The first essential step is to develop an inventory of tasks that
employees must complete on a daily basis. The current work credit
system does not include an inventory of employees' daily tasks.
Some of the main problems with the current work credit system
include:
Lack of consistency
Lack of a solid methodology
Failure to update its ``system''
Lack of participation from the front line employees
and veterans service officers with direct knowledge of the work
process
Lack of work credit for a variety of tasks
The only study AFGE is aware of is the 2008 IBM Gap Analysis study.
However, the study is outdated now with VBMS' implementation.
In 2013, AFGE conducted an informal survey of Regional Offices to
identify how well the current work credit system measures (or does not
measure) the hours and skills required to complete different tasks.
Responses from employees working in approximately a dozen different
offices indicated widespread inconsistencies in how much work credit is
awarded for the same tasks. Perhaps more troubling, employees in every
Regional Office and position are required to perform daily tasks for
which they are provided zero credit or only partial credit. By denying
credit for significant tasks, the current work credit system increases
workplace stress, puts pressure on employees to rush through claims,
and results in unwarranted negative performance ratings.
AFGE encourages the House of Representatives to endorse the
approach set forth in Chairman Sanders' S. 928, which is currently in
the Senate VA Committee's Omnibus legislation S. 1950. Chairman
Sanders' approach brings the major stakeholders to the table, including
management, employees, and VSOs, into a working group. The working
group would be tasked with evaluating and recommending changes to the
current work credit system based on data. This approach encourages
productivity, while ensuring employees will be evaluated fairly and
accurately.
More specifically, employees reported that they receive inadequate
or zero work credit for the following tasks:
Productive time lost due to breakdowns in VBMS: As
noted earlier, VBMS still has frequent and significant
malfunctions, at both the RO and national levels.
VBA must create a standardized plan to keep ROs
productive during VBMS shutdowns, as well as grant
excluded time. Employees must not be evaluated based on
the system becoming inoperable.
Deferred ratings: Deferred ratings occur on a daily
basis in Regional Offices. It is important to spend time on
these issues since the veteran should be assisted and informed
accurately about additional medical evidence they will need for
their claim. RVSRs do not receive any credit for cases where
there is a deferred rating an RVSR may work on a case where the
veteran has claimed ten issues, but only two can be rated. The
RVSR must spend significant time on the other eight issues, but
will receive no credit for this.
VBA must provide credit for employees giving
deferred ratings.
Multi-issue and complex cases: VSRs are not given
adequate credit for rating a case with significantly more
issues or complexity. Given VBA's segmented lanes initiative
with VBMS, this problem is now exacerbated. Employees receive
additional credit for completing cases with at least three
issues. VSRs do not receive any additional credit for
developing a case with thirty issues versus a case with three
issues. Employees also are denied sufficient credit for
processing cases involving complex claims such as military
sexual trauma and TBI.
RVSRs Working Development: RVSRs regularly work on
developing cases. Sometimes, RVSRs will receive a case to rate
that needs additional development. Other times ROs do not have
the proper ratio of VSRs to RVSRs; consequently, there are not
enough cases to rate. When a case needs additional development,
RVSRs do not receive credit for this work.
VBA must provide credit for VSR work done by
RVSRs.
Mentoring: Experienced processors often mentor newer
employees, an essential role for ROs. Congress and VBA have
long recognized the benefits of mentoring from experienced
employees, yet claims processors receive no credit for
assisting or mentoring newer employees.
VBA must provide adequate credit for mentoring by
experienced employees.
Training: Employees are not given sufficient work
credit for time spent during training. Often times, training is
shifted away from classroom instruction to reading slides or a
packet at their desk with less time allotted by managers than
required by the curriculum.
VBA must provide adequate time and work credit
for training.
The absence of a valid work credit system exacerbates the well
documented problem of VBA managers manipulating backlog data to improve
performance measures. Veterans who fought for this nation deserve to
have their claims processed in a timely manner, and waiting over two
years for a decision from VBA is unacceptable. While undergoing
transformation, VBA must accurately determine productivity and quality
and judge an employees' performance based off of data driven metrics.
Veterans Relationship Management Initiative
VBA has not provided AFGE with an opportunity to play an active
role in the implementation of the majority of aspects with the Veterans
Relationship Management (VRM) initiative. It is both good policy and
required by our labor management contract to engage in meaningful
discussions and bargain over changes to the workplace and new
initiatives. AFGE did sign a memorandum of understanding with VA on the
Customer Relations Management and Unified Desktop aspects on February
9, 2012, two of the VRM aspects. AFGE urges VA to approach us with
other initiatives for employee input moving forward and to comply with
its contractual obligations to notify us of new pilot projects and
initiatives.
Contracting
AFGE recently learned that VBA is considering the use of an outside
contractor for dependency claims, work which is currently completed in
ROs nationwide. VBA plans on beginning the program in March. AFGE
strongly urges Congress to prohibit this counterproductive and illegal
solution to the claims backlog. The FY2009 Omnibus Act, P.L. 111-8,
Division D, Sec. 735 prohibits work last performed by federal employees
from being given to contractors without first conducting a formal cost
comparison. Past evidence with other contracts, such as the ACS
contract, demonstrates that contracts can actually add to the backlog.
With the ACS contract, the files set for development were not processed
for 9 months and then were sent back to the ROs where they were
processed. This contract hurt taxpayers, wasted VA resources, and
forced veterans to wait longer for their benefits.
HAIMS and VBMS
Currently, HAIMS, DoD's file system, and VBMS are not well
integrated, resulting in unnecessary delays and a worsening of the
backlog. The number of delays in claims for veterans would be greatly
improved if these two systems were in sync. AFGE encourages VA and DoD
to integrate their two files systems for greater ease in transmitting
medical evidence for claim processing.
National Work-Queue Strategy
VBA plans on using a national program to assign work to ROs
nationwide, once all of the files have been digitized. For example, if
a veteran submits a claim with ten contentions, and one is PTSD, the
PTSD claim may be sent to a different RO than the rest of the claim.
AFGE remains cautious regarding VBA national work queue strategy.
Specifically, AFGE has concerns over how VBA plans on assigning
work through the national work queue strategy. For example, AFGE has
not received a definition of an ``under performing office.'' There may
be discrepancies in the levels of production between offices, but this
must be clearly defined before VBA begins diverting cases away from an
RO. If an office is considered under performing by VBA, there are
concerns that they will now be starved for casework. Also, supposedly
high performing offices may fall further back in the pack with the
additional casework.
Undersecretary Hickey has referred to improving VBA's current
resource allocation model, where struggling ROs are starved of
resources (while higher performing offices receive additional
resources). However it appears that little progress has been made.
Therefore we urge VBA to review its resource allocation model. While
implementing any national work queue strategy, VBA must simultaneously
review and change its resource allocation model.
Thank you for the opportunity to provide input from AFGE and its
National VA Council on this important legislation.
Eric Jenkins Bio
Eric Jenkins works as an RVSR in the Winston Salem RO. Eric has
worked at VBA for 9 years, first as a VSR for 6 years, and now as an
RVSR for nearly 4 years. Eric is a 15 year veteran of the Marine Corps
and a service connected veteran. He is a combat veteran, deployed in
Afghanistan and in Iraq for both Operation Desert Storm and Iraqi
Freedom. Eric also works as a shop steward in AFGE Local 1738. Eric
graduated from North Carolina State University with a degree in
political science.
Prepared Statement of Diana M. Rubens
Deputy Under Secretary for Field Operations Veterans Benefits
Administration (VBA)
Good Morning, Chairman Runyan, Ranking Member Titus, and Members of
the Subcommittee. Thank you for the opportunity to discuss VA's
transformation initiatives with a focus on technology, workload
management, and a proposed rule to require standardized forms. I am
accompanied today by Mr. Richard Hipolit, Assistant General Counsel and
Ms. Lorraine Landfried, Deputy Chief Information Officer for Product
Development in the Office of Information and Technology (OIT).
Backlog Update
I would like to start by providing the Subcommittee with a brief
update on our progress to date in eliminating the disability claims
backlog. During fiscal year (FY) 2013, VA completed a record 1.17
million claims with 90-percent accuracy at the claim level and 96-
percent accuracy at the medical-issue level. Claim-level accuracy
measures the accuracy of the entire claim, regardless of the number of
medical issues. The claim is either 100 percent accurate or 100 percent
in error. However, medical issue accuracy evaluates individual medical
conditions. Since its peak in March 2013, the backlog has been reduced
by 211,000 claims, or 35 percent, and the overall inventory of pending
claims has been reduced by 200,000 claims, or 22 percent, through the
end of December 2013. The average number of days rating claims are
pending has also been reduced from a peak of 281 days in March 2013, to
170 days at the end of December 2013, meaning Veterans are currently
waiting 111 fewer days for a decision than they were just 9 months ago.
None of this progress would be possible without the tremendous
support VA receives from its partners including this Subcommittee, the
rest of Congress, our Veterans Service Organizations (VSO), and county
and State Departments of Veterans Affairs. Our progress is also the
result of the unprecedented effort and dedication of VBA employees, 52
percent of whom are Veterans themselves, and the support provided by
our partners in VA's OIT and the Veterans Health Administration.
Veterans themselves have contributed to our progress by participating
in the Fully Developed Claims program and submitting claims
electronically through the e-Benefits Web site. We appreciate the
support of all of our partners and stakeholders as we continue working
to eliminate the claims backlog, and we fully expect the reductions in
backlog to continue.
Technology-Focused Transformation Initiatives
VA's Transformation Plan includes initiatives to retrain and
reorganize our people, streamline our business processes, and build and
implement new secure technology solutions that are getting us out of
paper-bound, manual processes to improve our service to Veterans, their
families, and Survivors. The Department takes seriously our obligation
to properly safeguard personal information. The technology tools being
developed to transform VBA are accredited as secure under VA's strict
security standards. These products are protected by VA's numerous
scanning tools, firewalls, and network and host intrusion prevention
systems, as part of VA's arsenal to ensure a strong, multi-layered
defense to combat evolving cyber security threats to VA's sensitive
personal information and VA information systems.
At the Subcommittee's request, I would like to update you on a few
key technology initiatives that have had a significant impact on our
increased production and quality and show promise for the way ahead.
Veterans Relationship Management (VRM)
VRM continues to engage, empower, and serve Veterans and other
clients with seamless, secure, and on-demand access to benefits
information and services. Veterans now have improved access to benefits
information from multiple channels--on the phone, online, and through
our shared Department of Defense (DoD)/VA portal called e-Benefits.
From FY 2009 to FY 2013, the number of contacts with VA through these
channels increased from 9.1 million to 56.3 million.
Currently, VA has over 3.3 million e-Benefits users, representing a
51-percent increase from FY 2012. Through 58 self-service features, e-
Benefits users have generated over 410,000 requests for official
military personnel documents, 405,000 requests for VA guaranteed home
loan certificates of eligibility, 31 million claim status requests, and
over 3.4 million self-service letters. Additionally, there has been a
steady increase in electronic claim submissions for disability
compensation benefits. Since October 2012, over 40,000 compensation
claims and 44,000 dependency claims have been submitted online, and VA
expects electronic claims submissions to continue to increase. Over 50
percent of dependency claims submitted online via the automated Rules
Based Processing System are now processed in 1 business day.
VA is relying on VSOs to continue to perform their vital advocacy
and assistance role within VA's transformed benefits delivery model.
The Stakeholder Enterprise Portal (SEP) is a secure, Web-based entry
point that complements e-Benefits and gives VSOs and other authorized
advocates access to assist Veterans with electronic claim submissions.
Using the portal, 1,200 registered users can check the status of
claims, review payment history, and upload documentation on behalf of
the Veterans they represent--all within a digital environment. When
filing a claim online in e-Benefits, a Veteran can request the
assistance of a VSO by choosing from a list of accredited
representatives in VA's database. When logging into SEP, the chosen VSO
representative is alerted to the Veteran's request, and upon
acceptance, is given power-of-attorney authorization to access the
Veteran's claim and assist with preparation. Once the VSO
representative believes the claim is ready for submission, he or she
can send notification back to the Veteran in
e-Benefits, and the Veteran submits the claim to VA.
VBA ``Digits to Digits'' is a technology initiative which will
enable VSOs to submit claims directly to VA using their own claims
management systems. It is scheduled for implementation in FY 2014. This
machine-to-machine interaction will benefit Veterans by accelerating
the speed in which claims are filed. Veterans' representatives will
also benefit by being able to leverage their current claims management
systems and reduce printing and shipping expenses. The eight current
pilot participants include: AMVETS; and the States of California,
Georgia, Illinois, Kansas, Kentucky, Tennessee, and Virginia.
Telephone systems improvements have also increased access to
benefits information and services. Eight call centers now utilize a
consolidated queue to improve efficiency and utilization of call
agents. The consolidated queue allows calls to be routed to the next
available agent with the appropriate skill set. Veterans and other
callers have also benefited from the Virtual Hold feature, which
automatically calls the individual back. More than 10 million calls
have been returned since this feature became available in September
2011; and in FY 2013, VBA had a 95 percent reconnect success rate.
Additionally, callers have the option to pick a date and time for VA to
call back. JD Power and Associates found that callers who use VBA's
Virtual Hold feature have a customer satisfaction score 11 points
higher than the customer satisfaction scores for non-Virtual Hold
callers.
VBA also improved the tools that call agents use. Unified Desktop
technology was deployed to over 750 agents at the National Call
Centers. This technology combined 13 separate applications into one
consolidated view of the Veteran. Call agents can now access the
caller's contact history and utilize ``smart scripts'' to provide
quick, consistent, and high-quality responses to callers. For example,
Unified Desktop technology has helped VBA reduce the length of calls by
an average of 30 seconds for 354,000 callers requesting benefits
letters since June 2012.
Veterans Benefits Management System (VBMS)
VBMS, VA's Web-based electronic claims processing system, was
deployed to all 56 regional offices 6 months ahead of schedule in June
2013. VBA has also successfully deployed VBMS to the Appeals Management
Center, the Records Management Center, the Board of Veterans' Appeals
(Board), all National Call Centers, and all VA medical centers. More
than 25,000 unique end-users throughout VA have access to VBMS. This
technology helps us move away from paper-based to electronic claims
processing and begin to gain processing speed within a digital claims
processing environment. Currently, more than 78 percent of our claims
inventory which equates to 535,000 claims can be processed
electronically, which is an increase from 32 percent in June 2013. In
addition, VBMS improves access, drives automation, and enables greater
exchange of information and increased transparency to Veterans, our
workforce, and other stakeholders.
The evolution of VBMS is occurring across four distinct generations
of development. Generation One of VBMS began in 2010 with the
conceptualization, piloting, development, and deployment of baseline
system functionality with improved quality and efficiency. The
development of Generation One of VBMS concluded with the successful
implementation of Release 4.1 in January 2013.
As we moved into the development of Generation Two of VBMS, the
focus was on building additional system capabilities while leveraging
simple automation features. VBA deployed three major Generation Two
software releases: VBMS 4.2, 5.0, and 5.1. These releases included
improvements to correspondence and work queue tools, additional rating
functionality, and more extensive data exchange and system integration
capabilities.
In December 2013, VBMS entered Generation Three of system
development with the Release 6.0. The focus of this generation of
development are increasing system functionality, adding more complex
automation capabilities, reducing dependency on legacy systems, and
enabling the capability to accept Veterans' electronic service
treatment records (STR) from DoD. VA has been actively working with DoD
to accelerate development of the Healthcare Artifacts and Image
Management Solution (HAIMS) so STRs would be available in the HAIMS
repository for Servicemembers separated from January 1, 2014, forward.
We have developed an automated interface capability to enable the
secure electronic transmission of disability benefit claimants' STRs
between DoD's HAIMS and VBMS. With the HAIMS-VBMS connection, VA can
now retrieve certified and complete electronic versions of STRs for
Servicemembers separating on or after January 1, 2014. This major
milestone for VA and DoD reduces the amount of time it takes VA to
gather required evidence and helps improve the accuracy of claims
decisions.
Release 6.0 also contained the first generation of awards
functionality, integrated additional correspondence functionality, and
delivered initial capabilities to the Board. With this release, Board
end-users now have access to a unique eFolder view with the ability to
maintain notes on documents and enter bookmarks within the eFolder.
Release 6.1, which is scheduled to deploy in March 2014, will
continue to focus on increased automation by mapping and pre-populating
Disability Benefits Questionnaires and Evaluation Builders. This
release will also integrate VA's legacy electronic records store,
``Virtual VA,'' to reduce our dependency on legacy systems. Throughout
2014, VA will continue to gather end-user feedback on VBMS, assess and
validate the effectiveness of the claims processing model as a whole,
and implement improvements as needed.
Generation Four of VBMS, which is scheduled to be deployed sometime
in 2015, will capitalize on efficiencies and quality improvements
gained during the previous year. VA will utilize enhancements made in
Generation Three to identify additional automation and process
improvement opportunities that can be incorporated into Generation
Four, allowing employees to focus on more difficult claims by reducing
the time required to process less complex claims.
VBA established the Veterans Claims Intake Program (VCIP) in 2012
to streamline the process for receiving records and data into VBMS and
other VBA systems. VCIP converts claims and other paper records into a
digital format that is usable within VBMS. Under VCIP, documents are
scanned and converted into electronic format, and important information
and data are extracted and populated in an electronic folder accessible
to claims processors through VBMS. As of January 10, 2014, VCIP has
converted from paper and uploaded into VBMS more than 430 million
images.
Workload Management
As we continue to execute our claims Transformation Plan, we are
adjusting the way we manage and measure our work. Leveraging
technology, we are finding ways to more efficiently manage claims to
deliver more timely and accurate decisions to Veterans, their families,
and Survivors. As workload management is adjusted and new technology is
introduced, we are also evaluating how work credits and performance
management should change.
National Work Queue
Historically, regional offices have been primarily dedicated to
processing claims of the Veterans living within the state or area of
jurisdiction. These jurisdictional boundaries were driven by
limitations of operating a paper-based system, where claims records and
files were physically stored, processed, or mailed between the Veteran,
the regional office, and the closest supporting VA medical facility.
This geography-bound process led to significant inefficiencies and
variances in timeliness in overall claims production. As VA transitions
to a paperless claims process, we are in a better position to adopt a
national workload strategy that is ``boundary-free'' and thus improve
overall production capacity to serve Veterans in the same way they
served--side by side without regard to state affiliation.
VBA's previous ``brokering'' strategy helped balance the inventory
of pending claims across regional offices to better serve Veterans,
their families, and Survivors. Dedicated brokering centers were
established at 15 regional offices to handle claims from regional
offices with workload challenges and claims associated with national
priority missions, such as the special processing of Agent Orange
claims subject to the provisions of the Nehmer court decision. While
somewhat effective in handling ``surge'' work, these brokering centers
did not fully optimize capacity that still existed within regional
offices from a national perspective.
In April 2013, VBA launched its Oldest Claims Initiative to
expedite decisions for Veterans who had waited at least 2 years for a
decision on their claim. VBA redistributed the oldest claims across the
Nation to best utilize the resources of all regional offices. This
centralized workload management and redistribution achieved excellent
results. Within 2 months, we completed more than 97 percent of the
67,000 claims identified for processing under the 2-year initiative. In
June, the focus turned to completing all claims that had been pending
more than 1 year. VBA completed 98.2 percent of the claims that were
pending over 1 year by October 31, 2013. Over 500,000 Veterans received
decisions on their claims under this initiative. VBA could not have
accomplished these results without the capability to nationally manage
the workload without jurisdictional borders. VBA's experience in
managing this initiative demonstrates the potential of a national
workload management strategy for improved benefits delivery by
optimizing every member of the VBA workforce.
The new paperless claims processing environment offers even greater
potential for more streamlined and efficient processing, with claims
being directed to the right decision makers at the right time, no
matter where that decision maker is physically located.
The national work queue is being developed in a two-phased
approach. In Phase I, claims will be managed from a central location
and routed based on individual station capacity as well as national
priorities. With more claims being processed electronically,
centralized management will enable VBA to more easily adjust workload
distribution. In Phase II, claims will be assigned to different
regional offices based on claim-specific data. Assigning claims to
employees based on specific characteristics of a claim will improve the
timeliness and accuracy of decisions.
As VA implements the national work queue, Veterans will still be
able to visit regional offices or call our National Call Centers for
personal assistance with their claims. They will also be able to go
online to check the status of their claims and explore other self-
service features. VSOs and other authorized representatives will still
have full access to claims information for the Veterans they support
through SEP. Congressional staff will have access to VBA employees as
they do today to check on the status of a constituent's claim. The
electronic claims process provides real-time updates, no matter where
the claim is assigned for processing.
Work Credit System
In conjunction with the advancements in technology, VBA is
diligently working to update performance tracking mechanisms. To create
organizational consistency, VBA maintains performance standards for
timeliness and accuracy. These standards are routinely evaluated and
revised to keep pace with changes. With VBA's transition to electronic
claims processing, it is more important than ever to consider the
impact of technology on employee performance and ensure the
expectations of our workforce align with the tools employees have to
complete their work.
In response to organizational and process changes, VBA regularly
revisits and revises performance standards. These standards have
historically been developed via a committee consisting of
representatives from the Compensation Service; Pension and Fiduciary
Service; Office of Field Operations; Human Resources; our labor
partners; field managers; and subject matter experts. Revised standards
were most recently implemented in February 2013, and a further revision
to Veterans Service Representative (VSR) and Rating VSR production and
quality standards was recently presented to our national labor partners
and is in the final stages prior to implementation. VA works diligently
to ensure standards are developed that accurately align performance
expectations with the overall organizational mission and goals, as well
as the current claims processing environment.
Currently, VBA uses the Automated Standardized Performance Elements
Nationwide (ASPEN) system. ASPEN is a proprietary software system that
does not connect to VBA information systems. Because of the existing
limitations and growing challenges from using a proprietary software
product in a developing VBA digital environment, VBA is addressing the
need for performance management services. In November 2013, VBA
established a team to capture business requirements for new performance
management services. These new services will enable current, real-world
scalability and unlimited configurability, with powerful security
features to provide the support and functionality necessary to
integrate into our existing and future systems.
Proposed Rule To Require Standardized Forms
In order to get benefits into Veterans' hands as quickly as
possible, with the most accurate decision possible, VA has proposed a
rule that would require claims to be filed on a standard form and would
require appeals to be initiated using a standard form whenever one is
provided for that purpose. VA's proposed rule does not require that
Veterans file electronic claims in order to receive benefits.
VA gave interested members of the public the opportunity to comment
on the proposed rule from October 30 through December 30, 2013. VA is
carefully reviewing the 53 comments it has received from stakeholders
and will be responding to them in accordance with regular
Administrative Procedure Act procedures.
Conclusion
While we know there is more work to be done to reach our goals, the
combined effects of our Transformation Plan are having a significant
impact. The gains we are making in information technology and the
automation of our processes are critical, and going forward, we will
need to sustain the resources for programs like VBMS in order to
eliminate the backlog in 2015 and achieve our quality goals. FY 2014 is
a crucial year in our transformation, and I look forward to your
continued support and commitment on behalf of Veterans, their families,
and Survivors.
This concludes my statement, Mr. Chairman. I would be happy to
entertain any questions you or the other Members of the Subcommittee
may have.
Statement By Richard W. Thomas
Director, Healthcare Operations and Chief Medical Officer, Defense
Health Agency
and
Mr. David M. Bowen, Director, Health Information Technology, Defense
Health Agency
Executive Summary
As a direct result of the collaborative efforts by DoD and VA,
Veterans Benefits Administration (VBA) claims adjudicators who use the
Veterans Benefits Management System (VBMS) in all 56 VA Regional
Offices now have the capability to retrieve certified and complete
electronic versions of the DoD Service Treatment Records (STRs) for
Service members who separated or were discharged after January 1, 2014,
to assist in processing disability benefits claims. This enables VBA to
process future Veterans' disability claims for newly separating Service
members in a fully digital claims-processing environment; reduces the
amount of time it takes to gather required evidence; and helps to
improve the accuracy of disability claims decisions.
DoD is responsible for providing VA with Service members'
information to allow accurate and fair claims adjudication. STRs
provide the necessary military service related healthcare evidence
needed to reach a decision of a Service connection on a VA disability
claim. VA has recently required that these records be certified prior
to transfer from the DoD to VA. DoD subsequently issued policy to
ensure compliance.
The certification process requires that the final military
treatment facility (MTF) for each military Service verify the
completeness of each Service member's STR at the point of separation
from military service. When the MTF certifies the STR, it indicates to
VA that no further records exist and the STR for the Service member is
complete as of the date of certification.
In January 2013, in support of VBA's transition to a fully digital
environment for claims processing, DoD committed to accelerate the
deployment of the Health Artifact and Image Management Solution (HAIMS)
for the purpose of transferring electronic STRs to VA. DoD committed to
the development and implementation of a secure interface to allow VA to
query the HAIMS repository for relevant STRs effective not later than
January 2014. We have achieved this goal.
To do this, DoD revised its HAIMS deployment strategy, refocused
its training strategy to deliver training to Patient Administration
Department (PAD) personnel and clinic administrative staff, and formed
a VBA interface ``tiger team'' to plan and develop the automated
interface. The certification process was also modified to ensure that
the complete STR has been uploaded and is retrievable from HAIMS. In
DoD, the process begins with authorized DoD personnel scanning the
paper-based elements of a newly separating Service member's STR. This
and the Service member's DoD electronic health record, is submitted
into the HAIMS repository and made available to the VA as a single
record. HAIMS now fully supports the electronic transfer of digital STR
information, including military and private-sector treatment records,
to VA.
As of December 31, 2013, the Services stopped mailing hard copies
of STRs to the VA and the STR scanning process commenced on January 2,
2014.
Chairman Runyan, Ranking Member Titus, and distinguished members of
the subcommittee, thank you for extending the invitation to discuss the
collaborative actions taken by the Department of Defense (DoD) and the
Department of Veterans Affairs (VA) to enable the secure electronic
retrieval of disability benefits claimants' certified Service Treatment
Records (STRs) by VA. As a direct result of our collaborative efforts,
Veterans Benefits Administration (VBA) claims adjudicators who use the
Veterans Benefits Management System (VBMS) in all 56 VA Regional
Offices now have the capability to retrieve certified and complete
electronic versions of STRs for Service members who separated or were
discharged after January 1, 2014, to assist in processing disability
benefits claims. Achieving this milestone represents a meaningful step
forward - it enables VBA to process future Veterans' disability claims
for newly separating Service members in a fully digital claims-
processing environment; reduces the amount of time it takes to gather
required evidence; and helps to improve the accuracy of disability
claims decisions.
DoD is responsible for providing VA with Service members'
information to allow accurate and fair claims adjudication. STRs, in
particular, are an important part of that information in that they
provide the necessary military service related healthcare evidence
needed to reach a decision of a Service connection on a VA disability
claim. Because of the reliance on this information, VA has recently
required that these records be certified prior to transfer from the DoD
to VA. DoD subsequently issued policy to ensure compliance with this
process.
The certification process requires that the final military
treatment facility (MTF) for each military Service, including the
National Guard and Reserve component, verify the completeness of each
Service member's STR at the point of separation from military service.
When the MTF certifies the STR, it indicates to VA that no further
records exist and the STR for the Service member is complete as of the
date of certification.
In January 2013, in support of VBA's transition to a fully digital
environment for claims processing, DoD committed to accelerate the
deployment of the Health Artifact and Image Management Solution (HAIMS)
for the purpose of transferring electronic STRs to VA. Specifically,
DoD committed to the development and implementation of a secure
interface to allow VA to query the HAIMS repository for relevant STRs
effective not later than January 2014. We have achieved this goal.
In order to accommodate this new requirement, DoD revised its HAIMS
deployment strategy by realigning technical resources to support HAIMS
deployment, refocusing its training strategy to deliver training to
Patient Administration Department (PAD) personnel and clinic
administrative staff, and forming a VBA interface ``tiger team'' to
plan and develop the automated interface. The certification process was
also modified to ensure that the complete STR has been uploaded and is
retrievable from HAIMS. As a result of this focused effort, HAIMS fully
supports the electronic transfer of digital STR information, including
all military and private-sector treatment records, to VA.
Funding for this effort included Joint Incentive Funds (JIF) used
to support the Military Departments' procurement of high-volume
scanning equipment and additional personnel to digitize paper-based
medical information for newly separating Service members.
As of December 31, 2013, the Services stopped mailing hard copies
of STRs to the VA and the STR scanning process commenced on January 2,
2014. The process for digitizing a Service member's STR and making it
retrievable by VBA begins with authorized DoD personnel scanning the
paper-based elements of a newly separating Service member's STR. The
digitized STR, comprised of the scanned information and digital content
from the Service member's DoD electronic health record, is submitted
into the HAIMS repository and made available to the VA as a single
record.
Chairman Runyan, Ranking Member Titus, and members of the
distinguished subcommittee, thank you for the opportunity to testify
today. The Secretary of Defense is committed to ensuring that
information is made available to VA when a Service member's status
changes to civilian status as a Veteran and he or she files a
disability benefits claim. DoD continues to work closely with VA to
ensure that important information regarding a Service member, including
relevant medical information, is available for ongoing healthcare
delivery or adjudication of VA benefits.
We look forward to your questions.
Paralyzed Veterans of America
Chairman Runyan, Ranking Member Titus, and members of the
Subcommittee, Paralyzed Veterans of America (PVA) would like to thank
you for the opportunity to offer our views on the Department of
Veterans Affairs (VA) current status of its transformation and the
secondary effects of the Veterans Benefits Administration's (VBA) use
of technology. While PVA has been encouraged by many of the effects
that the integration and wide-spread implementation of technology has
had, we still have concerns that we have expressed in the past, both to
VBA and to Subcommittee members and staff.
As VA progresses in its new processing model for disability
compensation claims, we are seeing a flurry of activity and updates to
the Veterans Benefits Management System (VBMS). Currently VBMS 6.0
appears to be on target, but this timeliness does not necessarily
address the real potential problems. This system has been able to
accommodate many of the myriad of adjustments designed to standardize
and automate VA claims processing and access to information. The
tradeoff has been the often incompatible gateways to retrieve
information, such as the need to access multiple systems with various
passwords to retrieve required information. These VBA problems are
short term, however, because VBMS will ultimately morph into the
Stakeholder Enterprise Portal (SEP), a secure web-based portal which
facilitates access to VA systems under a single umbrella. VBMS is
currently being utilized to implement scheduled program releases at
this point because SEP cannot be programmed in time to accommodate the
targeted release dates. Incremental program changes are thus being made
in VBMS and will be available in the SEP Portal when VBMS effectively
morphs into SEP. This update will greatly simplify access to all
available VA systems via a single gateway.
Supporting the improvements to VBMS is the national work queue
strategy within VBA which is a critical and reasonable component of
VBMS. The system was designed to be fluid and to facilitate the
movement of work where it can best be done. In the past the only way an
NSO could review a claim was to have the C-file on their desk. The
significant impact of VBMS will be to expand their capability beyond
the confines of the office which will help to reduce the backlog and
maintain the reduction, though PVA still has concerns with the backlog
simply moving into the appeals realm.
In conjunction with the queue strategy is the work credit system
which has always been a problem with VBA, and the automated IT
component of this issue doesn't change the situation. The issue stems
from what is measured and how the date is utilized once it is
collected. This issue has historically steered VBA in the wrong
direction when it comes to resource allocation, which is the end result
of the application of work measurement data. Under Secretary of
Benefits Hickey has been wise not to strip resources from offices that
place on the lower end of the work measurement graph as that doesn't
address the real problem.
One concern that PVA and other Veterans Service Organizations (VSO)
have recently expressed is VA's recent statements on requiring
electronic forms submission. This plan, if enacted, would significantly
disadvantage veterans in seeking their earned benefits. If a veteran
doesn't express his intention to secure a benefit on the right form, he
or she won't be recognized as having made a claim. The burden is on the
veteran and VA's duty to assist will be seriously diluted, potentially
interfering with a veteran's access to their rightful benefit. This is
a path that PVA cannot endorse.
PVA's major concern at this point is the ability of VBA employees
to effectively comprehend and implement the new transformation
initiatives as these new programs are rolled out. VA employees are
conscientious, hard working individuals, however, the ongoing changes
have always been a challenge, as it would be for any employee. In
addition, PVA has often testified on the lack of good training programs
by VA that provide adjudicators with the base of knowledge needed for
the complicated job of claims processing. Additionally, there often
seems to be difficulty in getting the new policies, procedures or
processes down to the lowest staff level. We believe this trend
continues despite the transformation.
VBA has implemented a policy of designating super users to receive
extensive training on new transformation applications, and these
employees are subsequently directed to train their fellow employees on
the use of the program. Our concern in this area is that the employees
selected to receive this training may be highly qualified and may have
the requisite IT skills to effectively utilize the full potential of
the new initiative, but the employees that this person is designated to
train, may not be as IT savvy. The potential for major
misunderstandings is an aspect that cannot be ignored. PVA is concerned
that the transformation initiatives can only work if there is adequate
effective training and this may or may not be correlated with the
number of documented hours recorded for this purpose.
The process of transformation has progressed to the point where
turning back is not an option, nor is redesign of the entire process
feasible. Unfortunately, if this training plan was a bad decision, it
will not be known until it is too late. Thus we reiterate our concerns
that PVA has emphasized in the past that the success of VBMS greatly
depends on the process design, like rules-based processes, and
supportive technologies like Special Monthly Compensation (SMC)
calculators, that undergird the system. This is the challenge for a
rules-based computer system, it does not have the human interaction to
fully understand the circumstances of a specific injury, particularly
for those with catastrophic disabilities. The numerous issues faced by
veterans with catastrophic injuries create a complex set of outcomes
that cannot be easily reconciled by logic-based systems that cannot
appreciate nuance in disability assessments. Calculators used in rules-
based systems historically fail to compute the right ratings for
persons with multiple issues. This type of decision analysis uses
decision trees that attempt to enable the rater to simplify and resolve
complex questions. This technique, however, can be problematic when the
analysis involves highly qualitative assessments that are reduced to
binary choices.
In summary while we see many obstacles to the progress of
transformation based technologies, we see the potential to overcome
these problems by empowering first line supervisors to effectively
manage their employees. This level of management is responsible to
evaluate the ability of their employees to effectively utilize the
tools that are available to them. They are the ones who must decide if
it is necessary to forgo a short term gain by requiring additional
training for an employee who is not able to effectively utilize the
potential time savings afforded by any of the new automated features of
claims processing. While there is great pressure to increase efficiency
and to reduce the claims backlog, employees must be properly trained
and motivated by their first line supervisor. If not, they are simply
moving the backlog downstream to the detriment of the veteran.
One final concern we have is recognition of the fact that VBA
transformation initiatives are being scrutinized by multiple interested
parties, not the least of which is this Subcommittee as well as other
members of Congress. While oversight is critical, excessive reporting
requirements and requests for responses to defend actions discovered in
investigative committee reviews can be unreasonably burdensome and time
consuming. This can also cause the parties to focus more on protecting
their own jobs than on providing the best services for our veterans.
Mr. Chairman, we would like to thank you once again for allowing us
to address VBA's technology transformation. We continue to hope that
the advances in technology use will benefit all veterans, but VA must
remember that technology is not the easy fix many portend it to be.
This is particularly true when considering those with catastrophic
disabilities.
PVA would be pleased to take any questions for the record.
Information Required by Rule XI 2(g)(4) of the House of Representatives
Pursuant to Rule XI 2(g)(4) of the House of Representatives, the
following information is provided regarding federal grants and
contracts.
Fiscal Year 2013
National Council on Disability--Contract for Services--$35,000.
Fiscal Year 2012
No federal grants or contracts received.
Fiscal Year 2011
Court of Appeals for Veterans Claims, administered by the Legal
Services Corporation--National Veterans Legal Services Program--
$262,787.
Vietnam Veterans of America
Submitted by James R. Vale, ESQ., Director, Veterans Benefits Program
Chairman Runyan, Ranking Member Titus, and other members of this
distinguished and important committee, Vietnam Veterans of America
(VVA) appreciates the opportunity to offer our statement for the record
concerning VBA Technology. Please know that VVA appreciates the efforts
of this committee for the fine work you are doing on behalf of our
nation's veterans and their families. There are 5 issues we would like
to bring to your attention.
I. Scanning Veterans Claims Folders (CFILES)
VBA has to complete its transformation from paper to electronic
files if it is going to make significant progress in improving its
timeliness in claims processing. To accomplish this huge undertaking
VBA is scanning millions of veterans' claims folders (CFILEs). These
CFILEs are the agency's official record of the veteran's current claim
and any past claims and appeals. These CFILEs can range from less than
50 pages to literally thousands of pages (enough to fill several filing
cabinet drawers).
Inside a CFILE
On the left flap is the accounting and payment history. The middle
section should contain, in chronological order, the initial claim form
(21-526), reopened claims, private medical records, past rating
decisions, other evidence submitted by the veteran or the veterans
representative, evidence added by VA (such as printed pages from the
Veteran's medical records from VA hospitals), evidence from other
agencies (such as the Social Security Administration), and all
correspondence sent to the veteran. The right flap contains the
veteran's Power of Attorney form (VA Form 21-22), and DD214.
The service treatment records (STRs) including the veterans
military medical and dental records are contained in a large envelope,
usually attached in the middle section of the CFILE. The STRs contain
the veteran's enlistment physical, contains outpatient treatment
records, and separation physical. Lab results (usually on sticky notes)
are stuck on the outpatient treatment notes. X-rays are also included.
Older records are usually hand-written and hard to read. Records from
WWII are very delicate and require careful handling.
Once the first CFILE is completely full a second folder is created
(Volume II), then a third (Volume III), and so on. Sticky notes are
used to help flag key parts in the file. Highlighting is also used. All
the volumes are bound together by large rubber bands.
Unfortunately, Veteran Service Officers all too often find the
paper documents in CFILES in complete disarray. For whatever reason,
these documents are not in chronological order, but in random order,
much like what is left over after playing a game of ``52 Pickup.''
Sometimes documents from other veteran's CFILEs get mixed in. I
personally have seen a CFILE containing documents from 3 different
veterans.
Not all CFILEs are Scanned
VSOs were promised by VA the CFILEs would be scanned and
searchable. To date, VA says 82% of the CFILEs are scanned. This 82%
are initial claims, and do not include over 800,000 reopened claims,
appeals, dependency claims, and claims already decided. We understand
VA has had to prioritize which CFILES get scanned first, and noticed
this massive scanning effort has led to delays in veterans claims at
ROs across the country, but we recognize this is a temporary situation.
CFILEs are not Fully Searchable
The VA promised efficiencies would be gained by the electronic
CFILEs being searchable. In practice, what has happened is after each
page is scanned it is grouped together with similar documents and
categorized under a specific label. Only the label, and not the
document's contents, are globally searchable in VBMS. To search within
the document you must open it and perform a separate search within that
document (if it was scanned using Optical Character Recognition or
OCR). What we now have is a pile of paper being replaced with a ``Pile
of PDFs.''
VBA should be appropriated sufficient funding to ensure that each
veteran's electronic CFILE is truly searchable without having to open
each document separately. Opening each document separately delays
adjudication, and may actually prevent some VA attorneys and Veteran
Law Judges from seeing important documents if they rely solely on
searching the document labels and do not open every single document.
CFILE Pages are Mislabeled
VVA represents veterans at the Board of Veterans Appeals, and our
appellate attorneys have noticed a problem with pages in electronic
CFILES in VBMS being mislabeled. For example, our attorneys' legal
briefs and third party correspondence have frequently been mislabeled
as ``Board of Veterans Appeals Decisions.'' Consequently, we are
concerned this is a much broader problem given the large scale of
scanning that is taking place across VBA. We suggest this mislabeling
problem be looked at more closely.
Quality Control Concerns
As mentioned previously, CFILES range in size and content. Also,
documents contained in these CFILEs may be single or double sided. Many
of these pages have staples, paper clips, or sticky notes or flags
which have to be removed before being scanned. This is a labor-
intensive and mistake prone process. How do we know both sides of each
page was scanned? How do we know all the pages were scanned? What if
the scanned image is illegible? Once the paper CFILE is destroyed,
there is no going back if a quality problem is later discovered with
the electronic copy. This potentially creates an electronic ``St. Louis
Fire'' for veterans whose files were either not scanned completely, or
have illegible scans.
VBA plans to retire scanned CFILEs, but no official decision has
been made on what to do with the STRs. They are DoD property, but DoD
does not want the STRs back. VA does not want to continue paying to
store them. Prior rating decisions contained in the paper CFILE may not
be accessible in legacy VBA systems such as Virtual VA.
VVA recommends retiring the entire CFILE to NARA. That way if there
is ever a problem with the scanned file the Veteran can go back to the
paper file. Otherwise, we will have a situation similar to what is
found within the airline industry where the airlines claim 98% of
passenger baggage makes it to their destination, but if you are part of
the unlucky 2% whose bags didn't make it, you are out of luck. Here,
veterans whose CFILES were not completely scanned or have scanning
errors may face denials by VA, much like their predecessors whose
military records were destroyed by the infamous 1973 St. Louis Fire.
II. VA National Work Queue
VBA has Regional Offices in every state, some states (NY, PA, & TX)
have 2 ROs, and CA has 3 ROs. VBA is trying to balance its work across
its 57 regional offices. VBMS will give VA the opportunity to balance
its workload across all these ROs. It may also allow the creation of
Centers of Excellence for complex or difficult claim issues such as
PTSD, TBI, hearing loss, and vision loss. This could improve the
consistency of rating decisions, especially for those conditions that
are not adjudicated very often, but are complex. For example, vision
loss conditions make up only 1.5% of all service connected conditions
(2012 VBA Annual Report), but tend to be very difficult and challenging
for RVSRS to adjudicate. Using the National Work Queue vision loss
claims from around the country could be channeled to specific RVSRs who
are experienced in rating these types of claims. Furthermore, RVSRs at
every RO could be incentivized to become Subject Matter Experts in
particular claims.
Need for Formal Process To Resolve VSO Sign off Issues
As a service officer I have signed off rating decisions at the
rating table, and in the cases where I found an error in a rating
decision I was able to go straight to the RVSR (or the RVSR's Coach)
and get the issue immediately resolved, thus saving the RVSR a quality
review error, and saves the veteran a lengthy 2-3 year appeal. This is
a win/win for the veteran and the VA.
Not every RO allows service officers access to RVSRs. Some ROs only
allow the service officer to meet with the RVSR's coach (when the coach
can be found. They are very busy and can be hard to locate). VVA
proposes ``office hours'' at each RO so the service officer can get the
issue resolved without the RVSR or coach being interrupted throughout
the entire work day by service officer inquiries.
Now that VBMS is here, VBA needs to establish a formal process to
deal with service officer sign-offs. If a claim is to be signed off by
a service officer in VBMS via SEP, how do sign-off issues get resolved
if a service officer finds an error in a rating decision? This become a
bigger problem if the service officer is not located at the same RO
that generated the decision. VVA proposes a ``Dispute Queue'' be
created where the service officer can send the rating decision for
review by the RVSR or Coach.
The advantages of a National Work Queue have to be carefully
balanced with the disadvantages. The service officer who is on station
and has face to face contact with the RVSRs and DROs is a more
effective advocate for veterans than those service officers who are not
on station or do not have access to adjudicators. If designed
correctly, the National Work Queue can help effectively balance
workloads within an RO and across multiple ROs, but carefully planning
must be taken to ensure the working relationship between service
officers and RVSRS is not weakened.
III. Issues With Stakeholders Enterprise Portal (SEP)
SEP allows VSO many benefits including the ability to accept or
reject a veteran's request for representation, submit a claim
electronically for a veteran (either take over a claim that was started
in e-Benefits, or submit a whole new claim in SEP), and check the
veteran's claims status. It basically allows the VSO to see what the
veteran sees in e-Benefits. SEP holds great potential to enable VSOs to
better serve veterans, but it does have a few issues that need to be
addressed.
Veteran Must Already Have an e-Benefits Account
In order for a VSO to submit a claim for a veteran via SEP, the
veteran must already have already created an e-Benefits account.
Currently it is not possible to submit a claim for a veteran via SEP if
the veteran does not have an e-Benefits account. VA is working on a
solution.
POA Request Glitch
In response to multiple VSO requests to improve VA policy governing
VA Form 21-22 ``Appointment of Veterans Service Organization As
Claimant's Representative,'' known as the ``POA Form,'' VA created
functionality in e-Benefits to allow veterans to select their
representative online rather than submitting a paper 21-22 form. VSOs
were told the veteran can submit a POA request in e-Benefits, and that
this request would appear in the VSO's ``Service Representation
Request'' queue in SEP where the VSO can click a button to accept or
decline the request. The veteran's e-Benefits account would receive an
immediate response from SEP once the VSO accepts or declines the POA
request.
Unfortunately, due to a programming bug or glitch, there is a
communication error between e-Benefits and SEP that is preventing the
veteran's e-Benefits account from updating with the new POA request
status after the VSO accepts or rejects the POA request. Thus, the VSO
must contact the veteran directly by phone, email, or paper letter to
communicate the acceptance or rejection of the veteran's POA request.
Imagine a VSO finding 1,000 POA requests to respond to in SEP. That is
1000 phone calls, emails, or paper letters that need to be generated.
This creates an unnecessary burden on VSOs, and needs to be corrected
by VA as soon as possible.
Out of Date POA Database Impacting e-Benefits
A veteran's ability to find an accredited service officer in e-
Benefits is significantly impacted because the database maintained by
the VA Office of General Counsel (OGC) used to feed into e-Benefits is
woefully out of date.
The VA Office of General Counsel (OGC) only has 4 FTE to monitor
approximately 30,000 accreditations (service officers, attorneys, and
VA Agents), and these staff are responsible for maintaining the online
database that feeds into the POA request feature in e-Benefits (see:
http://www.va.gov/ogc/apps/accreditation/).
The lack of resources at OGC to monitor these accreditations is
well documents by the Government Accountability Office in its report
``Improvements Needed to Ensure Claimants Receive Appropriate
Representation.'' The GAO recommended the VA OGC, ``. . . take steps to
ensure an appropriate level of staff and IT resources are in place to
implement the requirements of the accreditation program.'' GAO-13-643:
Published: Aug 1, 2013. Publicly Released: Aug 30, 2013. Available:
http://www.gao.gov/products/gao-13-643.
Although some short-term fixes are being made to help clean up the
database, the long-term solution is for OGC to allocate sufficient FTE
to this important OGC function so that the database is up to date.
IV. Diffused Accountability
VBA has to transform its paper-based claims system into a modern,
electronic-claims based system, and is making great progress. However,
unless structural changes are made to VBA's organizational structure,
no amount of technological transformation will fix VBA's underlying and
deep-rooted problem: the existing separation of VBA's Operations and
Policy Functions.
There are at least two major structural/corporate culture barriers
that need to be changed at VBA. First, the bifurcation of separate
reporting lines of managers between ``operations'' and ``policy'' does
not make sense. It only creates too many middle managers and disperses
accountability. This needs to be corrected at VBA (and at the Veterans
Health Administration (VHA) as well we might add), for the same reasons
of reducing managerial slots and affixing clear accountability. The
second is the fact that nobody ever got in trouble at Compensation &
Pension for saying ``No.'' The default position needs to change from
``No'' to ``how do we get to yes?''
VVA commends VBA on the progress it is making to become an
electronic claims system, but strongly urges VBA's organization
structure also undergo transformation.
VVA Proposed Rule Rin 2900-AO81--Standard Claims and Appeals Forms
VVA understands the VA's stated intent to improve the quality and
timeliness of the processing of veterans' claims for benefits and
appeals, and in principle, we do not oppose VA modernizing its claims
system and use of standardized forms. However, we find many of these
proposed rule changes in RIN 2900--AO81, as currently written, do NOT
have the intended effect of increasing efficiency, and are in fact
adverse to veterans' interests by formalizing the claims and appeals
processes to the point where benefits are unfairly restricted.
Although the title of this proposed rule is, ``Standard Claims and
Appeals Forms,'' the proposed change goes well beyond mandating the use
of forms. VA proposes to:
Eliminate all informal claims, potentially costing
veterans millions of dollars in retroactive payments currently
allowed under existing law.
Essentially change a claim from an application of
``formal or informal communication in writing requesting a
determination of entitlement or evidencing a belief in
entitlement, to a benefit'' to ``a written communication
requesting a determination of entitlement or evidencing a
belief in entitlement, to a specific benefit under the laws
administered by the VA.'' This gives VA the opportunity to
raise the bar to an unreasonable level where veterans are
denied claims for issues that are not specifically claimed.
Create the concept of a ``complete claim,'' and
providing VA the opportunity to unfairly deny claims for
failing to meets its arbitrary standards of what it deems to be
``complete.'' Veterans' claims should be decided on their
merits, and not summarily dismissed for failing to dot every
``I'' and cross every,``t''.
Currently, the claims clock starts when a veteran submits an
informal claim, and the veteran has 365 days to follow up with the
formal claim and evidence to perfect the claim. VBA policy makers claim
this hurts and unfairly skews VA's claims timeliness statistics. There
is nothing in Title 38 that prohibits VBA from starting the claims
clock from when the formal claim is received. Thus, VA could start the
claims clock when the formal claim is received rather than eliminating
informal claims. This would reduce VBA timeliness statistics by up to
364 days without costing veterans the retroactive awards they are
currently entitled to under the existing informal claims process.
VVA has serious concerns that these proposed changes are adverse to
many classes of veterans--especially Vietnam Veterans--seeking VA
benefits under Title 38, and some of these proposed changes may be in
direct violation of existing court rulings. Furthermore, some of these
proposed changes may not pass Constitutional muster given they appear
to run afoul with the Due Process and Equal Protection Clauses of the
U.S. Constitution. The end result of these proposed changes, if
enacted, would be a significant departure from the longstanding,
``nonadversarial and pro-claimant'' VA system originally intended by
Congress.
Although VA is granted authority under 38 U.S.C. 501(a) to make
regulatory changes, these proposed regulatory changes appear to be
ultra vires. Therefore, VVA strongly opposes these proposed changes as
currently written and urges that they be withdrawn.
Mr. Chairman, VVA thanks you and this subcommittee for the
opportunity to present our views for the records regarding today's
hearing ``Beyond Transformation: Reviewing Current Status And Secondary
Effects Of VBA Technology''.
February 5, 2014
Vietnam Veterans Of America
Funding Statement
The national organization Vietnam Veterans of America (VVA) is a
non-profit veterans membership organization registered as a 501(c)(19)
with the Internal Revenue Service. VVA is also appropriately registered
with the Secretary of the Senate and the Clerk of the Senate of
Representatives in compliance with the Lobbying Disclosure Act of 1995.
VVA is not currently in receipt of any federal grant or contract,
other than the routine allocation of office space and associated
resources in VA Regional Offices for outreach and direct services
through its Veterans Benefits Program (Service Representatives). This
is also true of the previous two fiscal years.
For Further Information, Contact:
Director of Government Relations Vietnam Veterans of America. (301)
585-4000, extension 127
James R. Vale, ESQ.
Mr. James Vale is the National Service Director and Senior Attorney
for Vietnam Veterans America. He is a licensed attorney from the State
of Washington, leads a legal team of 6 appellate attorneys, and
oversees accreditation, training, and VBP Program compliance for over
600 accredited service officers. He has been an accredited service
officer for 10 years and is accredited by the Associates of Vietnam
Veterans, American Legion, Blinded Veterans Association, and Vietnam
Veterans of America. He has represented veterans for VA claims at the
VA Seattle Regional Office and at the Board of Veterans Appeals.
Mr. Vale is a former Government Relations Intern with the Blinded
Veterans Association, and a former David Isbell Summer Law Clerk with
the Veteran Pro Bono Consortium. He is a past-presenter at the National
Organization of Veterans Advocates (NOVA), has written an article in
the National Veterans Legal Services Program (NVLSP), The Veterans
Advocate, and has a column in VVA's Magazine, The Veteran.
Mr. Vale is a disabled Navy Gulf War-era Veteran and is legally
blind. He earned his Master of Business Administration (MBA) and Master
of Aeronautical Science (MAS) from Embry-Riddle Aeronautical
University, and Master of Public Administration (MPA) and Education
Specialist Degree (Ed. S.) from the University of Arizona, and Juris
Doctorate (JD) from Seattle University School of Law. He is also a
graduate of both the VA Blind Rehabilitation Service and the VA
Vocational Rehabilitation & Employment Program.
Mr. Vale resides with his wife Rowena and his daughter Gabrielle in
the DC metro area.
Letter From Hon. Titus To Hon. Shinseki
February 27, 2014
The Honorable Eric K. Shinseki
Secretary, Department of Veterans Affairs
810 Vermont Avenue, NW., Washington, DC 20420
Dear Mr. Secretary:
In reference to our Subcommittee on Disability Assistance and
Memorial Affairs hearing entitled, ``Beyond Transformation: Reviewing
Current Status and Secondary Effects of VBA Technology'' that took
place on February 5, 2014, I would appreciate it if you could answer
the enclosed hearing questions by the close of business on April 10,
2014.
In an effort to reduce printing costs, the Committee on Veterans'
Affairs, in cooperation with the Joint Committee on Printing, is
implementing some formatting changes for materials for all Full
Committee and Subcommittee hearings. Therefore, it would be appreciated
if you could provide your answers consecutively and single-spaced. In
addition, please restate the question in its entirety before the
answer.
Due to the delay in receiving mail, please provide your response to
Carolyn Blaydes at [email protected]. If you have any
questions, please call (202) 225-9756.
Sincerely,
Dina Titus, Ranking Member Subcommittee on Disability
Assistance and Memorial Affairs
Questions For The Record-VA
Production
1. Can you please explain, in detail, how station targets for VA
Regional Offices are created? Consistently committee staff has found
that station targets are not being met. Are the station targets
unrealistic? If not, what is being done to hold offices accountable for
not reaching their targets?
2. The most recent performance data available in ASPIRE is more
than two months old. Can VA commit to providing Congress and the public
with timely information regarding the performance of VA Regional
Offices?
3. How does VBA define an under performing office?
4. What are the performance standards for individuals working in
the various segmented lanes? How many claims is a VSR/RVSR expected to
complete if the work in the ``express lane'', the ``core lane'', the
``special operations lane'', and on non-rating work?
a. Do these standards vary by office or are they the same
across the country?
b. If the standard is the same but actions are weighted, please
provide us an index explaining how different actions are
weighted.
5. Can we please receive a briefing and documentation on the NLA
pilot?
6. Can VA please provide the formula for determining ``claims
produced per Direct FTE'' on the executive dashboard as well as the
figures used in that calculation?
7. VARO Directors indicated that they are challenged to provide
incentives to employees. Can you please provide the code/regulation
that governs RO leadership's abilities to provide such incentives?
8. How many provisional rating decisions have been made since the
inception of tactic.
a. How many of those claims have been appealed?
9. How many VA Regional Office Director positions are currently
vacant? How long have they been vacant for?
National Work Queue
1. One of the concerns raised in the VFW's testimony is the fact
that service officers are not provided lists informing them of what
claims have been brokered? How does VA currently inform the VSO's of
the location of brokered claims, and how does VA expect this to change
moving forward?
2. Why was the national work queue not communicated to Congress
prior to its implementation?
3. In a National Work Queue, how will poor performing offices and
employees be held accountable?
4. How will the resource allocation model be modified in
consideration of the National Work Queue?
5. According to the fact sheet provided to the committee on
February 3, 2014, with regards to the National Work Queue, VBA has
suggested that they will support medical-issue and skill-based workload
distribution. Can you please expand upon this; will this be for all
medical conditions, what are VBA's intended goals?
6. What is the Area Director's role in the new model and who
specifically will manage workload at the National level?
7. VSOs are concerned about losing the ability to have face-to-face
interaction with the VA employee processing the claim. How is VA going
to ensure VSO service officers can contact the case workers?
8. What is VA doing to ensure the ``sense of ownership'' is not
undermined as the claims are sent to other regions?
9. Please provide statistics on the quality of brokered and non-
brokered claims.
10. In the future phase of NWQ, how is VA ensuring that the
holistic view of complex claims is retained as the individual issues
are sent off to other regions and employees?
11. How is the VA going to allocate resources (FTE, budget, etc.)
to high and low performing ROs?
12. There is concern that previous attempts to centralize claims
for death pensions and Dependency and Indemnity Claims (DIC) were
problematic with high error rates and delays. Is VA incorporating any
lessons learned from that experience?
e-Benefits
1. What percent of claims are being submitted through e-Benefits?
What are VA's goals for online claim submission?
2. Can you please provide the findings of the breach core data
team's investigation to the committee?
HAIMS
1. Is the VBMS-HAIMS interface fully operational? How many service
and treatment records has VA retrieved using the HAIMS interface? The
November update to the Transformation Plan indicates DoD committed to
providing 100% complete searchable electronic records, has DoD now met
its commitment and is this capability fully rolled out at all 56 VAROs?
2. Where is HAIMS scanning conducted?
VBMS
1. What is the total for VA spending on VBMS from inception?
Work Credit
1. Can VA provide an update on the current work credit system and
any labor agreements and discussions?
2. Can VA provide the committee with a copy of the AFGE labor
agreement?
IDES
1. In the hearing VA suggested that it would eliminate the backlog
of IDES claims by March (Final Rating) and August (Initial Rating). Can
VA please provide additional clarity on its plan to achieve this goal?
2. Can more claims be brokered to the Providence DRAS to reduce the
wait times of Servicemembers waiting on rating decision from the
Seattle DRAS?
3. Can more IDES ratings decisions be brokered to additional VA
Regional Offices?
4. Numerous references have been made to negative experiences from
the SM's in IDES with regards to QTC physicians and facilities. How is
VA checking the quality and consistency of the QTC examinations,
facilities, and personal?
Responses From VA to Hon. Dina Titus
Question 1: Can you please explain, in detail, how station targets
for VA Regional Offices are created? Consistently committee staff has
found that station targets are not being met. Are the station targets
unrealistic? If not, what is being done to hold offices accountable for
not reaching their targets?
VA Response: The performance of regional offices (RO) is evaluated
against national and RO-specific targets that are based on the Veterans
Benefits Administration's (VBA) strategic goals. These targets are
established at the beginning of each fiscal year (FY), across all the
business lines and for a variety of measures, including quality,
timeliness, production, and inventory. Challenging performance
expectations are established that build on the previous year's
performance, giving consideration to current staffing levels and
anticipating that each RO is working to ensure the most efficient
utilization of those resources. RO directors are held accountable for
their performance, which is reflected in their end-of-year evaluations.
As appropriate, performance improvement plans are put in place for
employees and closely monitored by the area director.
Question 2: The most recent performance data available in ASPIRE is
more than two months old. Can VA commit to providing Congress and the
public with timely information regarding the performance of VA Regional
Offices?
VA Response: VBA has increasingly been asked for production
statistics that reflect the status of claims actually being worked at
each RO, referred as claims at the Station of current Jurisdiction
(SOJ), instead of the production credited to the station where the
claim was originally received, referred to as Station of Origination
(SOO). We acknowledged this requirement in recent changes to the Monday
Morning Workload Report, which now shows production statistics for each
RO both before and after any brokering of claims to or from other ROs.
As brokering will continue to increase in FY 2014 and FY 2015, VBA
adjusted the data for ASPIRE to reflect SOJ versus SOO in our monthly
statistics towards achieving our FY 2015 goals. We have recalculated
the previous months of ASPIRE data in FY 2014 accordingly and reposted
October 2013 through January 2014. These new files were available
online on March 7, 2014. February end-of-month data for Compensation
and Pension was posted to ASPIRE on March 11, and we expect to continue
publishing prior-month data to ASPIRE no later than the 10th business
day of the following month. We apologize for any confusion that may
have resulted during this changeover period.
Question 3: How does VBA define an underperforming office?
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Question 5: Can we please receive a briefing and documentation on
the NLA pilot?
VA Response: VBA can provide a briefing at the Committee's
convenience.
The Veterans Benefits Management System (VBMS) notification letter
automation (NLA) automates the award notification letter with very
little manual handling by the end user. The expectation is that the
implementation of this new process will reduce the time that claims
await award generation and authorization. This allows VBA employees to
focus their critical expertise on award processing. The new process
will facilitate standardization of the letters nationwide in a way not
previously possible. The new system supports much more rapid language
changes than legacy products, facilitating timely updates to our
standardized system language.
This functionality uses rules-based logic to drive generation of
notification letters based on various inputs as part of a rating
decision or award action. Prior to this automated process, users were
required to manually select paragraphs to populate the notification
letter.
The Portland RO began the VBMS NLA pilot in August 2013, and it is
being used by two of the RO's teams (Express and Non-Rating). The
Lincoln RO began piloting VBMS NLA in November 2013.
Program successes include:
365 automated letters were generated as part of the
pilot.
84percent of automated letters generated after VBMS
6.0 release.
The VBMS NLA pilot supported and led to incorporation
of NLA functionality in the VBMS-Awards application.
Time-study results showed a 40 percent reduction in
letter generation time and resources using the VBMS NLA
process, compared to the traditional legacy system processing.
The Lincoln and Portland ROs are currently piloting VBMS NLA.
National deployment of the VBMS-Awards application with the embedded
NLA functionality is currently in the planning stages.
Question 6: Can VA please provide the formula for determining ``claims
produced per Direct FTE'' on the executive dashboard as well as the
figures used in that calculation?
VA Response: Claims produced per direct full-time equivalent (FTE)
employees represents total claims completed during a given month
divided by the cumulative FTE employees for that month. Since rating
claims are processed by both compensation and pension employees,
cumulative end of month FTEs for both business lines is used.
Direct FTE includes VSRs, RVSRs, Decision Review Officers (DRO),
Pension and Veterans Service Center field employees such as Claims
Assistants, Fiduciary employees, National Call Center employees,
Military Service Coordinators, Homeless Veterans Coordinators, and
Women Veterans Coordinators. The end of month February calculation was
based on 14,101 direct FTEs.
Question 7: VARO Directors indicated that they are challenged to
provide incentives to employees. Can you please provide the code/
regulation that governs RO leadership's abilities to provide such
incentives?
VA Response: RO directors are allowed to provide performance incentives
under the following statute, regulations, and publications:
5 United States Code, Chapter 45 - Incentive Awards;
5 Code of Federal Regulations (CFR), Part 451 -
Awards;
5 CFR, Part 531, Subpart E - Quality Step Increases;
VA Handbook 5017 - Employee Recognition and Awards;
and
Office of Personnel Management publication ``Human
Resources Flexibilities and Authorities in the Federal
Government.''
VBA utilizes a three-tier incentive program to recognize individuals
and ROs for excellent performance during the fiscal year.
Individual recognition (level one) awards are given to those employees
whose performance significantly exceeds their performance requirements.
All performance requirements for claims processors contain critical
elements for both quality and timeliness/production. At the heart of
the performance award program is a foundational focus on quality. Group
awards (level two) are made to offices or elements of offices that
achieve and exceed performance targets, including all claims accuracy
goals. Special contribution awards (level three) are reserved for
recognition by the Under Secretary for Benefits.
Question 8: How many provisional rating decisions have been made since
the inception of tactic?
a. How many of those claims have been appealed?
VA Response: Between April 19, 2013, and November 2013, approximately
14,500 provisional ratings were completed (7,300 for 2-year claims and
7,200 for 1-year claims). This represents approximately two percent of
the rating-related decisions made under the Oldest Claims Initiative
through November 8, 2013.
In April 2013, the Department of Veterans Affairs (VA) implemented a
temporary initiative to expedite compensation claims decisions for
Veterans who had waited one year or longer. Between April 19, 2013, and
November 8, 2013, VA claims raters made provisional decisions on some
of the oldest claims in inventory, which allowed Veterans to begin
collecting compensation benefits more quickly, if they were eligible.
Provisional decisions were based on all evidence VA had received to
date and during the time the claim had been pending.Provisional rating
notices noted the evidence;
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already had a decision made on them, and brought to the DRO's attention
because of some conflict with the facts or law as applied in the case.
This would also apply to any cases assigned to the DRO by Veterans
Service Center management based on the complexity/sensitivity of the
case. This credit does not apply to routine rating development cases
and, again, can only be claimed exclusive of any other weighted action
listed above.
3. The case credit review for an SOC [EP 172 or 174] should be
taken per the parameters in M21-4 Appendix C. Concerning formal
hearings (EP 174), a full case credit is only available if the formal
hearing is actually held; otherwise, the only credit available is the
1/2 case for preparation time, if applicable.
4. The term ``DRO decision'' is defined as any rating related to an
appeal where the DRO has made a favorable decision requiring some type
of award action. Separate DRO decision and rating decision documents
for the same issue are not required.
5. Weighted case credit for non-appeal cases is the same as the
RVSR weights.
SUCCESSFUL LEVEL: Three weighted cases per day (cumulative)
INDICATORS: Production reports
Leave, union time, special projects or assignments pre-approved at
the discretion of the supervisor, and 2nd signature reviews (of
trainees only) are considered deductible time.
ELEMENT 3 - CUSTOMER SERVICE
Functions as a team member to enhance resolution of claims and
customer service contacts by work actions. Maintains professional,
positive, and helpful relationships with internal/external customers by
exercising tact, diplomacy, and cooperation.
Performance demonstrates the ability to adjust to change or work
pressures, to handle differences of opinion in a businesslike fashion,
and to follow instructions conscientiously. As a team member,
contributes to the group effort by supporting fellow teammates with
technical expertise and open communications and by identifying problems
and offering solutions. Successful achievement in this element reflects
support of all scorecard goals.
SUCCESSFUL LEVEL: No more than three instances of valid complaints
or incidents.
INDICATOR: Verbal and/or written feedback from internal and/or
external customers. Observations by a manager with the complaint
documented.
A valid complaint or incident is one where a review by the
supervisor, after considering both sides of the issue, reveals that the
complaint/incident should have been handled more prudently and was not
unduly aggravated by the complainant. Disagreeing, per se, does not
constitute ``discourtesy''. Valid complaints or incidents will be
determined by the supervisor and discussed with the employee.
ELEMENT 4 - TIMELINESS
Works in a manner that supports and contributes to meeting established
Veterans Benefits Administration timeliness requirements.
At present the timeliness element is not officially measured. Methods
are currently being discussed concerning accurate and equitable ways to
measure appeals timeliness. At that time, this element will be
revisited.
ATTACHMENT A
Were all claimed issues addressed?
Were all inferred issues addressed?
Were all ancillary issues addressed?
Was effort to obtain all indicated evidence documented?
Was requested VA exam necessary and appropriate or was a necessary exam
requested?
Was all evidence received prior to denying claim?
Was the grant or denial of all issues correct?
Were there percentage evaluations assigned correct?
Was the combined evaluation correct?
Were the effective dates correct?
Was all of the applicable evidence discussed?
Was the basis of each decision explained?
[all]