[Senate Hearing 114-609]
[From the U.S. Government Publishing Office]
MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES
APPROPRIATIONS FOR FISCAL YEAR 2016
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THURSDAY, MARCH 19, 2015
U.S. Senate,
Subcommittee of the Committee on Appropriations,
Washington, DC.
The subcommittee met at 10:30 a.m., in room SD-124, Dirksen
Senate Office Building, Hon. Mark Kirk (chairman) presiding.
Present: Senators Kirk, Boozman, Capito, Cassidy, Tester,
Udall, and Schatz.
DEPARTMENT OF VETERANS AFFAIRS
Veterans Benefits Administration
STATEMENT OF HON. ALLISON A. HICKEY, UNDER SECRETARY
FOR BENEFITS
ACCOMPANIED BY:
JAMES E. MANKER, JR., CHIEF FINANCIAL OFFICER
THOMAS MURPHY, DIRECTOR, COMPENSATION SERVICE
OPENING STATEMENT OF SENATOR MARK KIRK
Senator Kirk. The subcommittee will come to order. We are
very happy today to have Under Secretary Allison Hickey, who
led a long and distinguished career in the wrong service, the
Air Force.
I was joking with you why you did not join the Navy, which
you should have. I would just advise you of that. Let me say
that we have now Allison Hickey, the Under Secretary of the
Veterans Benefits Administration (VBA), and Jamie Manker, the
CFO for VBA. And I am very happy to have you here.
With that, let me recognize my good friend, Jon Tester.
STATEMENT OF SENATOR JON TESTER
Senator Tester. Well, thank you, Mr. Chairman, and thank
you for being generous with your time. Thank you very much.
And, Secretary Hickey, Mr. Manker, Mr. Murphy, thank you all
for being here today in front of this subcommittee.
VA compensation and pension benefits provide a lifeline of
support for millions of Americans who have worn the uniform of
this Nation, especially disability compensation for those who
have been injured in the line of duty. And, Secretary Hickey, I
appreciate your aggressive efforts that you and your colleagues
have made to reduce the disability claims backlog, streamlining
the claims process, and transforming the way VBA does business.
These efforts have reduced the backlog from 611,000 in
March 2013 to 215,000 claims as of today. But I think we all
recognize that there is much more work that has to be done not
just to eliminate the backlog, but also to position the VBA so
that we do not see a future backlog, particularly given the
continuing rise in filings and the complexity of the claims.
Secretary Hickey, you are facing a tough challenge, and I
look forward to hearing the details of your budget request and
the reforms that you are recommending to bring the VBA into the
21st century. With that, once again, thank you all for being
here, and I will turn it back to you, Mr. Chairman.
Senator Kirk. Thank you. Let us go with--sure, I will do my
opening statement here. Secretary Hickey, you have aggressively
tackled the veterans' claims backlog. We have talked a lot
about this with my obvious interest in the Chicago regional
office, to make sure--the general question that I would have
for you, the issue I would put before you, now I think it is an
average of 172 days in Chicago.
The point that I would like to make, you know, for normal
Americans, for a veteran who has suffered a catastrophic
injury, like amputation, there should be a way within 24 hours
of adjudicating the disability of that person. Most Americans
would say if there is a missing leg, boom, we should just
adjudicate that within a day. I would just highlight that
point. That concludes my statement.
I wanted to recognize you for helping. You may give your
opening statement.
SUMMARY STATEMENT OF HON. ALLISON A. HICKEY
Secretary Hickey. Thank you very much, chairman. Chairman
Kirk, Ranking Member Tester, members of the subcommittee, thank
you for the opportunity to present VBA's 2016 budget request.
In addition to Jamie Manker to my left, I also have with me
today Tom Murphy, who is the director of compensation service.
Our 2016 budget request includes $2.7 billion in
discretionary funds and $95.3 billion in mandatory funds,
reflecting the ever-growing demand for VA benefits and
services. Our obligation to veterans continues to grow because
demand for benefits continues to increase long after war's end.
The percent of the veteran population receiving
compensation was nearly constant for 40 years at 8.5 percent.
Over the last 15 years, it has increased to 19 percent. The
average disability rating has also increased. After 45 years
with a consistent average rating of 30 percent, the average has
risen to 48 percent since 2000. In addition, the number of
veterans filing claims and the number of medical issues within
those claims has soared. GWOT veterans separating through our
Benefits Delivery at Discharge Program claim an average of 16
medical issues compared to only four issues that were claimed
by our World War II veterans and six issues by Vietnam era
veterans.
Despite these challenges, VBA's workforce, 53 percent of
whom are veterans themselves, are making major strides in
increasing productivity and reducing the claims backlog. The
number of claims completed per full-time equivalent (FTE)
increased 25 percent from 2012 to 2014. A more accurate
representation is the 67 percent increase in productivity at
the issue level from 2009 to 2014.
As a direct result of our transformation, we have reduced
the pending disability claims inventory by 46 percent and the
claims backlog by 66 percent. Progress made has not come at the
expense of quality. We have increased claim-based accuracy from
83 percent in June 2011 when I arrived to nearly 92 percent
today, and issue-based accuracy has improved to 96 percent.
Veterans are waiting less time for decisions and benefits. The
average time to decide a claim has improved by 170 days, and
the average age of pending claim has improved by 144 days.
In 2014, we completed a record breaking 1.32 million
claims, a 35-percent increase over the 980,000 claims completed
in 2009. But there has even been more dramatic growth in the
number of issues completed, 2.7 million in 2009 to 5.5 million
in 2014. That is a 101 percent increase over just 5 years. We
expect it to grow to 115 percent increase by 2017. With
investments provided by the President and this Congress in
recent years, we are on track to eliminate the claims backlog
by the end of 2015.
Our budget request includes critical investments in
transformation initiatives and IT support. Previous IT
investments helped VBA to now process over 6,500 education
claims per day without any human intervention, while increasing
accuracy to 99.6 percent. Our request also includes funding to
right size our workforce. As VBA continues to receive and
complete more rating claims, the volume of appeals, non-rating
claims, and fiduciary exams correspondingly increases.
In July 2014, VBA notified Congress of a need to hire
nearly 1,700 FTEs to address this increase in workload. We are
grateful for funding in 2015 to hire 250 of those who are
asking for funding in 2016 to hire another 770. The hiring
would include 200 appeals processors.
The 11 to 12 percent appeals rate has not changed for over
20 years. However, as we complete record breaking numbers of
claims, the volume of appeals continues to grow. We need your
support. Our only options are for Congress to either change the
complex laws around appeals or provide additional resources to
address this workload. Our 2016 request would also fund hiring
320 non-rating claims processors and 85 field examiners for
fiduciary.
We appreciate the opportunity to discuss our budget request
and look forward to working with you to identify and prioritize
spending to best serve the interests of our Nation's veterans,
their family members, and their survivors. And I am prepared to
take your questions.
[The statement follows:]
Prepared Statement of Hon. Allison A. Hickey
Chairman Kirk, Ranking Member Tester, Distinguished Members of the
Senate Appropriations Committee, Subcommittee on Military Construction,
Veterans Affairs, and Related Agencies: Thank you for the opportunity
to present the President's 2016 budget and 2017 advance appropriations
requests for the Veterans Benefits Administration (VBA). I am
accompanied today by Mr. Jamie Manker, VBA's Chief Financial Officer,
and Mr. Thomas Murphy, VBA's Compensation Service Director.
VBA has the incredibly important mission of effectively delivering
the benefits our Nation's veterans and their families have earned and
deserve. In carrying out its mission, VBA employees have adopted and
embraced the Department's core values of Integrity, Commitment,
Advocacy, Respect, and Excellence--appropriately captured in the phrase
``ICARE.'' Our workforce includes over 21,000 employees, 53 percent of
whom are veterans themselves, and 34 percent of whom have service-
connected disabilities.
summary of 2016 budget request
The President's 2016 budget for the Department of Veterans Affairs
(VA) will allow VBA to manage integrated benefits and services,
administered through a nationwide network of 56 regional offices (RO).
The 2016 budget requests $2.7 billion in discretionary funds and $95.3
billion in mandatory funds for VBA. The budget also requests a first
time advance appropriation of $104.0 billion for 2017 for VBA's three
mandatory appropriations, including Disability Compensation and
Pensions, Readjustment Benefits, and Insurance and Indemnities. Funding
for VBA is critical to continue providing the following benefits:
--Disability compensation for 3.9 million veterans with service-
connected disabilities;
--Dependency and indemnity compensation for 369,000 veterans'
survivors;
--Pension for 308,000 wartime veterans and 209,000 of their
survivors,
--Vocational rehabilitation and employment benefits paid for over
99,000 veterans and servicemembers;
--Education and training assistance for 1.2 million veteran students
and their families;
--Home-loan assistance for 2.1 million veterans with active VA loans;
--Fiduciary activities providing estate protection services for
173,000 VA beneficiaries unable to manage their own funds; and
--Life insurance programs for 6.5 million servicemembers, veterans,
and their families.
The President's 2016 budget request includes critical information
technology investments supporting VBA's claims processing
transformation and other essential initiatives to continue improving
benefits delivery. For example, the Veterans Claims Intake Program
makes investments in the conversion of paper claims to digital images,
and the Veterans Benefits Management System facilitates electronic
claims processing. In addition, the request includes funding to right-
size our workforce. As VBA continues to receive and complete more
disability rating claims, the volumes of appeals, non- rating claims
(claims that in most cases do not require a rating decision but
directly impact benefits, such as survivors pension, burial claims,
dependency claims, income adjustments, and drill pay adjustments), and
fiduciary field examinations correspondingly increase. We anticipate
that demand for benefits will continue to grow in fiscal year 2016.
VBA's request for 770 additional FTE is necessary to meet veterans'
expectations for more timely actions on non-rating claims and appeals
and ensure strong fiduciary oversight.
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increased demand for disability benefits
Our obligation to veterans grows over time because veterans' demand
for benefits continues to increase long after wars end. Even as we are
becoming more productive through our Transformation, the demand for
benefits and services from veterans of all eras continues to increase.
For example, the population of Vietnam Era Veterans receiving
disability compensation has not yet peaked--40 years after the Vietnam
War ended. VBA anticipates a similar trend for Gulf War Era Veterans,
26 percent of whom have already been awarded disability compensation.
The total number of service-connected disabilities for veterans
receiving compensation has grown from 11.8 million in 2009 to 17.8
million in 2014--an increase of over 50 percent in just 5 years. This
dramatic growth portends even greater growth in claims for increased
benefits as veterans age and their disabilities worsen. It is also
significant to note that VA is still providing benefits to the child of
a Civil War Veteran 150 years after the Civil War ended.
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Fueled by more than a decade of war, Agent Orange-related
disability claims, a disjointed claim appeal process, demographic
shifts, increased medical issues claimed, and other factors, veterans'
demand for benefits has exceeded VBA's ability to timely meet it. VBA
must build the capacity now to meet current demand and ensure we are
prepared to meet future demand. We look forward to working with you to
identify and prioritize spending to best serve the interests of
veterans and our Nation.
While the percent of the veteran population receiving compensation
was nearly constant for over 40 years at 8.5 percent, over the past 15
years there has been a striking increase to 19 percent.
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The increase in veterans receiving disability compensation is
accompanied by the significant rise in the average degree of disability
compensation granted to veterans. For 45 years, from 1950 to 1995, the
average degree of disability held steady at 30 percent. But, since
2000, the average degree of disability has risen to 47.7 percent. VBA's
mandatory spending is projected to reach $106 billion in fiscal year
2017, twice the amount spent in fiscal year 2009.
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transformation results
In order to meet this ever growing demand for benefits, VBA is
undergoing the largest transformation in its history--bringing the
delivery of VA benefits and services into the 21st Century. VBA is
aggressively implementing its transformation plan--a set of actions
targeted to reorganize and retrain its people, streamline its
processes, and deploy technology designed to achieve VA's goal of
processing all claims within 125 days with improved accuracy by the end
of 2015. VBA has achieved the following transformation results:
--VBA is reducing the pending disability claims inventory.
--Peak: 884,000 claims in July 2012.
--Now: 477,000 claims--Improvement: 46 percent.
--The number of claims pending over 125 days and considered part of
the claims backlog has decreased.
--Peak: 611,000 claims in March 2013.
--Now: 215,000 claims--Improvement: 65 percent.
--Rating accuracy has improved.
--3-month claim-based accuracy increased from 83 persent in 2011 to
92 percent, an improvement of 9 percentage points.
--3-month issue-based accuracy improved to 96 percent.
--Veterans are waiting less time for decisions and benefits.
--The average time to decide a veteran's disability claim:
-- Peak: 348 days as of September 2013.
--Now: 186 days--Improvement: 162 days.
--The average age of pending disability claims:
--Peak: 282 days in February 2013.
--Now: 142 days--Improvement: 140 days.
Improving quality and reducing the length of time it takes to
process disability claims are integral to our mission of providing the
care and benefits that veterans have earned and deserve in a timely,
accurate, and compassionate manner. The disability rating claims
workload continues to increase, due to the reduction in military
forces, servicemembers returning from wars, and the aging of the
veteran population. Also, the complexity of the workload continues to
grow because veterans are claiming greater numbers of disabilities and
the nature of disabilities--such as posttraumatic stress disorder
(PTSD), combat injuries, diabetes and related conditions, and
environmental diseases--is becoming increasingly complex.
The number of separating servicemembers filing disability claims--
and the number of medical issues within those claims--have soared in
recent years. The chart below highlights this growth, with Global War
on Terror Veterans separating through our Benefits Delivery at
Discharge program now claiming an average of 16 medical disabilities as
a result of their military service--compared to only 3.9 issues for
WWII Veterans and 6.4 issues for Vietnam Era Veterans.
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In 2009, VBA completed almost 980,000 claims. In fiscal year 2014,
we completed over 1.3 million--a 35 percent increase. But there has
been even more dramatic growth in the number of medical issues in
claims--2.7 million in 2009 to 5.5 million in 2014, a 101 percent
increase over just 5 years.
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Despite these challenges, VBA has made major strides in increasing
its productivity and thereby reducing the claims backlog by 65 percent
since its peak in March 2013 (from 611,000 to 215,000). Through VBA's
claims transformation initiatives, the number of claims completed per
FTE increased 25 percent from 2012 to 2014. An even more accurate
representation of VBA's increase in productivity is seen at the medical
issue-level rather than the claim-level. From 2009 to 2014, VBA's
issue-level productivity increased by 67 percent. VBA greatly
appreciates the investments provided by the President and Congress over
the past 6 years, and we are on track to meet the President's goal to
eliminate the disability claims backlog and processing all claims
within 125 days by the end of 2015.
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transformation initiatives in the 2016 budget request
VBA's transformation progress is the result of an integrated series
of initiatives designed to eliminate the backlog. The President's 2016
budget will allow VBA to continue building on the success of the
following initiatives:
--Veterans Claims Intake Program (VCIP): VCIP streamlines processes
for receiving digital records and data into the Veterans
Benefits Management System (VBMS) and other VBA systems,
transitioning VBA from a paper-based claims environment to a
digital operating environment. It scans paper claims, converts
them into digital format, and extracts important data for input
into electronic folders. VCIP has converted and uploaded more
than 1.2 billion images from paper. In addition to supporting
scanning operations for incoming claims, VBA's 2016 request of
$140.8 million will allow the digital intake of military,
income, and employment records from other Federal agencies and
private providers. This will broaden electronic evidence
exchange for processing all types of claims more accurately and
more rapidly by building additional interfaces for Official
Military Personnel Folders (OMPF) from DOD and interfaces with
health networks, hospitals, and private clinicians.
--Centralized Mail: Centralized mail consolidates inbound paper mail
from VA's ROs to a centralized intake site. This initiative
expands VBA's capabilities for scanning and conversion of
claims evidence, increases electronic processing capabilities,
and assists in converting 100 percent of received source
materials to electronic format. VBA has deployed centralized
inbound mail for all ROs. The 2016 budget request of $18.3
million provides resources to sustain operations at all 56 ROs
and positions VBA to expand centralized mail operations to
other lines of business and centralize outbound correspondence
to veterans.
--Veterans Benefits Management System: VBMS, as VBA's key business
transformation initiative, provides a paperless claims-
processing environment and improved business processes to
provide veterans and their dependents with timely, high-quality
decisions. National deployment of VBMS was completed June 2013
and provides access to over 28,000 end users. VBMS allows VBA
to centrally manage the claims workload at the national level
and direct cases electronically across its network of ROs to
more efficiently match claims demand with available processing
capacity. VBA went from touching 5,000 tons of paper annually
to now processing 95 percent of the claims inventory
electronically in VBMS. VBA has now completed over 1.32 million
claims in VBMS. In 2015, VBMS is focused on delivering the
National Work Queue (NWQ) and reducing reliance on legacy
systems. In 2016, VBMS enhancements will focus on the
Integrated Disability Evaluation System, appeals, and pension.
--National Work Queue: VBA will distribute claims electronically from
a centralized queue based on RO capacity using the electronic
NWQ, a national workload management strategy. With all claims
placed in the electronic NWQ, veterans' claims will be
automatically directed across all ROs to efficiently match
claim demand with available expertise and processing capacity
regardless of RO jurisdiction, delivering benefits to veterans
more quickly and accurately. The electronic inventory provides
real-time updates, no matter where the claim is assigned for
processing. Veterans are still able to receive assistance with
their claims by visiting their RO for personal assistance at
the public contact sites, going on-line through eBenefits from
anywhere, and utilizing VBA's National Call Centers across the
Nation. In 2016, VBA is requesting $3.2 million to provide the
requisite funding to resource and support 13 employees to
manage the NWQ across the VBA enterprise.
--Veterans Relationship Management: The VRM initiative continues to
facilitate an increasingly more veteran-centric digital
operating environment. VRM is delivering a scalable,
enterprise-wide, services-based technology environment that
will be the foundation for how veterans are served and how
benefits and services are delivered. This new model will
provide VA an integrated services delivery platform with the
approach of placing the veteran at the center of the service
with all business requirements and design being driven from the
veteran perspective.
Components of VRM include eBenefits, the Stakeholder
Enterprise Portal (SEP), Customer Relationship Management
solutions, Digits-to-Digits, Knowledge Management, and Veterans
Online Application Direct Connect. Through the eBenefits
portal, veterans can submit claims for benefits, administer
their accounts, and receive status updates. The eBenefits Web
portal standardizes claim intake and enables collaboration with
VSOs to assist veterans with all interactions with VA. VA
continues to expand the capabilities available through the
eBenefits portal as more veterans use the site. Today eBenefits
has 4.4 million registered users and over 48 million visits
annually. VBA's 2016 request for $13.8 million, in addition to
the $67 million requested for VRM in the Office of Information
Technology, will support ongoing operations and continued
efforts to pilot and deploy new solutions for VBA mobile
applications that expand access to self-service tools and
benefits/services information in VBA portal environments;
develop new service features in SEP for medical providers, loan
officers, fiduciaries, and funeral directors; and integrate
VetSuccess with Career Center for Veterans, enabling searches
for jobs posted by unique employers targeting veterans.
right-sizing vba's workforce
VBA's success in reducing the disability claims backlog is also
due, in part, to its strong reliance on mandatory overtime by claims
processors. Staff at all ROs worked mandatory overtime for 8 months in
2014 and resumed mandatory overtime on January 12, 2015, to accelerate
the reduction in the backlog following the heavy leave usage period
during the holiday season, and to mitigate the impact of any additional
weather-related office closures during the winter months. Employees
processing disability compensation claims are working 20 hours of
mandatory overtime per month. However, this strategy is not sustainable
from a human capital management perspective, and VBA is investing in
other initiatives, like right-sizing our workforce and training, to
improve performance. We are also taking the lessons learned in
eliminating the disability claims backlog and applying them to
transform business processes supporting the fiduciary program, the
delivery of non-rating benefits, and the appellate workload.
For 2016, VBA requests $2.7 billion for general operating expenses,
an increase of $165.8 million (6.6 percent) over the 2015 enacted
level. These resources will support 21,871 Full-Time Equivalent (FTE)
employees and allow VBA to administer compensation and pension benefits
totaling $83.1 billion to over 5.2 million veterans and survivors;
education benefits and vocational rehabilitation and employment
benefits and services to nearly 1.3 million participants; guarantee of
more than 431,000 new home loans; and provide life insurance coverage
to 1.1 million veterans, 2.3 million servicemembers, and 3.1 million
family members.
As highlighted earlier in this testimony, VBA continues to receive
and complete more disability rating claims, resulting in corresponding
increases in the volumes of appeals, non-rating claims, and fiduciary
field examinations.
--Appeals. Over the last 20 years, appeal rates have continued to
hold steady at between 11 and 12 percent of completed claims.
As VBA continues to receive and complete record-breaking
numbers of disability rating claims in recent years (1.3
million claims completed in 2014), the volume of appeals
increases concomitantly. The number of statements of the case
and other appellate actions completed by VBA on veterans'
appeals has increased 31 percent since 2011, from 135,000
actions to 177,000 actions. VBA currently has approximately
290,000 pending appeals.
--Non-rating claims. VBA's success in completing rating decisions has
driven an increase in non-rating claims. Despite completing a
20-year record number of non- rating claims in 2014, this work
continues to grow. In 2015, VBA expects to receive 2.9 million
non-rating claims and review actions, an increase of 7.4
percent over 2014 (2.7 million) and 20.8 percent over 2013 (2.4
million).
--Fiduciary program. In 2014, VBA's fiduciary program protected more
than 173,000 beneficiaries, which is a 42 percent increase in
the number of beneficiaries from 2011 (122,000). Primary
drivers of the growth in this program are the increase in the
total number of beneficiaries receiving VA benefits and an
aging beneficiary population. In 2014, fiduciary personnel
conducted over 86,000 field examinations, and VBA anticipates
field examination requirements to exceed 117,000 in 2016.
To ensure all aspects of the claims process are improved for
veterans, VBA is requesting additional claims processors and field
examiners. VBA is requesting $85 million to fund 200 appeals
processors, 320 non-rating claims processors, 85 fiduciary field
examiners, and 165 support personnel (including 13 FTE for the National
Work Queue (NWQ)), for a total of 770 additional FTE. VBA employees--53
percent of whom are veterans--are leading advocates for veterans,
servicemembers, their families, and survivors and are key to our
success. With the additional 770 employees, VBA will provide veterans
with more timely decisions on their appeals and non-rating claims, and
conduct thousands more vital fiduciary home visits.
VBA is able to accommodate additional staff without additional
space requirements by digitalizing veterans folders:
Winston-Salem RO: Before and After Transformation:
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high levels of demand continue in all benefit programs
In addition to benefits provided through VA's compensation and
pension programs, VBA's fiscal year 2016 budget request supports
delivery of insurance, education, vocational rehabilitation,
employment, transition, and home loan guaranty benefits.
VBA, through its Insurance program, maintains life insurance
programs that give financial security and peace of mind for
servicemembers, veterans, and their families. Insurance claims are
currently paid in an average of 3 days at 99 percent accuracy. The
Insurance program request is $35.14 million, of which $867,000 is in
the GOE appropriation and $34.27 million is reimbursable by the
Insurance funds. This request will support 347 FTE and provides
servicemembers and their families with universally available life
insurance, as well as traumatic injury protection insurance for
servicemembers. In 2016, VA insurance programs will provide $1.3
trillion of insurance coverage to 2.3 million servicemembers, 1.2
million veterans, and 3 million spouses and children.
VA's education programs provide education and training benefits to
eligible servicemembers, veterans, and dependents. The 2016 budget
request reflects VBA's commitment to their needs. The request is $207.5
million and 1,904 FTE to provide veterans, servicemembers, Reservists,
and qualified family members with educational resources. These programs
are designed to assist in the readjustment to civilian life, help the
armed forces both recruit and retain members, and provide the
opportunity to enhance the Nation's economic competitiveness through
the development of a more highly educated and productive workforce. The
most utilized of VA's education programs is the Post-9/11 GI Bill. As
of February 21, 2015, VA has issued approximately $49.5 billion in
Post-9/11 GI Bill benefit payments to 1,359,148 individuals and their
educational institutions since program inception in August 2009. As a
result of VA's success in automating the processing of Post-9/11 GI
Bill claims, VBA is now providing benefits to the majority of Post-9/11
GI Bill beneficiaries in an average of 6 days at 99 percent accuracy.
The Vocational Rehabilitation and Employment (VR&E) program request
is $322.8 million and 1,594 FTE. VR&E is a veteran-centric program
providing the services and assistance to enable veterans with service-
connected disabilities become employable and obtain and maintain
suitable employment or, to the maximum extent feasible, achieve
independence in daily living. Through the VR&E program, VBA provides
employment and independent living services including career vocational
counseling, job search assistance, and post-secondary training for
service-disabled veterans. VBA will also enhance outreach and service
delivery of educational and vocational counseling services. These
services will be delivered by Vocational Rehabilitation Counselors,
Integrated Disability Evaluation System counselors, and contract
rehabilitation counselors. These counseling services will also be
provided through the VetSuccess on Campus programs at more than 94
schools.
VBA is also investing in the successful transition of
servicemembers, building pathways to meaningful career opportunities
for veterans by bringing them together with educators and employers
across U.S. cities and communities and leveraging unique VA and
interagency programs and resources to improve economic outcomes for
veterans. VBA's plan to support these veterans includes the following
strategic areas:
--Veterans Employment Center (VEC): Provides transitioning
servicemembers, veterans, and their families with a single
authoritative Internet source that connects them with job
opportunities, and provides tools to translate their military
skills into plain language and build a profile that can be
shared--in real time--with employers. Employers have made
commitments to hire over 390,000 individuals. Over 1.7 million
private and public-sector jobs are listed on the VEC.
--Transition Goals, Plans, Success (GPS): The Transition GPS program
helps separating servicemembers prepare for civilian life by
providing benefits briefings and other transition activities.
VBA has provided over 45,000 benefits briefings, career
technical training courses, and support for capstone events to
over 550,000 servicemembers and their family members (this
count does not represent unique servicemembers).
--MyVA (City) Economic Opportunity Campaign: VBA is collaborating
with public and private partners in more than 20 communities
across the country to help connect and amplify available
resources and support for veterans and their families.
The VA Home Loan Program ensures veterans can obtain, retain, and
adapt their home by guaranteeing their loan against foreclosure. The
Housing program request of $139.4 million and 907 FTE is funded through
appropriations to credit accounts and helps eligible veterans, Active
Duty personnel, surviving spouses, and members of the Reserve
components and National Guard purchase, retain, and adapt homes in
recognition of their service to the Nation. VA's partial guaranty on
loans made by private lenders enables our clients to purchase homes
with little or no down payment. Many of these borrowers would be unable
to purchase a home without VA's assistance. VBA guaranteed 438,398 home
loans and helped 80,000 veterans avoid foreclosure in 2014, while
maintaining the lowest foreclosure rate (1.56 percent) in the industry
for 25 of the last 27 quarters.
legislation
In addition to presenting VBA's resource requirements, the 2016
President's budget proposes legislative actions that will benefit
veterans. VBA in this budget proposes changes in disability claims
processes, an area where reform is greatly needed, for the benefit of
all veterans who are frustrated with the time it takes to resolve
claims and appeals. We are open to all ideas from the subcommittee and
from VSO's to modernize this process, and make it work for veterans.
Our increased manpower and great strides in automation are helping, but
these cannot replace statutory changes to modernize the process.
closing
We appreciate the opportunity to provide additional information on
VBA's 2016 budget request and to share with you the progress we are
making in transforming the delivery of benefits and services for our
veterans and their families. The work we do continues and grows for
decades after the end of America's conflicts. I assure you of our
commitment to achieving improvements that will expedite the delivery of
benefits, improve quality, and ensure we are providing timely,
accurate, and comprehensive information and assistance to all those we
serve.
In today's challenging fiscal and economic environment, we must be
diligent stewards of every dollar and apply them wisely to ensure that
veterans--our clients-- receive timely access to the highest quality
benefits and services we can provide and which they earned through
their sacrifice and service to our Nation.
This concludes my remarks. I am happy to respond to any questions
from you or other members of the subommittee.
SOCIAL SECURITY ERRONEOUS DEATH NOTIFICATION
Senator Kirk. Thank you, Under Secretary. I will start the
questions. Let me ask you, 60 Minutes did a big, long report on
the deceased Americans that were still getting benefits. Can
you describe your work to make sure we are not paying people
who have already passed away?
Secretary Hickey. Thank you, chairman, for the question.
And prior to the 60 Minutes show this past weekend, we had been
working extensively with the Social Security Administration, as
have we with other agencies, and had done some really good work
with them to help move us forward on claims.
One of the conversations I had a week before the 60 Minutes
show was a note to the current acting Commissioner at the
Social Security Administration to ask if we could set up
another team effort like we have done in the past to address
whether veterans might show up on those lists, and how we can
avoid sending a veteran a letter who is alive and saying you
are not alive, you are deceased. And then how we can go about
being part of the solution for both Social Security and
preventing any of those letters from showing up to our veterans
that are in error.
Senator Kirk. I would say that almost the entire private
sector does not bother to send mail or sales promotions to
people who are dead. We want to make sure that we are as good
as any mass mailer in America with your operation. I would hope
you would also work with the big list providers in America to
make sure that we are following the same practices and not
wasting money by issuing checks to people who are already in
the great beyond.
Secretary Hickey. So, chairman, a great question, a great
comment. Certainly as I have been doing for the last several
years, I am working with commercial industries that do similar
work to what VBA does. In fact, I have been repeatedly over the
last 2 years meeting with their chief claims officers and
learning about what they do. And this is one I would be happy
to discuss with them as well.
CHICAGO REGIONAL OFFICE
Senator Kirk. Thank you. Let me drill into the Chicago
regional office. Right now I am told that we have about a 172-
day delay in adjudicating a disability claim there. I ask you
to facilitate my visit there so I could personally go through
the process there.
Secretary Hickey. So, chairman, happy to do so. In fact, I
would love to join you in that process. And I think when you
get there, what you would find is that we are phenomenally
different than we were even a couple of years ago.
Senator Kirk. There may be some deep dish pizza and some
Italian beef in it for you.
Secretary Hickey. I will do that. I would love that. I have
had good food in Chicago before, and I would look forward to
the opportunity to do so again.
VETERANS BENEFITS MANAGEMENT SYSTEM
Let me just tell you nationally, I mentioned in my opening
statement we have fundamentally transformed this organization.
We are now 95 percent of our work is done in a digital
environment where we have scanned over 1.3 billion images into
Veterans Benefits Management System (VBMS), and now processing
just about everything we do in a digital way. That did not
exist 2 years ago, and it certainly did not exist in Chicago 2
years ago, and it made us very inefficient. We were touching
5,000 tons of paper every single year with little rubber
fingertips on our fingers trying to make a very ineffective and
inefficient process better.
We now today have VBMS built. There are 28,000 or more
users on it, and that has resulted in some very good effects
for our veterans, their family members, and survivors. By
example, in Chicago, since they peaked in their backlog in June
2012, they now have reduced that backlog by 65 percent, and
they are on target to bring it all the way down. And they did
not trade speed for quality.
I think it is worthy to know they have increased their
quality at the claims level by more than 11 percentage points,
and at the issue-based level they are now at 92, almost 93
percent in their quality. So doing better answers and faster
service to our veterans. And they will be part of our getting
all the way down in this backlog this year.
Senator Kirk. Thank you. Mr. Tester.
Senator Tester. I am going to defer to Senator Schatz.
ELIGIBILITY DETERMINATION AND CLAIMS PROCESSING
Senator Schatz. Thank you, Senator. Schatz, yes, you got it
right. Thank you, Senator Tester. Thank you, Mr. Chairman. Ms.
Hickey, thank you for your great work, and I know you have been
making good progress.
I want to ask--I want to drill down a little bit on where
the choke points are in terms of eligibility determination and
claims processing--disability claims processing. The specific
question I have is obviously you are getting into the modern
era. You are making the IT investments, the software
investments that are necessary. But presumably, there is a sort
of suite of solutions that you have had to apply, and maybe it
is personnel. You know, obviously you have had shortfalls in
terms of clinicians. Sometimes it is clerical, and then
sometimes it is policies and procedures.
Can you describe to me where the various choke points are
and how you kind of do real time assessments, because it seems
to me you could add clinicians, but if you are not processing
the claims, then you are stuck. You could add clerks or you
could improve IT, and if you do not have the clinicians, you
are stuck.
And so, how do you kind of make those assessments, and then
how do you report back to the Congress, because presumably
those are operational questions. But we have a tendency to sort
of say we did 1,500 additional FTEs; therefore, go do your
thing. And I am concerned that we are not giving you enough
flexibility, and there is not enough of a dialogue about where
the actual choke points are where we fix last year's choke
point and there may be a new emerging one.
Secretary Hickey. So, Senator, thanks for the question, and
what you are describing basically is the transformation plan.
When I came into this job in June 2011, I had to deliver to the
Senate within 45 days a transformation plan that we have
largely executed to today 45 different initiatives. Let me give
you a sense of some of the big ones--people, process, and
technology that we did.
First thing we did is what industry has done, which is we
looked at how could we segment the work. So we took and
segmented the work by complexity of the claim. Obviously lower
numbers of medical issues and claims that have really sort of a
simple answer go now in our express lane, and we do those much
faster. Really hard ones, like Parkinson's, and diabetes, and
even military sexual trauma (MST) that have much--many more
implications and inferred conditions on them go into our most
senior people in our special operations lane. And then the rest
goes into body of work. Simply doing that process and breaking
up the work gained us about a 10 to 12 percent improvement in
our productivity.
The second thing we did was obviously move out of this
lumbering paper-bound--by the way 5,000 tons of paper,
touching, looks like 10 Mount Everests stacked end to end, and
200 Empire State Buildings stacked that we were doing in paper-
bound ways. So we have looked lots of things. You asked about
really those big muscle movements of what we really depend on.
First and foremost, when I came here in June 2011, we did not
have a particularly effective relationship with DOD. We have
moved mountains in that respect between us and DOD.
One of those big muscle movements is getting a hold of the
complete service treatment record from the day they signed up
for the MEPs exam to get in the door until the day they leave
in a separation health exam. That did not exist then and that
relationship with DOD does now. First in the discussion, DOD
had the impression they were giving us all those things within
45 days, and they did not understand why we were sort of not
feeling good about that.
We now measure them all, and the first data points that we
showed them about a year and a half ago that showed them, no,
in fact, 83 percent of them were late to us, very late to us.
That woke them up, and they went into high gear to resolve
that. We now still get about 37, 40 percent late, but they have
made major movement to reduce the late Service Treatment
Records (STRs) that we get. That was one big issue.
Another big issue that we solved for is getting the fully
developed claims. We were getting claims that were only
partially ready to be looked at. So we have implemented, with
the help of our great veterans service organizations out there,
a fully developed claim process whereby the veteran comes in
with all the parts and pieces that help us move immediately
into the adjudication process.
REAL TIME VISIBILITY AND ACCOUNTABILITY
Senator Schatz. So just one final question. How are you in
terms of visibility into the process in real time? I mean, if
the analogy is a private healthcare delivery system, you should
be able to run reports about current claims, about, you know,
all of your personnel. You should be able to literally press a
button and kind of know where you are at. I am assuming that
you are not quite where you need to be eventually in terms of
having the visibility that gives you the leverage for
accountability to make sure that--first of all, you are making
real time adjustments, but second of all, you are able to hold
people down the chain accountable. Are you there--are you where
you need to be yet?
Secretary Hickey. So, Senator, I am probably further than
you would expect me to be. So let me just describe a VBA that
might be different than some of the things you have heard about
relative to data, very quickly. My data is held--our VBA data
is held at a national level. It is not held at the local level.
It is turned over every night, so, in fact, if you would allow
me for at least a 24-hour view, I do see data every single day,
and I get reports, detailed reports, every single day. I make
those reports available to you and the free world every Monday
morning that we put out that data. I do not give it to you
daily. I think you could not do your job if I was giving the
amount of data I have daily, but we do it every single Monday
so you get that.
I have also a VBA stat that I do and have been doing now
for 3 years. Eight to 10 regional office directors sitting
across from me once a month, all the rest on the phone, where
we dig into in a 6-hour meeting their data in ways that are eye
opening. And we do it in a lead-up way to make sure I know of
any anomalies in the system, and they are accountable for
describing what is going on.
Senator Schatz. Thank you very much, Madam Secretary. I
really appreciate the work you have done. It is very
impressive.
Secretary Hickey. Thank you, Senator.
Senator Kirk. Mr. Boozman.
APPEALS FTE INCREASE REQUEST
Senator Boozman. Thank you, Mr. Chairman, and thank you for
being here, Madam Secretary, you and your staff, and we
appreciate all of your hard work. In the 2016 budget, you
requested an additional 200 employees to work on appeals, and I
know you mentioned that earlier. I guess the question is, how
many people do we have working on appeals now, and if the 2016
budget were enacted, how many would--what would be the total
number of people that we have working on appeals?
Secretary Hickey. So thank you, Senator. So you are right.
There is a request for 200. It is not the full requirement. We
also had a 2015 omnibus add that I really appreciate that gave
us the ability to hire 250. Some of those--100 of those we put
into appeals, so that would take us up to 300 in appeals.
But the real requirement is north of about 750, about 769,
to get us to the point where we take appeals down to a year-
long process. Today it is far too long. I know that. I hear it
every single day because I am getting between 200 and 300
emails from veterans that I answer myself. But to get that down
from sort of that 3-year unacceptable level, it would get us
down to a 1-year level.
Senator Boozman. So how many employees now?
Secretary Hickey. Do you have that? I can get that for you,
Senator, and I am happy to give you the breakout for that.
[The information follows:]
Senator Boozman. In the 2016 budget, you requested an additional
200 employees to work on appeals. How many people do we have working on
appeals now, and if the 2016 budget were enacted, how many would be the
total number of people that we have working on appeals.
VA Response. If VBA's fiscal year 2016 budget request is fully
funded, VBA would have 1,440 FTE working on appeals. VBA currently has
approximately 950 employees on board dedicated to working on appeals in
regional offices and 190 employees at the Appeals Management Center. VA
is leveraging the funding provided in the 2015 appropriation to
increase appeals staffing levels by 100 FTE, and the 2016 President's
budget includes a request for an additional 200 FTE for appeals.
Senator Boozman. And so, how did you arrive at the 200
number?
Secretary Hickey. So we looked at the--there are several
things that are key indicators for work required in appeals.
The first is responding to the notice of disagreement, so when
you get a notice of disagreement, it triggers something called
an SOC, which is a statement of the case. And that is where
somebody has to write the statement of a case, and then send
that out to the veteran, and then have the veteran decide
whether they wish to go forward with their appeal. So we take
that number and see in general how many we have there and what
the requirements for those statements of the cases are.
Then we also take and look at--once we move past that
point, there is another trigger called a supplementary
statement of the case. If after the veteran has moved forward
in the appeals process, which, by the way, is a really open
process that is not one that is described anywhere else like
it. If we get information back that says the veteran now has
created more evidence post the decision we made, it comes back
to us to write another statement of the case to see if we can
resolve that without it having to go through the full Board of
Veterans Appeals and court process.
So it is based on all those sort of work requirements built
into our side of the process, but Senator, that brings us to a
broader point on appeals. Appeals for us is an issue that I
need your help on, and at the end of the day, it is so wired in
law, it looks worse than tax code. I need a solution that
either changes the law or gives me the people that we need to
do this. There is no other resolution that I can find that does
a fundamental shift in it. Fully developed appeals will help
with the margins, but they will not solve this for the long
haul without law or people.
LITTLE ROCK, ARKANSAS AND OLD CLAIMS INITIATIVE
Senator Boozman. Right. Thank you. We had a situation in
Little Rock where a number of old claims were found, and there
was some confusion as to what you do with old claims that were
found. And some of these were very old, and they were told to
stamp them as current. I guess the question is, is this a
problem throughout the country? How do we have these old
claims? What are we doing with them?
If you find like an old claim that goes back to 1998, and
you might comment on maybe the oldest that you are finding,
okay? How do you--are we going ahead and putting those--are we
treating those as old claims in the sense that they need to be
done immediately, or are they just putting in--being put into
the current day that they are found? And then also if a person
is in that situation, do you go back and pay them back to the
time that they made the initial claim, or are we doing it--
post-dating to the situation where they were found?
Secretary Hickey. Thank you, Senator, and I am glad you
asked that question because I would like to get this on the
record for everyone. Back when we were starting the old claim
initiative, I asked the staff to bring the 10 oldest claims in
the inventory, and when they did, here is the backdrop I got on
most of them. It was a claim that came in----
Senator Boozman. But these are claims, like I said, that
were not really in the inventory that have just kind of popped
up that they are finding behind desks?
Secretary Hickey. No, sir, not at all. That is why I would
like to explain it to you very quickly. And I will do it with
one--and frankly I will do it with one that we have got in
Little Rock. Here is the claim. It is more than 20 years old,
but it came in 2 weeks ago. And you would go, that does not
make any logical sense, and it did not to me either. So I said,
how do I rationalize a 20-year-old claim that came in 2 weeks
ago?
And what happened is when it came in 2 weeks ago, that
Little Rock employee picked it up and did what a Little Rock
employee is supposed to do. They go back through the entire
claims folder looking to scrutinize everything that has
happened over that veteran's life. When they did, they found
that 20 years ago someone in the VBA system could have noticed
there might have been a way to do a claim on something that
they did not do 20 years ago, but they just got the claim 2
weeks ago. Then I said this does not make any sense to me. Why
can we not go ahead in a policy and give the veteran the
benefit, that gets to your second question, on the effective
date of 20 years, but not charge that employee who just got
this claim from the veteran 20 years later that he just started
working on 2 weeks ago, 20 years against that in the system?
So what I said is let us be smart about this. Let us take
the disincentive out of the system to go, well, the veteran did
not know it is even here, and I found it, and let us instead
put an incentive in the system for that employee to pick it up,
do it, and give it to that veteran effective the 20 years ago
date. So I did a policy that I briefed everyone on. We briefed
the veteran service organizations (VSOs), we briefed the
inspector general, we briefed the staffs of the four corners of
the two veterans committees. We sent it out in a mail message.
We did a public affairs address on it. We got out there saying
we were going to do this.
We put controls on it. You could only have them--if the
director or the assistant director signed it off, you had to
write them on a sheet and send them up to Comp Service so they
could track them. In fact, even the inspector general report on
this one clearly states the Little Rock regional office did
nothing wrong. In fact, they exceeded the requirement I had in
policy for them.
I have subsequently in the last month met with one of the
very large VSOs, who looked at me and said we actually think
that is a good policy. Why did you cancel it? And I said,
because I had recommendations from my counsel and because we
did not understand what we were doing. They want me to restart
it because they think it puts a good incentive in the system
for the employee to do the right thing by old things they find.
Senator Boozman. Good. Thank you. That is very helpful.
Thank you, Mr. Chairman.
Senator Kirk. Mr. Tester.
Senator Tester. Udall has a meeting, so I am going to defer
to Senator Udall.
Senator Udall. Thank you, Senator Tester, for your
courtesy. Really appreciate that. Secretary Hickey, thank you
for your service, and we really appreciate your hard work.
Hearing some of the things that you have talked about where you
have moved from a paper system to a computerized system, I
think in the long run that is really going to make a
difference. And I know that you are making tremendous progress
there.
This subcommittee has taken the lead effort to reduce the
VBA claims backlog, and this has been a resource and efficiency
issue since the beginning, as you know. And I am proud to have
supported the increased appropriations which have led to the
national decline in the claims backlog. And I am going to show
you a graph here behind me, and I think you have a copy of that
up there in case you cannot see all the details here.
CLAIMS BACKLOG AND ALBUQUERQUE REGIONAL OFFICE
This increase in funding also had an initial positive
impact in New Mexico, and I think you can see right about here
where the money came in, you saw a dramatic drop. But then what
happened after that, we had a leveling off in terms of the
claims process. And I think most veterans would say, you know,
we made some progress initially, but what happened with that? I
know we have a new director of the VA in New Mexico dealing
with some of the problems, but I am wondering if you could
focus in and see--what is your explanation for why there has
been a national increase in the claims backlog, but in the case
of New Mexico we are seeing not only stagnated progress, but an
uptick in the percentage of backlog claims?
Secretary Hickey. So, Senator, I would be happy to address
that. First, I would like to tell you, your regional office run
by Chris Norton in New Mexico is doing an awesome job. In fact,
they have reduced the backlog in Albuquerque by almost 53
percent. And their quality is through the roof, 95 percent at
the claim-based level and 98.9, almost 99 percent at all those
medical issues inside of it. So doing an amazing job.
Here is what I would share with all of you on this issue.
We have not stagnated on taking the backlog down. In fact, the
Monday morning workload report this week shared with you that
the backlog was 209,000. This morning it is 206,000, and it
will start increasingly cycling faster as we have literally cut
the inventory in almost half. You will start to see over the
next several months a really significant bend in the curve.
Here is a phenomenon I would share with you that happens
every single year, and it is a--I am sorry, but I am stuck to
the way the calendar was built. The fall--first quarter of
every year, which you can sort of see there is when it starts
to stagnate, has more Federal holidays and more holidays in it
that affect productivity and production. It is a fact of the
calendar. You will always see us do better the second, third,
and fourth quarters routinely. So I have to try not to react to
a calendar problem in the first quarter, but you will see that
we have made significant progress second, third, and fourth
quarters.
What I will share with you is I have been--we have done
that increased productivity, that 67 percent increase in
productivity, largely because we have transformed. So to the
paper issue, we can simultaneously in parallel operations now
share the electronic record between the hospital that has got
to do the exam, the reviewer who is looking at it, and the VSO
who is helping move it through. All of them can see it at the
same time. Could not do that before. We are not mailing things
around. We are taking that out of the system.
The centralized mail is going to take another 20 days out
of the process. We are starting to see the effects of going
into the full centralized mail now. Days are coming down out of
the system because they are doing and scanning those in in 5
days rather than 22 days. So we will see, and we will get to,
functional zero; I will say that. I am going to have people in
the backlog by their choice or by the really unique
circumstances of their life. But functional zero, you will
agree with who is in functional zero and understand and nod
their heads. And even a veteran in many cases who is in there
will say that was by my choice. I do not want to do the exam
yet. I want to add a new contention now.
I think you are going to be very happy with where
Albuquerque gets. That is one station I was headed to when I
got changed up on. I still have to get there, and I am looking
forward to a visit.
Senator Udall. Well, we look forward to having you, and we
look forward to working with you on continued decline in terms
of those numbers. And we really appreciate, as I said before,
all of your work. Thank you, Mr. Chairman.
Senator Kirk. Ms. Capito.
Senator Capito. Thank you, Mr. Chairman, and I want to
thank the witnesses for their hard work, and would really like
to tell the Under Secretary and those who are working for you
that after our meeting yesterday, really have a full
appreciation of the volume of what you are doing. But
appreciate that you are able to, you know, with the data show
all the improvements that you are making, and certainly
appreciate that.
DOD TUITION ASSISTANCE PROGRAM
I have a question surrounding the tuition assistance issue.
On January 1, 2014, the Army issued a policy change to its
Federal Tuition Assistance Program (TAP), and this change
requires soldiers for all three components--Army components to
wait 1 year after they complete advanced individual training or
a basic officer leadership course before receiving tuition
assistance. You know, we have talked with our National Guard,
and there are some questions. This could have some negative--
the year wait--negative impacts on recruiting and educational
levels within our Guard.
In the State of West Virginia, 65 percent of our National
Guard has either a college education or is working towards
that, and it is a good recruitment tool. I can vouch for that.
Could you explain the reasoning and how you plan to address the
already declining numbers of students that are utilizing this
benefit?
Secretary Hickey. So, Senator, thanks for the question. I
will tell you that tuition assistance is a DOD program. I own
seven other education programs that we process claims for in
VBA, the 9/11 GI Bill and other kinds. There are seven other
chapters----
Senator Capito. Right.
Secretary Hickey [continuing]. Seven other chapters that I
know you are well aware of.
Senator Capito. Right.
Secretary Hickey. And I appreciate, by the way, your
National Guard in the State of West Virginia, having been
active Guard and Reserve, have a strong heart and family
feeling for the National Guard.
Here is what I can tell you. We expect any time there is an
implication to DOD programs on tuition assistance, there is
going to be a reciprocal load request to utilize the benefits
that they may be entitled to on our side. National Guard and
Reserve has a unique opportunity on the 9/11 GI Bill
perspective because they are both a still serving member, but
maybe a qualifying veteran who can access resources while they
continue to serve. So there are other changes I know that DOD
has talked about in tuition assistance that could put further
pressure on the GI Bill. We will have to respond to that if
that is the case.
I will tell you that as we are taking military members
through TAP, 75 percent of them are telling us at the point of
meeting in TAP that they will plan to leverage their GI Bill.
So I expect this benefit to continue to have a high demand.
One last thing I might offer is that I need your help
across the entire Congress. We appreciate the benefit that came
out in the Choice Act for Section 702 that gives veterans and
service members the opportunity to use in-State tuition no
matter where they have been based. We think it is a tremendous
benefit. I went out immediately with letters to every governor
and all the schools asking them to please comply by the
required 1 July date.
We do have now--every State now has signaled intent to
comply, but I only have four that are in compliance with the
requirements for that in-State tuition that goes on the 1st of
July. I need help from you all getting the word out across all
the States to please comply as soon as possible. We are not
going to let our student veterans suffer, so we will have to be
prepared for our Secretary to take some kind of authority he
has been granted to keep those veterans in school. But we
really need the States to be in full compliance absolutely as
soon as possible.
Senator Capito. Do you have those States?
Secretary Hickey. I do. I will tell you the four that are
in compliance.
Senator Capito. The four that are in compliance.
Secretary Hickey. The four that are in compliance are
Georgia, Texas, Kentucky, and Wyoming.
Senator Capito. Thank you.
Secretary Hickey. All others----
WOMEN VETERAN ISSUES
Senator Capito. Okay, second question. Thank you for that,
and we will follow up with the DOD on that on the tuition
assistance. As you know, and I think we might have talked about
this yesterday slightly, there are 200,000 women who have
served in Iraq and Afghanistan, and now approximately 20
percent of the recruits are females, which creates more female
veterans. I did not know if you were--if there were any
specific--I know some of the hospitals have created women's
clinics for the returning women's veterans. I did not know if
there was anything specific that you are doing to address
women's issues maybe in the area of sexual assault or any kind
of mental health coverages along that area.
Secretary Hickey. We are, and as you might imagine as a
woman veteran myself, I have a great deal of advocacy for my
sisters in service. So let me just give you a little bit of a
drumbeat on that. We have in every single regional office a
woman veterans coordinator, and that person is--we post it in
public context so they all know who it is. We also have in
every single one of our regional offices a military sexual
trauma coordinator, one woman and one man, for the choice of
the veteran who would like to speak more privately with them.
MILITARY SEXUAL TRAUMA
Of recent times, and this is a function of my email going
viral and my willingness to actually answer them all myself
last sort of May/June timeframe, that somehow I ended up as a
person that was taking care of MST victims, which I have a
special place in my heart for them as well. And now I have got
a lot of requests for ways in which we could put people on very
high density sites that are specifically addressing that to try
to get better information out there.
About 2 months ago, I put an MST coordinator on one of
those blog sites, and she has been actively helping. And at the
same time, I released the names in the public domain for every
single MST coordinator in every single regional office, their
emails, so that people could reach them, and talk to them, and
get help from them for this really difficult and sensitive
topic. When I arrived----
Senator Capito. If you could just tell us, ``MST?''
Secretary Hickey. Military sexual trauma or MST.
Senator Capito. Right, I just wanted to make sure we had it
out there, yes.
Secretary Hickey. Right after I arrived, one of my first
steps to do because I just know far too many people that have
dealt with this, and it is just--we have got to do something
about this. I asked, because I had heard that we were rating
these lower than--granting these lower than we were doing our
regular PTSD claims for combat, and fear, and terrorism. And,
in fact, in the review, we determined we were substantially
about 20 percentage points lower.
I mandated that we go through an extensive effort to train,
and we did that in conjunction with the Veterans Health
Administration (VHA) folks together, the examiners. And as a
result of that, in very quick fashion we got those levels up to
par with the normal grants that we do for PTSD, and they remain
there because I keep watching it. We do a review and I demand a
review every 6 months, and we have remained on par with those
claims.
Senator Capito. Thank you. Thank you very much. Good work.
Thank you.
Secretary Hickey. Thank you.
Senator Kirk. Mr. Tester.
AVERAGE DISABILITY RATING AND PTSD
Senator Tester. Yes, thank you, Mr. Chairman, and once
again, thank you for being here. I have got a chart here from
the VA. You mentioned in your opening statement about the
average disability rating being at 30 percent for basically 45
years, and now it is at 48 percent. I know we went into war in
Iraq in 2000, but the question is why the difference. Why when
it was static for 45 years at 30 percent, why today we have it
at 48?
Secretary Hickey. Really good question, Senator Tester, and
lots of good data to show the following. Today's veteran is 10
times more likely to survive their wounds of war than World War
II, Vietnam, and every other conflict, Korea and all the rest.
So 10 times more likely to survive wounds means you are coming
back with many more. That jumps you up.
Also we relaxed the rules for PTSD. We had 47,000 people on
the PTSD rolls in the 1990s. Today we are breaking 800,000 on
the rolls for PTSD. That is not just today's veteran. Those are
World War II veterans who were never able to file before
because of the threshold level to be able to have to produce
proof----
Senator Tester. Gotcha.
Secretary Hickey [continuing]. Of what you endured at the
Battle of the Bulge. It is also--we also----
Senator Tester. So could you just give me an idea what--the
veterans that served--of the overall veterans that served, the
numbers that have served since the war in Iraq, how many of
those veterans have post-traumatic stress disorder (PTSD)
issues as a percentage?
Secretary Hickey. I think--I do not know that I can do it
as----
Senator Tester. Is it half?
Secretary Hickey. I do not even know that I could do that.
Senator Tester. That is all right.
Secretary Hickey. I do not know if I have it in that way.
Senator Tester. If it possible and you can get it easily--
--
Secretary Hickey. I can get that back to you.
Senator Tester. It is just for my edification.
[The information follows:]
Senator Tester. So could you just give me an idea what of the
overall veterans that served since the war in Iraq, how many of those
have post-traumatic stress disorder issues as a percentage?
VA Response. As of December 2014, 12.7 percent, or 262,904 of
2,065,944 GWOT veterans were service-connected for PTSD.
APPEALS PROCESS
Senator Tester. So, okay. Let me talk about appeals, and I
know you want to talk about legislation because I heard it in
your answer to Senator Boozman, and I will let you get to that
in a second. But how long does it take for a decision on an
appeal currently, start to finish?
Secretary Hickey. Sadly it is upward in the neighborhood of
800 to 1,000 days depending on the station.
Senator Tester. Okay. And you talked about the appeal
process being disjointed. You said in your opening statement
that it is a complex law.
Secretary Hickey. It is a complex law.
Senator Tester. Which indicates you may need some help. Do
you have a proposal?
Secretary Hickey. I do. We have put one in front of you,
and this one has come over before, our proposal frankly to fix
it once and for all, is the legislation we have in front of you
that says close the evidentiary record at the time the decision
is made. And then what you are doing----
Senator Tester. So the question is, have you put this
proposal in front of the VSOs also?
Secretary Hickey. I have.
Senator Tester. And what has been their response?
Secretary Hickey. In transparency, they do not favor
closing the evidentiary record at the time the appeal is made.
They prefer instead, and I give great credit to Disabled
American Veterans (DAV), who has taken the charge to do and
try a fully developed appeal, which also requires a legislative
fix from the Congress that allows us to move 25 percent of
those people who will say here is all my stuff, I am not going
to add anything else to it, move me through the appeals
process. And the current approach they have is 25 percent of
those would be allowed to do that. That could help at the
margins. That is not going to solve anything for the long haul,
and it is not going to solve anything soon.
Senator Tester. This is absolutely your subcommittee, Mr.
Chairman, but this may be something that we could have a
hearing on to talk about the proposals and the ups and the
downs. I think it would be very difficult to get legislation
passed unless you get the VSOs on board. It is just going to be
tough to do.
Secretary Hickey. I agree.
Senator Tester. But if there are ways we can make it work,
because the VSOs are going to represent the veterans, quite
frankly, that is who the chairman and I represent, too. Then we
can try to figure out solutions. There has got to be middle
ground here. There has to be.
Secretary Hickey. Senator, I would love to find any
solution. Right now, I have done everything possible within
people, process. There is a little technology we need to do on
the board side to get them more efficient. But I have done
everything on my side I can do short of changing law or a lot
more people.
MILITARY FAMILY RELIEF ACT
Senator Tester. Okay, and I am going to be very brief with
this because I think this is a slam dunk. There is a bill
called the Military Family Relief Act. What it does is it
expedites the process for recently widowed spouses of disabled
veterans to receive their benefits. In other words, a veteran
dies, their spouse get their benefits. Right now, it could take
up to a year. It does not make a lot of sense to me, quite
frankly.
Is there any reason why we could not just make it
immediate? I mean, you are given the veteran, they are not
divorced, they are married, whether it be a man or a woman that
is the veteran. Is there not an easier way to get this done,
because I cannot imagine what they are going--I mean, I just
cannot. Someday it will probably happen to me or my wife, but I
cannot imagine what they are going through. Is there some way
to make it more streamlined, and would you support this bill?
Secretary Hickey. Senator, I am fond of saying in my
offices with my employees that I have a flat spot on the back
of my head from banging my head on a wall on this very issue.
Though it sounds a little bit trite, I could hug you or anyone
else who would move forward this legislation to do this right
thing by people who are suffering, and who deserve this, and
are poverty level veterans and now poverty level survivors.
Senator Tester. We will do that. I do not want a hug right
now because I got a cold, but I will take a raincheck. Mr.
Chairman.
Senator Kirk. Mr. Cassidy.
Senator Cassidy. Hello, Secretary Hickey. Thank you again
for coming by yesterday afternoon. It really helped. Now, one
thing you mentioned just to follow up, and my staff has done a
good job subsequent, and this may have been talked about
earlier. I apologize; I was in another committee hearing. You
had mentioned the progress you all have made in terms of
accuracy of claims, expeditious, et cetera. And you had
mentioned that even though there might be some centers which do
not perform as well as others, that nonetheless it is constant
across all centers as regards to percent accuracy, et cetera.
GAO REPORT ON REGIONAL OFFICE CLAIMS DATA
Now, the GAO report, though, seemed to take a little bit of
issue with that from November of last year. And when they
ranked the different sites, I cannot help but notice--I always
take a city that has a pro football team is a big city. So in
the bottom half we have 15 different, if you include Los
Angeles, 15 different NFL football cities, which are poorly
ranked in terms of accuracy of claims. And in the top we have
seven. And in the bottom we have New York, Los Angeles,
Baltimore, St. Louis, Houston, some really big cities,
Philadelphia. And in the north, in the kind of top half we have
New Orleans, Milwaukee, St. Paul, Twin Cities, so relatively
small cities.
Long context to ask. As you look at your--the criticism was
that you are not weighting according to the number of claims
processed in each office the percent accuracy, which
artificially inflates your accuracy. What are your comments on
that?
Secretary Hickey. Senator, first of all, the Government
Accountability Office (GAO) report, if you look back to the
dates that they pulled the data, are well--a long time ago for
the range where they pulled the data, not reflective of today's
quality improvements that we have made across the system.
Second, there is variance across regional offices, but I will
tell you there is not one I cannot identify where they have not
made significant improvements in their accuracy and their
quality. And that is what has driven up the full nine
percentage point increase in claims quality.
The other thing I will tell you about the GAO study that
was released last year, one of the--they make two points that I
would say listen to as well. One of the points was they said
that we were over sampling--first they validated that we had a
statistically valid sample, but they said you are over
sampling, you know. You do not have to do that many, and maybe
if you did not do that many you could take some of those
auditors and point them towards other things you want to do. I
actually agree with them. We have done some work with two, now
three independent parties looking at our quality process. We
are likely to move forward in that regard.
The second thing that they said was, well, you are over
sampling for the small cities or regional offices, under
sampling for the large ones. So I said, good, let me see what
happens if I change the--if I look at the data and I weight it
based on size of what is being done. We did that. It made a 0.6
percent difference when we did that, so not much moving the
needle at all on the differences between what we are showing
you in our quality and our accuracy today.
But I still will probably likely do that because we could
always do what we should do to even make it more refined and
better. But you are right also, New Orleans has done a
phenomenal job on their quality. Today, by example, their
quality is 95 percent at the issue--claims-based level and
97.34 percent at the issue-based level. And they have reduced
their backlog by a full 65.5 percent.
Senator Cassidy. Well, let me compliment Fort Harrison,
Montana, who apparently has been number one for a while. And
so, whatever they are doing in Fort Harrison we need to export
across the rest of the country, particularly to Baltimore and
Los Angeles who are the worst.
I have no more questions. Again, thank you for coming by
yesterday, and thank you for you all's good work in addressing
the issue.
Secretary Hickey. Thank you, Senator. And if I might just
add, I do not have Baltimore and--oh, I do have Baltimore in
front of me and L.A. But I will tell you in both cases,
significant improvements made, and I thank this subcommittee
for the additional resources you gave me to apply to the new
training that we did where we literally stood the offices down
and retrained everybody top to bottom. So I thank you for those
resources to do that. And we are seeing improvements as a
result.
Senator Cassidy. Thank you. I yield back.
Senator Kirk. Mr. Tester.
FT. HARRISON MONTANA REGIONAL OFFICE
Senator Tester. Thank you, Mr. Chairman. I have got just a
couple of questions. And thank you, Senator Cassidy, for
recognizing Fort Harrison, Montana. The first one is a bit
parochial. Recently Fort Harrison's VBA facility created 25
work spaces. Does the VBA intend to fill those spaces with
people?
Secretary Hickey. So, Senator Tester, some of that depends
on what you all do in my budget. I will tell you I have--any of
the people that you give me up to my full requirement, not even
my budget, I will have room for because, guess what? I am not
using paper anymore, and I have got lots of space to be able to
put people in to effect it. So I know they have space for an
additional 25. Depending on the budget, we might have the
opportunity to grow the footprint.
Senator Tester. So let me ask you, if they hire another 25,
if we give you the budget authority and the money, and we hire
another 25 additional folks, we would be up to 100 in Montana.
Would that mean we would also get a VBA director in Montana
then, or are there numerics around that kind of a thing?
Secretary Hickey. Typically, when you are crossing into the
100 category, we are starting to think of you as a standing RO,
so we would look at that. You would be considered a small one,
and those are typically run by GS-15s. That would require a few
extra--you know, not a lot, but a few extra FTEs because with
that comes requirements for support services, things of that
nature. So we are not talking a lot, but it could be upwards of
a dozen more people.
SERVICE TREATMENT RECORDS
Senator Tester. Okay. One of the most time-consuming pieces
of the claims process is collecting evidence, and much of that
evidence is gathered not by you, but by the DOD. Last summer, I
wrote to Secretary Hagel after the DOD inspector-general-issued
report revealing that the DOD was taking entirely way too long
to transmit complete records to the VA. This is an issue that
not only I have been involved in, but several on the Senate
side. There have been reforms implemented, and your
communication and cooperation with the DOD has strengthened
over the last couple of years, and I commend you for that. Can
you elaborate on how the transmission is going with the DOD of
documents?
Secretary Hickey. So we have--so thanks, Senator, for that,
and they are doing better, and I am really appreciative of that
because they are a critical supplier to our process. A year
ago, about 80 to 83 percent of everything they sent us was
late. We were getting it in paper. We were not getting it
digitized. But that has all changed.
Now, they have built their Health Artifact and Image
Management (HAIMS) system. Basically they are scanning all of
their full and complete service treatment records at central
cells at different places across the country. And then they are
uploading them into this HAIMS system. Our VBMS system has been
built and coded such that when we say--when we get a request
for a claim, it automatically goes into the HAIMS system, no
human intervention, asks for that record, finds that record,
pulls it back across, and puts it into VBMS so it is ready to
be looked at and worked by a VBA employee.
They have gotten better. They are now down to about 37 to
40 percent of them are still late, but they are doing better,
and they are really working hard at it. So we will continue to
keep pushing so that we get them all the way down only because
it is so critical to our ability to get and stay at 125. So we
need them to stay eyes on target as much as we are right now.
Senator Tester. Yes, and I appreciate that. I would just
ask you if--I mean, there are many people on this
subcommittee--I am not one--but they do serve on Armed
Services. And there can be pressure applied to make sure that
the DOD is doing their part in this transaction because it is
an important part. I want to talk about National Guard and
their records. Are they also as timely?
Secretary Hickey. No, they are not, Senator, and I need
more work there in rapid fashion.
Senator Tester. And what is the pressure point to make that
happen?
Secretary Hickey. They have recently stood up a National
Guard single point of entry cell as well. And as you well know,
with a State that has a lot of National Guard in it, the
National Guard has not always served with the same units and in
various places. And as you well know, chairman, as a naval
reservist, you often went as an IMA or an individual
mobilization augmentee, and nobody was keeping track of your
records anywhere. This is a real problem.
We actually let a contract to try to go understand better
how we could figure it out because we were not getting enough
in-depth understanding of how this could be made better on the
DOD side. That is literally coming to me here in the next
couple of weeks to tell me what they have discovered and found.
As I see that and I look for opportunities to improve, I will
be taking that to DOD from my perspective.
We need to do more about this. We have nearly a million in
the Guard and Reserve who have served this country well and
faithfully over this last 15 years of war and beyond.
Senator Tester. Yes. I would just say, and then this will
just be a side comment, that if you need help, we will help. I
mean, we are using the Guard in a way that they have never used
before. And so, I think it is important that we meet their
needs, too. And if we are falling down, we have just got to
figure out where to apply the pressure. We will work on it.
So once again, Secretary Hickey, thank you for your good
work. I very much appreciate it.
Secretary Hickey. Thank you, Senator.
Senator Kirk. Let me conclude with one last question. Is
there any way we could establish something I would call the
Hickey process for any amputee where in 1 day we could
adjudicate that claim?
Secretary Hickey. Chairman, when we have very seriously
injured individuals, we put them at the top of the priority
list along with POWs, Medal of Honor recipients, and terminal
veterans. It will sometimes take a little bit longer than a day
to do them, but we do prioritize them well in front of the
rest.
I usually will find someone who is a double amputee has
many more conditions we need to address. Can we take one and do
it? Yes, we do that to try to get something started for that
veteran all the time.
Senator Kirk. All right, thank you.
Secretary Hickey. Thank you, chairman.
Senator Kirk. Thank you. Well, I remind members that we
will keep the record open until close of business, and we will
meet next week, Thursday. For those members who may want to
submit additional questions, they can do so for the record.
SUBCOMMITTEE RECESS
Senator Kirk. The subcommittee will be meeting again on
March 26 at 2:30 p.m. With that, we will close the hearing.
Secretary Hickey. Thank you, chairman.
Senator Kirk. Thank you.
[Whereupon, at 11:26 a.m., Thursday, March 19, the
subcommittee was recessed, to reconvene Thursday, March 26,
which was later postponed to Thursday, April 15, at a time
subject to the call of the Chair.]