[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]
EXAMINING SHORTCOMINGS WITH
VA'S NATIONAL WORK QUEUE
VETERANS BENEFITS CLAIMS
MANAGEMENT SYSTEM
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HEARING
BEFORE THE
SUBCOMMITTEE ON DISABILITY
ASSISTANCE AND MEMORIAL AFFAIRS
OF THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTEENTH CONGRESS
SECOND SESSION
__________
WEDNESDAY, JUNE 26, 2024
__________
Serial No. 118-70
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via http://govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
56-328 WASHINGTON : 2026
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COMMITTEE ON VETERANS' AFFAIRS
MIKE BOST, Illinois, Chairman
AUMUA AMATA COLEMAN RADEWAGEN, MARK TAKANO, California, Ranking
American Samoa, Vice-Chairwoman Member
JACK BERGMAN, Michigan JULIA BROWNLEY, California
NANCY MACE, South Carolina MIKE LEVIN, California
MATTHEW M. ROSENDALE, SR., Montana CHRIS PAPPAS, New Hampshire
MARIANNETTE MILLER-MEEKS, Iowa FRANK J. MRVAN, Indiana
GREGORY F. MURPHY, North Carolina SHEILA CHERFILUS-MCCORMICK,
C. SCOTT FRANKLIN, Florida Florida
DERRICK VAN ORDEN, Wisconsin CHRISTOPHER R. DELUZIO,
MORGAN LUTTRELL, Texas Pennsylvania
JUAN CISCOMANI, Arizona MORGAN MCGARVEY, Kentucky
ELIJAH CRANE, Arizona DELIA C. RAMIREZ, Illinois
KEITH SELF, Texas GREG LANDSMAN, Ohio
JENNIFER A. KIGGANS, Virginia NIKKI BUDZINSKI, Illinois
Jon Clark, Staff Director
Matt Reel, Democratic Staff Director
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
MORGAN LUTTRELL, Texas, Chairman
C. SCOTT FRANKLIN, Florida CHRIS PAPPAS, New Hampshire,
JUAN CISCOMANI, Arizona Ranking Member
ELIJAH CRANE, Arizona CHRISTOPHER R. DELUZIO,
KEITH SELF, Texas Pennsylvania
MORGAN MCGARVEY, Kentucky
DELIA C. RAMIREZ, Illinois
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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WEDNESDAY, JUNE 26, 2024
Page
OPENING STATEMENTS
The Honorable Morgan Luttrell, Chairman.......................... 1
The Honorable Chris Pappas, Ranking Member....................... 2
WITNESSES
Panel I
Mr. Willie Clark, Deputy Under Secretary, Field Operations,
Veterans Benefits Administration, U.S. Department of Veterans
Affairs........................................................ 3
Accompanied by:
Mr. Ken Smith, Assistant Deputy Under Secretary, Operations
Management, Veterans Benefits Administration, U.S.
Department of Veterans Affairs
Panel II
Mr. Herman Breuer, Policy Director, National Association of
County Veterans Service Officers (NACVSO)...................... 15
Ms. Ashlynne Haycock-Lohmann, Deputy Director, Government and
Legislative Affairs, Tragedy Assistance Program for Survivors
(TAPS)......................................................... 17
Mr. James R. Swartz, President, Local 2823, American Federation
of Government Employees (AFGE)................................. 18
APPENDIX
Prepared Statements Of Witnesses
Mr. Willie Clark Prepared Statement.............................. 29
Mr. Herman Breuer Prepared Statement............................. 33
Ms. Ashlynne Haycock-Lohmann Prepared Statement.................. 34
Mr. James R. Swartz Prepared Statement........................... 40
EXAMINING SHORTCOMINGS WITH
VA'S NATIONAL WORK QUEUE
VETERANS BENEFITS CLAIMS
MANAGEMENT SYSTEM
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WEDNESDAY, JUNE 26, 2024
Subcommittee on Disability Assistance &
Memorial Affairs,
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The subcommittee met, pursuant to notice, at 10:12 a.m., in
room 360, Cannon House Office Building, Hon. Morgan Luttrell
(chairman of the subcommittee) presiding.
Present: Representatives Luttrell, Franklin, Ciscomani,
Self, Crane, Pappas, Ramirez, and McGarvey.
OPENING STATEMENT OF MORGAN LUTTRELL, CHAIRMAN
Mr. Luttrell. Subcommittee will come to order. Thank you to
the witnesses for joining us today. We are here to take a
closer look at the U.S. Department of Veterans Affairs (VA)
National Work Queue, also known as the NWQ, which
electronically manages and distributes the majority of the
Veterans Benefits Administration's (VBA) workload of the VA
benefits claims. In March 2013, the backlog of VA benefits
claims peaked at over 600,000 claims. In response, VA created
an electronic claims file system called the Veterans Benefit
Management System, or VBMS, to electronically process veterans
claims. In 2016, the National Work Queue was implemented to
ensure that these paperless claims were efficiently processed.
The National Work Queue avoids funneling claims through a
single VA Regional Office (RO). Instead, the National Work
Queue uses pre-programmed rules to automatically distribute
claims every day to ROs across the country based on RO's
capacity to take claims more efficiently. I am pleased that the
National Work Queue has largely decreased wait times for
veterans waiting for decisions on their claims.
Because of the VA's efforts, the backlog is half of what it
was in 2013. There is still room for National Work Queue to
improve, always in its goals of efficiently processing all
veterans and survivors claims. Right now, the current system
only allows the most recent VA employee who managed a claim to
learn from when they have mistakenly undertaken unnecessary
steps to obtain evidence. Therefore, most VA employees never
are able to learn from those mistakes, and they continue to
conduct unnecessary development in other veterans claims.
Although the National Work Queue has improved wait times for
general types of disability compensation claims, veterans and
survivors who have filed special types of claims continue to
experience longer wait times for decisions. Today, we will take
a closer look at the National Work Queue shortcomings when it
comes to efficiently processing claims based on Military Sexual
Trauma (MST) and claims for survivor benefits.
In October 2023, VA attempted to address the backlog of
20,000 military sexual trauma claims by consolidating MST
claims with the San Juan, Puerto Rico Regional Office. Since
then, the backlog of MST claims has grown to more than 26,000.
In reaction to this, VA designated the Roanoke Regional Office
as a temporary MST special mission site effective April 1,
2024, and it remains to be seen whether the effort will be
enough to work down that extreme backlog. We have heard that
this backlog was part due to the National Work Queue automated
claims establishment rules failing to properly label MST
claims. As a result, claims processors across the country
manually relabeled claims as MST claims, resulting in a higher
number of MST claims being routed to the San Juan office. There
obviously are not enough employees assigned to the San Juan
office to process all these military sexual trauma claims.
Further, we continue to see backlogs in survivor benefits
claims. At our full committee hearing in January, we learned
about how certain claims for dependencies and indemnity
compensations filed by surviving spouses and surviving children
are not being routed in a timely manner through the National
Work Queue. Today, we will examine what steps VA has taken and
will take to address the wait times for the survivors. Every
veteran and survivor has earned a timely decision on their
claims. I look forward to hearing from our witnesses today
about the National Work Queue and how it can be improved.
Again, I thank you Mr. Clark and Mr. Smith for joining us
today. I now recognize the Ranking Member for his opening
remarks.
OPENING STATEMENT OF CHRIS PAPPAS, RANKING MEMBER
Mr. Pappas. Thank you, Chairman Luttrell. I appreciate you
holding today's hearing as part of our efforts to continue to
serve our Nation's veterans. For most veterans, the very first
interaction they have with VA is when they file a disability
claim. Once their claim is filed, it joins over 900,000 others
in the national inventory. Our witnesses from the Office of
Field Operations are tasked with managing the distribution and
processing of these claims across the country. The National
Work Queue is a tool developed by their office to manage that
workload. The National Work Queue and the team managing its use
have been critical to bringing veterans and survivors into VA's
care to include over one million The Sergeant First Class Heath
Robinson Honoring our Promise to Address Comprehensive Toxics
(PACT) Act related claims granted to date. No IT system, no
operational program is perfect. The needs of our veterans,
their families, caregivers, and survivors continue to evolve.
The National Work Queue must evolve with them. Right now, there
are over 250,000 claims that are older than 125 days. That is
200,000 veterans or survivors that have been waiting over 125
days to gain access to the benefits and services that they have
earned. Unfortunately, I continue to hear from veterans and
veteran service organizations and frontline VBA employees that
older backlog claims are not being prioritized, or worse yet,
they are stuck in the system.
We must also recognize that the administration of the
National Work Queue tool does not only affect our veterans, but
it affects the VBA employees that do their absolute best to
carry out VA's sacred obligation. During visits to VA regional
offices, we repeatedly hear the National Work Queue tools
complex routing is causing frontline VBA employees to duplicate
claim development already done by their colleagues in other
parts of the country. That duplicated work wastes time and puts
additional strain on claims processors abilities to meet
increasingly demanding production quotas. As another unintended
consequence claims processors rarely receive feedback on errors
they have made in their work. This significantly hinders the
rate an employee will learn and by effect, the overall quality
of the workforce's service. To me, unnecessary deferrals and
their unintended effects produce large scale inefficiency and
inequity to both your employees and customers.
Today, I encourage our witnesses to recognize the need to
address these key issues and to evolve National Work Queue
alongside the needs of those most affected by its use. I thank
you all for the work you have done, continue to do, and to
ensure that we support our veterans, survivors and their
families, and caregivers. I yield back.
Mr. Luttrell. Thank you, Mr. Pappas. Our lead witness from
Veterans Affairs is Mr. Willie Clark, Deputy Under Secretary
for Field Operations at the Veterans Benefits Administration.
Mr. Clark is joined by Mr. Ken Smith, Assistant Deputy Under
Secretary for Field Operations. I ask the witnesses, please
stand. Please raise your right hand. Do you solemnly swear that
the testimony you are about to provide is the truth, the whole
truth, and nothing but the truth, so help you God? Thank you.
Please be seated. Let the record reflect that the witnesses
have answered in the affirmative.
[Witnesses sworn.]
Mr. Luttrell. Thank you again for being here, Mr. Clark,
you now are recognized for 5 minutes to deliver your opening
statement.
STATEMENT OF WILLIE CLARK
Mr. Clark. Good morning, Chairman Luttrell, Ranking Member
Pappas, and members of the subcommittee. I appreciate the
opportunity to appear before you today to discuss the
Department of Veterans Affairs National Work Queue. I am joined
today by Mr. Kenneth Smith, the Assistant Deputy Under
Secretary responsible for NWQ. We could not have processed the
number of claims we have and handle the increase in receipts
due to the PACT Act without the National Work Queue, we could
not have done so. Prior to implementing NWQ in 2016, VBA used a
manual process to move claims folders between regional offices.
With NWQ, claims are distributed electronically using automated
rules which allow for more consistent and reliable means for
distributing work leading to improvement in customs service and
efficiency, regardless of whether veteran or survivor lives.
Let me give you a recent example. A 10-percent service
connected Minnesota veteran in his late seventies recently
filed a claim for malignant condition based on a toxic exposure
risk activity. The claim was established by the Houston
Regional Office 4 days after submission and transferred by NWQ
to the Milwaukee Regional Office. That evening, a Milwaukee
employee developed for evidence to include ordering of
examinations. The claim was marked as ready for decision, a
status where VBA has a significant volume of nearly 300,000
claims that have been awaiting review for an average of 44
days. 5 days later, we received additional medical evidence
which identified the veteran as terminal. The file was
annotated, prompting NWQ's routing rules for terminal veterans
to be reassigned back to the Milwaukee RO for priority action.
On day 34, 1 day after the veteran was identified as terminal,
the RO, Milwaukee RO completed a decision to award a 100
percent evaluation with eligibility for dependent educational
assistance for his spouse, an increase of over $3,700 per month
in disability compensation.
NWQ now recalls and distributes more than 130,000 claims
per day, which has led to an historic increase in output in
Fiscal Year, FY `24. As of May 31st, VBA completed more than
10,000 disability survivor claims, disability and survivor
claims, in a single day on 70 occasions, the first time in our
history that we have accomplished this feat. Additionally,
during the same period, VBA completed over 28 percent more
claims compared to the same time last year. VA has historically
centralized processing for certain claim types that require
specialized handling, such as those related to mustard gas,
radiation, pension or Agent Orange exposure, or from veterans
residing overseas. Centralization develops the specialized
knowledge required for each of these unique workloads, thereby
improving efficiency through improved consistency, quality, and
employee proficiency. As an example, VBA centralized this
Military Sexual Trauma workload from eight interim locations to
the MST Ops Center, a single site led by a senior executive
director to enhance organizational oversight and effectiveness.
In fact, we have more resources now assigned to MST than we had
at the other eight locations combined.
As these new employees are onboarded and complete the
unique requirements for MST claims processing, VBA is poised to
further reduce inventory and improve service delivery. We also
know many times MST claims are not initially identified as an
MST claim. Rather, the claim is initially identified as a
mental health disorder, with MST later being identified by the
examiner. This necessitates additional development, elongating
the claims process. Consolidating the MST claims provides
focused attention to improve timeliness and quality while
remaining compassionate to the mission of serving MST
survivors. While VBA is providing more benefits and service to
veterans than ever before, it is clear that we still face the
twin challenges of unprecedented workload and workforce growth,
and we are committed to continued improvements in NWQ.
Accordingly, we have modernization improvements scheduled for
completion by Fiscal Year 2026. In addition, our Under
Secretary for benefits commissioned an NWQ Red Team to evaluate
operational and functional capabilities, and we are currently
reviewing additional recommendations by the team. As always,
VBA looks forward to the continued oversight provided by
Congress and partnership of our stakeholders to improve service
delivery. Chairman Luttrell, Ranking Member Pappas this
concludes my testimony. I am happy to respond to any questions
you or the subcommittee may have.
[The Prepared Statement Of Willie Clark Appears In The
Appendix]
Mr. Luttrell. Thank you, sir. The written statement, Mr.
Clark will be entered into the hearing record. Subcommittee
will stand in recess, subject to call it a Chair. I expect us
to reconvene 10 minutes after the closing of votes. Thank you.
We will bring the committee back in order. Again, we will have
a few others. Mr. McGarvey is, I am sure, moving as fast. What
do you say? There he is. Outstanding. I now recognize myself
for 5 minute questioning and then I will pass it off to the
Ranking Member.
Mr. Clark, I am going to start with you, sir. As we know
from the January `24 full committee hearing on survivors,
National Work Queue, more or less fails to route surviving
children's Dependency and Indemnity Compensation (DIC) claims
for processing. They are just basically in a holding pattern in
the National Work Queue for an extended period of time. Why
does--if you will, if you can, please answer. Why do surviving
children of veterans have to wait for VA to revise? From what I
understand, there is a form that needs to be adjusted, and from
what I understand, that is taking upwards of a couple of years
before. Can you kind of walk me through that, sir, and tell me
where we stand and----
Mr. Clark. Yes, sir, 21674 is the form, but I would like to
ask my colleague to answer that question, please.
Mr. Luttrell. Okay. Mr. Smith.
Mr. Smith. Yes, sir. In January, when we identified the
problem, or when the problem was identified, we began to
manually find those forms and then get them out to the
responsible Pension Management Center. We continue to do that
at this point. We have already done more than 600 of those and
we are continuing to do about 40 a week to keep that inventory
down. We can keep those children of deceased benefit veterans
enrolled in school and still receiving their benefits.
Mr. Luttrell. 40 per. You said 40 per week? I am sorry.
Mr. Smith. About 40 per week.
Mr. Luttrell. 600 in totality. What is our gross number?
You have that off top of your head?
Mr. Smith. I do not have that off the top of my head.
Mr. Luttrell. Okay, I am sorry. Go ahead.
Mr. Smith. Our pension service is working on the form to
simplify it because right now when the child is ready to turn
18, a letter is sent to the parent 3 months before and that
sometimes causes some confusion because the child may sign the
form. We are working to revise that so we can get both
signatures on it and continue that benefit or frankly, change
the process altogether. Again, our pension service is working
on that.
Mr. Luttrell. I do not know if I want to ask what changing
the process altogether may look like that may be another
hearing altogether.
Mr. Smith. Yes, I believe that that is something that we
would appreciate having a discussion with staff.
Mr. Luttrell. No problem.
Mr. Smith. Get into further details.
Mr. Luttrell. Is there a timeframe if we go, let us say we
go the route of revising the form. Do you have a window? Do you
have bookends you can give me? Excuse me. Give the committee so
we have a date that we are looking at. I do not want to have to
revisit. When we revisit this National Work Queue, I do not
want to ask this question again and say, where are we at? I
want to say, why are not we done?
Mr. Smith. The National Work Queue is distributing these
cases manually. This is not a National Work Queue issue. The
issue with the 2-years that you stated before is a rulemaking
process to change when we send the forms out and can accept
signatures from the children.
Mr. Luttrell. This does live inside the National Work
Queue, from what I understand, or it is supposed to.
Mr. Smith. Claims routing is inside the National Work
Queue. We distribute the workload. The rules for adjusting or
making these decisions is controlled by the policy lane. They
are working on changes to that policy.
Mr. Luttrell. Okay, thank you, Mr. Smith. Mr. Clark,
National Work Queue only allows the most recent VA employee who
made an avoidable deferral to learn from that mistake. Why does
not the National Work Queue have the capability to ensure that
all VA employees who have made an avoidable more or less
deferral can learn from the mistakes in the past? Let me
preface this one, sir, cause I am almost pretty positive how
you are going to answer this question. Just remember where we
engage with the ROs, and we are at the, I am going to say the
front line trace, and we are hearing exactly what they are
telling us. It is sometimes in conflict from what we are
hearing from leadership. Go ahead.
Mr. Clark. Yes, thank you for that, for that question. I
will start, and then again pass on to the NWQ.
Mr. Luttrell. I am not going to let you off the hook again
there Mr. Clark. I appreciate it.
Mr. Clark. Yes, sir. Here is what happens. The National
Work Queue again distributes work.
Mr. Luttrell. Yes, sir.
Mr. Clark. By age and what we have got is a situation where
when there is an avoidable deferral, that deferral then is set
back. It is a mistake that is made by a particular person.
Again, it should have been avoided. That is why it is called an
avoidable deferral. We route those back to the individual that
made the error. Now, our quality review staffs take all of
those errors that are done at a particular RO as well as it
goes back to our comp service. That is rolled up and it is then
used to provide better training. That phenomenon that you speak
of is happening for all employees to get the training or the
results of the errors that are made by individuals. We do take
those errors and again push them back into training for VBA.
Mr. Smith.
Mr. Luttrell. My time is actually up, sir. I am going to
pass. We will revisit that in second line of questioning. Mr.
Pappas, you are recognized, sir?
Mr. Pappas. Thank you, Mr. Chairman. I want to start by
recognizing the great work that our VBA employees do day in and
day out to assist our veterans. Sometimes we look at
statistics, but I know that these VBA employees that work
directly with veterans do not see them as numbers. They see
them as human beings, and they do incredible work to make sure
they get the help that they need and deserve. Mr. Clark, you
mentioned in your testimony that National Work Queue
prioritizes veterans whose claims are the oldest. But we heard
from VA Office of the Inspector General (OIG) recently in a
report last month where a senior VBA employee said that age is
just a guideline, not a rule. I am wondering if you could
clarify that. What priority does National Work Queue give to
backlog claims, especially in relation to new or new
specialized or packed presumptive claims?
Mr. Clark. We do specialize or, excuse me, we do prioritize
all of our work. First in, first out is what we typically use
to determine what work is given to regional offices. There are
times, such as when cases are terminal, such as if we have
financial hardship, we have exceptions to those rules, and
certain cases then go to the front of the line.
Mr. Pappas. But can you comment on the issue of age and
whether age gets priority, or whether that is just a guideline
that the oldest claims get worked on?
Mr. Clark. Well, it is a priority, and that is that first
in, first out is the acknowledgement to age. Our guiding
principle is to work the oldest case that comes into our
inventory. However, there are times when the age of the case
does not take the preeminent priority for all work that is
being done.
Mr. Pappas. Let me move to another area. Character of
discharge determinations. To my knowledge, these determinations
are initiated automatically once a veteran submits their claim
and are completed by the same Veterans Service Representatives
(VSR) that assess benefits claims. Could you clarify, are
character of discharge determinations routed through the
National Work Queue, or is the eligibility determination
completed separately before the claim reaches the work queue?
Mr. Smith. Thank you for the question, sir. Those are
handled by the National Work Queue, and they can come in
through one of two different directions. One is with an
original claim. We will make that character of discharge
determination based on military records and information from
the veteran. The second avenue is a referral from Veterans
Health Administration (VHA) for healthcare purposes, so they
will present to the hospital. The hospital will not be able to
establish eligibility based on their character discharge and
will ask us for a determination. We do both. All of those
claims are managed by the National Work Queue.
Mr. Pappas. These discharge determinations require a
fundamentally different experience than benefits claims, I
would imagine. Would you agree that character of discharge
determinations would be a good candidate for specialization?
Mr. Smith. I would say that they are very much part of our
training background for all of our Veteran Service
Representatives. I think that all of them need to understand
basic eligibility criteria for VA benefits, and all of them are
trained to do that.
Mr. Pappas. But not carved out specifically as an area of
specialization?
Mr. Smith. I would have to look at that, but I think based
on the volume, they are probably better handled by a larger
workforce so that we can ensure that we keep those claims
moving. I should say though, they are specialized at nine
regional offices when we receive them through the hospital,
which is our biggest intake point.
Mr. Pappas. Okay. We have repeatedly heard from frontline
VBA employees that one unintended consequence of deferrals
within the National Work Queue is that VSRs and Rating Veterans
Service Representatives (RVSR) are duplicating the work that is
already been done by their colleagues. Duplicated work means
that for every claim completed, there may be several VA
employees that do not receive performance credit for the work
that they have done on these claims. What is preventing VBA
from finding a solution here? One example could be to make
prior assignment routing logic the default. A single regional
office maintains accountability for a claim, if possible. But
can you comment on this credit issue?
Mr. Smith. I am unaware of duplicate or redundant work. I
would have to see some examples and would happy to have further
discussion about that. I would say that in terms of routing
claims back to the last employee, we have logic already
established for that, and we are looking to refine that to
ensure that we route it back to the last person that actually
produced work that moved the claim forward.
Mr. Pappas. Well, thanks for those responses. Look forward
to continuing the conversation. I yield back.
Mr. Luttrell. Thank you, Mr. Pappas, Mr. Self, you are
recognized, sir, for 5 minutes.
Mr. Self. Thank you, Mr. Chairman. I want to follow up on
that because the committee tells us that multiple VSRs might
handle any particular claim. Why do you even allow? Redundancy
is the key point here, I think, because, and apparently they,
every VSR handles it without deference to any previous VSR
action. If that is correct, redundancy is built into this
because that suggests to me that every time a new VSR handles a
claim, they start over from ground zero. If that is the case, I
think that we have a major fundamental infrastructure issue
here with allowing, not only allowing, but directing this
redundancy. Why do you pass it to multiple VSRs? First
question.
Mr. Smith. The National Work Queue is designed to send it
back to the last person that touched the claim. We have logic
that is built in both at the national level, to send it back to
the last regional office, and we have a local logic that allows
those claims to go back to the last person that touched it. All
employees that touch a claim are expected to perform all
necessary actions to move it to the next stage. If that
happens, the claim should move forward and continue down the
process. Avoidable deferrals, or mistakes, as Mr. Clark
referred to them earlier, sometimes happen. It will come back
from the more senior employee and it should be routed back to
that same person to make sure that they learn from those
mistakes and can make that right.
Mr. Self. Let us go to the avoidable deferrals. Do you
know, do you keep track of how many avoidable deferrals any
individual VSR has?
Mr. Smith. Yes, that data is available.
Mr. Self. That data is available. You know, you have people
that make more mistakes than other people?
Mr. Smith. Yes.
Mr. Self. Now, how in the world if multiple VSRs and only
the last VSR. Yes, the only last VSR is going to be corrected,
what are you going to put in place so that every VSR can learn
from their mistakes?
Mr. Smith. I would say that the quality mechanism is in
place to do just that. We have a separate quality mechanism
that looks at the individual work of each employee as a sample.
As those errors are identified, there is interaction with the
quality review specialist, as well as the supervisor to provide
feedback and mentoring to those employees.
Mr. Self. Next question is how many VSRs? Order of
magnitude. Order of magnitude. How many VSRs work every
avoidable deferral claim? You got an idea?
Mr. Smith. One avoidable deferral is worked by one VSR.
Mr. Self. No, I mean, because we know, we are told that
multiple VSRs might work an avoidable referral. On average, for
an avoidable deferral, how many VSRs actually work them? One?
Two? Three? Five?
Mr. Smith. If a claim is deferred back, it goes to a single
employee to correct and then move forward.
Mr. Self. That is not what the committee staff is telling
us. They said, in fact, it is rare over the lifetime of a
claim, many VSRs may differ a claim, that is what I am trying
to get at. What is the order of magnitude here that we are
dealing with?
Mr. Clark. If I can chime in here, claims do not come in
just one issue at a time. You will have upwards of 20, 30, 40,
50 issues or more. If multiple exams are ordered, what has to
happen is that as these exams come back and what we want to do
in VBA is get the benefits out. That is what we are supposed to
be doing, not waiting until the claim is ready in its totality
for all 50 or 30 or whatever issues. As a result of that, when
that claim goes back, when multiple sets of evidence comes
back, then that claim is looked at by different people.
Mr. Self. Actually, Mr. Clark, I think I am talking about
an avoidable deferral. How many VSRs work each and every
avoidable deferral? That is my question. If you need to get
back to me, I would appreciate it. Because the committee staff
is under impression that many VSRs could work an avoidable
deferral. Because I think this redundancy is a major part of
the problem, not going back to a single VSR and the redundancy
that we have built in, if there is no deference to the previous
work, I think that could be a major part of the infrastructure
issue here. I yield back, Mr. Chairman.
Mr. Luttrell. Thank you, Mr. Self. Mr. McGarvey here.
Recognized for 5 minutes, sir.
Mr. McGarvey. Thank you, Mr. Chairman. Appreciate the
comments from everyone today. Mr. Clark, these issues we are
discussing today have a devastating impact on veterans and
their families. Claims that require special handling are
getting caught in a system that is not equipped to manage the
complex reviews necessary. As you know, the process itself, as
well as staffing shortages, cause extreme delays. I just want
to highlight a few of the things we have dealt with in the last
year and a half in my office. There is one veteran in my
district who filed a military sexual trauma case in February
2023 requesting a higher level review after previous denial.
Two months later, she received a response from the VA stating
they would found a, quote, duty to assist error. But there has
been no contact from the VA since then, and that was more than
a year ago. When our office reached out to the VA, we learned
that her claim is being processed at, quote, the Decision
Review Operations Center that specializes in military sexual
trauma cases, and that her claim is still in the decision
phase, awaiting distribution, quote, when capacity allows, more
than a year.
Another veteran submitted a disability claim after
experiencing a stroke. He has not heard anything back from the
VA in 8 months. Another veteran we were assisting in Kentucky,
he submitted a claim in early 2023 when he was diagnosed with
cancer. He was notified of a duty to assist error.
Unfortunately, he passed away in February of this year and
still has never heard back from the VA. These are the kind of
claims we are talking about today. These are the issues with
the process itself, with the distribution of the claims back
and forth between the NWQ division, the VBA regional offices,
and there are problems with the incentive structure for the
veterans service representatives as reviews are being
completely restarted when a federal deferral has been made
because of representatives that may be penalized for mistakes
made in previous stages of development.
Mr. Clark, my question is, what is the VA doing today to
address these problems and mitigate these inefficiencies,
especially considering the recommendations of the VBA Red Team?
Could you provide a concrete update on those recommendations,
for example, the timeline on fulfilling each of those
recommendations?
Mr. Clark. We are doing several things. First, we just had
a quality stand down day where we, rather than rating claims,
we took a look at all of the errors that we were making being
forthcoming here. Obviously, we do not get it right all the
time. When you rate or you make 2.4 million decisions in a
year, then some of them will not be right. But we understand
and we keep foremost in our minds that our purpose is to serve
veterans because decisions make changes in their lives. Our
quality standdown day, we used to do just that. We wanted to
find out what errors are being made and we provided training
that entire day. We did wellness training for 2 hours, and the
other six we provided training on mistakes being made. We will
continue that process. That was our down payment. Our first
time we have ever not produced ratings with the benefit
expectation that we will discern what errors we are making,
develop additional and better training products, and then
provide that training back to regional offices. This was a
joint VA central office, regional office endeavor, and it was
successful. Very successful. Again, our efforts here are to
continue to improve upon what we are doing.
Mr. McGarvey. Thank you. I appreciate your acknowledging
the errors, and I appreciate you stating the desire to improve.
That is something we all share. Just because of the limited
time we have here today, I am going to ask you my next
question, but do want to continue to hear from you all on what
you need to make sure these veterans are getting what they need
from the VA. My next question is going to be: the Veterans
Service Officers (VSOs) and American Federation of Government
Employees (AFGE) are here today to offer testimony as well, and
they are explicitly advocating for more special mission
regional offices, like the one processing Camp Lejeune water
contamination claims in Louisville, Kentucky, to manage the
claims that require this type of special handling. What is the
VA's response to those views?
Mr. Clark. Our response is we do specialized training, as
the VSOs mentioned, MST. I gave an example of military sexual
trauma. We discern the receipts, the amount of income and
claims coming in, and we need to keep our requisite indices at
a point that represents outstanding service to the folks that
make it possible for us to live in this great country. However,
having said that, we have a lot of work as a result of the PACT
Initiative, which we are responsible. We appreciate Congress
passing that bill and giving us the moneys and funding to take
care of that. We have hired a lot of people, and what we are
doing is funding these special missions and putting the amount
of resources in there to make sure that we provide optimum
service for veterans and their survivors and independents.
Mr. McGarvey. Thank you very much. I yield back.
Mr. Luttrell. Thanks, sir. The machine, the National Work
Queue, it is moving forward as best it can. You guys are doing
a great job. Okay, just , and I understand, and I say this
quite often in here. I mean, that is a very, extremely heavy
rucksack you guys are carrying. The committee here is kind of
pointing out a few things that we are trying to thread this
needle. From what we are hearing from everyone inside the
organization to the leadership, that is, there seems to be like
a hinge point or a choke point or a bottleneck, where because
what you are saying, Mr. Smith, is that the system is designed
to bring the information back to the originator of the file.
That is not what we are hearing. We are also hearing that, you
know, VSOs, sometimes they do not have enough work, and they
are sitting idly by while other VSOs are saying, hey,
overwhelmed. I think there is a more or less, maybe a glitch in
the matrix somewhere. We are trying to figure out exactly what
that looks like, because our concern is, one, is that the
individuals are not receiving information if they have made a
mistake, if it progresses up to multiple VSOs, because we--I
got to say, more or less here, that multiple VSOs touch a
single package more than one individual touches a package from
start to finish. But that kind of conflicts what you guys are
telling us today. Kind of help me out on this one, Mr. Smith.
Mr. Smith. It is possible that more than one Veteran
Service Representative will touch a single claim----
Mr. Luttrell. VSR. Excuse me, I am sorry.
Mr. Smith [continuing]. from start to finish. That is true.
We prioritize returning claims to the last regional office that
touched that claim so that they can use local rules to route it
back to the last VSR that touched the claim. However, if that
VSR does not have capacity, it has to go to someone. What we
are trying----
Mr. Luttrell. Who makes the decision. Is it a supervisor's
decision to move packets back down inside to the VSRs? It is
correct?
Mr. Smith. Yes. The division level and frontline
supervisors have the ability to leverage automated rules or to
make that decision.
Mr. Luttrell. Supervisor can make the decision to not push
that back down inside the organization and send it out into
the, what we most certainly would call the metaverse or the
NWQ?
Mr. Smith. No, they would have to send it back to another
employee at their regional office.
Mr. Luttrell. It will not leave the regional office and go
to another regional office somewhere in the United States? I
think that is--that happens.
Mr. Smith. Once it is been assigned to an office for
action, it is that office's responsibility to take full and
appropriate action to move that claim forward.
Mr. Luttrell. Until completion, or until it moves?
Mr. Smith. Until the next, until, you know, they have fully
developed the claim. Then it would be recalled to the NWQ to
wait for that evidence request to come back.
Mr. Luttrell. Then if that happens, it may not necessarily
go back down to give me a little rope here. It may not go down
to Houston. It will go to Ohio, or could possibly.
Mr. Smith. Could possibly. If there is not capacity at that
regional office that touched it, it could go to another place.
Mr. Luttrell. Okay.
Mr. Smith. Because we are trying to make sure that we are
sequencing these claims to get the fastest decision possible
for a veteran.
Mr. Luttrell. Should it go back to the original office from
start to finish?
Having discussions, it seems like there is--they are almost
having to start the process completely over if it leaves a
regional office. These are discussions I am having with my
particular office where I come from. I am not saying it is not,
it is not effective means of moving these packets. Again, I am
not trying to wire brush you here. I am just trying to make--
continue to increase the National Work Queue in a way that,
hey, we do not have outstanding numbers. We are down to zero
and with no mistakes. That is a grandiose statement. Just hear
me out on that one, Okay?
Mr. Smith. There is no shortage of work right now, sir. We
will push claims back whenever possible to the last regional
office that touched it. But again, like, if they do not have
the ability to take that claim because they are already, you
know, over their three and a half days worth of work onsite,
then it will go to another site.
Mr. Luttrell. That is a supervisor's call?
Mr. Smith. No. Well, that is part of the NWQ logic if it is
coming from NWQ down.
Mr. Luttrell. Okay, Mr. Pappas? Thank you.
Mr. Pappas. Thank you. I will not keep on that issue, but I
share the Chairman's concerns there. I think we have got a
system that is, you know, obviously quite complicated given the
nature of the work, but that there is duplication and
inefficiency here that, you know, we should continue to take a
look at.
I want to ask about one specific issue, and it was raised
in the VA OIG report, which identified over 10,000 specialized
herbicide related claims that were ready for a decision, but
instead were stuck in the National Work Queue Division and
committee staff continues to hear about this issue despite
corrections that have been made in response to the report. Can
you talk about specific actions that have been taken out of the
Office of Field Operations to improve these rule sets and what
progress you think has been made? What work needs to continue
to be done?
Mr. Smith. The work that was identified by the OIG audit
was related to the 2019 Blue Water Navy Act, as well as the
National Defense Authorization Act that added new Agent Orange
related disabilities. VBA at the onset knew that we were going
to have to re-adjudicate, I think, about 140,000 claims, and we
dedicated about a quarter of our workforce to doing just that.
We knew that we would develop, you know, that it would take
time to work through this massive workload that was identified
on one single day. But we also knew that we had to continue
providing benefits and services to people filing normal claims
each and every day. That is why we fenced off 25 percent of our
workforce. We communicated that to the court as well as to all
of our stakeholders, and we have made good progress. We have
resolved all of those claims. We continue to receive some new
claims, but we continue to get them worked as quickly as we
can.
Mr. Pappas. The 10,000 that were mentioned in the report,
those have all been resolved?
Mr. Smith. I believe so, yes.
Mr. Pappas. Okay. There are additional claims that continue
to be processed, you know, through, under the same
circumstances?
Mr. Smith. Correct. On that basis, for, you know, as new
veterans and survivors identify claims based on Blue Water Navy
Service or the three new Agent Orange presumptives.
Mr. Pappas. Okay, well, we will certainly bring you
specific examples if we do still have some pending, but
appreciate your attention to those. I yield back.
Mr. Luttrell. Thank you, Mr. Pappas. Mr. Self, you are
recognized for 5 minutes, sir.
Mr. Self. Thank you, Mr. Chairman. As I have listened to,
just real quickly, as I have listened to all the comments about
the redundant work, it looks to me like we might have multiple
ROs for any single claim. We might have multiple VSRs for any
single claim, and we might have multiple RVSRs for any single
claim. Again, I just share my colleagues comments with, it
looks inefficient. I want to go to MST's backlog. You
consolidated back in November 2023, right? Puerto Rico.
Mr. Smith. Yes, sir.
Mr. Self. The backlog looks to be growing by basically
several hundred per month over the 6-months between October and
April. Then in April of this year, you designated 225 out of
478 Full-Time Equivalents (FTEs) at Roanoke to help process. My
first question is, from a managerial standpoint, were those 225
people gainfully employed before you redesignated them? Since
you have redesignated them, what has fallen through the cracks
of what they previously did, or were they gainfully employed?
Mr. Clark. They were gainfully employed.
Mr. Self. What is fallen through the cracks now that you
have redesignated them to work on MSTs?
Mr. Clark. Well, MST claims are part and parcel of the
general population of claims, so we are working all of those
claims. It is not a separate subset.
Mr. Self. What were they, Mr. Clark?
Mr. Clark. Yes, sir.
Mr. Self. What were they doing before you put them onto
MSTs, and what is falling through the cracks? Because 225 is a
significant workforce across all of VA, I would submit. I fail
to see how you have taken 225 employees out of some function,
put them toward MSTs, and something is not suffering.
Mr. Clark. Our backlog is being reduced. You made a comment
which was spot on when you mentioned that the inventory in MST
had been going up.
Mr. Self. Right.
Mr. Clark. We were not meeting receipts. Receipts were
coming in faster than the output. While we do not like for that
to happen, it was a result of a couple of things. Just like in
the general population of claims, we crested at a particular
point and receipts. We used mandatory overtime to assist us in
exceeding the receipts, thus lowering the backlog. Right now,
in MST, we have actually crested and the inventory is going
down just like it is going down in the rest of the remaining
cases. We realize we have a lot of work. This is why we are
producing 2.4 million, and we have exceeded, on pace to exceed
that again this year.
Mr. Self. Okay, so a simple question. Let us simplify this.
What were these 225 FTEs doing before they got assigned to
MSTs?
Mr. Clark. They were working the remaining. They were part
of the 2.4 million claims that we had worked for the year.
Which are part of that general number of claims. I understand
your question. It is as if they are now what they are not doing
is working the remaining portion of that 2.4 million. But keep
in mind, sir, we are hiring new individuals every month. We are
training new individuals and we are working overtime to make up
for the work they are not doing with the regular output of
claims.
Mr. Self. Right. You peaked at 600,000. What is your
backlog? Total backlog today in the NWQ?
Mr. Smith. The total rating claims inventory backlog right
now is about 278,000. That is as of end of May.
Mr. Self. Okay. Thank you. I yield back.
Mr. Luttrell. Thank you, Mr. Self. That is down. What was
the number at the start of the year? I am sorry, Mr. McGarvey,
I am jumping in front real quick.
Mr. Clark. That was an excess of 400.
Mr. Luttrell. 400, now it is down to 200. Okay.
Mr. Clark. Yes. We are, again, going back to your question,
sir. The inventory is going down across VBA.
Mr. Luttrell. You good? Okay. Okay. Mr. Clark, Mr. Smith,
thank you for your time. You are excused. Second panel. You are
welcome to join us, please. You guys ready? Outstanding. Thank
you for coming today. I will introduce our second panel. Mr.
Herman Breuer, Policy Director of the National Association of
County Veterans Service Officers. Ms. Ashlynne Haycock-Lohmann,
Deputy Director of--I got it right? All right. Deputy Director
of Government Legislative Affairs at the Tragedy Assistance
Program for Survivors (TAPS). Mr. James Swartz, President,
local president, Local 2823, American Federation of Government
Employees. I ask that you all please stand. Please raise your
right hand.
Do you solemnly swear that the testimony you are about to
provide is the truth, the whole truth and nothing but the
truth, so help you God? Thank you. Please be seated. Let the
record reflect that the witnesses have answered in the
affirmative.
[Witnesses sworn.]
Mr. Luttrell. Mr. Breuer, you are now recognized. 5
minutes, sir, for your opening remarks.
STATEMENT OF HERMAN BREUER
Mr. Breuer. Distinguished members of the subcommittee, the
National Association of County Veterans Service Officers,
commonly referred to as NACVSO, thanks you for the opportunity
to provide testimony before you today, as well as for your time
and your dedication to improving the benefits for the men and
women who have worn our Nation's uniform. I am here today to
bring to your attention some opportunities for refinement as it
pertains to the claims adjudication process. As you are all
aware, and I am happy to attest, the VA claim process has been
significantly reduced with the implementation of the NWQ, but
further efficiency can be achieved by enhancing collaboration
between VA representatives and the veterans advocate to
expedite the collection of necessary information and evidence.
I am an army veteran of the Iraq War. I was wounded by an
Improvised Explosive Device (IED) in March 2004. My personal
experience with VA came at a time when documents were reviewed
on paper rather than electronically. The initial development of
my own claim took approximately 14 months, primarily to the
delays caused by the location of my medical records within the
Pennsylvania Army National Guard. A year after returning home,
I became a Veteran Service Officer. Delays in the disability
process were evident, particularly during the development
phase, and I would like to emphasize that. At that time the VA
would issue a development letter called the Veterans' Claims
Assistance Act (VCAA) Notice Response. Similar to today's 5103
Notice. This letter allowed veterans to declare whether they
had submitted all of their evidence or needed an additional 30
days to gather more. The Regional Office would only send this
letter after opening the mail and beginning to build the file,
a process that often took 60 days. If the veteran did not reply
promptly, they would then issue another letter 30-day response
time, perpetuating a cycle that could extend the claim
development phase up to 12 to 18 months, and that is an extra
year plus before veterans could even attend a compensation and
pension exam.
As an advocate at that time, we submitted the claims by US
Mail or fax and then we waited. These delays were frustrating,
especially when telling veterans or their dependents to be
patient, many of whom had just returned from Walter Reed, where
they were literally patients just being patient. The practice
of transferring files from busier ROs to less busy ones helped
reduce workloads, but continued to add delays. The transfer
process taking a minimum of 30 days to complete the National
Work Queue was introduced to address these types of issues.
While it was initially met with skepticism from advocates who
feared losing the personal touch of knowing the right people in
their RO, which can be very helpful to the advocate.
Personally, I welcomed the NWQ as I fielded hundreds of calls
each month from veterans and dependents inquiring about the
status of their claim. The NWQ, combined with the fully
developed claim process led to noticeable reductions in wait
times.
Now that the NWQ has been standard operating procedure for
the last 8 years, we can provide an honest assessment. The NWQ
system is a solid improvement, but I know we can make it
better. To optimize this system, it is crucial to truly partner
with the advocates on the ground. If a Veteran Service
Representative or a Rating Veteran Service Representative sees
that a claim requires additional information or evidence, they
should first work together with the veteran and then the
veteran's accredited representative to obtain that information
expediently. Currently, a phone call or email will be sent to
the veteran alone, and if they do not respond immediately, the
claim is returned to the NWQ for an additional 30 days. In the
past, the VA was shuffling paper and files manually. Today, the
shuffle still occurs, but it is digitally. Seeing this happen
as an advocate can be extremely frustrating. Unfortunately,
there are incentives in the current system to kick the claim
back to the NWQ because there are no risks to following the
procedure to the letter. The unfortunate outcome is that this
often leads to unnecessary delays in benefits to a veteran who
may desperately need them. By adding contact between VSRs,
RVSRs, and a veterans accredited representative as a required
step within the development procedure, we will empower those
with the greatest understanding of the claim to collaborate on
behalf of the veteran. This will also discourage delays in the
claim development, all while making that personal touch to the
NWQ that detractors were initially so worried about.
In conclusion, while the NWQ has brought about many
improvements, fostering a collaborative relationship between VA
and veteran advocates will further enhance the efficiency and
effectiveness of the claim process, minimizing delays and
ensuring that veterans receive the benefits that they deserve
in the timeliest manner possible. Chairman, Ranking Member and
members of the subcommittee, thank you for the opportunity to
share your input from the field regarding the issues before the
panel today. We look forward to your continued work together
and we would be happy to take any questions for the record.
Thank you.
[The Prepared Statement Of Herman Breuer Appears In The
Appendix]
Mr. Luttrell. Thank you, sir. The written statement of Mr.
Breuer will be entered into the hearing record. Ms. Haycock-
Lohmann, your opening statement. You have 5 minutes.
STATEMENT OF ASHLYNNE HAYCOCK-LOHMANN
Ms. Haycock-Lohmann. Chairman Luttrell, Ranking Member
Pappas, and distinguished committee members, the Tragedy
Assistance Program for Survivors is grateful for the
opportunity to testify on behalf of the over 120,000 surviving
family members of all ages, representing all services and with
losses from all causes, who we are honored to serve. TAPS
appreciates the committee for holding this important hearing as
challenges with the National Work Queue are one of the biggest
pain points in the survivor community. The most crucial is for
our surviving children. If a surviving child turns 18 before
graduating high school, dependency and indemnity compensation
should be paid to the child through high school graduation.
This is not happening. TAPS has consistently raised this issue
with the VA over the past 5 years. Unfortunately, the VA has
yet to develop a way to process these claims in a timely
manner, leading to 18 months and longer delays in payments for
these students. These should be easy supplemental claims, but
every child has experienced a delay in payment due to the lack
of a reasonable process.
The biggest challenge is that instead of these forms
automatically dropping into the National Work Queue, they
disappear into a file and have to be manually placed into the
NWQ for processing. Many of these surviving children give up
after years of trying and never receive the back pay they are
owed. In addition, not only is DIC supposed to be paid until a
child graduates high school, they should receive DIC for the
months between graduating and starting college. Despite this
being the law, students are rarely paid during those summer
months. This is happening during an incredibly financially
difficult time for our surviving families when costs for
graduation, college applications, deposits, and other costs are
incurring. VA has put forward a proposal to address both issues
by updating VA form 21-674 to allow both the child and parent
to sign, as well as an option for students to acknowledge that
they will be using education benefits the following semester.
Their expected timeline on that updated form is 18 to 24 months
from the January oversight hearing. At that point, they intend
to look at the larger problem, the fact that these forms do not
automatically drop into the National Work Queue.
TAPS recommends a process for students to submit a single
school certification form that will generate into the NWQ.
Additionally, the VA's education services should be required to
notify the pension management center of a surviving child
enrollment and education benefits. Most importantly, TAPS
highly recommends that the Office of Field Operations
prioritize the fix to automatically drop these claims into the
National Work Queue. TAPS also has concerns about the current
wait times we are seeing for initial claims for DIC. We have
seen cases where the where the processing time is over a year
for an initial claim. We are also concerned that the response
our team is receiving from VA has generally been along the
lines of we are backlogged. A case example of this is a Navy
Vietnam veteran who died in June 2023 from Chronic Obstructive
Pulmonary Disease (COPD) as a result of Agent Orange exposure.
His surviving spouse applied for accrued benefits in DIC in
September 2023. In December, she received a request for
additional information as they did not have him listed as
having deployed to Vietnam. The surviving spouse immediately
provided the relevant information. TAPS reached out to the VA
for an update on the status of the claim in February 2024 and
received a response on April 8th. At that time, TAPS was
informed that there had been no movement on the claim. TAPS
followed up on May 6th and again on June 6th, where it was
confirmed that claims processing was quite behind and that
processing for many Agent Orange claims for non-Vietnam boots
on the ground in littoral waters are temporarily suspended.
We understand that many of these DIC cases are incredibly
complicated due to challenges such as contributing factors not
being listed on death certificates, but the delays leave
surviving families and financial hardship in the interim.
Additionally, because the backlog is so high at the
Philadelphia Regional Office where most of the DIC claims are
processed, they have been sending them to Milwaukee, who
appears to be ill equipped to handle them. We have seen several
letters that were erroneous due to the backlog. One example is
a letter that stated denied service connection on the first
page, but all subsequent pages stated that the service
connection was approved. VA did later confirm that the death
was ruled service connected and that the letter was erroneous
due to human processing error. VA has confirmed that they have
hired 35 new Veteran Service Representatives and 25 new Rating
Veterans Service Representatives that should be fully trained
in August. We are hopeful that this will fix the backlog in
Philadelphia.
In conclusion, while we appreciate VA sharing these
updates, our biggest challenge has been and still is a lack of
updated timelines. We know that the additional staff will help
decrease wait times and clear the backlog, but an updated
timeline would help TAPS and survivors better manage
expectations for such critical benefits. We thank you for the
opportunity to testify today and I look forward to your
questions.
[The Prepared Statement Of Ashlynne Haycock-Lohmann Appears
In The Appendix]
Mr. Luttrell. Thank you, ma'am. The written statement of
Ms. Haycock-Lohmann will be entered into the hearing record.
Mr. Swartz, you are now recognized for 5 minutes to deliver
your opening statement.
STATEMENT OF JAMES SWARTZ
Mr. Swartz. Chairman Luttrell, Ranking Member Pappas, and
members of the subcommittee on behalf of AFGE and the National
VA Council (NVAC), I appreciate the opportunity to testify
today. My name is James Swartz, and I am President of AFGE
Local 2823, representing the Cleveland, Ohio VBA Regional
Office. I am a US Army vet service connected disabled veteran
and have had the privilege of continuing to serve my fellow
veterans, first as a registered nurse at the Cleveland, VA and
then in VBA for the last 23 years. On behalf of the 304,000 VA
employees AFGE represents, including thousands of claims
processors, it is a privilege to offer AFGE's views on the
National Work Queue and how VBA could better utilize this tool
to serve veterans. I also want to personally thank Chairman
Luttrell and Ranking Member Pappas for attending the AFGE VBA
roundtable in February of this year, listening to the frontline
employees and holding today's hearing.
Before the National Work Queue, each Regional Office sorted
claims into an efficiency lane, regular lane, and special
operation lane. AFGE agrees with the Inspector General's (IG)
2018 conclusion that VBA's decision to eliminate specialization
of claims processing had harmed veterans with more complex
claims. VBA has heeded those recommendations and created
several special operations centers, allowing claims processors
to repeatedly use their nuanced experience and expertise on
certain complex claims benefiting veterans with these
conditions. AFGE encourages VBA to identify additional complex
claims suitable for special operations centers. The VBA should
reestablish the efficiency in moderate lanes. An efficiency
lane provides newer claims processors a chance to hone their
skills and gain experience. Also, the veteran will not have to
wait in line behind more complex claims and receive benefits
sooner.
Within these lanes, there should be a first in, first out
system to ensure that veterans of all complexity levels receive
timely benefits. VA should modify the National Work Queue so
that the claim remains within the same Regional Office for the
duration of its processing. Variations between regional offices
can cause claims processors from different regional offices to
misunderstand each other's work and result in correct claim
being unnecessarily deferred. Furthermore, by keeping a claim
in a single Regional Office, managers have more control to send
claims back to the original VSR who worked on it. This would
allow VSRs to learn from the error and not repeat it,
especially because the employees are responsible for any error
that occurred prior to them receiving it. This would also let
the VSR and RVSR who are already familiar with the claim
quickly address follow-up work, saving other employees from
using time to familiarize themselves with a new claim.
Despite the claims backlog, one of the most consistent
complaints from claims processors is that they are not assigned
enough work to meet their performance metrics and must wait
time asking for more work. The reason for this problem is the
internal controls VBA has put on the National Work Queue. To
address this, AFGE recommends, first, the National Work Queue
should automatically provide claims to an individual claims
processors work queue when they are out of cases to develop a
rate. Second, claims processors should have the limited ability
to temporarily hold onto a claim before it is retracted by the
National Work Queue. Claims processors will benefit from the
National Work Queue, notifying them on how much longer they
have to work on a claim before the claim is retracted. Having a
claim stay within one Regional Office for its duration would
avoid delays and give ROs more control over their workload.
Third, the National Work Queue must better filter automatically
ready to rate cases, ensuring employees do not waste time on
cases that the National Work Queue can determine are still not
ready to rate. Fourth, VBA should program the National Work
Queue so employees who have previously worked on the claim have
claims returned to them. This would allow claims processors to
learn from any mistakes that were previously made and improve
efficiency.
Each veteran's claim could have many contentions not
necessarily related to each other. Often, some contentions are
developed and ready to rate prior to other parts.
Unfortunately, VBA has an internal metric that awards credit to
regional offices only on the claims that are rated and
promulgated on all contentions. For example, if a veteran's
claim has ten contentions and nine can be advanced prior to
providing benefits, VBA does not credit ROs for rating almost
completed claims. In contrast, individual claim processors are
incentivized based on actions taken, not claims completed. The
incentives that the RO's and claims processors have should be
aligned so that they are working toward the same goal.
Otherwise, the claims processor is pressured to complete a
claim that may not be ready. AFGE and NVAC stand ready to work
with the VA committee and VBA to fix the national war queue to
better serve veterans. Thank you, and I look forward to
answering your questions.
[The Prepared Statement Of James Swartz Appears In The
Appendix]
Mr. Luttrell. Thank you, sir. The written statement of Mr.
Swartz will be entered into the hearing record. We will move to
questioning. Mr. Swartz, have you had that exact conversation
about internal controls with any leadership in the National
Work Queue infrastructure?
Mr. Swartz. Thank you for your question. I have had that
conversation with multiple levels of VBA leadership, including
the director at the Cleveland Regional Office. Well, as we are
sitting here today, a lot of it has not been taken really into
consideration.
Mr. Luttrell. Who in that? Who in the organization? Let us
just say the committee was to have a hearing, and I am taking
the internal controls and that list you just rattled off. Who
needs to be sitting there in front of us to talk to about this?
Mr. Swartz. I believe, sir, the best. Thank you for that
question. I believe the best answer to that would be Mr. Clark.
Mr. Luttrell. I am sure Mr. Clark is listening to
everything you just said because he is still in the room with
us. Next time I will be curious to see if any of those internal
controls have been moved left or right of center. They seem to
be viable, in my opinion. It comes--when it comes from your
organizations and you all. I mean, you are the ones that are
getting dirty. It seems like it would be a good win.
Ms. Haycock-Lohmann, with the age limit on the coming out
of high school, what is the pushback and why? Okay, so I am
trying. When you said that, I have been trying to play this out
in my head, and believe it or not, I graduated high school with
a guy that was 20 and I am, you know, from the South Texas
area. You know, we kind of stretch it out a little bit. We like
to do that. But what is the give or take on this one? Why is it
18 and you are done? Because I get that. But play this out for
me.
Ms. Haycock-Lohmann. We understand all benefits generally
end at age 18. Just reaching majority. That is about the age
most children graduate high school. I graduated at 17, my
brother graduated at 19. But kind of in that age range. But
what we are seeing is that they cannot figure out whose issue
this is. Pension and fiduciary has said it is an Office of
Field Operations issue of OFO just told us that it is a policy
issue.
Mr. Luttrell. There is an argument between two
organizations trying to figure out who is supposed to handle
it.
Ms. Haycock-Lohmann. Correct.
Mr. Luttrell. That just keeps going back and forth?
Ms. Haycock-Lohmann. Yes.
Mr. Luttrell. Okay. I am assuming we have those names. We
will address that for you. Thank you. Okay, Mr. Breuer, it is
almost the same question as I asked Mr. Swartz, in your opening
testimony, the information you provided is the receiving end of
that conversation, are they receptive of what you are saying?
Mr. Swartz. We have addressed that at the highest levels.
Mr. Luttrell. What is--Okay.
Mr. Swartz. Secretary.
Mr. Luttrell. The Secretary? Mr. McDonough?
Mr. Swartz. The Secretary.
Mr. Luttrell. Okay. Mr. McDonough is always very open eared
and wide eyed when he is in front of us. I am going to just
make the assumption that he was very--he received that very
well?
Mr. Swartz. Absolutely.
Mr. Luttrell. Should I make the assumption, which I
normally do not do, that once it goes down inside the
organization is where it hits friction points?
Mr. Swartz. I would think that is correct.
Mr. Luttrell. Okay, interesting. Mr. Pappas. Go ahead, sir.
Mr. Pappas. Thank you. I appreciate all of your testimony.
I think you contribute greatly to this discussion. Mr. Swartz,
maybe I can start with you. I think you gave us some terrific
ideas that we should be taking a look at and working with VA on
here. Is there a top priority that you can name that will help
us address the effectiveness of the National Work Queue?
Mr. Swartz. Thank you for that question. Yes, sir. I think
the top priority would be that the Regional Office would
receive the claim and keep it through its entirety. I believe
that the rationale behind that would be for the relationship
between a VSR and the RVSR. If there is a question about some
development that was done, it could be answered immediately
without having to worry about sending emails or trying to get
somebody that perhaps works in a different time zone. With a
lot of that as well, it also gives better control over the
workflow within the Regional Office itself. While an employee
is responsible for any of the errors that are called before
them, as an employee, I would rather be responsible for my own
errors and to be able to learn from them so I could correct it
and develop as an employee, and also to ensure that the claims
are being done as efficiently as possible.
Mr. Pappas. Well, no one knows this work better than you
and the other VBA employees, so we are grateful for that
suggestion. Wondering if you can elaborate on the benefits of
specialization and claims processing, and if you feel like
there are other areas where we should move toward special
missions?
Mr. Swartz. Thank you. The specialization, I believe, is
very important if they were to keep the different lanes. For
instance, the MST claims, you have certain areas that you have
to go to get the information, certain things that need to be
addressed specifically for development of that claim or that
type of claim. If you have specialized areas that are doing it,
they are more familiar with it and less likely to make
developmental errors. That would allow for employees to move
quicker and also for greater accuracy in those decisions. The
same would go for the Blue Water Navy or any of the other
claims that there are in specialized lanes. As far as it goes
with any of the other things that need to be specialized at
this point. That may be a little bit farther than I am able to
answer at this time, but I am more than happy to look into it
and follow up with your office.
Mr. Pappas. Terrific. Thank you. I have heard a great deal
about the production quotas, Mr. Swartz, from workers in the
Regional Office in my district, but also from that roundtable
discussion we had with VBA employees. It creates an environment
that incentivizes Regional Offices to prioritize throughput
over quality in some circumstances. Is that a concern of yours?
Are you seeing that? What recommendations would you have with
respect to production quotas?
Mr. Swartz. Thank you for that question. I believe that,
yes, that is a very big concern that we have as employees, and
also for the union as well. When they have certain. As I
mentioned earlier, the Regional Offices have metrics of claims
completed per month. As a result of this, often less complex
claims are moved to the head of the list so that they can
increase their production. This usually occurs during the
overtime where I have been told that the rationale behind that
was a greater bang for the buck. My response to that was, we
are not a business, we are a Federal Government agency. We do
not have investors, we have constituents. All veterans deserve
to be treated fairly and equally, despite the number of claims
that they may have. I do think that it is used by the Regional
Offices to meet self-imposed metrics from either CO or from the
office itself.
Mr. Pappas. Mr. Breuer, would you agree that the
performance production quotas, excuse me, create some different
incentives and that affect the performance of the National Work
Queue?
Mr. Breuer. Absolutely. What I see is that, you know, when
we are looking at the claims through VBMS, and we are working
remotely out there with the boots on the ground, and we are
watching in real time as that claim gets processed, we are
painfully watching a claim get returned to the NWQ for some
piece of evidence that was missing. That is why we are asking
for more cooperation from the VA with the veterans advocates on
the ground, because that could have been taken care of
immediately, either by phone call, email, fax, whatever medium
that they chose. We could have given that information and
avoided that, extending the life of that claim.
Mr. Pappas. Great. Thank you. I am out of time, so I will
yield back.
Mr. Luttrell. Thank you, Mr. Pappas. Mr. Self, sir, you are
recognized for 5 minutes.
Mr. Self. Thank you Mr. Chairman. For each of you, what do
you think the percentage of backlog is reasonable? Percentage
of the total claims? Backlog of total claims over the year?
What is a percentage?
Mr. Breuer. In my opinion, I would say maybe 10 percent.
That may even be too high. I do not see why we have the backlog
that we have.
Ms. Haycock-Lohmann. I would say probably no more than 5
percent. But once again, we do not see any reason why there
should be a backlog.
Mr. Swartz. Thank you for the question. I would actually
think that the backlog itself, and this is going to sound a
little bit backward, the backlog should not be the major
concern. It is the timeliness that it takes to get the claim
from beginning to end is where it needs to be, the efforts need
to be concentrated. As a veteran, I actually think that the
backlog, as long as things continue to move appropriately,
means that the VA is actually reaching out to more and more
veterans, and more and more veterans are applying for the
benefits that they deserve.
Mr. Self. Okay, so it looks to me, if I heard Mr. Clark
right, we are at about 10 percent right now, and I think for
anyone to have that. Mr. Swartz, I want to read from your
written testimony. Now understand who Mr. Schwartz is. He is
the President of a Local Union. Is that correct?
Mr. Swartz. Yes sir, that is correct.
Mr. Self. I quote from your written testimony, despite a
claims backlog that has significantly grown following the
enactment of the PACT Act, one of the most shocking yet
consistent complaints from claims processors is that they are
not assigned enough work to meet their performance metrics and
must frequently ask their coaches for more claims to work on.
Mr. Swartz, why is that in your written testimony?
Mr. Swartz. Thank you for that question. The reason that is
in my written testimony is because the way the National Work
Queue works, if you have not been able to address a claim quick
enough within the 3-days or whenever it was put into your
queue, there is a certain amount of time, the National Work
Queue will pull it back into the void. A lot of times they will
do that at the end of the day, so often you will have the
people who promulgate or complete the claim itself cut the
check, so to speak, will not have work in the morning because
anything that was already made, completed will go back, and
then the National Work Queue will redistribute that work in the
morning. Which is one of the reasons I think if you keep the
work at the Regional Office from being beginning to end, you
could avoid a lot of that problem.
Mr. Self. My point, and I think we need to explore this
because I think that is a major issue and I will be putting in
a question for the record. Mr. Chairman, I yield back.
Mr. Luttrell. Thank you, Mr. Self. Mr. McGarvey, you are
recognized for 5 minutes, sir.
Mr. McGarvey. Thank you, Mr. Chairman. Appreciate you all
being here today. I think regardless of where things come out,
what you see is we need to do everything in our power to ensure
that all of our veteran's claims are processed accurately and
efficiently. Of course, that means without delay. I appreciate
your testimony to this committee so that we may better
understand what steps need to be taken to improve the system.
Ms. Haycock-Lohmann, in your testimony, you suggest the VA
increase the number of Special Mission Regional Offices to
manage the development, rating, and promulgation of claims that
require special handling. I understand VA did operate this way
prior to the National Work Queue, which was designed to improve
the efficiency of all claims. But given the specific expertise
required for special mission claims, the VBA has been bringing
them back. My question is, I am curious what you think are the
risks and benefits of implementing these specialty offices.
Under the NWQ system, the special mission claims are delayed
when there is a lack of specific expertise needed to complete
the development and rating these claims. But then when there is
a specific team with that particular expertise, claims may be
delayed due to staffing shortages on those teams. Just truly
asking you, what is the right balance?
Ms. Haycock-Lohmann. I do not know if that was specifically
in our testimony, but where we have seen specialization work
very, very well has been the Philadelphia office, where they
handle an overwhelming majority of DIC claims. Claims that are
straightforward move very quickly if it is very
straightforward, if everything is in the file to begin with, we
see turnaround oftentimes for an initial claim in three to 9
months. Where we see issues is these less straightforward
claims. Issues with things like the death certificate stating
the cause of death as heart failure, but that heart failure was
caused by cancer, or as they were declining, something along
those lines, and the coroner's office is not putting those on
the death certificate. The extra steps of having to prove that.
But we have found that having those cases very specialized has
helped at least increase the process. But of course, we do see
a major backlog right now in those processes, because they are
understaffed. Though, VA has assured us that they have hired
about 55 new VSRs and RVSRs that are expected to start, start
July 1st and be fully operational by August.
Mr. McGarvey. Thank you. You know, sometimes up here we ask
questions to make a point. Sometimes we ask questions to get
answers. I am truly interested in the answers of these
questions. Mr. Swartz, I will go to you next. Thank you for
your service. What are your thoughts on the risks and benefits
of implementing more specialized offices?
Mr. Swartz. As far as the risk of more specialized offices,
I think that it is very low risk. The more specialized offices
we have, as I had mentioned in the testimony, that the
different nuances for the development of specialized areas
would be a lot more efficient. If you have people who are used
to doing it and know what tools and where to go for the
information, I could only see it benefiting. The slightest risk
that I could see is if everything is specialized, then the less
or non-specialized claims, you only have so many employees.
Even with the PACT Act, we have a lot of employees that came on
who have really little experience at this point. But the more
people that are pulling the different carts in different
directions, it is going to leave less employees to handle more
generalized claims.
Mr. McGarvey. Thank you. Mr. Chairman, I yield back.
Mr. Luttrell. All right, ladies and gentlemen, thank you
very much. Thank you to all the witnesses for testifying for us
today about the important issues of ensuring that National Work
Queue accomplishes the goal and timely processing of all types
of veterans and survivors claims, and ensuring that the
National Work Queue allows VA employees to learn from their
mistakes when developing claims. With that, I yield to the
Ranking Member for any closing remarks.
Mr. Pappas. Well, thank you, Mr. Chairman, for holding this
session. I thank all of our witnesses for their testimony.
Clearly, this is an issue where I think we have received some
important feedback that we have to continue to dig in on. But I
just want to thank all those who assist veterans, all our VA
workers, for what they do each and every day. We have got to
make sure that the systems that are in place ultimately are
serving our end veterans in the best way possible, the most
efficient way possible, and that we are rewarding those who are
doing this work. I think we have got some constructive feedback
that we can get to work on here, and look forward to working
with you, Mr. Chairman, on some improvements. I yield back.
Mr. Luttrell. Thank you, Mr. Pappas. Thank you all for
joining us. Mr. Clark, Mr. Smith, again, thank you for taking
the time today. I ask unanimous consent that all members have 5
legislative days to revise and extend their remarks and include
extraneous material without objection, so ordered. This meeting
is adjourned.
[Whereupon, at 12:23 p.m., the subcommittee was adjourned.]
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A P P E N D I X
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Prepared Statements of Witnesses
----------
Prepared Statement of Willie Clark
Good morning, Chairman Luttrell, Ranking Member Pappas, and Members
of the Subcommittee. I appreciate the opportunity to appear before you
today to discuss the efficacy of the Department of Veterans Affairs
(VA) National Work Queue (NWQ) I am joined today by Mr. Kenneth Smith,
the Assistant Deputy Under Secretary directly responsible for NWQ.
VA is committed to providing outstanding customer service to all
Veterans, their families, and their survivors. VA built its NWQ with
this goal in mind: to ensure that our claims processing workforce
renders timely benefit eligibility determinations to Veterans,
especially those who have been waiting the longest for a decision or
fall into one of the agency's priority categories. Today I will focus
my testimony on the purpose and functionality of claims distributions
by NWQ for the Veterans Benefits Administration's (VBA) disability
compensation, pension, survivor, and decision review programs.
NWQ Purpose and Functionality
Prior to implementing the NWQ in 2016, the Veterans Benefits
Administration (VBA) historically processed claims according to the
beneficiary's State of residence and addressed imbalances in workload
distribution by manually transferring large cohorts of claim files from
one regional office (RO) to another who had greater processing
capacity. This manual transfer process, known as ``brokering,'' was
able to address small workload imbalances, but it was impossible to
adjust each RO's workload in ``real time,'' address large or chronic
capacity shortfalls at some ROs, or enforce a ``first in, first out''
strategy uniformly, while also ensuring VA priority claims were
addressed expeditiously. VBA's national brokering strategy relied on
shipping massive quantities of paper files between ROs across various
states. Once entirely paperless in 2015, claims could be moved
electronically, but still through a very labor-intensive process that
replicated the paper-based manual brokering due to a lack of central
management structure or a workload distribution functionality to
support daily reprioritization and assignment of oldest claims or local
rules to assign claims to individual employees. Now, national claims
distribution using automated rules allows more consistent and reliable
means for distributing workload to the field, leading to improvement in
customer service by reducing variance in processing timeliness across
RO, regardless of where the Veteran or survivor lives. Prior to NWQ,
claims awaiting initial evidence development at one RO waited an
average of 123 days, while at another, claims in the same cycle were
waiting 15 days--a 108-day variance. Today, that same variance is
approximately 5 days.
NWQ Workload Distribution
The NWQ is a rules-based, technology solution that automates
workload distribution to assign the national workload assignment to the
existing capacity at each RO or special mission site. The Central
Office NWQ Team is comprised of 28 employees, about half of whom are
Veterans themselves, conduct daily reviews and assessments of VBA's
entire workload, adjusting as necessary to ensure equitable
distributions via automated production jobs. Each night, NWQ's rules
engine ranks claims based on age and priority to assign claims for
action while also balancing the national workload across all ROs to
provide the same level of timely customer service to Veterans, their
family members, and their survivors, no matter where they live. As the
VBA team assesses the distribution, they make adjustments and
additional claim assignments to ensure the oldest and highest priority
claims are distributed to deliver benefits decisions as timely as
possible.
At times, the implementation of new legislation, such as the
Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT
Act) and the Blue Water Navy Vietnam Veterans Act of 2019, or court
orders like those in the Nehmer case have increased workload demands
through an influx of new claims or re-adjudications. In other
instances, unexpected circumstances such as the coronavirus disease
(COVID-19) pandemic have disrupted supply chains and slowed processing.
Local circumstances, such as weather related emergencies, can be easily
mitigated by NWQ's capability to quickly recall and redistribute claims
from impacted offices. Despite these challenges, using a national
workload distribution system has been very successful in leveraging
resources to balance workload across the Nation and help VBA rapidly
recover from unforeseen challenges.
The NWQ's daily rules ensure that each RO has approximately 3.5
days' worth of work, which ensures that all employees have sufficient
work to complete based on their performance standards. RO performance
metrics are structured to ensure that claims are worked within 3 days
of assignment to the RO. This process ensures that VBA uses full
capacity to produce decisions, and that the oldest and highest priority
work as distributed by the NWQ continue to advance through the process
efficiently. As VA has added new staff, its capacity has increased. NWQ
now recalls and distributes more than 130,000 claims per day, which has
led to a historic increase in output--in Fiscal Year (FY) 2024 as of
May 31, 2024, VBA completed more than 10,000 disability and survivor
claims in a single day 70 times.
From October 1, 2021, to May 18, 2024, thanks to Congress' support
for additional staffing through appropriations and new legislation such
as the Toxic Exposure Fund, VBA has onboarded 15,142 claims processors;
4,912 were onboarded during Fiscal Year 2022, and 10,230 were onboarded
from the start of Fiscal Year 2023 to May 18, 2024. The change in
onboarded staff improves VBA's claim processing capacity, with
approximately 59.3 percent more onboard claims processors than Fiscal
Year 2021 levels. Using the NWQ as a national workload distribution
tool provided a huge return on investment by allowing VBA to hire the
most qualified candidates across the country and balance workload
through distribution rather than being constrained by local labor
markets. This hiring flexibility supports continued improvements in
claims processing performance and efficiency.
As the VA Office of Inspector General (OIG) noted in its report
published on May 8, 2024, the NWQ's distribution of work is limited to
the capacity of each RO to complete the work timely.\1\ This capacity
is based on the experience level of employees in their position and the
number of employees at the RO. Through training and mentoring, VBA
expects claims processors to improve in proficiency during the first 2
years in their position. Although VA has hired a record number of new
staff, it continues to improve its quality and output to reduce the
increased backlog that resulted from the short-term surge in claims
following passage of the PACT Act. In the 22 months since the PACT Act
was signed into law, VA has received on average 195,857 claims per
month. In comparison, in the 22 months prior to PACT Act being signed
into law, VA averaged 138,345 claims received per month, an increase of
over 57,000 claims per month. On January 4, 2024, the backlog, which
are compensation and pension rating claims pending greater than 125
days, peaked at 423,179 claims, but has since been reduced by over 32
percent, and on May 2, 2024, the backlog fell below 300,000 claims.
Overall inventory has been reduced by over 13 percent from the
beginning of Fiscal Year 2024. At the end of May 2024, VBA completed
28.6 percent more claims compared to the same time last year, and it
even completed its one millionth claim of the year on March 1, 2024,
more than a month faster than last year. Thanks to the NWQ's continued
distribution of the oldest claims first, at the end of May 2024, VBA's
Rating Average Days Pending (ADP) was 115 days and Non-Rating ADP was
112 days, each consistently averaging well under backlog status of 125
days.
---------------------------------------------------------------------------
\1\ Delays Occurred in Some Veterans' Benefits Claims While
Awaiting Decision, available at https://www.vaoig.gov/.
---------------------------------------------------------------------------
Routing of Quality Reviews and Deferrals
VBA is building requirements for future Veterans Benefits
Management System (VBMS) functionality that will improve claims
processor efficiency and accuracy, while also improving the employee
experience. Part of this process is our commitment to providing high
quality decisions and ensuring our workforce can improve through non-
punitive feedback from more senior employees through a process known as
a deferred decision or ``deferral'' for short.
Deferrals are opportunities to mentor and provide constructive
feedback to junior employees. VBA's higher-graded decision-making
employees perform a review of work performed at earlier stages of the
claims process to determine if all necessary actions and evidence to
support the Veteran's claim have been completed. If they have not,
these employees will defer a decision, sending that deferred claim back
to an earlier stage for additional work. The deferral process has
existed since VBA's paper claims processing days, but now leverages
claims routing functionality to ensure non-punitive feedback is
efficiently routed through VBA's NWQ routing logic. VBA categorizes two
types of deferrals for corrective action: avoidable and unavoidable.
Avoidable deferrals are those that should have been preventable by
the prior employee and are commonly missed actions to collect necessary
evidence. The NWQ routes these deferrals back to the prior station that
completed the work, regardless of the volume of work currently at that
station, to ensure awareness of the issue and ensure prompt correction
as a learning opportunity for the employee. ROs may use rules to
automatically route avoidable deferrals back to the responsible
employee, or first line supervisors may review these deferrals and
manually route them to their employees to better detect trends and
provide supportive training. Avoidable deferrals are not considered to
be formal errors for accountability purposes, which are conducted on
independent and random samples of all employees' work through separate
oversight mechanisms.
Unavoidable deferrals are those that may not have been preventable,
such as those resulting from evidence or correspondence received
following the prior employee's action. Because these deferrals do not
represent a defect in workmanship, the NWQ distributes them with all
others requiring further development, with first preference for the
prior RO, following Prior Assignment Routing (PAR) logic.
To formally assess quality, VBA has three primary programs of
quality assessment: VBA's national Systematic Technical Accuracy Review
(STAR) program, Individual Quality Reviews (IQRs), and In-Process
Reviews (IPRs). These reviews and quality assessments are handled by
the Quality Management System (QMS), which is external to VBMS and the
NWQ. By policy and agreement with our labor partners, VBA employees
must receive feedback from qualified quality review personnel or their
supervisor and are allowed to appeal that determination. These formal
assessments help identify required training and support VBA's formal
accountability processes. Each assessment provides the employee with a
manual reference of legal citation fully describing the deficiency
identified.
Claims processors generally prefer to receive work that they had
worked in prior stages, because they can frequently recall certain
aspects of the claim. NWQ will return claims to the most recent RO of
jurisdiction through PAR functionality if there is sufficient capacity
to complete it at that RO. Once a claim is distributed from the NWQ to
an RO, the RO's locally established routing rules and prior assignment
settings determine the actual assignment to a claims processor(s).
Centralized Workloads
NWQ supports decisions to centralize specialized work and
automatically routes identified claims requiring specialized knowledge
for unique workloads to improve efficiency, productivity, and accuracy.
VA has historically centralized processing for claim types that require
specialized handling, such as those related to mustard gas, radiation,
pension, or Agent Orange exposure, or from Veterans residing overseas.
More recently, VA consolidated Camp Lejeune contaminated water
claims and military sexual trauma (MST) claims. Because NWQ distributes
claims based on capacity at these special missions, backlogs at special
mission sites are indicative of a need for additional staffing at that
site. VA is aggressively hiring and shifting its workforce at special
mission sites to address imbalances to ensure continued improvement in
service delivery.
Backlogs in these smaller claim inventories occur when there is
insufficient capacity to address the volume of work on hand at these
special mission sites. VA historically has addressed challenges through
overtime and, where possible, increased staffing. An example of
centralization improving outcomes for specialized claim types is the
assignment of foreign work to the Pittsburgh RO. Through this expanded
capacity, the timeliness of the foreign claim inventory has improved by
7.9 percent from the end of Fiscal Year 2023 to May 2024, and the
volume of claims pending has decreased by 33 percent.
Agent Orange-related claims were centralized to ensure tight
control over a set of cases requiring re-adjudication under Court
Supervision. In the OIG's review dated May 8, 2024, they identified a
backlog of Agent Orange-related claims that were incorrectly ranked by
NWQ tool and ranking rules. The ranking rules were corrected
immediately after the flaw was identified. However, the delayed
distribution of ready for decision claims identified by OIG stemmed
from a management decision to dedicate 20 percent of the workforce to
processing these claims to support the simultaneous need to address the
Court's requirement for a plan of action and to ensure timely
processing for all other Veterans, their families, and their survivors.
VA transparently communicated with stakeholders about this plan and the
state of this inventory to stakeholders and continues to provide a bi-
weekly report on Blue Water Navy claims to the Committees.
VBA also centralized the MST workload based on the OIG's
recommendations. MST workload initially routed to MST-trained claim
processors at eight ROs until the MST Operations Center (MST-OC) in San
Juan was fully operational. The MST-OC has a single site lead by an
Executive Director to enhance organizational effectiveness. As part of
this model, the NWQ routes claims to specially trained MST claims
processors through NWQ.
The MST-OC was operational and began receiving claims distributions
from the NWQ in June 2022. The pending inventory of MST claims
incrementally increased as receipts outpaced claims completions,
requiring VA to recalibrate employee processing capacity to draw down
this inventory and improve timeliness. Upon MST-OC reaching full
staffing and stabilization of the MST inventory, the designated
employees at the eight MST sites resumed processing non-MST workload.
However, the inventory continued to increase, requiring VBA to
increased staffing for MST claims processing. An additional 143
employees were assigned to the MST--OC, and starting in April 2024, 250
staff from an additional RO were designated and trained for MST
processing. Currently, the MST ``surge site'' is in progress of
completing the rigorous training and a quality proficient release
program, with full employee process capacities on the horizon. As
additional capacity is trained for MST claims processing, the NWQ
distribution flexibilities allowed the agency to quickly pivot and
ensure that the oldest claims were assigned to claims processing
resources at each RO.
Three designated Pension Management Centers (PMC) process pension
and survivor benefit claims focusing on benefit delivery to some of our
most vulnerable claimants. Survivor benefit claims relating to
Dependency and Indemnity Compensation (DIC) and service-connected
burial claims are generally processed by the Philadelphia PMC. Our St.
Paul and Milwaukee PMC's focus efforts on processing original income-
based pension claims for Veterans, their families, and their survivors,
non-service-connected burial claims, as well as pension maintenance
claims such as income and dependency adjustments.
Since Fiscal Year 2023, VA has increased staffing at our three PMCs
by 18 percent and in May 2024, VA further increased staffing for
survivor processing at the Philadelphia PMC by 7 percent to address
increasing workload and improve timeliness. In addition, the rapid
hiring authority under the PACT Act contributed to lost PMC capacity,
because many experienced claims processors in the St. Paul and
Milwaukee PMCs were promoted to higher-graded claims processing
positions. These offices are actively backfilling these losses and are
expected to be fully staffed in 2024. NWQ continues to be flexible in
routing specific survivor workload to improve the timeliness of service
to survivors.
NWQ Red Team
VBA recognizes that the NWQ can always be improved, and based on
internal feedback in June 2023, the Under Secretary for Benefits
commissioned a ``Red Team'' to evaluate the operational and functional
capabilities of the NWQ in the current landscape of workload management
and the claims processing environment. The review team consisted of RO
Directors, Division Managers, NWQ staff, and first line supervisors,
who rigorously analyzed the claims distribution process focusing on the
robust voice of the customer, a comprehensive review of the process,
and root cause analysis steeped in data.
The review findings resulted in 12 recommendations in 3 thematic
buckets: systems, rework, and workload management. Four of these
recommendations pertained directly to NWQ programming and
functionality. These recommendations dovetail with existing plans to
modernize and improve NWQ and are scheduled for completion by Fiscal
Year 2026.
The first recommendation is a technical enhancement to the PAR
logic to improve routing to the employee who performed the last claims
processing action. Current logic routes the claim to the employee who
last touched the claim, which may have been a supervisor or quality
reviewer, which may require a subsequent touch to route to the intended
recipient. This enhancement request has been prioritized for completion
in Fiscal Year 2025. Second, the NWQ proposes to create a badging
system to link employee quality, training, and experience to work
assignments to allow for greater control of complex claims that require
greater expertise and improved accuracy. Although ROs already can
establish local routing rules to distribute workload based on unique
claims attributes, badging functionality will improve oversight of
VBA's capacity and streamline claims assignments and pinpoint training
needs.
Next, the Red Team recommended more frequent updates to the
capacity engine driving the NWQ, which is currently updated once per
week. This improvement will allow more agile distribution and reduced
latency that today requires manual NWQ analyst intervention.
Last, the Red Team recommended a hybrid ``push/pull'' workload
distribution of Veteran's claims to allow dynamic claims prioritization
throughout each day. This enhancement would no longer limit claims
distribution and prioritization to the daily national distributions
while also allowing RO personnel to pull work into their queue more
easily.
Conclusion
The NWQ continues to function as intended from inception,
nationally distributing workload across geographical boundaries, and
ensuring the timeliest service for Veterans, their families, and their
survivors. For example, the average time to complete a claim in 2013,
prior to NWQ, was 347.8 days, with a variance between stations of 394
days. Ten years later, and 7 years following implementation of NWQ, the
average time to complete a claim was 130.4 days, with a variance
between stations of 19.4 days.
VBA knows that more work remains to be done and is committed to
continued transparency for stakeholders to explain the NWQ and to
improve the status of claims for Veterans on VA.gov. In May 2024, VA
made improvements to the Claims Status Tool on VA.gov, making it easier
to identify when action is needed by a Veteran, what claims are in
progress, when specific claims were submitted, and where to find
available decision letters. Accredited representatives for the Veteran
or survivor need to only call our dedicated customer service line or
reach out to the service officer liaison at the RO where the claimant
resides for information or assistance. Likewise, caseworkers from
congressional offices may call or email their local RO's point of
contact for questions or assistance with a constituent's claim. We
remain committed to the strong partnerships between stakeholders and
ROs, while also ensuring the most efficient benefits delivery to
Veterans, their families, and their survivors.
As always, VBA looks forward to the continued oversight provided by
Congress and the partnership of our stakeholders to improve service
delivery. Chairman Luttrell, Ranking Member Pappas, this concludes my
testimony. I am happy to respond to any questions you or the
Subcommittee may have.
Prepared Statement of Herman Breuer
Chairman Luttrell, Ranking Member Pappas, and distinguished members
of the Subcommittee, the National Association of County Veteran Service
Officers--commonly referred to as NACVSO--thanks you for the
opportunity to provide testimony before you today, as well as for your
time and your dedication to improving the benefits for the men and
women who have worn our Nation's uniform.
I am here today to bring to your attention some opportunities for
refinement as it pertains to the claim adjudication process. As you are
all aware--and I am happy to attest --the VA Claim process has been
significantly improved with the implementation of the National Work
Queue (NWQ), but further efficiency can be achieved by enhancing
collaboration between VA representatives and the veterans advocate to
expedite the collection of necessary information and evidence.
I am an Army veteran of the Iraq War, wounded by an IED in March
2004. My personal experience with VA came at a time when documents were
reviewed on paper rather than electronically. The initial development
of my own claim took approximately 14 months, primarily due to the
delays caused by the location of my paper medical records with the
Pennsylvania Army National Guard.
A year after returning home, I became a Veteran Service Officer.
Delays continued in the disability process and were evident,
particularly during the development phase. At that time, the VA would
issue a development letter called a VCAA Notice Response, similar to
today's 5103 Notice. This letter allowed veterans to declare whether
they had submitted all of their evidence or needed an additional 30
days to gather more. The Regional Office (RO) would only send this
letter after opening the mail and beginning to build the file, a
process that often took 60 days. If the veteran did not reply promptly,
they would issue yet another letter with a 30-day response time,
perpetuating a cycle that could extended the claim development phase up
to 12-18 months, that is, an extra year-plus before veterans could even
attend a compensation and pension exam.
As an advocate at that time, we submitted claims by US Mail or fax
and then waited. These delays were frustrating, especially when telling
veterans or their dependents to ``be patient,'' many of whom had just
returned from Walter Reed where they were literally patients being
patient.
The practice of transferring files from busier ROs to less busy
ones helped reduce workloads but continued to add delays; the transfer
process taking a minimum of 30 days to complete. The National Work
Queue (NWQ) was introduced to address these types of issues. While it
was initially met with skepticism from advocates who feared losing the
``personal touch'' of knowing the right people in their RO, which can
be very helpful to the advocate.
Personally, I welcomed the NWQ. As I fielded hundreds of phone
calls each month from veterans and dependents inquiring about their
claim status, the NWQ, combined with the fully developed claim process,
led to noticeable reductions in wait times.
Now that the NWQ has been the standard operating procedure for at
least 8 years, we can provide an honest assessment: the NWQ system is
solid improvement, but I know we can make it better. To optimize this
system, it is crucial to truly partner with the advocates on the
ground. If a Veterans Service Representative (VSR) or a Rating Veterans
Service Representative (RVSR) sees that a claim requires additional
information or evidence, they should first work together with the
veteran and then with the veteran's accredited representative to obtain
that information expediently, currently a phone call will or email will
be sent to the veteran alone, and if they don't respond immediately,
the claim is returned back to the NWQ for an additional 30 days, in the
past VA was shuffling paper and files manually, today the shuffle still
occurs, but digitally, seeing this happen as an advocate can be
frustrating. Unfortunately, there are incentives in the current system
to kick the claim back to the NWQ because there are no risks to
following the procedure to the letter. The unfortunate outcome is that
this often leads to unnecessary delays in benefits to a veteran who may
desperately need them. By adding contact between VSR's, RVSR's and a
veterans accredited representative as a required step within the
development procedure, we will empower those with the greatest
understanding of the claim to collaborate on behalf of the veteran.
This will also discourage delays in claim development, all while adding
that ``personal touch'' to the NWQ that detractors were initially so
worried about.
In conclusion, while the NWQ has brought many improvements,
fostering a collaborative relationship between VA and veteran advocates
will further enhance the efficiency and effectiveness of the claim
process, minimizing delays, and ensuring that veterans receive the
benefits they deserve in the timeliest manner possible.
Chairman, Ranking Member, and members of the subcommittee, thank
you for the opportunity to share our input from the field regarding the
issues before the panel today. We look forward to our continued work
together and would be happy to take any questions for the record. Thank
you.
Prepared Statement of Ashlynne Haycock-Lohmann
The Tragedy Assistance Program for Survivors (TAPS) is the national
provider of comfort, care, and resources to all those grieving the
death of a military or veteran loved one. TAPS was founded in 1994 as a
501(c)(3) nonprofit organization to provide 24/7 care to all military
survivors, regardless of a service member's duty status at the time of
death, a survivor's relationship to the deceased service member, or the
circumstances or geography of a service member's death.
TAPS provides comprehensive support through services and programs
that include peer-based emotional support, casework, assistance with
education benefits, and community-based grief and trauma resources, all
delivered at no cost to military survivors. TAPS offers additional
programs including, but not limited to, the following: the 24/7
National Military Survivor Helpline; national, regional, and community
programs to facilitate a healthy grief journey for survivors of all
ages; and information and resources provided through the TAPS Institute
for Hope and Healing. TAPS extends a significant service to military
survivors by facilitating meaningful connections to peer survivors with
shared loss experiences.
In 1994, Bonnie Carroll founded TAPS after the death of her
husband, Brigadier General Tom Carroll, who was killed along with seven
other soldiers in 1992 when their Army National Guard plane crashed in
the mountains of Alaska. Since its founding, TAPS has provided care and
support to more than 120,000 bereaved military survivors.
In 2023 alone, 9,611 newly bereaved military and veteran survivors
connected with TAPS for care and services, the most in our 30-year
history. This is an average of 26 new survivors coming to TAPS each and
every day. Of the survivors seeking our care in 2023, 34 percent were
grieving the death of a military loved one to illness, including as a
result of exposure to toxins; 30 percent were grieving the death of a
military loved one to suicide; and only 3 percent were grieving the
death of a military loved one to hostile action.
As the leading nonprofit organization offering military grief
support, TAPS builds a community of survivors helping survivors heal.
TAPS provides connections to a network of peer-based emotional support
and critical casework assistance, empowering survivors to grow with
their grief. Engaging with TAPS programs and services has inspired many
survivors to care for other more newly bereaved survivors by working
and volunteering for TAPS.
Chairman Luttrell and Ranking Member Pappas, and distinguished
members of the House Committee on Veterans' Affairs, Disability and
Memorial Affairs Subcommittee, the Tragedy Assistance Program for
Survivors (TAPS) is grateful for the opportunity to provide a statement
for the record on issues of importance to the 120,000-plus surviving
family members of all ages, representing all services, and with losses
from all causes who we are honored to serve.
The mission of TAPS is to provide comfort, care, and resources for
all those grieving the death of a military loved one, regardless of the
manner or location of death, the duty status at the time of death, the
survivor's relationship to the deceased, or the survivor's phase in
their grief journey. Part of that commitment includes advocating for
improvements in programs and services provided by the U.S. Federal
Government--the Department of Defense (DOD), Department of Veterans
Affairs (VA), Department of Education (DoED), Department of Labor
(DOL), and Department of Health and Human Services (HHS)--and State and
local governments.
TAPS and the VA have mutually benefited from a long-standing,
collaborative working relationship. In 2014, TAPS and the VA entered
into a Memorandum of Agreement that formalized their partnership with
the goal of providing earlier and expedited access to crucial survivor
services. In 2023, TAPS and the VA renewed and expanded their formal
partnership to better serve our survivor community. TAPS works with
military and veteran survivors to identify, refer, and apply for
resources available within the VA, including education, burial,
benefits and entitlements, grief counseling, and survivor assistance.
TAPS also works collaboratively with the VA and DOD Survivors
Forum, which serves as a clearinghouse for information on government
and private-sector programs and policies affecting surviving families.
Through its quarterly meetings, TAPS shares information on its programs
and services as well as fulfills any referrals to support all those
grieving the death of a military or veteran loved one.
TAPS President and Founder Bonnie Carroll served on the Department
of Veterans Affairs Federal Advisory Committee on Veterans' Families,
Caregivers, and Survivors, where she chaired the Subcommittee on
Survivors. The committee advises the Secretary of the VA on matters
related to veterans' families, caregivers, and survivors across all
generations, relationships, and veteran statuses. Ms. Carroll is also a
distinguished recipient of the Presidential Medal of Freedom, the
Nation's highest civilian honor.
DEPENDENCY AND INDEMNITY COMPENSATION FOR HIGH SCHOOL STUDENTS
If a surviving child turns 18 before graduating high school,
Dependency and Indemnity Compensation (DIC) should continue to be paid
to the child until their high school graduation. Unfortunately, this
has not been happening. TAPS consistently raised this issue with the VA
over the past 5 years, but during that time the VA has not developed a
way to process claims for continuation of benefits until graduation in
a timely manner, delaying payments for these surviving children up to
18 months and longer.
Approximately 6 months before a child turns 18, the VA sends them a
copy of VA Form 21-674 to complete in order to maintain DIC until
graduation. The VA has stated they cannot legally begin to process
these forms until the day the child turns 18. At this point, the
applications should be dropped into the National Work Queue (NWQ), but
because they are supplemental claims, they are not. When the VA finds
the application, usually on average 3 months after the child has turned
18, if the parent signed it, they kick it out as they need the child's
signature as a legal adult. If the child signed it before turning 18,
the VA has kicked it back requesting it be resubmitted and dated after
the child's 18th birthday. At this point, the application disappears
into the VA system but does not go into a file or the NWQ.
Approximately six to 12 months later, when the claim is processed,
after repeated calls from the survivor or their representative, and
usually after the child has graduated high school and started college,
it's kicked back for a third time. This happens because the student is
now utilizing VA education benefits and is no longer eligible for DIC,
despite the claim being for the timeframe between their birthday and
before they began utilizing VA education benefits. This is the point
where most survivors give up because they feel it is not worth
continuing to try to obtain their benefits.
In order for the Pension Management Center (PMC) to take immediate
action to process these student claims, ``the claim needs assignment
from the NWQ.'' The problem is that these student claims are
supplemental claims and are not typically dropped in the NWQ. On
occasion, the PMC has contacted the Office of Field Operations (OFO) to
expedite claim assignments to the PMC, but it is on a case-by-case
basis, usually at the request of a VSO or NSO, and still takes months
for movement on the claim. Most claims to extend benefits for surviving
children who are adults still in school are well over 6 months to 2
years.
We have seen three methods to extend the benefits work: complete
the 21-674 Approval of School Attendance; complete the 21-534EZ
application for DIC; or both. Additionally, sometimes the forms
completed by the parent are accepted; other times the requirement of
the child's signature is requested by the VA, or vice versa based on
the date of the form and the child's 18th birthday. There has been no
consistency as to which of the above processes works. There has also
been no consistency as to who is required to sign the form that is
eventually accepted.
TAPS elevated this issue to the Veterans Benefits Administration
(VBA) Under Secretary Josh Jacobs in December 2023. The VA has provided
us with what they view as a temporary fix as well as a long-term
solution. The short-term solution has been to pull the list of
applications, manually, weekly and put them into the NWQ. To date, we
have not seen shorter processing times with the temporary fix, but we
hope this begins to address the issue in the short term.
The proposed longer-term fix is to redo VA Form 21-674 and to add a
secondary signature block so that both the parent and child can sign
the form. The VA expects this to take 18-24 months to complete.
However, this does not fix the fact that these applications do not get
dropped into the NWQ. The VA has stated that once they finish redoing
the form, they will start to look for a fix to the NWQ issue. TAPS
appreciates the form being updated to reduce many of the challenges our
survivors face, but the bigger issue has always been that these forms
do not get automatically dropped into the NWQ, which is something the
OFO must prioritize.
As a temporary solution, TAPS has suggested to survivors that once
a student turns 18, to avoid years of extended delays as mentioned
above, the student should complete both the 21-534EZ and the 21-674 to
bypass the supplemental claim delays in the NWQ. On average, this
workaround usually takes three to 6 months, but this is not a real or
permanent fix.
To break it down, a case example of an actual surviving child who
``gave up'' after 3 years of trying:
A surviving child's Army retiree father succumbed to a service-
connected illness in November 2018. Prior to turning 18 in August 2019,
his mother had been receiving DIC benefits on the child's behalf.
September 2019: Because the child was enrolled in school
and not accessing VA education benefits, TAPS confirmed with the VA the
adult child submitted the VA Form 21-674 Request for Approval of School
Attendance, the VA Form 21-674b School Attendance Report, the VA Form
21-686c Application to Request to Add and/or Remove Dependents, and the
updated Direct Deposit notice.
About a week later the Pension Management Center
(PMC) advised TAPS, ``one of the coaches would review the
claim.''
December 2019: The VA advised that there had been ``no
activity'' regarding the DIC claim.
January 2020: The BVA liaison told TAPS and the survivor
``to call the VA hotline'' and to involve the liaison ``when the matter
is urgent or an emergency,'' but also confirmed there were ``no updates
available on the status of the DIC claim.''
February 2020: The VA advised that the adult student now
needed to submit his own VA Form 21-534 Application for Dependency and
Indemnity Compensation, Survivors Pension, and Accrued Benefits by a
Surviving Spouse or Child to apply for DIC ``in his own right.''
May 2020: The VA confirmed the mother was not receiving
benefits for the adult student since he reached the age of maturity.
Additionally, the VA advised the VA Form 21-674 could not be used to
``continue'' his DIC award, but then also said there was no 21-674b on
file to show he was enrolled in college. Later that month, the VA then
recommended the adult child also submit the VA Form 21-534a Application
for Dependency and Indemnity Compensation by a Surviving Spouse or
Child In-Service Death Only and stated the original submission of the
VA Form 21-674 ``only complicated things.''
July 2020: The VA advised that all the ``paperwork'' was
received in early June and to expect a ``few months'' to process.
While waiting for his DIC to process, the adult
student did apply for DEA and started using the benefit.
August 2020: The VA advised that ``no further action had
been taken'' in regard to the claim.
September 2020: The VA advised there ``was no update as
of yet'' in regard to the unpaid DIC claim.
October 2020: The VA advised the claim ``was still
pending.''
Late October: The VA advised because he started using
DEA, he was not eligible for DIC. TAPS raised the question of
the unpaid months for DIC between the time his father passed
before he started using DEA, as he was enrolled in school the
entire time and would be eligible.
The VA provided the additional response that
the family has ``missed some time requirements''--that
the mother originally submitted the 21-674, but he was
already 18. On June 20, the VA received his 21-534EZ
along with the 21-674, and the 21-674b which was not
signed by the school. The student started using DEA in
August 2019, so the VA denied his claim for DIC due to
receiving education benefits. TAPS again questioned the
unpaid DIC between November 2018 (when the veteran
passed) and August 2019 (when the child started using
DEA).
Late October 2020: The adult student formally submitted
the VA Form 20-0995 Decision Review Request: Supplemental Claim, VA
Form 21-4138 Statement in Support of Claim, VA Form 21-674 Request for
Approval of School Attendance, and VA Form 21-674b School Attendance
Report for the ongoing unpaid DIC benefits prior to accessing DEA
benefits. The VBA confirmed receipt on Nov. 4, 2020.
November 2020: The VA confirmed the documents were
``entered into the system on Nov. 17, 2020.'' The VA advised it was in
the ``National Work Queue'' and would ``likely be resolved within the
next several weeks.''
January 2021: The VA advised the claim had been
``assigned to a specific office, however, there was no final
determination as of yet.''
Later that month, the VA advised there were again
concerns with the VA Form 21-674b being incomplete and that an
updated Direct Deposit form was required.
The adult student again resubmitted the VA Form 21-
674b School Attendance Report and the VA Form 29-0309 Direct
Deposit Enrollment/Change.
February 2021: The VA advised they had sent a letter
dated Jan.19, 2021, which stated, ``Since he is already getting his
DEA, he can't be back paid for the DIC he didn't receive.'' This denial
was despite his efforts to apply for DIC 1 week after turning 18, and 9
months before he started receiving DEA.
After this second denial and 18 months of trying, the
student gave up trying to ``fight'' for the unpaid DIC
benefits.
* VA did pay the child in December 2023 after Under Secretary for
Benefits, Josh Jacobs, was provided this case example from TAPS.
The DOD experienced similar problems with executing benefits for
child option, Survivor Benefit Plan (SBP) recipients, which, for years,
was a much bigger issue than the DIC issue for transitioning students.
The Defense Finance Accounting Service (DFAS) rolled out a new process
in 2019 that is heavily based on an honor system. It recognizes that
the application and supporting documents required to process benefits
are legally binding documents. Survivors are expected to report any
changes related to their eligibility statuses, offering more
straightforward navigation for survivors and more efficient processing
for the agency.
Survivors are no longer required to have their school officially
certify forms; instead, they sign acknowledging that they must
immediately notify DFAS if any information needs updating. For example,
if students transfer schools or discontinue school, reduce school
attendance to less than full-time, or change their marital status, they
must contact DFAS to update their information. Survivors receive a
notification after submission that DFAS received their forms along with
a case file number. If survivors file these forms electronically,
assigning a processor and notifying the survivor is often a matter of
days.
If there are any errors with the submitted forms, DFAS will often
contact survivors and guide them through corrections. After updating
student annuities, survivors receive a final communication confirming
the processing of the annuity with the account in ``paying status.''
Now that this process is streamlined and filed electronically, what
used to take up to 9 months to address is now on average 30 days.
Surviving families have repeatedly told us that navigating only one
new form is easy and that electronic filing has prevented payment
delays. Thus, TAPS highly recommends the VA switch to a similar
process.
TAPS RECOMMENDATION: Allow students to submit a single school
certification form, such as, or similar to, the VA 21-674, upon their
18th birthday, along with a new direct deposit form that will generate
a process into the NWQ upon receipt. This will ensure students' DIC
payments continue through their high school graduation. Additionally,
if the VA Education Office awards benefits, the Pension Management
Center is required to be notified by the Education Office to release
additional funds for the summer months between high school graduation
and their first day of utilizing the education benefits.
To help further highlight this important issue, the following are
personal testimonials from survivors who have been fighting for DIC
while in high school:
Rebecca Eggers, Surviving Spouse of CPT Daniel W. Eggers, U.S. Army
``My son turned 18 in December 2018, during his senior year of high
school. In January 2019, we faxed the paperwork to the VA to indicate
he was still in school and that his DIC should continue. In August
2019, he began using Chapter 33 benefits for college. We received a
letter in March 2020 indicating that his DIC eligibility was approved
and he received a retroactive payment of approximately $3,500 for DIC
for January 2019 through July 2019.
``In the spring of 2022, he received notification that an audit was
done on his account and that he received DIC while also receiving
education benefits. We filed a dispute; however, we still have not
received anything back in the mail on whether the debt was resolved.
Although the retroactive payment was made in 2020, the payment was for
January through July 2019 when he was not receiving education benefits.
Had the VA processed the initial student verification in a timely
manner, rather than taking over a year, the payment would not have
conflicted.''
Lisa Luttrell, Surviving Spouse of LTC Stuart Luttrell U.S. Army
``I actually paid my children so I didn't have to fill out or
assist them with the paperwork. I just gave them the amount. When I
called the VA and was told what I had to do to submit, the sheer amount
of `man-hours required' on my part outweighed a few hundred dollars
apiece. DIC was already awarded and shouldn't require more than one box
to check.''
DEPENDENCY AND INDEMNITY COMPENSATION FOR HIGH SCHOOL GRADUATES
Not only is Dependency and Indemnity Compensation (DIC) supposed to
be paid until a dependent child graduates high school, they are also to
be paid the months between graduation and starting college, if they
activate VA education benefits for the following term. The VA does not
do this but instead, DIC is terminated upon graduation from high
school. Most survivors do continue on to post-secondary education, and
as eligible surviving students, elect VA Education Benefits, that
application does not extend the DIC for the summer.
38 CFR 3.667(b) allows continued DIC benefits through summer break
when a school child receiving DIC in high school elects DEA/Fry
Scholarship starting with the fall school year. Continued payment of
DIC is warranted only if there is no break in school beyond summer. If
the child took the fall semester off or a gap year, then DIC ends with
high school. Adjudication procedures for VA field stations on this
topic are found in M21-1 III.iii.6.C.2.b
TAPS recently worked with the St. Paul, Minnesota Regional
Processing Office (RPO) who did provide a workaround. They recommended
that surviving children submit a second 21-674, but, instead of putting
in the dates of attendance, list the citation ``38 CFR 3.667 (b)'' to
show the claims processor where to look statutorily for what the
student is applying for in terms of benefits. While we are seeing this
work so far, with the handful of cases we have helped to submit, we do
not view this as a long-term permanent fix.
The VA has stated that the long-term fix for this is to update VA
Form 21-674 and add a box that states ``continuing education next
year'' or something similar to allow them to pay the student through
the summer months. We are optimistic that this will work, but these
forms do not get automatically dropped into the NWQ, so they have
extremely high processing times. The VA's estimated timeline for
updating this form is 18-24 months from the January 2024 House
Committee on Veterans' Affairs oversight hearing.
Additionally, the VA has stated that they do not have a way to
track these students as the Education system does not talk with the
Pension system to determine dates for when a child has graduated high
school and when they have activated education benefits, which could
create debts for students if they do not stop payments when education
benefits begin.
DELAY IN CLAIMS PROCESSING FOR DEPENDENCY AND INDEMNITY COMPENSATION
TAPS has concerns about the current wait times we are seeing for
initial claims for Dependency and Indemnity Compensation (DIC). We have
seen several cases where the processing time is over a year for an
initial claim. We are also concerned that the response our Casework
team is receiving from the VA has generally been along the lines of
``we are backlogged,'' but there have not been any updated timelines
provided.
A case example of this is a Navy Vietnam veteran who died on June
6, 2023, of Chronic Obstructive Pulmonary Disease (COPD) as a result of
Agent Orange (AO) exposure through Blue Water Navy. He only had a
disability rating of 10 percent for tinnitus. His surviving spouse
applied for accrued benefits and DIC on Sept. 10, 2023. TAPS Casework
reached out to the VA requesting a status update and confirmation of
receipt of claims in October, which was confirmed. In December, the
surviving spouse received a request for additional information, as they
did not have him listed as having deployed to Vietnam. The surviving
spouse provided this information within a few weeks. TAPS reached out
to the VA for an update on the status of the claim on Feb. 3, 2024, and
received a response on April 8, 2024. At that time, TAPS was informed
that there had been ``no movement'' on the claim. TAPS followed up on
May 6, 2024, and again on June 6, 2024, when it was confirmed that
claims processing was ``quite behind'' and that ``processing for many
of the AO claims for non-Vietnam boots on ground (BOG) or littoral
waters are temporarily suspended.''
We understand that many of these DIC cases are incredibly
complicated due to challenges, such as contributing factors not being
listed on death certificates. However, the VA has had all the
information on this file since January, and there has been no movement
on the claim. This leaves the family in financial hardship while
awaiting a decision that should be fairly clear-cut due to the Blue
Water Navy Vietnam Veterans Act of 2019 (PL-116-23).
Additionally, because the backlog is so high at the Philadelphia
Regional Processing Office (RPO), where most of the DIC claims are
processed, they have been sending them to the Milwaukee RPO which
appears to not be equipped to handle them. We have seen several letters
that were erroneous due to the backlog and Milwaukee being ill-equipped
to handle these cases. One example is a letter that stated ``Denied
Service Connection'' on the first page, but all subsequent pages stated
that service connection was approved. The VA did later confirm that the
death was ruled ``service-connected'' and that the letter was
erroneous, due to human processing error.
The VA has confirmed that they have hired 35 new Veteran Service
Representatives (VSR) and 25 new Rating Veteran Service Representatives
(RVSR) who will start in Philadelphia in July and should be fully
trained by August. We are optimistic that this should fix the backlog
in Philadelphia and pull all of the DIC claims out of Milwaukee and
back into Philadelphia, where they belong.
While we appreciate the VA sharing these updates, our biggest
challenge has been--and still is--lack of an updated timeline. We know
that the increased number of VSRs and RVSRs will help decrease wait
times and clear the backlog. We hope to see an updated timeline for
processing times from the VA soon. Having a clearer timeline would help
TAPS and survivors better manage expectations for such critical
benefits.
CONCLUSION
TAPS thanks the leadership of the House Committee on Veterans'
Affairs, their distinguished members, and professional staff for
holding this important hearing on survivor issues. TAPS is honored to
testify on behalf of the thousands of military and veteran surviving
families we serve.
Prepared Statement of James Swartz
Chairman Luttrell, Ranking Member Pappas, and Members of the
Disability Assistance and Memorial Affairs Subcommittee:
The American Federation of Government Employees, AFL-CIO (AFGE) and
its National Veterans Affairs Council (NVAC) appreciate the opportunity
to testify at today's subcommittee hearing titled ``Examining
Shortcomings with VA's National Work Queue Veterans Benefits Claims
Management System.'' My name is James Swartz, and I am the President of
AFGE Local 2823, representing the Cleveland, Ohio Veterans Benefits
Administration (VBA) Regional Office (RO), and am a member of the
National Veterans Affairs Council VBA Legislative Committee. I am a
U.S. Army veteran having attained the rank of Sergeant and I am a
service-connected disabled veteran. After my military service, I have
had the privilege of continuing to serve my fellow veterans, first as a
Registered Nurse at the Cleveland VA Medical Center, and then in the
VBA for 23 years, including as a Rating Veteran Service Representative
(RVSR), Decision Review Officer, and as a Rating Quality Review
Specialist in the Cleveland, Ohio RO.
On behalf of the 304,000 Department of Veterans Affairs (VA)
employees AFGE represents, including thousands who are frontline
workers at the VBA, over 50 percent of whom are veterans themselves, it
is a privilege to offer AFGE's views on VBA's use of the National Work
Queue (NWQ) and more importantly, offer both basic and nuanced
suggestions that could improve VBA's use of this technology to enable
claims processors to better serve veterans more efficiently and
accurately. Additionally, I want to especially thank Chairman Luttrell,
Ranking Member Pappas, and DAMA staff for attending a roundtable on VBA
during AFGE's Legislative Conference in February of this year,
considering our input on the NWQ, and holding today's hearing.
Background
The NWQ was created in part to maximize the VBA's claims processing
capacity between regional offices. One justification for the NWQ is
that if one RO has a backlog of claims and another RO has capacity, VBA
can use the NWQ to easily transfer claims to a different RO for
processing. The NWQ certainly has helped achieve this original goal of
moving claims to where there is more capacity. However, VBA management
has utilized the NWQ beyond this basic transferring of claims, an
action that has caused numerous unintended consequences that must be
highlighted to this committee and addressed by VBA.
Specialization of Claims
Prior to the implementation of the NWQ, each regional office
operated in the ``Segmented Lanes model'' with three separate lanes,
including an efficiency lane for claims with few contentions or issues,
a regular lane for a moderate number of contentions, and a special
operations lane for certain complex claims or veterans with a
significant number of contentions. AFGE agrees with the Inspector
General's (IG) 2018 conclusion that VBA's decision to eliminate
specialization of claims processing has had a detrimental impact on
veterans whose claims are more complex and sensitive in nature. As the
IG report explains, prior to the implementation of the NWQ:
The Segmented Lanes model required VSRs and RVSRs on Special
Operations teams to process all claims VBA designated as
requiring special handling, which included MST [(military
sexual trauma)]-related claims. By implementing the NWQ, VBA no
longer required Special Operations teams to review MST-related
claims. Under the NWQ, VSRs and RVSRs are responsible for
processing a wide variety of claims, including MST-related
claims. However, many VSRs and RVSRs do not have the experience
or expertise to process MST-related claims.\1\
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\1\ VA OIG 17-05248-241 Page iii August 21, 2018
Because of the level of difficulty in processing these claims, AFGE
strongly supported returning to a ``Special Operations'' model for as
many complex claims as the system will support. Over the intervening 6
years since this report, VBA has heeded some of this advice as it tries
to reestablish what it did for to specialty claims. Now certain RO's
have Special Operations Centers within them where certain claims are
processed, including MST claims at the San Juan, PR RO, Camp Lejeune
Water Contamination claims in the Louisville, KY RO, and Radiation
claims in the Jackson, MS RO. This allows VBA to have its highly
skilled claims processors work on particular claims with veterans
benefiting from this expertise. As the VBA continues to build out these
Special Operations centers, AFGE encourages VBA to identify additional
complex areas suitable for a Special Operations center where
specialization would benefit additional veterans.
Beyond the Special Operations Centers, AFGE also recommends that
VBA use the NWQ to sort and distribute claims in a manner similar to
the efficiency and moderate lanes that existed as part of the
``Segmented Lanes model'' prior to the NWQ. This would serve two
specific purposes to help both veterans and claims processors. First,
by putting a veteran whose claim has a minimal number of contentions in
the express lane, the veteran will not have to wait as long in line
behind more complex claims and could receive benefits sooner. Much like
a shopper who goes to the grocery store for a gallon of milk and wants
to use an express checkout lane instead of waiting behind a family
doing their shopping for the week, veterans who have easier claims
should not be held up by VBA's preoccupation with meeting its own
internal metrics.
Second, the original ``Segmented Lanes model'' created the
opportunity to help new claims processors by assigning them to the
efficiency lane and allowed them to hone their skills on relatively
less complex claims, with more seasoned and experienced claims
processors in the moderate and special operations lanes. This provided
claims processors with on-the-job training, which benefited future
veterans, as well as current veterans with pending claims by having
more tenured claims processors focus on claims that required their
experience. AFGE urges the VBA to leverage the NWQ to best maximize
claims processors expertise while efficiently serving veterans.
Keeping Claims in One Regional Office for their Duration
There is a cliche in the VA that if you have been to one VA Medical
Center, then you have been to one VA Medical Center. This holds true
for VBA ROs. For this reason, AFGE also encourages the VA to modify the
NWQ so that cases remain within the same RO for the duration of the
claims process. Every RO, despite uniform production standards and
training, often has its own way of conducting specific tasks. These
small but critical differences between ROs can cause claims processors
from different ROs to misunderstand each other's work, and result in a
correct claim being unnecessarily deferred, delaying veterans from
receiving their benefits. Having a claim stay within one RO for its
duration would avoid these inconsistencies and delays. Additionally, by
having the claim stay withing the same RO, communication and
collaboration is improved. For example, an RVSR, having a working
relationship with VSRs in the same RO, could easily ask a VSR who
worked on the claim a clarifying question, receive a quick response,
and address a small problem with the claim, instead of requiring the
claim to be deferred and reworked, causing delays. This would be
significantly less likely to work for claims processors in different
offices, who might be slower to respond to an e-mail from an unknown
colleague or might be working in a different time zone.
To take this a step further, by keeping claims in one RO for the
duration of their processing, managers who assign work would be more in
control to send claims where a RVSR caught an error or required a
deferral back to the original VSR. This would allow the VSR to learn
from the error so as to not repeat it. This would also let the VSR and
RVSR who are already familiar with the claim quickly address follow-up
work, instead of having different claims processors taking significant
time and energy to understand an entirely new claim. Under the current
rules of the NWQ, this scenario is extremely unlikely.
Unlocking the NWQ
Despite a claims backlog that has significantly grown following the
enactment of the PACT Act, one of the most shocking yet consistent
complaints from claims processors is that they are not assigned enough
work to meet their performance metrics and must frequently ask their
``coaches'' for more claims to work on. The reason for this problem is
the internal controls VBA has put on the NWQ. Generally speaking, VBA
assigns an RO a certain number of claims each day, which are then
passed down to teams, and then individuals.
First, the NWQ should automatically provide claims to an individual
claims processor's work que when they are out of cases to develop or
rate. This would greatly improve efficiency.
Second, claims processors should have the limited ability to hold
onto a claim for a longer period than what is allotted before it is
retracted by the NWQ. Each individual claims processor works slightly
differently, notably in the order in which they work on their assigned
claims. These different preferences for working through claims can
result in claims being taken away from processors before they have had
the opportunity to work on it later that day or the following day.
Allowing each claims processor to ask the system for an extension on a
limited number of claims would be helpful to claims processors planning
their daily work. Similarly, claims processors would benefit from NWQ
notifying them how much longer they have to work on a claim before the
NWQ will retract a claim into the system. This would help the processor
appropriately budget their workday. Currently, claims processors know
on which day a claim is assigned, but not what time or how much time
they have left to work on the claim.
Third, the NWQ must address ``automatically ready to rate'' claims.
These claims are sent to a RVSR after they have not been worked on for
a certain amount of time. While no claim should fall through the
cracks, RVSRs must spend time determining why the claim has not
advanced, often discovering after a considerable amount of time that
the claim is still waiting on medical evidence or other information.
VBA should better filter ``automatically ready to rate'' claims so
those waiting on additional detail are not automatically sent to a
RVSR, harming efficiency.
Fourth, as was mentioned previously, VBA should program the NWQ to
allow VSRs and RVSRs who have previously worked on a claim to have
claims return to them if available. This would allow claims processors
to learn from any mistakes that were previously made and allow them to
use time and prevent a different claims processor from having to use
time to familiarize her/himself with an entirely new claim more
efficiently.
Examining RO Performance Metrics
AFGE would like to highlight, that in addition to the performance
standards for individual claims processors, each individual RO is
expected to meet VBA-imposed performance metrics. While measuring the
success of both individual claims processors and entire ROs is
important and within the VBA's purview, there are at least two RO level
metrics that AFGE believes do not serve the best interest of the
veteran, including ``Time in Queue'' as well as the way VBA awards
credit for the partial rating of claims.
``Time in Queue''
``Time in Queue'' is a term describing how long a claim has not
only been in the claims process, but also how long it has been at
certain steps withing the claims process. Each step has its own
countdown of days that a claim can be in a particular step before it is
considered late. For example, if a claim has 10 steps with 5 days
allocated for each step, a claim can spend 5 days in each of the ten
steps and be considered on time. Because of this, when prioritizing
which claims to assign when, VBA management looks at how much time a
claim has left in its current step before it is considered late for
advancement. This can lead to VBA slow-walking claims that are ready to
advance even though claims processors may be waiting for work.
Additionally, if a claim is late in any one of the 10 steps, the
entire claim is deemed late. Because of this metric and how VBA reports
claims, using the previous 10-step, 5-day example, VBA would prefer a
claim to spend the full 50 days with 5 days in each of the ten steps
and be considered on time, instead of a claim being completed in 36
days, where a claim spent 3 days each in nine of the 10 steps, and 6
days in one of the 10 steps as it would be deemed late, despite being
completed 2 weeks earlier. It is not hard to imagine that veterans
would rather have their claims deemed ``late'' and completed 2 weeks
earlier than having them be considered ``on time'' by a VBA internal
metric.
Rating of Partial Claims
Each veteran's claim can have as few as one contention and as many
as dozens of contentions, not all which are necessarily connected to
each other. Because of this, it is common that some parts of a
veteran's claim are developed and ready to rate prior to other parts.
Unfortunately, VBA has an internal metric that awards credit to ROs
only on the claims that are fully rated and promulgated on all of their
contentions. This in turn can hold up all of a veteran's claim on the
basis of a single outstanding contention. For example, if a veteran's
claim has 10 contentions, and nine are developed by a VSR, and the
remaining contention requires additional medical records or an
additional compensation and pension exam, VBA discourages ROs from
rating the 90 percent of the claim that is ready to rate by not
awarding credit until later. This has the doubly negative effect of
delaying a veteran from receiving a significant part of his or her
benefits, and delays ROs from assigning work to claims processors who
need claims to work on, all because the RO with the claim does not want
to let the last step be completed by a different RO and receive credit
for the entire claim. While not all ROs follow this practice and will
decide to rate partial claims, the mere existence of the metric and
certain ROs attempting to meet it is a classic case of VBA treating
veterans like widgets instead of warriors. AFGE calls on VBA to
eliminate these counterproductive metrics and instead create metrics
that facilitate and expedite the accurate delivery of benefits to
qualifying veterans.
Conclusion
I hope that my testimony today leads the subcommittees to conduct
further oversight of the NWQ and the claims process. The VBA should
calibrate the NWQ to better enable claims processors to serve veterans,
instead of meeting artificial internal metrics. AFGE and the NVAC stand
ready to work with the House Veterans' Affairs Committee and VBA to
reach this goal.
Thank you, and I look forward to answering your questions.
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