    [House Hearing, 119 Congress]
    [From the U.S. Government Publishing Office]

                            EXAMINING VA EFFORTS TO
                          DECREASE DELAYS IN VETERANS'
                          DISABILITY COMPENSATION CLAIMS

    =======================================================================

                                    HEARING

                                   BEFORE THE

                            SUBCOMMITTEE ON DISABILITY
                            ASSISTANCE AND MEMORIAL AFFAIRS

                                     OF THE

                         COMMITTEE ON VETERANS' AFFAIRS

                         U.S. HOUSE OF REPRESENTATIVES

                        ONE HUNDRED NINETEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                            WEDNESDAY, APRIL 9, 2025

                                   __________

                               Serial No. 119-16

                                   __________

           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
    61-149                    WASHINGTON : 2025

    -----------------------------------------------------------------------------------

                         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           CHRIS PAPPAS, New Hampshire
    MARIANNETTE MILLER-MEEKS, Iowa       SHEILA CHERFILUS-MCCORMICK,
    GREGORY F. MURPHY, North Carolina        Florida
    DERRICK VAN ORDEN, Wisconsin         MORGAN MCGARVEY, Kentucky
    MORGAN LUTTRELL, Texas               DELIA RAMIREZ, Illinois
    JUAN CISCOMANI, Arizona              NIKKI BUDZINSKI, Illinois
    KEITH SELF, Texas                    TIMOTHY M. KENNEDY, New York
    JEN KIGGANS, Virginia                MAXINE DEXTER, Oregon
    ABE HAMADEH, Arizona                 HERB CONAWAY, New Jersey
    KIMBERLYN KING-HINDS, Northern       KELLY MORRISON, Minnesota
        Mariana Islands
    TOM BARRETT, Michigan

                           Jon Clark, Staff Director
                      Matt Reel, Democratic Staff Director

           SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS

                        MORGAN LUTTRELL, Texas, Chairman

    AUMUA AMATA COLEMAN RADEWAGEN,       MORGAN MCGARVEY, Kentucky, Ranking
        American Samoa                       Member
    JACK BERGMAN, Michigan               CHRIS PAPPAS, New Hampshire
    NANCY MACE, South Carolina           MAXINE DEXTER, Oregon
    KEITH SELF, Texas                    KELLY MORRISON, Minnesota

    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

                                  ----------

                            WEDNESDAY, APRIL 9, 2025

                                                                       Page

                               OPENING STATEMENTS

    The Honorable Morgan Luttrell, Chairman..........................     1
    The Honorable Morgan McGarvey, Ranking Member....................     3

                                   WITNESSES
                                    Panel I

    Mr. Kenneth Smith, Assistant Deputy Undersecretary, Field
      Operations, Acting Executive Director, Education Services,
      Veterans Benefits Administration, U.S. Department of Veterans
      Affairs........................................................     4

            Accompanied by:

        Mr. James W. Smith, Deputy Executive Director, Policy and
            Procedures, Compensation Service, Veterans Benefits
            Administration, U.S. Department of Veterans Affairs

        Mr. Robert J. Orifici, Executive Director, Benefits and
            Memorial Services, Office of Information and Technology,
            U.S. Department of Veterans Affairs

    Mr. James "Jim" R. Swartz, President, AFGE Local 2823, American
      Federation of Government Employees.............................     6

                                    APPENDIX
                        Prepared Statements Of Witnesses

    Mr. Kenneth Smith Prepared Statement.............................    17
    Mr. James "Jim" R. Swartz Prepared Statement.....................    22

                           Statements For The Record

    Disabled American Veterans Prepared Statement....................    41
    The American Legion Prepared Statement...........................    44
    Veterans of Foreign Wars of the United States Prepared Statement.    55

                            EXAMINING VA EFFORTS TO
                          DECREASE DELAYS IN VETERANS'
                         DISABILITY COMPENSATION CLAIMS

                                  ----------

                            WEDNESDAY, APRIL 9, 2025

       Subcommittee on Disability Assistance &
                              Memorial Affairs,
                        Committee on Veterans' Affairs,
                                 U.S. House of Representatives,
                                                        Washington, DC.
        The subcommittee met, pursuant to notice, at 1:44 p.m., in
    room 360, Cannon House Office Building, Hon. Morgan Luttrell
    (chairman of the subcommittee) presiding.
        Present: Representatives Luttrell, Bergman, McGarvey,
    Pappas, and Morrison.

             OPENING STATEMENT OF MORGAN LUTTRELL, CHAIRMAN

        Mr. Luttrell. The subcommittee will come to order. Thank
    you all. Thank you to all of our witnesses for being here
    today. We are taking a close look at the U.S. Department of
    Veterans' Affairs (VA) efforts to decrease delays in veterans
    disability compensation claims resulting from VA
    overdevelopment. When a veteran files a claim for disability
    compensation, VA has a duty to assist them with proving their
    claim. This means helping veterans obtain service records and
    medical records or scheduling veterans for VA disability
    compensation exams. VA cannot make a decision on a veterans
    claim until all development is completed. Although I hear from
    veterans about how frustrating the wait is for a decision to be
    made, many times VA efforts to obtain records and/or exams
    leads to an award for disability compensation.
        On the other hand, overdevelopment is when VA takes
    unnecessary steps to obtain records or exams. Example, if
    existing documents in the veterans claims file are sufficient
    to support the claim, VA should not schedule a government-
    funded disability exam. Overdevelopment forces veterans to wait
    longer than necessary for a decision on their claims and can
    lead to incorrect decisions. Unnecessary exams also waste
    veterans time and money.
        Further, if a veteran misses a VA scheduled exam without
    good cause and they do not reschedule, VA automatically denies
    the veteran's claim even when it was unnecessary for VA to
    schedule the exam in the first place. H.R. 2137, the Review
    Every Veterans Claims Act will absolutely fix this injustice.
        Overdevelopment also drives government waste because VA
    pays contracted exam vendors for every exam, even those that
    were not necessary. In Fiscal Year 2023, about 2.4 million
    exams were completed, a number that rose to approximately 3.2
    million in Fiscal Year 2024. Contracted exam vendors were paid
    for nearly 95 percent of those exams. In December 2024 report,
    in the 2024 report, the VA Office of Inspector General (OIG) of
    the Inspector General (IG) found that VA spent about $1.4
    million on unnecessary exams from April through September 2023.
    The total amount of wasted taxpayer dollars each Fiscal Year is
    likely much higher. The OIG review did not cover the full
    Fiscal Year or examine all types of claims of decisions, both
    approvals and denials.
        We have heard from OIG and the VA employees that
    overdevelopment mistakes are due to an inadequate training.
    Claims processors as well as confusing and inconsistent
    guidance. To address overdevelopment, VA created an
    Overdevelopment Reduction Task Force. This task force
    recommended dozens of actions, including targeted quality
    reviews, updating policy guidance, and increased training.
        I look forward to hearing from VA today on the progress
    made in implementing the Task Force's recommendations,
    particularly I am interested in whether the VA has implemented
    a plan to evaluate the effectiveness of its efforts using clear
    result-driven metrics for success and I would like to hear
    about any efforts VA is undertaking to further enhance its
    strategies to decrease overdevelopment.
        Finally, I look forward to discussing whether VA will
    implement technology to ensure that every claims processor who
    overdevelops a claim learns from that mistake. The National
    Work Queue, also known as NWQ, electronically distributed the
    major--the majority of VA claims workloads across all regional
    offices (RO). The National Work Queue has largely decreased
    decision wait times, thankfully. A key feature of the National
    Work Queue is that when a claims processor defers a claim for
    development, it is returned to the National Work Queue. The
    National Work Queue often then routes the claim to a different
    claims processor at another regional office for additional
    action.
        We have heard about cases where one claims processor after
    another claims processor makes the same overdevelopment error
    in the same veteran's claim. These repeated mistakes are so-
    called avoidable deferrals, have resulted in months or years
    long delays for veterans even before a claims processor
    realizes that the development efforts were unnecessary. The
    current system only notifies the most recent claims processor,
    to my understanding, that they committed an overdevelopment
    error. All the other previous claims processors who committed
    the same mistake in the same claim are actually never notified,
    that is what we need clarification on, and therefore do not
    learn from that specific mistake.
        November 2024 letter then Undersecretary for Benefits, Dr.
    Josh Jacobs informed me that there are no technological
    barriers preventing VA from notifying all claims processors who
    have made the same overdevelopment mistake in a single claim.
    Mr. Jacobs told me the VA would conduct a pilot study to
    determine the value of additional functionality. I look forward
    to hearing about the study, progress, and any findings under
    the current Administration. Every veteran survivor deserves a
    timely decision on their claim decisions. Wait times will
    decrease if we can reduce or eliminate overdevelopment. I look
    forward to hearing from our witnesses today about VA's efforts
    to do so.
        I now yield to the ranking member.

          OPENING STATEMENT OF MORGAN MCGARVEY, RANKING MEMBER

        Mr. McGarvey. Thank you, Mr. Chairman. Good afternoon,
    everybody. Thank you all so much for being here today. You all
    have heard me say this a million times. I am going to say it a
    million more times. Everything we do on this subcommittee is on
    behalf of our veterans. Everything. It is to serve our
    veterans. Today, that means making sure that the VA systems
    used to process disability claims for our veterans work the
    best they can. It also means equipping and empowering the
    employees who serve the veterans. We need them to be able to do
    their best work without unnecessary limits or undermining their
    importance to the system.
        Unfortunately, this Administration continues to spread the
    false message that VA employees are not dedicated to their
    mission, that they do not have the veterans best interest at
    heart. There is an email from U.S. Office of Personnel
    Management (OPM) that castigated all Federal workers as low
    productivity. It is simply not true. It is also hurtful. It
    hurts morale at the VA, which ultimately affects the job
    performance, which hurts our veterans, which is what we are
    focused on in this committee, helping our veterans.
        The Veterans Board of Appeals employees, the Veterans
    Benefits Administration (VBA) employees, like those in my
    regional office in Louisville, Kentucky, are highly dedicated
    to their mission. Many are veterans themselves. They go to work
    every day in a stressful, high-pressure environment and work as
    hard as they can on behalf of the veterans they both serve and
    sometimes served with. They are in systems where they are
    forced to work in, and the systems fail. They are not given
    adequate training. They are subject to arbitrary performance
    metrics and sometimes arbitrary discipline and now even
    unnecessary insults. All of that makes it more difficult for
    them to do their job, which, of course, ultimately makes it
    more difficult to serve our veterans.
        I am interested today in exploring ways that we can improve
    outcomes for veterans by making the job of these dedicated VBA
    employees easier. The Administration's recent decision to end
    collective bargaining agreements with the unions representing
    these employees, it is a serious mistake. I think it is going
    to harm both the employees at the VBA and the veterans they
    serve. That is really important.
        I think it is going to have an adverse impact on our
    veterans because the unions are crucial to creating a workplace
    that helps employees perform their best, delivering better
    results for our veterans. They help employees feel more
    invested in their work, and they offer better chances for
    mentorship and personal growth. The public sector unions play
    an important role in creating a higher quality training for
    their members and providing important feedback to management
    and policymakers about what is actually happening on the ground
    in the organization. This means better retention rates. It
    means lower wait time for benefits, and ultimately better
    service for our veterans.
        Contrary to belief, public sector unions do not stand in
    the way of dismissing bad employees. In fact, they often
    facilitate it. It is in their best interest to make sure that
    all employees are doing their job well. Public sector unions
    do, however, make sure an employee's dismissal is justified,
    orderly, and most importantly, legal.
        I am hopeful today that the Secretary will listen to this
    committee and request an exemption from Trump's executive order
    (EO), because these employees deserve all the rights afforded
    to them under law and the Constitution to best fulfill their
    mission and, of course, deliver the best possible service and
    results for our veterans.
        Thank you, Mr. Chairman. I yield back.
        Mr. Luttrell. Thank you, Mr. McGarvey. Our lead witness
    from VA is Mr. Kenneth Smith, Assistant Deputy Undersecretary
    for Field Operations, as well as the Acting Executive Director
    for Education Services for the Veterans Benefits
    Administration. Mr. Smith is joined by Mr. James Smith, Deputy
    Executive Director for Policy and Procedures. You guys related?
        Mr. Smith. No.
        Mr. Smith. No.
        Mr. Luttrell. Just checking. Procedures and Compensation
    Services. Sorry, man, I lost myself. I am sorry. For the
    Veterans Benefits Administration. Mr. Smith is also joined by
    Mr. Robert Orifici. Got it. We have been together long enough.
    Executive Director for Benefits and Memorial Services for the
    Office of Information and Technology. Today's witness panel
    also includes Mr. James Swartz, sir, who is the president of
    Local 2823 in the American Federation of Government Employees
    (AFGE).
        I asked that the witnesses on our panel please stand and
    raise your right hand.
        [Witnesses sworn.]
        Mr. Luttrell. Let the record reflect that the witnesses
    have answered in the affirmative. Mr. Smith, you are now
    recognized for 5 minutes to deliver--Mr. James Smith, you are
    now recognized. What is that? I am sorry. Mr. Kenneth Smith,
    you are going to start us off with the Smiths. You are now
    recognized for 5 minutes to deliver your opening statement on
    behalf of the Department.

                       STATEMENT OF KENNETH SMITH

        Mr. Smith. Good afternoon, Chairman Luttrell, Ranking
    Member McGarvey, and members of the subcommittee, thank you for
    the opportunity to discuss VA's efforts to increase efficiency
    and process processing veterans disability compensation claims
    through the National Work Queue and improvements brought by the
    Overdevelopment Reduction Task Force. Joining me today are
    James Smith, Deputy Executive Director for Compensation
    Service, and Robert Orifici, Portfolio Director for Benefits,
    Appeals, and Memorial Services, Office of Information and
    Technology.
        The Veterans Benefits Administration has undertaken
    substantial efforts to enhance training and quality review
    programs by focusing on high standards of performance and
    continuous learning opportunities for VA staff. Today, I will
    highlight three specific ways VA is better supporting our
    employees and veterans.
        The first improvement is enhancing the Exam Scheduling
    Assistant, which helps employees correctly determine if an exam
    or medical opinion is necessary. Originally launched in 2023,
    this tool was refreshed last year through the most recent work
    of the Overdevelopment Reduction Task Force. Exam errors
    specific to overdevelopment have been one of the top categories
    of error and delay, resulting in avoidable deferrals and
    rework. Recent enhancements increase the tools used by 48
    percent and contributes to a reduction in monthly errors cited
    for exam overdevelopment. In Fiscal Year 2025, to date, these
    errors have decreased by 7 percent over Fiscal Year 2024. VBA
    will integrate this tool into the Veterans Benefits Management
    System (VBMS), which we expect to launch in Fiscal Year 2026.
        The second improvement involves training strategy. In June
    2024, VBA launched interactive hands-on learning modules and
    updated training content, including comprehensive lessons on
    requesting exams. These efforts reinforce concepts through
    interactive activities, ongoing assessments to gauge mastery of
    the content, remedial training, and follow-up assessments for
    those who need additional repetition. As recommended by a
    recent OIG audit, VA added The Sergeant First Class Heath
    Robinson Honoring our Promise to Address Comprehensive Toxics
    (PACT) Act specific related medical opinion requirements to all
    training products, ensuring employees are well trained to
    address common disabilities. During VBA's Quality Standdown on
    March 20th of this year, claims processors were provided
    additional training and live instructor engagement activities
    focused on ordering exams and medical opinions.
        Third, VBA and the Office of Information Technology are
    developing a solution to complete claims actions correctly the
    first time through improvements to the Veterans Benefits
    Management System. This upgraded functionality is being
    designed as an error check for the employee, providing real
    time feedback on potential errors before the claim is recalled
    to the National Work Queue. This effort is aimed at reducing
    instances of misdevelopment, while improving first touch
    efficiency and reducing avoidable deferrals. This functional
    enhancement is currently in development and is planned for
    initial testing beginning in Fiscal Year 2026. On the topic of
    avoidable deferrals, VA has recently completed preliminary data
    analysis for a pilot study. The study aims to develop a
    reporting solution for employees to receive feedback on any
    claim they touched that resulted in an avoidable deferral. I
    look forward to providing results to the committee on this
    study and its impact on training and mentoring.
        VA is also working on additional improvements to the
    National Work Queue to support improved timeliness through
    better workload management. These include advanced data
    analytics and predictive modeling to prioritize claims in near
    real time and distribute claims based on complexity, urgency,
    and employees skill and experience to speed up the claims
    process. These improvements will also allow employees to
    request additional work in real time directly from the work
    queue and promote supervisory focus on coaching and quality.
    Together, these upgrades ensure claims are handled by the most
    suitable staff, leading to a faster decision and continued
    reduction of the claims backlog, and higher quality decisions
    for veterans. This project is estimated for completion in
    Fiscal Year 2026.
        VBA remains committed to delivering the highest standard of
    service to our Nation's veterans, their families and survivors.
    While significant progress has been made, we recognize the need
    for continuous improvement and adaptive--adapting to evolved
    needs of those we serve.
        Thank you for continued support and collaboration as we
    honor our veterans' sacrifices. Mr. Chairman, this concludes my
    statement. My colleagues and I are ready to answer any
    questions you or other members of the subcommittee may have.

        [The Prepared Statement Of Kenneth Smith Appears In The
    Appendix]

        Mr. Luttrell. The written statement of Mr. Smith will be
    entered into the hearing record. Mr. Swartz, you are now
    recognized for 5 minutes, sir.

                       STATEMENT OF JAMES SWARTZ

        Mr. Swartz. Chairman Luttrell, Ranking Member McGarvey, and
    members of the committee, on behalf of AFGE and National
    Veterans Affairs 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 Regional
    Office. I am a U.S. Army Service-Connected Veteran and I have
    the privilege of continuing to serve my fellow veterans, first
    as an Registered Nurse (RN) at the Cleveland VA and then in VBA
    for the last 23 years. On behalf of over 320,000 VA employees
    AFGE represents, including thousands of claims processors. It
    is a privilege to offer AFGE's views on the National Work Queue
    training and how VBA can enable employees to more efficiently
    and effectively process veterans' and the beneficiaries'
    claims.
        VA should modify the National Work Queue so that a claim
    remains within the same regional office for the duration of its
    processing. Variations between regional offices can cause
    claims processors from different ROs to misunderstand each
    other's work, resulting in a correct claim being unnecessarily
    deferred or delayed. Furthermore, by keeping a claim in a
    single regional office, managers have more control to send
    claims back to the original Veterans Service Representative
    (VSR) who wants worked on it. This would allow the VSR to learn
    from this error and not repeat it. This would also let the VSR
    and our Rating Veterans Service Representative (RVSR) who are
    already familiar with the claim to efficiently address follow-
    up work, saving other employees from wasting time to
    familiarize themselves with a new claim.
        If VBA, despite record production and quality from
    employees while working from home during COVID-19 pandemic, is
    going to require claims processors to report to the regional
    office, why continue to shuffle work throughout the country and
    not instead leverage employee ability to collaborate with the
    colleagues sitting next to them?
        As Congressman Self asked about the last time I testified,
    despite the claims backlog, one of the most consistent
    complaints from the claims processors is they do not have
    enough work to meet the performance metrics and must waste 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 individual claims
    processors work queue when they are out of cases to develop or
    rate. Second, claims processors should have a limited ability
    to temporarily hold onto the claim before it is retracted by
    the National Work Queue. Having the claim stay within one
    regional office for its duration would avoid delays and give
    ROs more control over their workload. It would also allow
    secondary claims to be associated with the primary claim and
    worked on simultaneously. Third, the National Work Queue must
    better filter automatic ready-to-rate claims, ensuring
    employees do not waste time on cases that are not ready to
    rate. Fourth, VBA should program the National Work Queue so
    employees who have previously worked on the claim have the
    claims returned to them. This would allow claims processors to
    learn from any mistakes that were previously made and improve
    efficiency and quality.
        New employees do not understand the claims process or VA
    lingo that is critical for employees to do their job. This is
    an easy problem to fix. All training should require hands on
    experience using the tools employees will actually use.
    Training must also focus on mastering the basics, including
    learning the claims process, VBA terminology, and what a claim
    looks like. AFGE urges VBA to reorder its curriculum to allow
    instructors to reference the material that was just taught,
    reinforce the concept, and use this to teach higher level
    concepts. VBA must also improve PACT Act training as Talent
    Management System (TMS) self-reviewed courses are ineffective,
    especially considering constant updates to the Standard
    Operating Procedure (SOP) and manuals that are not reflected in
    the training.
        Finally, on behalf of AFGE and NVAC partners who have long
    worked with this committee to help improve the VA and its
    delivery of benefits in health care to our Nation's heroes, I
    respectfully urge you to ask Secretary Collins to use the
    authority granted to him by President Trump's executive order
    to certify VA employees, including the employees under the
    jurisdiction of the subcommittee at the Veterans Benefit
    Administration, National Cemetery Administration, and the Board
    of Veteran Appeals, are not involved in national security and
    are, in turn, exempt from the executive order.
        The rights guaranteed in our collective bargaining
    agreement are critical to our ability to support the VA's
    mission and better serve veterans and their families. VBA is
    two generations of employees, both the mentors with
    institutional memory who are close to retirement and the next
    generation who are just beginning their journey of caring for
    veterans. Within 5 to 10 years, this knowledge will be lost
    forever if there are no exemptions made, combined with the
    proposed rifts. AFGE and NVAC stand ready to work with the
    House VA Committee and VBA to address these issues.
        Thank you and I look forward to your questions.

        [The Prepared Statement of James Swartz appears in the
    Appendix]

        Mr. Luttrell. The written statement of Mr. Swartz will be
    entering into the hearing record. We will now move to
    questioning. Mr. Smith, Kenneth Smith, Mr. Swartz seems like he
    nailed it right on the head. Now, this is kind of the
    conversation you and I have been having the past couple of
    years.
        Can we have a, not totally granular, but dive into the
    National Work Queue 2.0? You mentioned first touch efficiency.
    I think that is brilliant. Then what Mr. Swartz said, how a
    specific claim will return to a particular Veterans Service
    Organization (VSO) before it is--so it can be completed or
    repopulated into the work queue and then out to another
    regional office.
        Mr. Smith. Thank you for the question. We are working on
    new capability to focus on direct feedback to employees at the
    development action. This is a solution that we have been
    thinking carefully about since our conversations over the last
    year, year and a half. The idea here is to provide an error
    check right after they have completed their actions and before
    it returns to the National Work Queue to prevent delay on that
    claim. This is part of an interactive discussion between my--
    VBA and the Office of Information and Technology, who is
    working on that solution right now.
        Mr. Luttrell. As we are doing our best to inform anyone
    that they have made a mistake from the top down, what are we
    doing from the bottom up as far as training and readiness is
    going, so the mistake window is closed?
        Mr. Smith. Yes. I mean, we have completely revamped our
    training. Mr. Smith and his team have been working diligently
    on that to build in more training about exams, to make sure
    that we order the right exams the first time and not
    overdevelop. It has been added into all of our existing
    training products as well as our most recent Quality Standdown,
    where we took our entire workforce offline for a day to focus
    on specific training needs.
        Mr. Luttrell. Mr. Swartz mentioned that some of the VA
    employees are saying there is not enough work for them, which I
    find that--I have heard that myself from VA employees. I would
    like to hear your response and I--okay, so you are going to get
    into the National Work Queue thing. I got it. All right.
    However, if we do have certain employees at regional offices
    say there is nothing here for me. We have a miss somewhere.
        Mr. Smith. Yes, sir. There are 918,000 veterans waiting for
    decisions in the National Work Queue right now.
        Mr. Luttrell. Is that number----
        Mr. Smith. I----
        Mr. Luttrell. That number is down?
        Mr. Smith. It is. Since over the last year we have dropped
    it almost 6 percent.
        Mr. Luttrell. Six percent?
        Mr. Smith. Mm-hmm.
        Mr. Luttrell. Okay.
        Mr. Smith. The very fact that we do not have any work,
    there are two potential reasons for that that I can understand.
    You know, one is it has not been assigned to the employee or
    they have depleted all the work in their queue. That is why we
    want to be able to allow them to pull claims in when they are
    ready and then have us, have the National Work Queue push
    claims to them that is matched to their experience and
    training. Newer employees that are trained on a smaller subset
    of disabilities or types of claims get disability claims that
    they can work until they are fully trained and able to do all
    of them. More experienced staff can handle the more complex
    claims.
        Mr. Luttrell. I understand this correctly, now a claim will
    move from the National Work Queue into a regional area. A VA
    employee will be able to pull that claim without having a
    supervisor load up their desktop more or less, and the
    supervisor providing, I guess, oversight and training. An
    employee can, can move as much as possible. I am sure there is
    a baseline somewhere. It is like, hey look, you are--your
    minimum is this weekly, monthly.
        Mr. Smith. My expectation, and this is still, we are still
    working on the exact development and solution with Mr.
    Orifici's staff. The concept that we are operating under is
    that we will be able to distribute enough claims every day,
    prospectively, to keep people busy. Then if they actually run
    out because things are not ready for them, that they will be
    able to request additional work.
        Mr. Luttrell. I know we do not have a stat yet on--I am
    going to walk that one back. I want to think about that one for
    a second. Sir, Ranking Member, I will yield to you for your
    questioning.
        Mr. McGarvey. Thank you, Mr. Chairman. Mr. Swartz, I want
    to dig in a little bit about the recent executive order and the
    collective bargaining agreement that AFGE negotiated with VA.
    Aside from just being a gross breach of good faith, it also has
    some very real practical and detrimental consequences on the
    day-to-day work of those who are involved in processing claims.
    Again, that means our veterans. Anything that harms our
    frontline employees' ability to do their job by definition
    harms their ability to serve the veterans who are at the heart
    of VA's mission, who are at the heart of the mission of this
    committee.
        Mr. Swartz, ask you some questions. To your knowledge, has
    the Secretary submitted a request for an exemption to the
    collective bargaining EO for VBA employees?
        Mr. Swartz. No, sir.
        Mr. McGarvey. Thank you. Mr. Swartz, can the union members
    at VA collectively bargain for wages or promotions?
        Mr. Swartz. No, sir. That is banned by law, I believe.
        Mr. McGarvey. Okay. Can the union collectively bargain
    performance standards surrounding either quality or timeliness
    of claims processing?
        Mr. Swartz. No, sir.
        Mr. McGarvey. When was the last time the union workers at
    VA went on strike?
        Mr. Swartz. Never. It is against law.
        Mr. McGarvey. Perfect. Can the union collectively bargain
    for more or better training?
        Mr. Swartz. No, sir. I do believe that is where the union
    would be very beneficial for both the employees, the VBA or VA,
    and also for the veterans. Most of us are workers ourselves. We
    are aware of what is going on. We do the work, we talk to the
    first line employees, and more often they will come to us and
    let us know what their training needs are. Many of them are
    afraid to actually go to managers or supervisors. We have even
    worked with a lot of supervisors when employees are running
    into trouble so that we can work with the employees to get them
    where they need to be.
        Mr. McGarvey. What would you say is the biggest impediment
    to frontline employees operating more efficiently with higher
    quality? How do you think AFGE can help remedy that?
        Mr. Swartz. The number one issue would have to be training,
    and that is where the VA would be, or, I am sorry, the unit
    would be able to work with the VA in order to establish what
    training is needed and to help the employees be able to get to
    their--get these training needs met when it becomes an issue,
    before it becomes a problem.
        Mr. McGarvey. Just looking at this, how does the lack of a
    union with collective bargaining rights impact the ability of
    frontline employees to do their job well and better serve
    veterans?
        Mr. Swartz. I would say one of the biggest things has
    probably have to do with moral, the moral impact that it would
    have. The employees will no longer have a voice. They will no
    longer feel comfortable or competent to be able to go to the
    agency and discuss what their training needs are or discuss
    even what some of the roadblocks are in the way of them
    performing the mission.
        Mr. McGarvey. Is VBA planning to consult frontline
    employees in development of new technology modules?
        Mr. Swartz. Not that I am aware of.
        Mr. McGarvey. Okay. What about the training content?
        Mr. Swartz. Again, not that I am aware of. I have been
    fortunate enough at, I hate to say it, at my regional office,
    but I have been able to work with management to get employees
    some of the additional training necessary.
        Mr. McGarvey. For Mr. Kenneth Smith, I will just ask you
    those exact same questions. Is VBA planning to consult
    frontline employees in development of new technology or
    training modules?
        Mr. Smith. Usually management develops the solutions and
    then we brief the union when it is time to implement.
        Mr. McGarvey. I would just suggest from being in the
    private sector and other things, getting the input from the
    people who are actually doing the work on the ground before you
    develop the training is a best practice. What about the
    training content, is it the same thing?
        Mr. Smith. I believe that there--and I will ask Mr. Smith
    to weigh in on this. I believe there are union members on the
    training team.
        Mr. Smith. That is correct. Not only are they on the
    training team, they develop the content and then also Subject
    Matter Experts (SMEs) from the field, more often than not are
    labor BUEs. They are actually the ones providing the training.
        Mr. McGarvey. Again, we want the best training. We want the
    best employees. This is what helps our veterans. Thank you guys
    so much.
        Mr. Chairman, I yield back.
        Mr. Luttrell. Thank you, sir. Mr. Smith, did the
    Overdevelopment Reduction Tax Task Force, was that disbanded
    last year?
        Mr. Smith. I would not say disbanded, sir. It completed
    work at the end of July. We are working right now on some
    additional initiatives. Such as, we are collaborating with the
    Board of Veterans' Appeals and Office of General Counsel to
    take a look at end-to-end automation and process and procedural
    efficiencies.
        Mr. Luttrell. Did it perform its functionality as it should
    have? It seemed like that was a pretty short window.
        Mr. Smith. Yes, sir. They made more than 50 manual updates
    to streamline and clarify guidance as well as promoted and
    executed some enhancements to the exam scheduling assistant to
    make it more--a little better for employees.
        Mr. Luttrell. That is onboard and running.
        Mr. Smith. It is up and running, but it is a standalone
    tool. What we are doing right now is building that into VBMS so
    that the claims processors do not have to lead the VBMS
    environment to use it.
        Mr. Luttrell. Besides updating the VBA manual on March 10,
    what else is the VA doing to ensure claims processors
    understand the long-standing rules for when to schedule an
    exam?
        Mr. Smith. That is core to our training. All of our
    training content reinforces the requirements for training for
    ordering exams and medical opinions. We have done that through
    our Overdevelopment Reduction Task Force. Those recommendations
    reinforce that leading to a 7 percent decrease in
    overdevelopment errors.
        Mr. Luttrell. You mentioned 7 percent reduction off of the
    gross number. What is projection for this year and what was
    our--did we break a record last year? Or last year--in February
    for disability claims?
        Mr. Smith. Yes. We completed more than a million claims
    earlier this year than ever before.
        Mr. Luttrell. Job well done.
        Mr. Smith. Thank you.
        Mr. Luttrell. I will share that with everybody I know. How
    are we looking for what month is it? April, May, June? How -
    what is the projection downstream?
        Mr. Smith. We are looking--right now we are running eight
    and a half percent ahead of where we were this time last year.
    We are looking to complete more than 2.5 million claims this
    year.
        Mr. Luttrell. What is our total that are outstanding? I
    mean, eventually I would assume we are going to run out of
    veterans.
        Mr. Smith. Well----
        Mr. Luttrell. If we are working at this rate, seems like. I
    probably should not say it like that. I got 40,000 veterans who
    will kick my butt for saying that. I did not mean that in a bad
    way. What I meant was, for the record, what I meant was
    eventually all our veterans will be whole.
        Mr. Smith. Yep. We continue to receive about 10,000 new
    claims a day. Our inventory right now is 918,000. We have been
    fortunate with some high productivity. We have been completing
    north somewhere between right around 11,000 claims a day to
    help us decrease the inventory and get ahead of the backlog as
    well.
        Mr. Luttrell. Okay, well. Outstanding. Before I move on,
    Mr. Smith, do you have anything you would like to add? I would
    hate for you to come all the way--we are having markup in
    multiple committees currently today. Obviously, that is why--
    the ranking member and I are the only ones here. Mr. Smith, I
    am not going to let you come all the way to DC. and not say
    anything.
        Mr. Smith. No, I appreciate the opportunity. I would like
    to circle back to the Overdevelopment Task Force. In addition
    to what Mr. Smith shared some of the feedback not only from,
    you know, our partners across the different business lines, but
    our SMEs from the field to include bargaining unit employees
    (BUEs), was that the class size was too large. We shrunk the
    class size. We focused on four phases of a training process.
    Planning, design development, implementation, evaluation, or
    the Kilpatrick Model. We are focused on making data-driven
    decisions and updates to the training based on feedback, the
    assessments that the employees complete themselves as well as
    data that has gleaned from quality reviews. We are committed to
    continuous process improvement with the goal of putting
    veterans first in every decision made.
        Mr. Luttrell. Mr. Orifici.
        Mr. Orifici. Thank you for the opportunity. We are
    extremely excited about the work that we are doing in support
    of VBA and claims process. We are utilizing a lot of the
    current technologies including Artificial Intelligence (AI) to
    help us get ahead of the claims process.
        Mr. Luttrell. Are you where you need to be or is the VA
    where they need to be in the AI space, since it is forever
    changing? I would recommend you keep us very well read on if we
    are slowing so we can get ahead of it.
        Mr. Orifici. No, we are definitely leaning into it. We are
    utilizing it to its most. We are very excited about the
    interactive assist that we have for claims with helping them to
    avoid deferrals and help them make the right decisions. This
    will also tie back into ordering the right exams when they are
    needed and not ordering exams when they are not.
        Mr. Luttrell. Mm-hmm.
        Mr. Orifici. We have a lot of very interesting pilots
    coming up that we are working with VBA on. That should yield a
    lot of benefits when it comes to making the right decision the
    first time versus having to defer back to correct later on.
        Mr. Luttrell. Okay, thank you. There will always be
    something that populates. There will always be a problem set
    that exists. The VA is such a wonderful working machine. Right?
    I mean, I say that wholeheartedly. It has its problems. It
    does. We should forever be changing in order to keep up with
    the wants and needs of our veterans' space. As we move into, as
    our older generations, we are moving into the younger
    generations, our generation of war fighters are coming into the
    VA, and there are a lot of us. Then, you know, it pains me to
    say this, but we are always on the threshold of activation
    again.
        If we do have to go to another theater of war, it will
    populate more and more and more of us. The VA, as hard as we
    work, will always have to work harder every single day. Every
    day, I am sure you do the same thing. Every day I wake up and I
    walk into the--I look in the mirror, I was like, it is not
    about me. It is about everybody I represent. Guess what,
    gentlemen? You represent the most cherished asset we have, and
    that is our veterans that allowed us to do the things that we
    do today. Okay?
        Ranking Member, you got any closing remarks?
        Mr. McGarvey. Thank you, Mr. Chairman. I echo those
    remarks. I thank you for your service and thank you all for the
    service you perform, particularly on behalf of our veterans,
    the men and women who are putting on a uniform, willing to
    sacrifice everything to keep us safe and keep us free. What I
    am going to ask you all to do is on this committee, we actually
    do our best to work together because we understand the mission
    of this committee is to serve our veterans. Make sure you got
    the best management, make sure you got the best labor, and that
    everybody is getting the training they need, and that everybody
    has access to the tools they need and the morale they need, the
    retention that we need to keep people there to keep these
    claims going forward, because that is what is going to help our
    veterans out. Hope you all can continue to do that good work,
    because it is going to take care of the men and women who took
    care of us.
        Mr. Chairman, I please ask unanimous consent to enter into
    the record the following letter to Secretary Collins, from Rep.
    Takano, yourself, Senator Blumenthal, and 126 other members of
    the House and Senate condemning the Trump Administration's
    decision to obviate the collective bargaining agreements,
    bargaining rights of Federal employees, and urging the
    Secretary request waiver from those requirements.
        Thank you.
        Mr. Luttrell. Without objection. Thank you again,
    gentlemen, for coming today. I ask unanimous consent that all
    members have 5 legislative days to revise and extend their
    remarks and include extraneous material. Without objections, so
    ordered. This hearing is adjourned.
        [Whereupon, at 2:18 p.m., the subcommittee was adjourned.]

    =======================================================================

                             A  P  P  E  N  D  I  X

    =======================================================================

                        Prepared Statements of Witnesses

                                  ----------

                      Prepared Statement of Kenneth Smith

        Good morning, Chairman Luttrell, Ranking Member McGarvey, and
    Members of the Subcommittee. I appreciate the opportunity to appear
    before you today to discuss VA's efforts to improve efficiency in
    Veterans' disability compensation claims processing through the
    National Work Queue (NWQ), and the efficacy of VBA's quality assurance
    and training programs resulting from the Overdevelopment Reduction Task
    Force (ODRTF). Joining me today are James Smith, Deputy Executive
    Director of Compensation Service, and Robert Orifici, Executive
    Portfolio Director for Benefits Appeals and Memorial Services, Office
    of Information and Technology.
        VA is committed to providing outstanding customer service to our
    Nation's Veterans, their families, and survivors, and we are steadfast
    in our commitment to timely and accurate decisions on Veterans'
    disability compensation claims. VBA has a robust training and quality
    review program holding employees, regional offices (RO), and program
    offices to a higher standard for producing quality claims decisions
    while also promoting continuous learning and performance improvement.
    We appreciate the Subcommittee's interest in this topic, and I know we
    share the same goal of collaboration and continuous improvement.

    Over-Development Reduction Task Force

        On January 31, 2024, ODRTF's second phase (ODRTF 2.0) kicked off
    with a focus on improving the claims examination process. The task
    force put an emphasis on contract examinations, utilization of private
    Disability Benefits Questionnaires (DBQ) submitted by Veterans,
    utilization of the Examination Scheduling Request tool, and
    effectiveness of automated examination ordering. It also explored
    opportunities in policy, processes, and technology to eliminate over-
    development.
        When ODRTF 2.0 concluded in July 2024, VA implemented numerous
    recommendations in several areas including improvement of the private
    DBQ submission process; guidance to field employees on appropriately
    requesting examinations; and employee training to assist claims
    processors in scheduling more informed, intentional, and accurate
    requests for disability examinations and medical opinions.
        One of the recommendations that VBA implemented were improvements
    to the Exam Scheduling Assistant (ESA). This tool provides claims
    processors with a series of questions for each claimed disability and
    helps determine whether an examination or medical opinion is warranted.
    VBA is in the process of integrating the web-based ESA tool into the
    Veterans Benefits Management System (VBMS) so that claim data can be
    auto-populated, reducing duplication of work and increasing the
    accuracy of examination decisions. The integrated tool will continue to
    present the claims processor with a series of questions to aid in claim
    development. The anticipated date of release of the integrated tool is
    Fiscal Year (FY) 2026.
        Additionally, since June 2024, VBA has made procedural changes to
    clarify and emphasize that examinations are not required when there is
    sufficient evidence of record to decide the claim. VA regulations
    direct decision-makers to render a decision without the need of further
    examination or development, if the medical evidence of record is
    sufficient. This includes accepting private DBQs when sufficient, which
    avoids scheduling unnecessary exams. VA is continuing to guide claims
    processors on this concept as another update to VA's procedures manual
    relating to medical evidence sufficiency was just published on March
    10, 2025.

    Training and Quality Initiatives

        In June 2024, VBA began efforts to modernize training for all
    disability compensation claims processors. This program has
    specifically focused on reducing over-development in medical opinions
    and examinations - streamlining when, why, and how they are ordered.
    These lessons emphasize hands on learning and reinforcement of concepts
    through interactive and engaging activities, ongoing assessments to
    ensure learners are mastering the content, and remedial training and
    follow-up assessments for those who fail to grasp the concept the first
    time it is assessed. Some of the specific training courses provided in
    support of minimizing over-development include courses on preventing
    deferred rating decisions in the claims process, identifying the need
    and sufficiency of VA examinations, reviewing DBQs to determine if a
    medical opinion is necessary to decide a claim versus when it can be
    decided based on the evidence of record, and a renewed training on the
    duty to assist requirements for our Rating Service Representatives who
    render decisions on Veterans' claims for compensation benefits.
        When training newly hired claims processors, VA emphasizes the
    negative impact over-development has on claims timelines. How, when,
    and whether to order examinations consistent with regulatory guidance
    are addressed in several courses during initial claims processor
    training. The courses emphasize the impact of 38 C.F.R.Sec.  3.326 -
    specifically, that medical evidence accompanying a claim, whether
    submitted by the claimant or received from a Federal records custodian,
    might render a claim ready for decision without the need of further
    examination or development. This scenario is frequently seen with cases
    of active, presumptive cancer, or claims for increase for total joint
    replacement - an examination would provide no new information beyond
    what is already available in the medical records, so the claim should
    be decided immediately.
        Examination and medical opinion training courses have also been
    updated to include the most recent guidance on requesting evidence,
    sufficient examinations, and Sergeant First Class Heath Robinson
    Honoring our Promise to Address Comprehensive Toxics Act of 2022 or
    PACT Act-related claims and toxic exposure risk activity opinions.
    These concepts are reinforced throughout training with knowledge checks
    and instructor guidance.
        Additional training is provided to claims processors on a recurring
    basis for topics such as the different types of medical examinations
    and opinions and in which scenario each is required or not required to
    grant a claimed issue. An important part of this training is
    specifically focused on preventing the ordering of additional
    development for examinations and medical opinions when the evidence of
    record allows the claimed issue to be resolved in the Veteran's favor.
    This information is laid out and reemphasized throughout the training
    program for new claims processors.
        In June 2024, VBA hosted the first ever VBA-wide Quality Standdown,
    highlighting the Agency's commitment to the importance of high-quality
    actions and positive work experience. This provided claims processors
    with targeted instruction on medical exam requests and the rework
    process. In the post-event survey, with 77 percent of employees
    reporting positive sentiments with improvements noted in 3 month
    rolling quality. In Fiscal Year 2025, VBA plans to host regular events
    collaborating with the Board of Veterans' Appeals and Office of General
    Counsel to further improve measurable outcomes and engage employees in
    content directly related to accuracy trends.
        VA acknowledges that there is always room for improvement, however
    VBA's quality data shows that monthly errors cited for examination
    over-development in Fiscal Year 2025 to date has decreased by just over
    7 percent from Fiscal Year 2024. VBA achieved this while the average
    number of claims processors on production increased by nearly 11
    percent. Additionally, in disability compensation rating claims, 3-
    month issue-based accuracy improved from 91.5 percent at the close of
    Fiscal Year 2024 to just under 93 percent at the close of January 2025.
    This portrays that the changes VBA implemented to improve quality
    assurance and training programs are having a positive effect. VBA will
    continue to find ways to improve.
        VA's commitment to continued process improvement of quality
    programs has been further strengthened by additional safeguards that
    have been built into the processing software used to develop and decide
    claims for benefits. For example, modifications were made to the
    examination process by updating a tracking indicator in the VBMS system
    to clarify the status of medical examinations and what additional
    evidence, if any, may be required. This allows claims processors
    involved with the claim to quickly surmise the status of the claim and
    to determine what other development actions are required to decide the
    claim.

    Implementing VA Office of Inspector General (OIG) Recommendations

        In the OIG Report, ``Staff Incorrectly Processed Claims When
    Denying Veterans' Benefits for Presumptive Disabilities Under the PACT
    Act,'' \1\ OIG made a process recommendation and a systems
    recommendation. VA has made significant progress in addressing both. As
    previously noted in this testimony, VBA is scheduled to implement the
    web-based Exam Scheduling Assistant (ESA) tool within the VBMS in early
    Fiscal Year 2026. However, the ESA tool has been available as a stand-
    alone, web-based tool for claims processors since November 2023, in
    addition to RO guides developed by the Medical Disability Examination
    Office such as the ``Exam Scheduling Request Reference Job Aid'' and
    ``Medical Opinion Guide.''
    ---------------------------------------------------------------------------
        \1\ https://www.vaoig.gov/reports/review/staff-incorrectly-
    processed-claims-when-denying-veterans-benefits-presumptive
    ---------------------------------------------------------------------------
        Transformative changes are currently being implemented in the
    National Work Queue (NWQ) system, as well as how the NWQ team trains
    the field on workload management, which will impact the efficiency of
    claims processing within VBA. VBA has implemented training to address
    workload management issues, to include local auto-assignment rules.
    Supervisors have provided positive feedback that the training has
    significantly helped, and they also bring that knowledge back to their
    RO peers.
        While the December 2024 OIG report highlighted inconsistencies in
    claims processing, VA is actively addressing these issues by refining
    the Adjudication Procedures Manual and enhancing examination tools.
    Most recently, on March 10, 2025, VBA published a revision to the
    Manual to add a note on the threshold for evidence of a current
    disability-or persistent or recurrent symptoms of disability-for the
    purpose of determining whether to request an examination and/or medical
    opinion and to cross-reference similar principles discussed in other
    portions of the Manual. Based on this progress, VBA has requested
    closure of the related recommendation and continues to work toward
    closure of the remaining recommendation.
        VA is committed to continued process improvement for processing
    PACT Act claims and is implementing OIG's recommendations. VA is
    continuing to update the Manual on when personnel should request
    medical disability examinations and opinions. Additionally, VA is also
    working on enhancing systems and tools involving the examination
    process.

    National Work Queue Initiatives and Improvements

    National Training and Supervisory Workload Management Training (SWMT)

        In August 2023, NWQ conducted national training for all regional
    offices, with over 600 claims processing managers attending, focusing
    on local rules and deferral routing. This content has since been
    incorporated into the SWMT, launched in February 2024. SWMT is designed
    to equip new supervisors with the principles and best practices for
    workload management. To date, 300 supervisors have benefited from this
    training. Additionally, NWQ offers personalized consultations with RO
    managers to enhance their understanding and application of local
    workload routing rules.

    NWQ 2.0 and Enhancements

        NWQ 2.0 will represent a significant leap forward in VBA's claims
    processing capabilities. One of the areas of concern raised by Congress
    during a previous oversight hearing and confirmed by an internal ``red
    team'' is the routing of work back to an employee who previously worked
    on a claim. The current system, which utilizes Prior Assignment Routing
    (PAR), has limitations, and does not always ensure that the claim
    reaches the actual claims processor who previously worked on it. To
    address this, VA has developed requirements for a new approach to
    replace PAR, allowing for claims to be routed back to the employee
    based on the last creditable transaction. VA is taking this one step
    further and is carefully evaluating other approaches to implement
    themes from the ODRTF while also reducing missed development. This
    targeted approach will is expected to improve the first touch
    efficiency and reduce avoidable deferrals, while still maintaining a
    routing process to get the claim back to the last person who took
    action on the claim.
        Another key improvement in NWQ 2.0 is the introduction of a
    ``pull'' capability to allow a claims processor the ability to take the
    next claim to be worked out of a dynamically optimized list of claims
    pending assignment. Through this capability, claims processors will be
    ``badged'' with attributes, including experience level and proficiency
    levels for specific categories of claims. When the employee is out of
    work, they may request an additional claim, and the system will
    automatically assign a claim that meets their competencies. Eventual
    functionality will allow employees and their supervisors specific,
    actionable feedback for additional training, while ensuring that claims
    requiring special handling are directed to claims processors who are
    both trained and qualified, thereby enhancing the efficiency and
    accuracy of our service to Veterans.
        VBA and the Office of Information and Technology (OIT) are
    currently working to define requirements to achieve outcomes for both
    reduction in erroneous development, the ability to leverage the prior
    claims processor's expertise as well as provide feedback on errors if
    subsequent development is necessary. This functionality will be
    released incrementally, with the first deployments starting in Quarter
    4 of this fiscal year. As functionality becomes available, VBA and OIT
    will collaboratively confirm that the functionality is working as
    intended and adapt requirements to ensure VBA has the capability needed
    to distribute claims effectively.

    Deferrals

        The deferral process is a critical component of VBA's commitment to
    quality and employee development. Deferrals are a mechanism for
    employees working later stages of the claims process, to ensure the
    completeness and accuracy of claims processing. It allows for mentoring
    and constructive feedback, particularly for junior employees. When an
    employee completes all required actions, they are certifying that the
    work done is accurate and is ready for the next action by subsequent
    claims processors to complete the claim. The most important movement of
    a claim is the movement from evidence development to the decision
    phase. In this scenario, if the decision-maker cannot make a decision
    due to a misstep in evidence development, they will issue a deferred
    decision and direct additional action be taken to remedy the issue.
    This type of deferral may be categorized as either avoidable or
    unavoidable. An avoidable deferral is an error in workmanship, while an
    unavoidable deferral typically arises when new evidence has been
    introduced subsequent to the last action. This process is not unique to
    NWQ; it is an electronic adaptation of VBA's longstanding practice.
        Avoidable deferrals are routed back to the last employee who
    handled the claim for correction. This reflects a simple accountability
    framework: employees are accountable for certifying the claim is ready
    for a decision and should only certify claims for decision when they
    have personally reviewed and have ensured that all necessary actions
    have been taken. This fundamental management determination and process
    ensure accountability and are longstanding principles that are hard
    coded into VBMS. As of February 2025, 99 percent of all avoidable
    deferrals were being routed back to the RO and 92 percent were routed
    to the specific employee that last worked the claim in the prior claim
    cycle.\2\
    ---------------------------------------------------------------------------
        \2\ Deferrals may not route back to the previous employee if the RO
    has the avoidable deferral routing turned off for specific employees
    due to a new work assignment.
    ---------------------------------------------------------------------------
        Supervisors play a crucial role in monitoring deferral frequencies
    and developing plans for improvement. As part of recent national
    events, such as the Quality Standdown and SWMT, supervisors have
    received training on new tools to evaluate deferral trends and errors
    trends. These tools include the Deferral, Error, and Transaction
    Dashboard which compiles six reports into one easy to use tool, for
    reviewing deferral data and recommending appropriate remedial training.
    This report also houses all errors in one report, providing a breakdown
    of errors by body system and claimed condition. These tools will allow
    VBA to make data driven decisions to enhance training and drive quality
    improvements.
        VBA is taking a data driven approach to construct a pilot for wider
    communication of a claim's deferral. VA's duty to assist often requires
    more than one review in the development process. While VA is working to
    ensure these claims are routed back to the same claims processor and
    has made substantial improvements in this area, employee leave and
    capacity may require assignment to another claim's processor for
    subsequent action. While the deferral process assigns accountability
    for full and complete evidence development to the last employee to work
    the claim in the development cycle, VBA does recognize the potential
    for feedback to the claims processor(s) who worked on the claim
    upstream from the final certification of completeness. This feedback
    would be focused on training and awareness of the need for quality at
    each step of the process, with the intended effect of constructive
    supervisor-employee discussions and continuous improvement. Available
    data will be evaluated and shared with RO supervisors to determine the
    utility of the feedback, which is in addition to existing feedback from
    VBA's formal quality management process.
        OIT and VBA are also evaluating other efforts to prevent deferrals
    before they occur. One area of exploration will use Artificial
    Intelligence (AI) and machine learning to analyze a claim, reference
    policy manuals and user training materials, and provide guidance to
    claims processors on which actions should be taken. These efforts are
    using historic claims and deferrals to train AI models to better
    understand what steps will be needed to lead to the correct outcomes
    the first time. VA plans to begin a small pilot on this and other
    efforts by the end of this fiscal year.

    Conclusion

        VA remains committed to identifying areas where we can improve our
    systems and processes to increase the efficiency and quality of
    benefits that we deliver to the Nation's Veterans. We will continue to
    leverage internal quality reviews, adapt our training programs, and
    continue advancements in NWQ 2.0 to ensure that all claim processors
    are equipped with the best tools to complete our sacred mission and to
    uphold President Lincoln's promise to care for those who have borne the
    battle and for their dependents. Mr. Chairman, this concludes my
    statement. We thank the Committee for your continued support of
    programs that serve the Nation's Veterans and look forward to working
    together to further enhance delivery of benefits and services. My
    colleagues and I are prepared to respond to any questions that you or
    other members of the Subcommittee may have.

                       Prepared Statement of James Swartz

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                           Statements for the Record

                                  ----------

                Prepared Statement of Disabled American Veterans

        Chairman Luttrell, Ranking Member McGarvey and Members of the
    Subcommittee:

        DAV (Disabled American Veterans) is grateful to provide a statement
    for the record for this oversight hearing titled, ``Examining VA
    Efforts to Decrease Delays in Veterans' Disability Compensation
    Claims''.
        DAV is a congressionally chartered and Department of Veterans
    Affairs (VA) accredited veterans service organization. We provide
    meaningful claims support free of charge to veterans, family members,
    caregivers and survivors.
        To fulfill our service mission, DAV directly employs a corps of
    benefits advisors, national service officers (NSOs) and transition
    service officers (TSOs), all of whom are themselves wartime service-
    connected disabled veterans, at every VA regional office (VARO) as well
    as other VA facilities throughout the Nation, including the Board of
    Veterans' Appeals (Board). During 2024, DAV filed 561,358 claims for
    over 1.5 million specific injuries and illnesses on behalf of thousands
    of veterans, resulting in more than $30.4 billion in earned benefits
    for veterans and their families.
        We currently provide representation for nearly 250,000 pending
    claims and appeals before the Veterans Benefits Administration (VBA).
    Based on over a century of direct experience, we are pleased to provide
    our insights and concerns related to the significant issue of
    overdevelopment within the VA claims and appeals processes. This issue
    directly affects the efficiency of VBA and the well-being of millions
    of veterans who rely on timely access to their earned benefits.
        Our testimony outlines the significant problems with
    overdevelopment in several areas, which include feedback from our
    service officers; claims related to the PACT Act; military sexual
    trauma (MST); and disability benefits, as well as appeals under the
    Appeals Modernization Act (AMA) and DAV's recommendations.
        Overdevelopment, characterized by redundant and unnecessary
    requests for additional evidence delays decision-making, creates
    inefficiencies and imposes undue burdens on veterans. Additionally, the
    implementation of the Veterans Benefits Management System (VBMS) and
    the National Work Queue (NWQ) have contributed to challenges in
    overdevelopment despite their intended purposes of streamlining the
    claims process.
        Examples of overdevelopment noted by our service officers
    illustrate the broader systemic inefficiencies within the VA that
    continue to hinder the timely and accurate resolution of claims and
    appeals. For example:

          Improper indexing of evidence in VBMS results in
    unnecessary efforts to develop evidence already present in the
    claimant's record.

          VA claims processors that initiate examinations for
    conditions unrelated to Toxic Exposure Risk Activity (TERA) leads to
    wasted resources and unnecessary processing steps for TERA claims.

          VA requests for additional examinations despite claimants
    providing DBQs completed by private physicians results in delaying the
    veteran's access to benefits.

        The VA's statutorily required duty to assist is a foundational
    obligation that requires the agency to assist claimants in gathering
    relevant evidence to support their claims. Unfortunately, unclear and
    inconsistent communication regarding the duty to assist has contributed
    significantly to overdevelopment. Claimants often receive vague or
    redundant notifications requesting additional evidence without
    sufficient guidance on what is needed. This ambiguity results in
    repetitive submissions, unnecessary delays, and excessive evidence
    gathering, which burden both claimants and the VA system. Notifications
    intended to update claimants on claim statutes frequently lack detail,
    leaving claimants uncertain about next steps and prolonging the process
    further.
        The severity of the overdevelopment problem is fully displayed in
    the 2024 Office of Inspector General (OIG) report titled, ``Staff
    Incorrectly Processed Claims When Denying Veterans' Benefits for
    Presumptive Disabilities Under the PACT Act'' (Report Number 24-00118-
    01), which identified critical systemic issues in PACT Act claims
    processing. Claims processors often requested unwarranted examinations
    and medical opinions, even for conditions presumptively linked to
    service. These unnecessary actions caused delays and incurred $1.4
    million in avoidable expenditures over 6 months. Underpayments totaling
    $56,700 were identified for improperly denied claims, along with 870
    potential errors affecting veterans' benefits. Examinations containing
    inadequate or conflicting information were not sent back for
    clarification but were prematurely used to deny claims, further
    exacerbating delays and appeals.
        Additionally, the OIG report indicated that the VA had an
    overdevelopment-reduction task force and the Deputy Under Secretary for
    Policy and Oversight stated that overdevelopment is expensive and time-
    consuming and has been a known problem for years.
        Another area that has been plagued with systemic inefficiencies and
    overdevelopment are claims dealing with MST. According to the 2021 OIG
    report, ``Improvements Still Needed in Processing Military Sexual
    Trauma Claims,'' (Report Number 20-0041-163), nearly half of MST-
    related claims denied during a 6-month review were processed
    incorrectly. Claims processors failed to apply liberal evidentiary
    standards, essential for MST cases due to the difficulty of documenting
    such incidents. The report attributed these failures to inadequate
    training and oversight, which perpetuates errors and prolongs the
    process. Claimants submitting MST-related claims often faced redundant
    evidence requests and unnecessarily lengthy appeals due to mistakes in
    the initial claims process.
        Appeals processing under the AMA has also been affected by
    overdevelopment. The 2023 OIG report--``VHA Faces Challenges
    Implementing the Appeals Modernization Act'' (Report Number 22-02064-
    155) highlighted inefficiencies in providing guidance for higher-level
    reviews and supplemental claims. Claimants often encountered delays
    caused by inconsistent processes, inadequate tracking systems, and
    excessive evidence-gathering requirements. These issues undermine the
    AMA's intent to streamline the appeals process and result in
    unpredictable outcomes for veterans seeking resolution.
        The VBMS has also contributed to overdevelopment. According to the
    GAO report titled ``VA Disability Benefits: Training for Claims
    Processors Needs to Be Enhanced'' (GAO-24-107510), VBMS faces technical
    limitations, including system defects and slow response times. These
    issues necessitate manual interventions that perpetuate redundant
    evidence requests and inefficiencies. Furthermore, VBMS has not fully
    integrated appeals capabilities, complicating claims resolution and
    adding to claimants' frustrations.
        The NWQ, established to balance workloads across regional offices,
    has created additional challenges. Less experienced claims processors
    often request additional evidence, which leads to redundant requests
    and delays as processors seek clarification or additional records
    unnecessarily. The lack of standardized protocols across offices
    further exacerbates disparities in decision quality and timeliness.
        Fragmented record retrieval processes also remain a significant
    hurdle. The NWQ and VBMS exacerbate these delays by frequently
    transferring claims between offices, further complicating an already
    disjointed system. As we have pointed out, overdevelopment is a
    significant problem within the claims and appeals processes.
        DAV recommends the following targeted reforms:

          Streamline the claims process: Eliminate redundant
    evidence requests and enhance automated systems to track claims
    progress in the NWQ and VBMS.

          Simplify forms: Redesign VA Forms, such as 21-526EZ and
    20-0996, to eliminate unnecessary sections and provide clearer
    instructions, ensuring veterans can submit accurate claims and appeals
    efficiently.

          Enhance communication protocols: Establish clear and
    consistent standards for duty-to-assist notifications, providing
    veterans with specific and actionable guidance on required evidence and
    detailing claim status updates.

          Expand training programs: Equip claims processors with
    specialized training to handle complex cases, including PACT Act
    claims, MST-related claims, and AMA appeals. Emphasize proper
    application of evidentiary standards and effective communication with
    veterans.

          Standardize NWQ protocols: Ensure claims are assigned to
    processors with relevant expertise to improve decision quality and
    consistency across regional offices.

          Strengthen compensation and pension examination
    protocols: Minimize errors by enforcing comprehensive evaluations and
    implementing peer reviews of examination reports for accuracy and
    accountability.

          Streamline record retrieval: Collaborate with the
    Department of Defense to create a centralized, efficient system for
    accessing veterans' medical and personnel records. Efforts should also
    focus on simplifying processes for obtaining private medical records.

        Systemic reforms are essential to eliminate the barriers imposed by
    overdevelopment and ensure the VA fulfills its obligation to serve
    those who have served. DAV urges Congress to enact these critical
    reforms, empowering the VA to provide timely and equitable benefits for
    all veterans.
        As an accredited veterans service organization, DAV remains
    steadfast in its commitment to advocating for the fair and timely
    resolution of claims and appeals. Our cost-free advocacy empowers
    millions of veterans and their families to navigate the complexities of
    the VA system.
        Mr. Chairman, this concludes DAV's statement for the record.

                   Prepared Statement of The American Legion
    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

      Prepared Statement of Veterans of Foreign Wars of the United States

        Chairman Luttrell, Ranking Member McGarvey, and members of the
    subcommittee, on behalf of the men and women of the Veterans of Foreign
    Wars of the United States (VFW) and its Auxiliary, thank you for the
    opportunity to provide testimony on this topic.
        Myriad reasons may cause delays in the Department of Veterans
    Affairs (VA) disability compensation claims process. However, despite
    the reason, they often result in underpayment of claimants and denial
    of benefits, at least for a period of time. We will limit our statement
    to four common causes of delay: failure to conduct a full review of the
    record prior to filing the claim, claim overdevelopment, review of the
    physician's medical opinion by a lesser credentialed medical
    professional, and anomalies in claims processing automated tools.

    Failure to Conduct a Full Review of the Record

        A VA Veterans Service Representative must perform a full review of
    a record during the development of the claim. In some cases, claims
    processors will focus on the first contention in the record and then
    base examinations and other actions only on that specific claimed item,
    rather than consider the entire scope of the claim. Ordering medical
    examinations based on an incomplete understanding of the record could
    cause unnecessary or duplicative examinations and medical opinions as
    the details of the record emerge. Superfluous medical examinations
    contribute to a disjointed process and unnecessary delays.

    Overdevelopment

        Overdeveloping the claim by ordering unnecessary medical
    examinations slows down the claims process and often frustrates the
    veteran. Claims for conditions related to toxic exposures seem
    especially prone to overdevelopment. Presumption of service connection
    satisfies the need for a medical opinion if the claimant's service
    record substantiates service in an exposure location and eliminates the
    requirement for further medical examination. Any additional
    investigation or medical examinations would be redundant and should be
    considered overdevelopment. As an example, for a veteran exposed to
    burn pits, VA would automatically grant service connection for a claim
    for chronic obstructive pulmonary disease (COPD), which is a
    presumptive condition attributed to that exposure. VA should not order
    a medical examination and incur a delay to determine some other cause
    of the COPD, such as the veteran's smoking habits. The VFW recommends
    that VA cross reference any previous claims and/or existing medical
    records to prevent ordering an unnecessary medical examination that
    would contribute to a delay in adjudicating the claim. VA also
    acknowledges claims overdevelopment as a problem area and established
    its own overdevelopment task force in 2021 to educate claims processors
    on strategies to reduce or eliminate this practice.

    Review by Lesser Credentialed Medical Professional

        Sending the physician's medical opinion to a lesser credentialed
    medical professional, such as a nurse practitioner, for confirmation/
    certification causes unnecessary delay and should not routinely occur.
    Claimants could perceive this practice as developing evidence to deny
    the claim rather than offering the veteran reasonable doubt. Time lost
    in sending the medical opinion report to this medical provider and
    awaiting action contributes to the delay with no increase in accuracy,
    quality, or completeness of the claim, and often results in an improper
    denial of benefits.

    Automated Tools Performance Degradation

        Automated tools ease claim preparation, submission, and tracking.
    However, VA must monitor their use to detect problems and develop
    solutions at the earliest possible opportunity to prevent delays.
    Beginning in May 2024, our VFW Service Officers noticed delays over
    several months in electronic claims submissions to the Veterans
    Benefits Management System. Delays of 40 days were routine persisting
    through December 2024. During those months, we met several times with
    VA to solve the problem and determine the cause. The situation is
    currently resolved with submissions occurring mostly within a day or
    two, but we still do not know conclusively what caused the delay or
    what to do if it occurs again. A 40-day delay to simply add evidence to
    a veteran's record is unacceptable and provides the opportunity for
    other situations that could have adverse effects, such as when VA
    decides a claim when there is additional evidence waiting for initial
    processing that would have resulted in a grant of benefits. When this
    happens, the veteran must file an appeal and wait months or years for a
    benefit delayed by an incomplete claims file.

    Information Required by Rule XI2(g)(4) of the House of Representatives

    Pursuant to Rule XI2(g)(4) of the House of Representatives, the VFW has
    not received any Federal grants in Fiscal Year 2025, nor has it
    received any Federal grants in the two previous Fiscal Years.

    The VFW has not received payments or contracts from any foreign
    governments in the current year or preceding two calendar years.

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