[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]
FASTER DECISIONS, STRONGER OUTCOMES:
VA'S WORK TO STREAMLINE THE
DISABILITY CLAIMS BACKLOG
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINETEENTH CONGRESS
SECOND SESSION
__________
WEDNESDAY, APRIL 15, 2026
__________
Serial No. 119-54
__________
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
64-343 WASHINGTON : 2026
=======================================================================
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
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, APRIL 15, 2026
Page
OPENING STATEMENTS
The Honorable Mike Bost, Chairman................................ 1
The Honorable Mark Takano, Ranking Member........................ 3
WITNESSES
Panel I
Ms. Margarita Devlin, MA, CRC, Principal Deputy Under Secretary
for Benefits, Veterans Benefits Administration, U.S. Department
of Veterans Affairs............................................ 5
Accompanied by:
Ms. Sandra Flint, Deputy Under Secretary for Field
Operations, Veterans Benefits Administration, U.S.
Department of Veterans Affairs
APPENDIX
Prepared Statements Of Witnesses
Ms. Margarita Devlin, MA, CRC Prepared Statement................. 33
Statements For The Record
Veterans of Foreign Wars of the United States Prepared Statement. 35
American Federation of Government Employees, AFL-CIO Prepared
Statement...................................................... 38
The Honorable Abe Hamadeh, U.S. House of Representatives, (AZ-08)
Prepared Statement............................................. 41
Questions for the Record Submitted by The Honorable Mark Takano,
U.S. House of Representatives, (CA-39)......................... 43
U.S. Department of Veterans Affairs Response to Questions for the
Record......................................................... 49
FASTER DECISIONS, STRONGER OUTCOMES:
VA'S WORK TO STREAMLINE THE
DISABILITY CLAIMS BACKLOG
----------
WEDNESDAY, APRIL 15, 2026
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The committee met, pursuant to notice, at 10:15 a.m., in
room 360, Cannon House Office Building, Hon. Mike Bost
(chairman of the committee) presiding.
Present: Representatives Bost, Bergman, Miller-Meeks, Van
Orden, Luttrell, Self, Barrett, Takano, Brownley, McGarvey,
Ramirez, Kennedy, Dexter, Conaway, and Morrison.
OPENING STATEMENT OF MIKE BOST, CHAIRMAN
The Chairman. Good morning. The Committee will come to
order. Without objection the Chair will--may declare a recess
at any time. I want to thank everyone for joining us here
today. You are going to notice that members, I think, will be
flowing in and out. We are here today to discuss some good news
that the U.S. Department of Veterans Affairs (VA) has. I want
to--but I want to first acknowledge some situations that are
occurring here in Congress and some concerns that certain
members have. We want to make sure we keep them in our prayers.
I want to first acknowledge the seriousness of the super
typhoon that is hitting Sinkalu, a dangerous Category 4
hurricane affecting the Northern Mariana islands.
Representative King Hines represents that great, the great
people of that territory. I ask that we all keep in--her and
them in our thoughts and prayers.
Also one of our members, Nancy Mace, lost her father, who
actually was an amazing, was an amazing war hero from the
Vietnam era. We want to remember their family as well.
With that, I want to thank you all for being here and turn
to the subject that we are going to have here today. Thanks to
the strong leadership of Secretary Collins and the President
Trump, the backlogs of veterans waiting for a decision for VA
for their benefits has decreased dramatically. That is great
news. In fact, the backlog has dropped by more than 57 percent
since the start of the Trump administration, decreasing by over
150,000 claims since the end of the Biden administration.
Under the last administration, VA saw a 24 percent increase
in the disability claims backlog. That dysfunction left
veterans and their families waiting far too long for their
early--their earned benefits. However, in 2025, VA processed a
record setting 3 million disability Compensation and Pension
(C&P) claims. These accomplishments are a testament to what
hard work--hard working men and women at the VA can do under
the right leadership. VA reported accuracy has improved from
91.6 percent in October 2024 to 93.5 percent in September 2025.
That is a step in the right direction.
Maintaining high quality decisions remains a core concern
of mine. In 2025, Office of Inspector General (OIG) published
its investigation on a senior Veterans Service Representative
(SVSR) at the Philadelphia Regional Office. This employee
personally authorized 85,000 claims from 2022 until 2024 under
the Biden administration. Now let us be clear that this is 19
times the national average. The SVSR spent 4.7 minutes on each
claim. Let me say that again; 4.7 minutes on each claim. The
national average is 21 minutes. OIG estimate these error
results in two--that these errors resulted in $2.2 million in
improper payments. VA has assured me that new leadership is in
place to ensure this never happens again, but OIG
recommendations remain open.
I look forward to a timely update on the case from VA to me
and my staff. President Trump has a singular focus; making sure
government runs better, cutting through red tape and political
bureaucracy, and empowering the regular folks at the agency who
help our government run. This administration knows quality
matters. We are moving in the right direction but I look
forward to our hearing more from our witnesses today on how the
VA plans to sustain these gains. I support the targeted use of
mandatory overtime, but we need permanent solutions and long
term planning.
I also want to thank our friends at the Veterans Benefits
Administration (VBA) for their partnership in improving the
processing of survivor benefits. Due to the recent rule change
VBA now processes Dependency and Indemnity Compensation (DIC)
and survivor pensions together, ensuring eligible survivors
receive the higher of the two benefits which they should. VA
also moves the Office of Survivor's Assistance back to the
Office of the Secretary where it was first promised that it
would be so that they could have the constant ear of whoever
the Secretary might be ensuring survivors issues are accounted
for across the VA. Those changes help real people now. I look
forward to hearing from our witnesses today about these changes
and the use of modernization tools Congress has provided to VA
to get veterans their decisions faster.
Now I want to thank Ms. Margarita Devlin for being here
today. Ms. Devlin is the Principal Deputy Under Secretary for
Benefits of VBA, performing the delegable duties of the
Undersecretary for Benefits. She oversees the VBA which
delivers the full array of non-medical benefits to service
members, veterans, their families and their survivors. Ms.
Devlin is accompanied by Ms. Sandra Flint, Acting Deputy Under
Secretary for Field Operations. VBA runs a nationwide network
of 56 regional offices, overseas delivery of more than $194
billion in benefits to over 6 million beneficiaries. VBA plays
an important role and that role is only going to grow.
Many of these benefits and processes were designed in the
1950's. It is important that we have a VA that leverages
innovative technologies and approaches to improve outcome for
our veterans today and tomorrow. To know I know we are all
looking forward to hearing from Ms. Devlin. Ranking member, I
now recognize you for your opening statement.
OPENING STATEMENT OF MARK TAKANO, RANKING MEMBER
Mr. Takano. Well, good morning. Thank you Mr. Chairman.
Good morning everyone. Thank you for being here today as we
examine the timeliness of VA disability claims decisions.
Veterans need, want, and deserve a timely decision on their
claims. Access to earned benefits and care can mean the
difference between financial stability and better health or a
life of hardship. I say that without exaggeration. Yes, it is
welcome news that the disability claims backlog has returned to
its pre-pandemic level. Veterans also deserve an honest
accounting of how we got here and why the backlog ballooned
over the last few years.
Now, the backlog did not materialize out of thin air, nor
was its trajectory a mystery. It reflects two major events. As
you can see on this chart behind me, we hit a peak of roughly
425,000 claims in the summer of 2024. That is right here. It
has been trending downward ever since. It is a very dramatic
trend downward. There are two prominent spikes that occurred
before. The first spike is in the beginning of 2020, which is
the pandemic. It was driven by the COVID pandemic, which no one
could have predicted.
The second is beginning in 2022, following the passage of
the Honoring Our Pact Act. That second increase was not a
failure, was not because of a failure or due to bureaucratic
malfeasance or, as the chairman mentioned, some dysfunction. It
was anticipated and intentional. When President Joe Biden
signed the Sergeant First Class Heath Robinson Honoring our
Promise to Address Comprehensive Toxics (PACT) Act in 2022, the
summer of 2022, the goal was not to suppress claims or to keep
numbers low. The goal was just the opposite. VA accelerated
implementation and surged resources to encourage veterans to
come forward and file. Actually, the President, I think,
actually signed some sort of executive action which made
veterans, cohorts of veterans eligible sooner. You know, what
the actions of the President and Secretary at that time meant
was that it ensured that veterans could secure their date of
claim and their place in line and as quickly as possible.
In other words, the backlog increase reflected increased
access. It reflected veterans finally getting into the system,
many for the very first time, after years of being shut out.
Now, VA's own projections from October 2022 anticipated all
this. Now, I have a second chart up here. This was created by
VA just after the passage of the Pact Act in August 2022. It
shows projections for claims inventory and backlogs based on
the then new law. You can see a projected peak of about 450,000
backlog claims in October 2023. That is right here. It drops to
roughly 100,000 claims in February 2025.
Now, and this is the projection, but in the real, in real
life, in the real world, you know, we get to 100,000 a few
months after the projected date. I will remind you, this was a
projection that was created by VA just after the passage of the
PACT Act in August. All told, VA's projections were pretty
accurate, albeit a shift to the right just a few months from
what we saw in the real world. Now, what we are seeing today,
you know, the victory lap that is being touted in this hearing
is not the result of some extraordinary turnaround by the new
administration. It is largely the system and hardworking VA
employees performing as expected under the weight of expanded
eligibility and long overdue access.
Now, that context matters, especially as we hear VA
boasting and taking credit for a trend that was already
happening. There is more to the story. There is a growing
concern about a distinct shift of emphasis to quantity over
quality at the department. Processing speed has become the
headline metric. Veterans do not experience the VA system as a
metric. They experience it as a decision that is either right
or wrong from their perspective. If it is wrong, the
consequences are significant, including a denial of a veteran's
access to health care. Veterans deserve to know what the
opportunity costs are of the department focusing solely on
processing times.
Now, I am confident in saying that veterans do not want
partisan blame games just as much as they do not want a
partisan cheerleading session. Unfortunately, the nakedly
political back slapping session the majority has arranged today
fails in that we have a single witness before us, the
Department of Veterans Affairs. VA is hardly in a position to
provide an independent assessment of its own performance. What
we are missing are key oversight voices like the Office of
Inspector General and the Government Accountability Office who
would be able to speak objectively about the quality of VA's
claims processing work. Now we are missing the voice also of
the VA workforce who would be able to talk about the challenges
of VA's increased emphasis on throughput and the toll that mass
firings and a return to mandatory overtime have taken.
Most importantly, we are missing the voices of veterans
themselves, either individually or collectively, through their
advocates in the Veterans Service Organizations (VSO). It is
impossible to justify hearing by this committee on VA's claims
without including a single actual user of the system or the
service officers who help veterans navigate it every day. We
need to hear beyond the carefully honed talking points that VA
is going to deliver today. We need to know what is actually
happening on the ground from veterans and those service
officers who are helping them navigate this complex process. We
need, we raised the need. We raised a need for other voices to
be heard to the majority more than a month ago, and sadly, we
were rebuffed.
We are here today with only VA as our witness.
Nevertheless, we on our side are going to do our best to draw
out what is actually happening with disability claims
processing beyond just how fast claims are moving. A quick
decision is well and good, but if we are moving so quickly that
errors are made, or if we are simply rushing to denials, there
are downstream effects we must consider. Anecdotally but
consistently, we are hearing that claims processing errors are
rising and denial rates are increasing. That, of course, is
problematic. Premature or erroneous denials lead to more
appeals where timelines are measured in years and not months.
It is imperative that the Veterans Benefit Administration get
it right the first time, because any delay in getting a veteran
their earned benefits is a problem. It can lead to the denial
of health care and needless suffering.
We need to spend this committee's time finding solutions to
the problems veterans face, not on engineering victory laps for
the administration so that it can pat itself on the back for
simply doing what it was supposed to do. Our responsibility
remains the same. The question for us is not how fast claims
are moving, but whether we are getting them right in the first
place. Unfortunately, the structure of today's hearing makes
that harder to assess. We need a clear understanding of what is
actually happening in claims processing, not just how quickly
decisions are issued, but whether those decisions are accurate,
durable and fair to the veterans who depend on them. Veterans
deserve both speed and accuracy, because one without the other
is not success, it is simply delay in another uniform. Thank
you, Mr. Chairman. I yield back.
The Chairman. Thank you, Ranking Member, for your opening
statement. As mentioned earlier, joining us today from the
Department of Veterans affairs is Ms. Devlin and Ms. Flint.
Thank you both for being here. I ask you to please stand and
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? Thank you. Let the record reflect that
the witnesses have answered in the affirmative.
[Witnesses sworn.]
Ms. Devlin, you are now recognized for 5 minutes present
the department's testimony.
STATEMENT OF MARGARITA DEVLIN
Ms. Devlin. Chairman Bost, Ranking Member Takano, and
members of the committee, thank you. It is good to see you all
again. Thank you for the opportunity to be here to discuss VA's
progress in reducing the disability claims backlog. I
appreciate your unwavering commitment to veterans, service
members, their families and their survivors. Joining here with
me to testify is Ms. Flint. She is the Deputy Undersecretary
for Field Operations, so she is responsible for the entire
field.
I want to start by saying that behind every claim waiting
for a decision is a veteran or a survivor whose health,
financial stability, or financial--or family situation depends
on us getting this right. These are not just numbers they are
people who have already served this Nation and deserve timely
and accurate decisions. I am proud to report that under
Secretary Collins leadership, we have made historic progress.
For the first time since May 2020, the backlog has fallen under
100,000, an achievement made possible through disciplined
management and focus effort. We reached this milestone really
by combining three things. I am going to start by naming those
three; our people, our tools, and our technology. A clear
leadership focus on the areas where claims were stacking up.
First, let me talk about our workforce. By the way, our
workforce is about a little over half of veterans themselves.
Last year, VA completed a record breaking 3 million
compensation and pension claims. This year we surpassed 1
million claims earlier than ever before. Our employees drove
that success. They reviewed records, they developed claims,
they made complex decisions and determined when medical exams
were needed. They partnered closely with our contract exam
vendors who completed more than 3.5 million disability exams.
Together we expanded access to exams in rural areas so that
veterans could get the evidence needed no matter where they
live. All of this was done without sacrificing accuracy.
Quality is now, as of the end of March, over 94 percent, the
highest it has been in 2 years.
Second, are technology and automation. By using new
automated tools, we were able to streamline routine tasks and
process claims more efficiently, ensuring that our experts, our
employees, could focus on the decisions that require human
judgment. We also work closely with our Federal records
partners to ensure we receive documents needed to support these
claims and move them more quickly through the process.
Third, focused leadership and operational discipline. We
made deliberate decisions, such as using overtime strategically
and prioritizing high impact workloads that allowed us to drive
throughput where veterans were waiting the longest. As a
result, the average time to process a claim has dropped by 42
percent since January 2025, from 141 days to just 81 days. That
is 60 fewer days a veteran has to wait for an answer. This
progress extends to survivors as well. The dependency and
indemnity compensation inventory of pending claims has dropped
by 67 percent and the backlog by 83 percent. Survivor pension
claims have seen an 80 percent drop in inventory and a 96
percent reduction in backlog, with average processing time now
just 73 days, down from 173. These improvements give surviving
spouses and families faster access to stability and support.
None of this happened by accident. It happened because of
the dedication of thousands of VBA employees across the
country. Employees who adapted to new systems, embraced new
tools, upheld accuracy under pressure and never lost sight of
the mission. Mr. Chairman, this is not the finish line, but it
is a strong foundation, one that positions us to keep driving
the backlog down while maintaining the quality, accuracy, and
care that veterans deserve. At the end of the day, every day we
save brings a veteran or survivor closer to the benefits they
have earned. Thank you for your support and for the opportunity
to testify today. Ms. Flint and I look forward to your
questions.
[The Prepared Statement Of Margarita Devlin Appears In The
Appendix]
The Chairman. Thank you, Ms. Devlin, for your opening
statement. Everything will be filed in the records for the
opening statement. We now want to go to questions. I will
recognize myself for 5 minutes. Ms. Devlin, can you describe
how VA claims backlogs look now compared to the last several
years? One more time.
Ms. Devlin. Yes. Thank you for the question. In January
2025, it was over 264,000 veterans that were waiting over 125
days for a decision on their claim. We are now under 100,000;
as of this morning at about 83,000.
The Chairman. You accomplished that by using what tools and
what program and what plans did you use with your staff to get
that done?
Ms. Devlin. We use a combination of things. In addition to
our dedicated employees, our leadership focus on this ensured
that we used our national work Queue (NWQ) to drive the work to
where we could be most productive. The disability claims
process includes a lot of development. With our national work
queue, we can drive the work to where the bottleneck might be.
A lot of times that is development. Our automated procedures
help us get medical records more quickly. One thing that we do
for our veterans is if they have private medical records from a
private physician or hospital, they do not have to go find
those. Our automated systems, all they have to do is sign a
release and we will go get that, and much of that is received
in an automated fashion.
All of these different things that we do to get Federal
records to automate procedures that are administrative in
nature help the claim move through the process faster so that a
decision-maker can look at the claim and make that decision.
The Chairman. Okay, faster is important, and we are glad we
are getting them down. Also, what do you have to put in place
to make sure those decisions are accurate? Quite often the
conversation here is, okay, we cannot just like what OIG
discovered, you cannot do a 4-minute job and think that that is
accurate. What is in the system to make sure it is accurate
when you are doing it?
Ms. Devlin. That is a really great question. We focus very
much on accuracy. It is also not by accident that we are at 94
percent accuracy now. What we do, there is a feedback loop and
we get feedback from a lot of different ways. One is through
the Board of Veterans Appeals decisions. We take a look at
patterns and trends. We also look at the individual employee
quality reviews and our national reviews to determine whether
there are certain areas where employees are making mistakes.
Then we focus dedicated training on those areas. We do what we
call quality training sprints, where we sort of stop everything
and focus training on those areas where we find that we are
seeing errors. We are very focused on making sure our veterans
get the right decision as much as possible the first time.
The Chairman. The one claims processor that did the 80,000
in such a short period of time, what have you put in place to
make sure that is not occurring throughout the system? What are
the stopgaps to stop that from occurring?
Ms. Devlin. Thank you for that question. We have put a few
things in place. We have systems now that were not in place
before to identify those employees that are producing at that
high of a rate. If they are producing above a certain rate, we
are instituting additional quality review measures to make sure
those employees quality is where it needs to be. We are going
above and beyond with special focus reviews.
The Chairman. Okay. Because of the accusations that are
obviously going to be made in the political world, what--who
does the oversight to say, okay, your accuracy is at this
level? Is it you inside that make this decision on how accurate
it is, or is there some oversight that is put in place that we
know why it is that you get one accuracy rating prior and then
the next one? What is, what is the stopgap there?
Ms. Devlin. I can let Ms. Flint talk a little bit more to
this, but we have several different quality review systems. We
have an in-process review, which is for the employee's direct
feedback. These are things that happen while the claim is
moving through the process so that if we find an error before
that claim is complicated completed, we can give the employee
feedback, have that corrected before the decision is finalized.
Then we have employee performance feedback. These are quality
reviews that go against their performance standards. There are
about three to five that get done per month, depending on the
volume.
Then we have our national star quality review, which is
done by our national headquarters. These are not people
checking their own work. We have regional offices that are
getting their work checked for quality by other regional
offices or by our national team. They are not checking their
own work.
The Chairman. Okay. I think this committee, regardless of
the side of the aisle, we want to make sure, one, that these
claims are processed at a timely manner, but they need to be
accurate. That is the most important thing about having this
hearing today, is making sure that, you know, every person out
there believes their claim should be 100 percent. They do. That
is just the way a veteran is going to react to this. You have
got to be able to safeguard against, and you have got to do
your fiduciary duty. I appreciate you being here today. With
that, I am going to turn the questions over to the ranking
member.
Mr. Takano. Thank you, Mr. Chairman. Ms. Devlin, we hear
consistently that denial rates for disability claims have been
rising. That is true according to data from VA, denial rates
have been rising, have risen from roughly 35 percent in 2024 to
39 percent in 2026. Now, 4 percent may not sound like a lot,
but when VA is processing several million claims a year, any
percentage increase in denials represents tens of thousands of
veterans who are denied access to crucial health care and
benefits. Ms. Devlin, can you explain to the committee why
denial rates have risen over the last 5 years?
Ms. Devlin. Thank you for the question. I am not sure what
date you are looking at--but I did look at the data on grant
rates, and it has been consistently around 60 to 61 percent
grant rate, with the exception of the 2-years right around the
time PACT Act was implemented. Those 2 years, the grant rate
did go up a bit, to about 64 to 65 percent. Now we are in the
place where some of those claims that we are still working on,
which are in the backlog, are some of the more complicated
claims that have a lot more evidence to review and to obtain to
substantiate whether a disability condition exists.
Mr. Takano. Okay. Well, moving on, Ms. Devlin, according to
VA data, in addition to denial rates rising, claim accuracy
rates are currently below historical averages as well. Can you
explain why that is going on?
Ms. Devlin. Thank you again for that. I have been really
watching very closely the accuracy rates, and it is going up.
It is going up by design because we are focusing more on the
error rates that we are seeing.
Mr. Takano. I am reclaiming my time. I am not talking about
that they have been going up. I am talking about, can you
explain accuracy rates currently below historical averages? I
mean, yes, they are creeping up. That is not--I do not dispute
that.
Ms. Devlin. Respectfully----
Mr. Takano. They are still below historical averages. That
is what I want you to explain.
Ms. Devlin. Respectfully, sir, they are higher than they
have been in 2 years at 94 percent.
Mr. Takano. Two years. We are talking about previous years,
I just explained over the last 2 years why we have seen claims,
why there was a bulge when we had the pandemic. We also had
this massive outreach to veterans to file claims. I mean, that
is--I mean, claiming a victory lap over that precipitous
decline, you know, after VA was given all these resources. I
mean, that is bit rich, but we can look at the prior two or 3
years, kind of get a better sense of what is going on.
Ms. Devlin. Respectfully, sir, my concern is that veterans
understand that the VA is here for them, that we respect them,
and we want to take care of their benefits and the purpose of
putting the good news story out----
Mr. Takano. You are not really responding to my question.
Ms. Devlin [continuing]. is to gain their confidence.
Mr. Takano. I reclaim my time. You are not really
responsive here. You state that the claim accuracy is
improving, but I am having trouble reconciling that with what
is actually happening at the Board of Appeals. Now, the number
of appeals is also is increasing, partly because of increased
denial rates. The number of times the Board catches errors and
sends a claim back to VBA to fix is also increasing, and that
speaks to the quality deficit at VBA. Ms. Devlin, how can both
of these things be true?
Ms. Devlin. Thank you for the question. The denial rates
have not been going up. In fact, we looked at the percent of
disagreement with VA's decisions, and that has consistently,
over many years, stayed at between 11 to 13 percent of our
veterans who disagree with the decision they receive. Eleven
percent of a bigger number is a bigger number. We are producing
more claims, but the rate of disagreement is the same as it has
been historically. It is not gone up.
Mr. Takano. Okay, well, moving on. What is a clear and
unmistakable error (CUE)?
Ms. Devlin. A clear and unmistakable error is when, upon
review, we determine that the employee made a mistake of law or
regulation in deciding the claim.
Mr. Takano. Okay, so does VBA track those CUEs? That stands
for clear and unmistakable error, as part of its quality
control process.
Ms. Devlin. Clear and unmistakable errors? Yes. Well, we
would track them for the purpose of feedback for the employee,
but also to make sure we correct those errors for the veteran.
Mr. Takano. What is the trend line for the volume of that
type of error?
Ms. Devlin. I do not have CUE data here. I do not know if
Ms. Flint tracks that individually.
Mr. Takano. You cannot tell me if they are----
Ms. Devlin. We can get that to you.
Mr. Takano. You cannot tell me if they are increasing or
decreasing as of now.
Ms. Devlin. I can tell you that our errors in general are
decreasing and our percentage of accuracy has been going up.
Mr. Takano. You can tell me whether CUEs are increasing or
decreasing. You just told me that, right?
Ms. Devlin. I do not have that data in front of me.
Mr. Takano. You do not have the data.
Ms. Devlin. I do not.
Mr. Takano. You should not have said that. These CUEs seem
very, seems very much like the type of error that occurs when
someone is rushing to get something done. Steps get missed,
mistakes are made. That is not something that can be solved
with just training alone. Since you cannot tell me what the
trend line is, you know, I, I really cannot get my question
about whether we, we can cut down those rate of CUEs. I yield
back, Mr. Chairman.
The Chairman. Thank you. Representative Van Orden, you are
recognized for 5 minutes.
Mr. Van Orden. Thank you, Mr. Chairman. Ms. Devlin, thank
you very much for coming. Can you tell me how the proposed
reorganization and streamlining essentially of the chain of
command is going to affect your ability to help our veterans
and get these claims processed?
Ms. Devlin. Yes, sir. Thank you for that question. The
reorganization essentially streamlined our headquarters. Over
the years, the headquarters had gotten very large. What we are
trying to do is make sure that we are focusing the resources
where the veteran receives the benefits, which is in the field.
Streamlining the headquarters means less layers to go through
for decisions to be made, for issues to rise to my level.
Mr. Van Orden. Yes, because currently at the VA,
everybody's got six bosses. Bob. I had a great meeting with our
union folks in my office back in the district who work at the
VA, and they are seeing improvements, but there needs to be,
you know, continuous improvement. I wanted to pass that on to
you. I am, you know, people have mixed feelings about certain
unions and I do not. A lot of these folks, you know, they are
going to work and they are working very, very hard. I am really
proud of them. That is the--from the administrative folks to
the people processing these claims.
Now, I am a veteran. I get all my health care through the
VA. My friend, dear friend Morgan, is also a veteran. Could you
maybe just in a short period of time, kind of wrap up for the
folks here that have not served what it actually means to get a
disability rating? What happens? I retire, what happens?
Ms. Devlin. Thank you for that question. For our veterans
who served, they might have had injuries while they were
serving, they might have become ill, or they might have been
exposed to toxic substances that resulted in them getting
serious disability conditions like cancer. The disability
claims process is such that we review that medical evidence and
help them to get compensation for those disabilities and
injuries that they will have often----
Mr.Van Orden. What does that process look like?
Ms. Devlin. The veteran files a claim and they tell us
which disability conditions they would like to claim for
disability compensation. They provide us with information, and
then we support them with our duty to assist by getting them
medical exams if needed, collecting all the evidence and
background information, and then making a decision that renders
them a percentage of disability, which then results in a
financial compensation for those percentages.
Mr. Van Orden. The veteran does not have to do this by
themselves. There is some of our outstanding veterans service
organizations, like the Veterans of Foreign Wars of the United
States (VFW), Disabled Veterans of America, the American
Legion. They do that pro bono, whether or not you are a member
of the organization or not, correct?
Ms. Devlin. Yes, they do.
Mr. Van Orden. Have you found in the past that the VA has
tried to impede our VSOs from being able to help veterans get
their disability rating?
Ms. Devlin. Absolutely not. In fact, we now include them in
our transition assistance program at the end of the course so
that they can introduce themselves to the service members and
tell them about their services and give them access immediately
after the class.
Mr. Van Orden. Excellent. If you are a Queen for the day,
what would you do, like right now to expedite this process?
Ms. Devlin. Sir, I am not Queen for the day.
Mr. Van Orden. You are today.
Ms. Devlin. A lot of the things that we are already doing
that we are going to continue to do more of, involves more
automation and continued focus on quality improvement and
making sure our employees have the resources they need to do
the best possible job. They care. They are mission driven.
Mr. Van Orden. I am going to translate that into English.
You are going to get rid of four out of the six bosses, Bob.
Streamline the process by making sure that we understand that
we are in 2026, and automation, and the implementation of
Artificial Intelligence (AI), and the ability to focus very
hard on what needs to get done. That is the expedited, accurate
adjudication of a veteran's disability claim happens in a much
more rapid manner, right?
Ms. Devlin. Yes, sir.
Mr. Van Orden. Okay. With that, I yield back.
Thank you, Ms. Devlin.
The Chairman. Representative Brownley.
Ms. Brownley. Thank you, Mr. Chairman. Thank you for being
here. This new system, the AI system, or the automated systems
and claims processing, how long has that been instituted? When
did you institute it, and how long has it been running?
Ms. Devlin. Thank you for that question. It is not brand
new. It has been--it started years ago. I am sorry, I do not
have the exact year when we first started automated decision
support, but we have accelerated the percentage of cases of
disability conditions that can be assisted through the
automated decision support. Remember that our employees are
still making decisions.
Ms. Brownley. Is that saying you are using it more? You
have had it for a long time. You are using it more now than you
were previously?
Ms. Devlin. No, it takes time and money to develop each
piece, each component. We have developed more of it so that we
can do more, support our decision-makers with more disability
conditions. It requires focused effort to create more of the
automation.
Ms. Brownley. Based on the system then you are not seeing,
it sounds to me like you are not seeing more denials for
veterans based on this system. I am just, I know in private
industry with insurance companies doing claims, they also use
an automated system to go through that. I continue to hear that
those denials--there are many denials that come in place. You
know, I think it is something that needs to be monitored very,
very closely because speed is great, but quality is more
important at the end of the day. I just worry that we are
trapping veterans in limbo that have to go to an appeals
process, which takes a really long time. I do not think that
process has sped up as it probably should. Regardless, veterans
can be caught in limbo. They are caught in limbo today
between--from a denial to an appeal and getting answers from
that.
Staff in my district office have, tend to be receiving now
more generic and unclear responses from VBA when assisting
veterans with their disability claims. Without the information
about estimated processing timelines, details that are under
review, or documentation requirements that are outstanding, it
is extremely difficult for veterans in my district, and I think
across the country, to know when they will receive a decision.
My question is, what steps are you taking to improve
communication and engagement with veterans about the status of
their outstanding disability claims?
Ms. Devlin. Thank you for the question. I just want to
clarify that our disapproval rates are not going up, so we are
not denying more veterans claims and we are expediting the
lanes that we have for disagreements, the VA Appeals
Modernization Act (AMA) lane for higher level review and
supplemental claims, so that the, the claims process can be
faster and our people are making the decisions. The automation
does not make any decisions and will not deny a claim. It
simply puts everything together for the decision-maker so that
they can make the decision faster.
Ms. Brownley. Okay. I would like to know more about that
because it certainly sounds as though--I just do not understand
when you talk about, in your statement, you talked about the
leadership of the new secretary and as a consequence this
process has improved and sped up and maintained quality all at
the same time. It just does not sound like--it sounds like you
have got a perfect system going here. I just, I cannot believe
that it is perfect. You probably will say it is not perfect. I
get that. You know, what I want to hear from you is where are
the points that we can still improve upon?
Denials are denials, and veterans are in limbo when there
are denials. I am wanting to hear some feedback from you in
terms of what you are doing to, on an ongoing basis, continuous
improvement on the system.
Ms. Devlin. I agree with you. Continuous improvement is a
necessity. We will never sit back on our laurels and think that
we are in a great place and we should not continue to evolve,
in particular as it pertains to quality and accuracy. You asked
about communication on the timeline because our claims are
moving more quickly. You know, we are giving more feedback to
veterans more quickly as well. If we can decide some portion of
the claim for a veteran, we will decide that portion and start
getting their compensation flowing. Even if there is another
more complicated condition. Also our, our call center, 1-800-
827-1000. We will be able to give them a very specific status
of their.----
Ms. Brownley. My staff at home is just saying we are
getting a generic response and we are. They are not getting
that kind of detail to help, you know, in terms of
communicating with our veterans, to give them some sense of
where the status is on their claim.
Ms. Devlin. Happy to work with you on any specific cases
that you are, that you are having issues with. We can look into
them.
Ms. Brownley. I yield back.
The Chairman. Representative Luttrell.
Mr. Luttrell. Thank you, Mr. Chairman. Ms. Devlin, does VA
create its own language models internally or is it outsourced?
Ms. Devlin. For language models, you mean for the
automation?
Mr. Luttrell. Yes, ma'am.
Ms. Devlin. The AI enabled automation. We have contract
companies that, that help us with that.
Mr. Luttrell. How often is that updated?
Ms. Devlin. We are making updates on a regular basis. I
mean, I do not have any time----
Mr. Luttrell. What is a regular basis? I am going to dig in
on you a little bit on this one.
Ms. Devlin. Yes.
Mr. Luttrell. This one drives the point home to Mr. Takano
and what Ms. Brownley are saying. If the, if the, if the
language models are not being updated at a, at the speed of
which technology is developed, the VA will obviously be lagging
behind. Given where we are, if you are talking about artificial
intelligence, machine learning injected into the VA system, if
it is in a timely manner, I think this will decrease those kind
of symptomatic issues that we are seeing with notifications.
Ms. Devlin. Yes. We have updates to the system on a regular
basis. I am going to say they are approximately about six to 8
weeks that we get updates to the system for new automated
decision support, new conditions.
Mr. Luttrell. All that information--okay. Six to 8 weeks.
That seems. That is impressive that you say that because, I am
trying in my mind to gather as much information as the VA
brings in daily, aggregated or retrospective and process that
into a language model that will allow the system to update
itself. Six to 8 weeks seems a bit aggressive.
Ms. Devlin. Well, the automated decision support is not
just AI. Right. It is rules based processing that helps the
employee have all the information in front of them to
understand what they need and what they already have in the
file without having to look through thousands of pages of
medical records.
Mr. Luttrell. Sure.
Ms. Devlin. Right. So. It is not making decisions on
claims.
Mr. Luttrell. It is really helping. I think that what it
does is it streamlines the process, puts that blue line right
in the middle so they, the rater can see that in a more----
Ms. Devlin. Yes.
Mr. Luttrell. They can get a clearer picture?
Ms. Devlin. Yes.
Mr. Luttrell. If you can get kind of--I would like to have
like a breakdown on that if you do not mind on kind of like
what the timeliness is, because I would--I do not--I am going
to speak freely with the committee. We are eagerly behind the,
the injection of AI models into the system so our veterans get
what they need in a, in a timely manner. Fair enough?
Ms. Devlin. Yes, definitely. Technology is a huge part of
how we continue to stabilize the system so that we are not
always chasing a backlog, but can focus on advancing the
mission faster for veterans and enabling our employees to work
on the more complex pieces of the work, which is really the
decision-making.
Mr. Luttrell. Where do we stand with information flow
between the Department of Defense and, Department of War (DOW),
Department of Defense, however you want to say it. Department
of Defense, the VA Information flow from one service into the
VA, and the backlog. The system seems when it bogs down, we
talk about national work queue. Now I am shifting gears on you.
We talked about national work and the veterans ability to hand
carry, speaking for myself on this one, all of my information
to the VA. Hopefully I did not miss anything. Okay. Now the
system itself is broken down in a way that we--there is no
ceilings there, so to speak. Where are we with conversations
Department of War and the VA on complete information transfer
from one site to the other?
Ms. Devlin. I will tell you the two secretaries have made a
commitment to work together on this. The Secretary of War has
committed to what we are calling sort of service treatment
records at day zero. We want to be able to get all of them
electronically.
Mr. Luttrell. Is there a timeframe on this? Do not say yes
and just walk away with that. I would like to hear--you know,
in 6 months, on this day, that will be set in stone and we are
moving forward.
Ms. Devlin. We are working on this in milestones. The first
milestone is to get a digital claim from the service member so
that everything is digital, not just the service treatment
records.
Mr. Luttrell. Great.
Ms. Devlin. This month we are implementing a soft launch on
a digital benefits delivery at discharge claim. Meaning we are
enabling both service members and VSOs, because a lot of
service members want to work with a VSO to submit the claim
electronically.
Mr. Luttrell. Yes.
Ms. Devlin. That then sets the stage for DOW to be able to
submit a----
Mr. Luttrell. It takes the guesswork out of it. It lets the
veteran know that, hey, I am, my information is over.
Ms. Devlin. Exactly. We are trying to--we will avoid the
situation where a service member is having to carry their
medical records anywhere or scan them and upload them.
Mr. Luttrell. Because once the veteran leaves the service,
the service has their own thing. If I had to go back into the
service and ask for my information, the service is not paying
attention to me, I am a name again. I am not a number. I am not
an asset anymore. Having that take place before the veteran or
the service member moves into the veteran community is, is, is
amazing. The--it is when it--I do not have time for that
question.
Mr. Chairman, I yield back. Thank you.
The Chairman. Thank you. Dr. Dexter, you are recognized for
5 minutes.
Ms. Dexter. Okay. Thank you, Mr. Chair, for holding this
hearing. Thank you also for being here and, and giving your
testimony. I think we all understand we share responsibility to
ensure our veterans are getting high quality, timely benefit
decisions. As amazing as it sounds, I tend to trust but verify.
Please bear with me. We also had an opportunity to speak with
local Oregon veterans service officers who made clear decision
times are indeed, that they are experiencing are improving.
Counter to what we are hearing, their impression is that errors
are increasing. These are not just, you know, we have not
changed the number of veterans being served in our area. Maybe
it could just be that the absolute number processed are getting
higher as you made a point of earlier. Mistakes do delay access
to care. Even if that were true, those mistakes still are
something we should address.
My first question is, is it true you have fewer VA
employees processing these claims? We have been told the answer
is yes. I just want to hear that for the record.
Ms. Devlin. We are working on a strategic hiring plan to
backfill some of those positions. Part of what we have to do is
evaluate how everything has changed in our ecosystem with all
the technology to make sure we put the employee resources in
the right places.
Ms. Dexter. We know that AI is threatening, you know,
positions across all sectors. This is obviously one where AI is
being used. We also know that when work is pushed faster with
fewer employees, that oftentimes quality can be compromised.
This, as I said, is unacceptable. Ms. Devlin, I want to also
ground this in something we all understand. Would you trust a
physician who gave you a prognosis based on a quick Google
search or AI tool?
Ms. Devlin. No, ma'am, I personally would not.
Ms. Dexter. I would not either. As a physician, I know
technology can support good care, but it cannot replace good
clinical training, expertise, and peer reviewed evidence. Yet
it seems that that is exactly the type of breakdown we are
seeing. Veteran service officers raised serious concerns about
VA decisions, citing inappropriate sources in some cases,
determinations on disabilities included references to WebMD and
Google searches in the actual letter being returned to the
veteran. I reviewed a claim where the VA explained a veteran's
employability by stating quote, according to Google, followed
by a quote, direct quote from language that certainly appears
to be AI generated content. I have that here if we want to
submit that for the record.
That is not a standard. That is a system under strain. It
is using artificial intelligence to do the work that these
employees have done previously. When staff are pushed to move
faster without the resources and support they need, I do
believe quality erodes and veterans are paying the price. I am
going to ask directly, Ms. Devlin, is this the level of quality
veterans should expect?
Ms. Devlin. That would be--I would like to look at that
actually, if you would submit that to us. I will let Ms. Flint
answer the question about employability and how an employee
might use things like a Google search to understand the labor
market for a specific veteran based on his or her specific
background. That would not be an AI generated action. That is
an employee generated action based on their individual use of
systems available to them. We do not use AI for medical
opinions or medical decisions or any decision-making.
Ms. Dexter. I mean, I have the exact quote from the letter
you attributed not working due to your service connected
disabilities. According to Google, in the letter, according to
Google quote, a person managing the conditions you described
and it has them could thrive in various jobs with some
adjustments. This is literally quoting Google and then there
are literally quotes from WebMD. I think that regardless of my
skepticism around whether that is an accurate assessment,
receiving that as a veteran certainly does not increase
confidence. I appreciate that you could walk through this, but
I am very conscious of my time. I want to get to the quality
review process because 94 percent accuracy sounds amazing. Does
that include veteran perceptions of the accuracy of the claims
or VSOs or others?
Ms. Devlin. No, that would be based on our review of were
procedures followed, were regulations followed and was the
decision right based on those requirements.
Ms. Dexter. I think that this is a self-fulfilling
prophecy. If we are using AI generated quality control
measures, we have fewer people, you know, reviewing more
claims. There has to be AI use looking over AI generated
decisions. I wonder where the actual peer review or quality
review is coming in that is not automated.
Ms. Devlin. That is not automated. Our quality review
systems are done by humans who are reviewing the regulations
and the statutes and the quality of the work.
Ms. Dexter. What percentage of decisions are being
reviewed?
Ms. Devlin. It is a, it is a validated sample. I think it
is three to five. Is it three to five, Ms. Flint? Three to five
cases per month, is that correct?
Ms. Dexter. Three to five cases?
Ms. Flint. Yes. At the national level. At our national
quality, they statistically valid sample to get a national
quality number is 3 to 5 individual quality reviews per
employee.
Ms. Devlin. Three to five total, per employee per month.
Ms. Dexter. Okay, and my time is up. I yield back.
The Chairman. Thank you, Representative Barrett. You are
recognized for 5 minutes.
Mr. Barrett. Thank you, Mr. Chairman. Ms. Devlin, Ms.
Flint, thank you for being here today and appreciate the
insight into how we are able to reduce the claims backlog that
veterans have experienced. I know that has been a legacy from
previous administration and previous Congresses and appreciate
the efforts to reduce that claims backlog.
Obviously, you know from hearing from other members and
hearing from veterans just how serious that is when a veteran
is waiting and chronically anticipating the resolution of a
claim. I have had that happen personally and I know others who
have as well, where time will go on and a review takes place
and you know, veterans can go on the veteran the VA app and see
kind of where they are in that process. The steps will
sometimes go backward instead of forward as process goes on.
One question I had for you is as we see the claims backlog
diminish, are we seeing a increase in appeals or are we seeing
an overall reduction in claims that are not or rather that are
fully adjudicated and finalized post appeal as well?
Ms. Devlin. We are not seeing an increase in the appeal
rates. It has been consistent. Around 11 to 13 percent of our
veterans disagree with the decision that we made on their
claim. They then have access to different procedures, right,
that they can choose.
Mr. Barrett. Right.
Ms. Devlin. A lot of times they will choose the
supplemental claim lane because they might realize that if they
had submitted additional evidence, it might change the
decision.
Mr. Barrett. Sure.
Ms. Devlin. In that case, our grant rates, about 35 percent
of supplemental claims get granted, so that sometimes that
additional evidence was just missing in the initial decision.
They can also access the higher level review, which really
takes the decision that was made by one person, one employee,
and has a second more senior employee reviewing the decision.
Our grant rate is a little lower than the 35 percent there, but
those processes are not taking a long time either. The
processing time is approximately, is very similar to the
initial claim.
Mr. Barrett. Do those higher level review and supplemental
claims, do those count in the, I guess, statistical capture of
appeals, or are those not considered an appeal until a more
formal appeal is granted?
Ms. Devlin. They are considered appeals under AMA and then
we still have some legacy appeal appeals that we are still
working through.
Mr. Barrett. They take longer.
Ms. Devlin. Mm-hmm.
Mr. Barrett. The, the lengthy appeals are those--those are
the ones that are a more formal appeal, not a higher level
review or a secondary claim submission. Is that correct?
Ms. Devlin. They are all formal appear, appeals. The legacy
ones are before the AMA went into law.
Mr. Barrett. Okay. Okay. Then I know we have talked a lot
about AI, the use of that. Certainly there is a lot of rightful
concern in various different areas that AI touches on, whether
it is in veterans benefits or other aspects of American life,
as we all kind of digest how this is going to affect all of us.
One thing I just wanted to ascertain from both of you today is
that in the circumstance that the VA is using AI for the, for
the use of claims processing and things of that sort is there a
human in that process that is reviewing anything before a
veteran's claim would be denied? Or can AI simply sweep through
that and, you know, dismiss a claim on its face? Or would a
human be involved in a process in that chain?
Ms. Devlin. There is no artificial intelligence in our
systems that makes a denial decision. Everything gets presented
to a human claims processor to make a decision. A couple things
that I would like to say about this. First of all, we are
assessing the quality of the automation to make sure that that
is functioning properly. Our employees have a method of
reporting to us when they are seeing something that is not
quite right so that we can fix it. The employee decides whether
the automated information presented to them is enough or not
enough. They are looking at that and ultimately making the
decision on the claim or pushing back and saying, I need
additional information as part of duty to assist.
Mr. Barrett. Could a AI assistant tool that the VA uses
say, yes, you have the appropriate documentation, either from a
Department of Defense physician or an outside physician, you
have this presumptive condition diagnosis. It could, it could
almost take that and say, all of these things are met by this
standard that we have. The human claims representative would
then quickly review that. It could also work in a way that
could approve or help to approve an expedited claim. Is that
equally, or is it only being used to detect fraudulent or
denial basis for a claim?
Ms. Devlin. Oh, no. Thank you for that question. It is
actually detecting everything in the file that that claims
processor must review to make a decision. It will look at
things like if the veteran served in the Navy, were they within
12 nautical miles of certain areas to qualify for certain
presumptives? It will look for what were their dates of service
and be able to put that all together. What the employee is
seeing is screens that present to them, this has been
satisfied. This piece has been satisfied. We have got the
DD214. We have got the length of service. We have got
presumptive exposure. We have got a disability diagnosis for
this condition. It presents it all to them and then shows them
what is missing. It might say, well, for these conditions, we
have got everything you need. You can go and grant the claim
for this condition, you are missing something. We might need to
go do a medical exam because we do not have a current
diagnosis. Ultimately, the employee is in the driver's seat in
every single claim decision.
Mr. Barrett. Thank you. Thank you, Mr. Chairman.
The Chairman. Thank you. Before I recognize our next
member, all members need to be advised that there is a protest
going on, on the second floor of the Cannon. If you are moving
from building to building, you might want to avoid that. The
police are, or the Capitol Police are dealing with that right
now. Representative Ramirez, you are recognized for 5 minutes.
Ms. Ramirez. Thank you, Chairman from the great State of
Illinois and ranking member from the great State of California.
We are being fair this morning. Look, all jokes aside, we have
a responsibility in committee to provide oversight of the VA's
processes, especially the processes that the VA is using to
address its disability claims backlog. As we have been
discussing the backlog, I would be remiss not to mention that
the speed at which claims are processed cannot come at the
sacrifice of the quality of service to our veterans, that
cannot ever be compromised. Simply reducing the backlog for the
sake of saying that the backlog is reduced at the expense of
accurate and successful outcomes for veterans is not, in fact,
putting our veterans first. It is certainly not honoring our
veterans' service.
As my colleagues are well aware, one of my primary concerns
in this administration has been its commitment to reducing the
Federal workforce and dismantling the VA. Secretary Collins has
made good on that commitment, has shrunk the workforce through
Reduction In Force (RIF) and he will continue to do that work
through the reorganization that he is leading. In July 2024,
after the robust hiring of new claims processors as a result of
the PACT Act, VBA ended its posture of mandatory overtime with
a few exceptions for certain types of claims. This was a relief
to a burnt workforce that had been torn apart by twin
pressures.
One, the COVID pandemic and then the other, which was
increase in Pact Act claims. When we fast forward to May 2025,
after losing thousands of claims processors through the
deferred resignation program, the voluntary early retirement,
and outright firings, VBA realized they had a capacity problem.
Then they reinstated the mandatory overtime at a rate of about
25 hours per month, if I am not mistaken. Ms. Devlin, is the
May 2025, 2025 mandatory overtime policy still in place?
Ms. Devlin. Thank you for the question. I would like to
point out, and I will answer your question, that our quality is
going up. We are focusing on quality and yes, we did institute
mandatory overtime. It depends--we are really focusing still
on.
Ms. Ramirez. It is still on now? You still have a
mandatory----
Ms. Devlin. We do not have mandatory overtime right now,
today. Ms. Flint can talk about the number of hours that we are
focusing on overtime.
Ms. Ramirez. Can you tell me how many hours then just for
the record that we have right now in overtime.
Ms. Flint. Yes, yes ma'am. We have several categories of
VSRs who are working 20 hours of mandatory overtime.
Ms. Ramirez. Twenty hours.
Ms. Flint. VSRs who do non rating work and a couple of
other missions. We have one group of VSRs who do Military
Sexual Trauma (MST) who are working 8 hours.
Ms. Ramirez. Let me follow up to that. Whether it is Ms.
Flint or Ms. Devlin who answers this question. Has VBA analyzed
the effects of mandatory overtime on the quality of the claims?
Have you done some analysis on that already as you have made
some reorganizations on this overtime?
Ms. Flint. The work that we perform in overtime is part of
our overall workload. Any quality questions would flow
naturally as part of our normal quality process.
Ms. Ramirez. You have been intentional about conducting
analysis on the impact of quality of, of overtime in the
quality of claims. You have done that work? If you have done
that work not just because people are doing the work, what were
the results of that?
Ms. Flint. We did not. We did. We do not make a distinction
between the work that is done on overtime and work that is
done, I will say, on straight time.
Ms. Ramirez. You have not really analyzed the effect of
mandatory overtime?
Ms. Flint. We have not analyzed the effect of mandatory
overtime on the process.
Ms. Ramirez. Let me, let me follow up on that. Ms. Devlin,
has VBA analyzed the effect on worker burnout, and/or
retention, or attrition as a result of its resumption of
mandatory overtime? Have you done that analysis?
Ms. Devlin. We do look at the attrition numbers and I just
want to point out that claims processors were not allowed to
elect into the deferred resignation program or VERA. Our
attrition has not changed from historic levels of attrition. We
are working on a strategic hiring plan, and as we mentioned
earlier, because of automation efforts, the employees that we
need might be in different categories of employees. We want to
make sure that we do avoid burnout by making sure that we are
resourced in the proper way in our new ecosystem that we are
operating in.
Ms. Ramirez. What are the systems that you are using to do
that analysis?
Ms. Devlin. We are looking at our pay files. We are looking
at production, we are looking at quality. There is a lot of
different things that, where the automation is helping the
most, where we still need more, more human intervention in the
development process. We will always need humans for decision-
makers.
Ms. Ramirez. Absolutely. I want to make sure you----
Ms. Devlin. Yes.
Ms. Ramirez. We, we have that on the record. Look, there
are a couple questions that I want to follow up with you
because it is not consistent with some of the reports that I
have here. Just as I wrap up in these last 15 seconds, it is
important to make sure that we are clear that the speed of
processing claims does not equate in quality of the processing
of the claims. I want to make sure that that is always a
priority, and automation overtime alone are not long term
sustainable solutions for addressing the backlog. We all know
that to truly honor our veterans, it is service with action. We
have to ensure that the VA is in fact fully staffed and that
our processes do not sacrifice quality. I do want to follow up
with you on some of these systems.
Thank you. With that, I yield back.
The Chairman. Dr. Miller-Meeks you are recognized for 5
minutes.
Ms. Miller-Meeks. Thank you very much, Mr. Chair. Ms.
Devlin, has the VA utilized overtime to help alleviate the
claims backlog?
Ms. Devlin. Yes, ma' am, we have.
Ms. Miller-Meeks. Does the VA see this as a long term
strategy for combating future surges and backlogged claims?
Ms. Devlin. Backlog--or sorry, overtime is a good surge
capacity assistant. It is not something that we would want to
rely on for sustenance of the backlog.
Ms. Miller-Meeks. You could use it in the event there are
future surges.
Ms. Devlin. Yes, that is correct.
Ms. Miller-Meeks. Then how do we ensure that the VA is not
continuously playing a game of catch up?
Ms. Devlin. I am glad you asked that question. We, we are
getting to a point now where we can seek more balance and by
continually continuing to develop more of the automation, we
can continue to focus our employees on the hard work of making
decisions and advocating for our veterans. By doing so, we will
get into more of a steady state where we would be able to then
handle surges using things like overtime, but not rely on it on
a day to day basis.
Ms. Miller-Meeks. You have done a remarkable job catching
up. Hopefully that can, we can get the rest of the VA in
scheduling to do the same. Is it the case that quality has
declined? Some people say because of the technology that you
are using, quality has declined. Some people are suggesting
that the work is rushed by claims processors. Is it correct to
assume that claims that take longer are better quality? I.e.,
if it takes more time, does that actually ensure that it is
greater quality?
Ms. Devlin. Thank you for the question. Our quality has
actually continued to improve. We are doing what we call
quality sprints where we sort of ask everybody across the
country to focus training on specific areas where we have seen
error trends. No, a claim taking a longer time just means a
veteran has to wait longer. It does not mean it is going to be
a better claim. The automation does not make decisions. It does
pull the information together so that the claims processor
cannot only get to a decision faster, but can also see is there
anything missing in this claim and get to that point faster and
understand what is missing so that we can then go out and get
it for the veteran to help them get a decision faster.
Ms. Miller-Meeks. I will say that I have heard from
veterans in my district about the time. That is a greater
complaint often. I have also heard some speculation that board
appeals might increase due to faster processing. This gets back
to the quality issue. Has that been the case and is that a fair
assumption?
Ms. Devlin. That is not the case where our disagreement
rate with our decisions has maintained pretty steady around
between 11 and 13 percent. That has not changed historically
even with the immense amount of production that we have done. I
will say, and I said this before, 11 percent of a bigger number
is a bigger number. When you look at the rate of disagreement,
it is maintained consistency.
Ms. Miller-Meeks. All right. Thank you for that. You have
already mentioned some of the things that you are doing to
ensure quality and level of success. Broader question, how
should we be thinking about success? Is backlog reduction the
right metric? If not, do we need a more complete picture of
system performance? I will just ask both of them.
Ms. Devlin. I appreciate that question. No, I would love to
get to a place where we are not constantly talking about
backlog. We are approaching sort of an equalizing moment in
time for the Veterans Benefits Administration where we can
start achieving more balance. That is part of what we have been
doing with focusing more and more on quality and these quality
sprints. We are talking about what more training needs to
happen and making sure that our automation efforts are adopted
by employees because employees ultimately make the decision on
whether the automation has given them everything that they need
or not. We are monitoring that for quality and then we are
looking at strategic hiring and determining how we can make
sure our employees are trained for the most complex decision-
making, you know, because we are always going to need human
decision-makers. How do we put them in the right places? How do
we evolve our processes to adapt to all of these tools that we
have at our disposal now that we did not have before?
Ms. Miller-Meeks. Well, I can just tell you as a 24-year
army veteran, we really appreciate the fact that the backlog is
being reduced and that claims are being handled in a more
expeditious way, but still with that human touch and human
oversight. Thank you so much.
Mr. Chair, I yield back.
The Chairman. Thank you. The gentlelady yields back.
Representative Kennedy, you are recognized for 5 minutes.
Mr. Kennedy. Thank you, Chairman.
First of all, I have a couple of quick questions. Talk
about mandatory overtime. Do you need congressional approval
for that mandatory overtime?
Ms. Devlin. We get approval for the funding in the budget
through the President's budget.
Mr. Kennedy. Specific to mandatory overtime for the
workforce, do you need congressional approval?
Ms. Devlin. No, sir, it is within our authority. The VA is
saying you are making progress on reducing the backlog
determinations. Obviously that is important to ensuring our
veterans have the care they need. As has been mentioned a
number of times here, speed does not equal success. The VA's
data that I am looking at says that there is an 83 percent
claim accuracy rate. Is that accurate?
Ms. Devlin. Our current accurate rate is 94 percent as of
the end of March.
Mr. Kennedy. Ninety-four percent issue level accuracy, but
83.31 percent claims based accuracy is that correct?
Ms. Devlin. I can let Ms. Flint speak to the difference
between those two.
Ms. Flint. Yes, that is correct. VA went to a issue based
quality because that gives us a level of detail about what is
actually happening in the claim so that we can hone in on the
things that are important to veterans. A claim based score sort
of masks what the real challenges are because if you get one
wrong, the whole thing is wrong. We started focusing more on
issue based quality because we believe that is a much better
indicator of actual quality.
Mr. Kennedy. A couple things to that point. You are no
longer using claim based accuracy whatsoever?
Ms. Flint. It is reported in our external sources, but we
do not use that.
Mr. Kennedy. According to your own data that--on your
website, the issues level accuracy upwards of 94 percent but
still lower than it was just a year ago. While you have made
progress in the last couple of months, it is still lower than
it was a year ago. That also means that there are
determinations and errors that are not simply numbers. These
are delayed treatments. These are unmanaged pain, worsening
health outcomes for our veterans. I just, I have a couple of
constituents that have been impacted by this in a number of
documented cases in my own district. A couple that I will
mention here. One for mental health, a number for palliative
care. While their appeals are pending, there are many that are
not receiving treatment. Does the VA track for what happens to
veterans medically while their claims are under appeal?
Ms. Devlin. I just want to address the question about
quality. The 94 percent is the highest it has been in 2 years.
We have steadily gone up in 2 years, not down. We can grant
whatever claim conditions we can grant while the other
conditions are being appealed, which can give the veteran
access to care in the VA medical centers while they are waiting
on certain decisions to be made by the board.
Mr. Kennedy. Okay, thank you. First of all, I am looking at
data from your Veterans Affairs website that shows the 12 month
accuracy issues level was at 95.91 percent at the end of March
and now it is at 93.95 percent. That shows me that there is a
decrease.
Back to the question about following and tracking our
veterans. If in fact they are appealing a case that they were
denied care, are we following to make sure that they are taken
care of medically?
Ms. Devlin. If your question is if the disability rating
was denied for a specific condition and while that denial is
being appealed, do we check to see if that veteran can receive
treatment for that specific condition? We would not because it
would be predicated on their ability to get a grant for that,
which would mean they would have to substantiate that they have
the diagnosis and it is connected to service. My earlier point
was if they are already rated 50, 60 percent for other
conditions, they can receive VA health care even while they
wait for another decision on a separate condition to be
decided.
Mr. Kennedy. Well, what is clear to me today is that the
VA's progress on processing time is real, but it does not
represent a full picture of our veterans' experience on health
outcomes within the system, which is the most important data
point that the VA needs to be measuring. A delayed decision is
delayed treatment. A system that cannot measure those outcomes
cannot fix them. We have clearly got a lot of work to do.
I am being respectful of time Chairman. I will yield back.
The Chairman. General Bergman, you are recognized for 5
minutes.
Mr. Bergman. Thank you, Mr. Chairman. Ms. Devlin, it is
good to see you again. Let me begin by saying I appreciate the
progress that Secretary Collins and the VA have made on the
claims backlog. This is real progress and veterans deserve to
see more of it. That progress also makes us step back a bit and
ask how the system got so backed up in the first place. In my
view, part of the answer is pretty simple. When claims are
incomplete on the front end, the whole system slows down
because you got redoes in there to get it right so it can begin
to be processed. That means more delay, more rework, more
frustration for veterans trying to get access to the benefits
that they have earned.
We all want to protect veterans from bad actors. Make no
mistake, bad actors are never going to get a chance to mess up
our veterans. We need to continue to move forward. We ought to
make sure that veterans can still get legitimate help in
understanding the process and putting forward complete claims
the first time to reduce the failure rate, if you will, and
speed up the decisions. If we want faster, better decisions,
then the front end piece truly does matter. Ms. Devlin, how
does the completeness of claims submitted to the VA impact a
claims processing time and the VA's ability to render a fast
decision?
Ms. Devlin. Thank you for the question. You know, we have a
lot of our veterans who work with VSOs or other accredited
agents, and it does help them to sort of navigate the system.
We are working on making the application process more simple
for veterans so that it is not as complex. Certainly if the
veteran submits a claim with all of the non government evidence
that they have available to them, private medical records and
such, it would certainly make the process go faster. However,
we are still moving fairly quickly, even if it is not a
complete claim, because we can get an exam for them through one
of our exam vendors or through Veterans Health Administration
(VHA) quickly.
Mr. Bergman. You are. I know you are deeply into this and
you are doing it for the right reasons. We can all seek to do
better on whatever our role is, whether it is the diagnosis,
the process, all of that. We all have a commitment, it is part
of our mission to be better on the front end. To lead to better
outcomes. Would you agree that it is a false choice to claim
consumer protection requires restricting lawful advisory
services?
Ms. Devlin. Sir, I cannot speak to the statute that covers
accreditation, and that is not my area of expertise on what is
allowable by law.
Mr. Bergman. Okay. Well, I am going to switch gears here
for a moment. It is my understanding that the VA started a
pilot program in August 2025 to better leverage technology to
expedite acceptable clinical evidence exams, and it started
producing Disability Benefits Questionnaire (DBQ) earlier this
year. Is it correct that this pilot has now completed over a
thousand reviews to date and that they are being generated with
over a 99 percent accuracy rating?
Ms. Devlin. Yes, the initiative has completed over a
thousand DBQs. The quality was 97.9 percent. I just want to
clarify, the AI puts everything together, but a clinician is
actually rendering the acceptable clinical evidence decision.
Mr. Bergman. This is about using the tools you have
available to you for better clinical outcomes, better
acceptance rates, better benefits created, et cetera. In my
last minute here, they also are being generated, these, these
are also being generated, reviewed and signed by appropriate
medical reviewers, all within a 72 hour timeframe. Is that
correct?
Ms. Devlin. That is correct.
Mr. Bergman. Okay. What is the normal time limit for other
providers outside of this pilot? You got the control group and
then everybody else. What are we talking about as far as 72
hours?
Ms. Devlin. Yes, it is definitely longer it takes. You
know, we can do some exams fairly quickly, but on average it is
25 days to get an exam in person. Our exam vendors can also do
acceptable clinical evidence exams. I do not have that number
separate for that.
Mr. Bergman. Okay. Well, the point is, we know that if
everybody puts their, you know, mind to this and their energy
behind it, we can do better for the veterans, for the companies
trying to do the right thing to help the veterans and to help
the Veterans Administration.
With that, Mr. Chairman, I yield back.
Oh, and I would like to. Before I yield, Mr. Chairman, I
ask unanimous consent to insert Rep. Hamadeh's opening
statement into the record.
The Chairman. Without objection. Dr. Morrison, you are
recognized.
Ms. Morrison. Thank you, Mr. Chairman. Thank you, Ms.
Devlin and Ms. Flint, for being here today. For your service to
VBA. I think we all agree that our veterans deserve to have
their disability claims decided in an efficient, transparent,
and fair manner. I look forward to hearing more from you about
how VBA can strengthen both the speed and quality of its claims
processing.
Ms. Devlin, as a physician myself. I want to begin by
asking about an issue we have been hearing about related to the
disability exam process. We have heard that software
incompatibility between VA and C&P examiners have prevented the
examiners from properly receiving a veteran's medical records.
As you know, this type of disconnect can lead to exam defects,
deficiencies. Which in turn can lead to an incomplete or
insufficient disability benefits questionnaire. Which, of
course, can result in the claim being unfairly denied. How is
VBA addressing this issue and working with its contractors to
ensure software compatibility?
Ms. Devlin. Thank you. I will let Ms. Flint argue--Ms.
Flint address.
Ms. Flint. Thank you for the question. I am not aware of
any major disconnect between those two systems. As you
mentioned, it is important that our examiners have access to
the information that we have about the veteran. I can take a
look at that and get you an answer on that.
Ms. Morrison. I would appreciate that. Thank you so much.
As you know, Ms. Devlin, the national work queue is
intended to evenly distribute work between regional VBA offices
who pass that work on to claims processors. However, we have
heard from claims processors that the system's not always
assigning them enough work during the day. In fact, some of
these employees have had to solicit work from their
supervisors. Are you aware of this problem. What are you doing
to fix this reported breakdown in the process?
Ms. Flint. Ma'am, I can answer that question. Thank you for
it. NWQ does, in fact, distribute the work, as you mentioned.
It distributes the work right now to the regional office. Then
the regional office distributes it to the employee. We just had
some upgrades to NWQ. That we believe in the future where if
there is a situation where an employee feels that they want
more work, they can go to NWQ and pull that down themselves.
Right now, if that is the situation, they are able to go to
their supervisors who can get that work for them. Chronic not
having enough work is--we, we have a lot of work.
Ms. Morrison. They can pull directly from the NWQ?
Ms. Flint. Now, they cannot. They can pull from their
regional office queue. The NWQ sends work to the regional
office, then the regional office decides about who gets what.
They have their own sort of days of work from the queue that
they can access.
Ms. Morrison. Would it help streamline it if they could
just go directly to the NWQ?
Ms. Flint. Not always. Since it is a national system. What
we do not want are people going in and sort of picking the
cases that they want. It disrupts the flow of things and it may
be not allowing us to strictly do first in, first out
processing of claims. We discourage that. There are of course
emerging cases where we need to go get a case. By and large
this distribution system, which in the old system you could
only do once a day, in the newer system, we hope we can, we can
do multiple distributions, but we do not want folks kind of
going into NWQ without--yes, it causes some challenges.
Ms. Morrison. Understood. I want to end by turning to the
use of artificial intelligence, a point of interest, I think
for all of us. AI obviously offers immense potential to
streamline claims processing. It is essential that these tools
are implemented with strong guardrails and transparency to be
sure that they are being used responsibly and effectively.
While we all want veterans to use get their claims processed as
soon as possible, I am sure you would agree, Ms. Devlin, that
it is essential the claims are adjudicated fairly and
accurately. Could you share a list of all the current and
planned AI use cases?
Ms. Devlin. Thank you for the question. AI is both an
enabler for the business process supports that I mentioned
earlier, the decision support. The use case we are looking at
right now is the one that takes and looks at every piece of
evidence inside the case to determine if all the medical
information that is necessary is already there. A lot of
veterans already have medical evidence that they are giving us.
Right? Between their service treatment records, their private
treatment records and what we are trying to do is make sure we
are not unnecessarily sending them to a medical examiner when
we already have all the information we need.
When I go to the regional offices and I talk to VSOs, that
is one of the concerns they phrase to me. We know there is
enough evidence in the file. Why are we making the veteran go
to an exam? This use case will use AI to determine if all the
evidence is there. We do not need an exam or if there is enough
evidence there, but we still need a clinician to basically
render an opinion and that would be the acceptable clinical
evidence. That is the use case we are looking at now to try and
reduce unnecessary exams. We will still do an exam when
necessary.
Ms. Morrison. It is pretty comprehensive, the use case. Can
you, and this has come up already, but I think we all just want
to hear it loud and clear on record. Can you guarantee that
there will always be a human making the final decision on a
claim?
Ms. Devlin. There will always be a human making the final
decision on a disability claim.
Ms. Morrison. Very reassuring. Thank you, ma'am.
With that, I yield back. Thank you, Mr. Chair.
The Chairman. Mr. Conaway you are recognized for 5 minutes.
Mr. Conaway. Thank you, Chairman Bost, and thank you also
Ranking Member Takano for bringing us here today. Thank you,
Ms. Devlin and Ms. Flint, for presenting yourself and to--here
to be ready to answer questions.
Veterans deserve quick and timely responses. While the
reduction in disability claims backlog seems promising, it is
not a reality for all veterans. Some of my very own
constituents are still waiting to receive a response from the
VA, a response. I would be remiss if I did not share their
stories. Last July, a constitution of mine opened a case with
her dad within my office. Her dad, Vincent, a Vietnam War
veteran, was terminally ill and suffering from dementia. The
constituent wanted to expedite her father's case at the VA due
to his illness. As of today, this case is still sitting in the
regional office. The last update we have received from the VA
was in September of last year. The veteran, unfortunately, has
passed away in December. Ms. Devlin, is the VA not prioritizing
claims for terminally ill veterans?
Ms. Devlin. I am so sorry to hear about that veteran's
passing. We want to make sure we take care of the survivor. We
do prioritize claims, in particular for terminally ill
veterans, and we have other prioritization categories.
Sometimes claims can take a long time because we are having a
hard time finding the evidence that is needed to substantiate
the claim. If you can give me that information after the
hearing, we are happy to make sure we can take care of the
survivors in their time of loss.
Mr. Conaway. Thank you for that answer and we will get you
that case and hopefully we will find out why it is that this
has languished for as long as it has had.
The next case I wanted to bring to your attention is the
story of my constituent, Christine. Her father, George, served
in the Air Force and the Army. George died a year after
applying for VA benefits in 2016. He died without getting a
rating. Now George's daughter has been handling his VA claim
for her mother, a surviving spouse and substitute claimant. His
wife has endured 10 long years of denials and appeals.
For years the VA has repeatedly asked for evidence that has
either been proven unobtainable or had already been provided.
Despite all the evidence she has sent, the VA has offered no
reasonable explanation as to why the evidence is insufficient
for granting George's claim. This 10 year wait is not unique to
George, as I understand it. This happens far too often for far
too many of our Vietnam veterans.
Ms. Devlin, just last month I heard--I reported to my
caseworker that a higher level review had been denied. The
family is appealing the case to the Board of Appeal. The family
attorney has informed the caseworker and the daughter
Christine, if they go to the Board of Appeals, they can expect
a two to five more year wait after a decade. Does this seem
like a reasonable timeframe under the duty to assist?
Ms. Devlin. Thank you for the question. I cannot speak to
the timeliness of the board. The board does not fall under VBA.
The legacy system did historically take several years. That is
the reason the Appeals Modernization Act was put into place to
provide faster lanes of, of decision-making for these reviews.
I am also happy to take a look at that case. If you can give me
the details afterwards. We are happy to look into it to see and
make sure that everything is moving as it should.
Mr. Conaway. Thank you. I will get that case over to you.
In conversations with service officers, we hear that one of
the often repeated claims processing errors is the mislabeling
of third party medical evidence. Is that what you have also
found? Is this report to us accurate? It is in the context of
the use of AI to pull these claims together, it certainly
raises a further concern about how the AI is working. When you
hear--or the system in general for putting these claims
together is working when you hear these sorts of stories. Now,
they are anecdotal. Have you heard this and what can you offer
us on that issue?
Ms. Devlin. I think Ms. Flint can speak to some of the
training we have done in that arena.
Ms. Flint. Yes. Yes, ma'am. We are very conscious of exam
errors and things like that. We want to make sure that we are
addressing any kind of error trends that we see. I have not
heard that sir, as a trend, but I will say that our automated
decision support tool, one of the benefits of that is that it
looks at the entire record. It would be, it would be more
difficult for information like that to not be a part of the
veteran's claim.
Mr. Conaway. Just getting, I guess my own AI question in
the time I have left. Have you reviewed the AI systems that you
are working to ensure that the data they are gathering is
accurate. Anybody who has used any of the these systems will
know; a lawyer make a mistake and you get case citations that
are not there.
If you review the, I guess, the architecture of the AI
systems you are using to ensure that they are actually bringing
all the claim information, claim data together and that they
are not either leaving things out because they have even
mischaracterized it because it is going to impact the decisions
about the benefit percentage that, to the individual veteran.
Has this internal review or auditing of the AI system been
undertaken?
Ms. Flint. Yes, sir, it has. In fact, as mentioned before,
the AI tool gathers the information into an automated decision
support tool. At that point, when that system was put out to
the field, there was lots of testing. People who actually
needed that information were a part of verifying the this was,
information was correct.
As Ms. Devlin said, even if it is not, that decision-maker
has the opportunity to go out and get the information or go
find the information he or she needs to support the veteran's
claim. Those tools have been tested, they have been field
tested. They continue to be tested to ensure that they are
providing what we need. There is also the opportunity for that
decision-maker to go get the information that may not be
available on that support tool.
Mr. Conaway. Thank you very much.
Thank you, Mr. Chairman. I yield back.
The Chairman. On behalf of the committee, I want to say
thank you for your testimony here today. I am going to ask the
ranking member for any closing remarks he might have.
Mr. Takano. Yes, Mr. Chairman, I do have closing remarks. I
want to just say the witness has stated that according to her
that rates denial rates are not rising. According to the data
that VA actually sent to the minority, as per our request, the
rates are rising. In 2024, denial rates were 34.8 percent in
2025.
Now these are, these are non, these are comp claim, comp
claims, grant and denial rates that I am quoting. In 2024 the
rates were 34.8 percent. In 2025 it was 38.2 percent. Far in
2026 it is 38.8 percent. I do not know how the witnesses can
reconcile what you stated with what we see here in the data
that VA provided. I hereby submit this for the record with
consent.
Mr. Chairman, our job as a co-equal branch of government is
to provide oversight and act as a check on the other branches
of government. By coming here today to cheerlead the
administration and not dig deeper, we simply abdicate our
responsibility to provide true meaningful oversight. It is a
disservice to the issue at hand and to the veterans I know we
care deeply about.
What we do here is critically important. We do no one any
good by overlooking legitimate procedural claims that leave our
veterans in difficult positions in favor of politically
convenient talking points.
I am glad that the backlog is down to pre-pandemic levels.
Honestly, I am glad about that. Just as I am glad that the PACT
Act and other presumptives, but I am also glad that the PACT
Act and other presumptives created new access. We all should be
pleased that more veterans are getting health care, VA health
care and benefits. Celebrating successes cannot be where our
work ends. We owe it to our veterans and survivors to pull the
curtain back, to get the real story and to advocate for change
that makes the system better for them. The time we have to do
that in this room, in this committee and in Congress is
precious and so we cannot waste it with shallow throwaway
hearings that barely move beyond the press releases and back
slapping.
I know that we agree about making the programs that support
veterans work better for them. We agree on that. Using the
valuable time we have in this way does not instill in me the
confidence that we truly can work toward that noble goal
together. Yes, the backlog is down, but many more veterans and
survivors are still out in the cold.
I just read you the statistics about the denial rates. Many
are still dying of cancer without service connection. The
veterans of the Nevada Test and Training Range have a list of
the fallen that continue to grow. Those who have experienced
sub concussive impacts, blast injury, and fertility are still
waiting to get the care and benefits that they have earned.
While we congratulate VA for taking credit for the sunrise,
let us not forget that so many others are fighting on, fighting
on borrowed time for their benefits and for the benefit of
those they leave behind. I hope that we can keep those people
at the center of this discussion and not the administration.
I yield back.
The Chairman. The gentleman yields back. I just want to say
thank you again for your attendance here today and I do think
this hearing was vitally important. You did give the, we did
give you the opportunity to, one, talk about the fact that the
backlogs are down, which is vitally important, but also how it
is that your accuracy on these claims is being done correctly.
We all work diligently on both sides of the aisle to try to
make sure that you are doing your job for our veterans, and we
thank you for that.
I also want to thank the ranking member for holding his
position as the loyal opposition and making sure no credit is
given to the administration at any time. We want to thank you
for that. On behalf of the committee, I want to say again to
the witnesses and members here today, I look forward to working
with you to address issues facing us in the future.
To complete, the complete written statements of today's
witnesses will be entered into the hearing record. I ask
unanimous consent. All members have five legislative days to
revise and extend their remarks and include extraneous material
in the record. Hearing no objection, so ordered.
The hearing is now adjourned.
[Whereupon, at 11:47 a.m., the committee 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 Margarita Devlin
Good morning, Chairman Bost, Ranking Member Takano, and
distinguished Members of the Committee. Thank you for the opportunity
to appear before you to highlight improvements the Department of
Veterans Affairs (VA) has implemented to reduce the backlog of Veterans
waiting for VA benefits and process claims more efficiently. Joining me
is Ms. Sandra Flint, Deputy Under Secretary for Field Operations,
Veterans Benefits Administration.
A whole lifecycle approach to claims processing
The Secretary of Veterans Affairs' vision for historic backlog
reduction has led to significant improvements in Compensation and
Pension (C&P) claims processing. VA continues to build upon the record-
breaking 3 million C&P claims completed in Fiscal Year (FY) 2025. VA
has completed nearly 1,418,000 disability claims in Fiscal Year 2026
through March 22, 2026. VA reached 1 million completions on February 2,
2026, earlier than any prior fiscal year. With increased productivity,
VA has also ensured accuracy rates have increased to 93.95 percent, the
highest 12-month issue-based accuracy rate in 2 years, while the
average days to complete have dropped 42 percent to 81 days since the
beginning of the second Trump administration.
These notable production achievements have led to historic
reductions in the rating backlog. As of March 18, 2026, the rating
backlog is below 90,000, a 66 percent decrease from January 20, 2025.
These are levels which have not been achieved since May 2020.
VA has also demonstrated a strong commitment to improving benefit
delivery for survivors. Both Dependency and Indemnity Compensation
(DIC) and Survivors Pension inventories have been significantly reduced
over the past year. By prioritizing resources, VA achieved a 68.1
percent reduction in the DIC inventory, lowering pending claims from
29,299 on January 20, 2025, to 9,349 on March 22, 2026--a decrease of
19,950. The DIC backlog inventory has been reduced by an astounding 83
percent. Survivors Pension claims have undergone similar transformative
improvements with an 80 percent decrease in inventory and a 96 percent
reduction in backlog since January 20, 2025.
Additionally, as of March 22, 2026, VA completed DIC claims in an
average of 85 days, reflecting an 89-day improvement since January 20,
2025. Similarly, Survivors Pension has seen significant improvements in
timely processing over the same period with the average days to
complete reduced from 173 days to 73 days.
The Veterans Benefits Administration (VBA) achieved these
milestones through relentless leadership commitment to results-driven
resource strategies, such as targeted use of overtime and automation
assist tools. Automated Decision Support tools reduce administrative
actions while National Work Queue (NWQ) modernization efforts focus on
advancing work queue capabilities. Furthermore, these accomplishments
reflect strong leadership and sound strategy and the extraordinary
dedication of VBA's employees, about half of whom are Veterans. Their
firsthand understanding of military service and its impact strengthens
our ability to deliver benefits with both precision and compassion,
adding momentum to keep improving service to Veterans, their families,
and survivors.
A Robust Culture of Continuous Improvement.
VA continues to optimize technology and improve claims processing
quality. Continued expansion of NWQ functionality will focus on
improved capability to route claims more efficiently. Additionally, VA
hosts Quality Sprint Days to affirm VA's commitment and focus on
quality, highlighting the Department's commitment to accuracy of
outcomes for those we serve. VA's approach to systematically analyze
outcomes to identify recurring quality issues and root causes supports
targeted corrective actions to address deficiencies.
Conclusion
VA remains committed to identifying areas where we can improve our
systems and processes to increase the efficiency and quality of
benefits delivery to the Nation's Veterans, their families, and
survivors. We remain steadfast in our commitment to timely and accurate
decisions.
Mr. Chairman, this concludes my statement. I thank you and 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 colleague and I are
prepared to respond to any questions that you and other Members of the
Committee may have.
Statements for the Record
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Prepared Statement of the Veterans of Foreign Wars of the United States
Chairman Bost, Ranking Member Takano and Members of the Committee:
The Veterans of Foreign Wars of the United States (VFW) appreciates
the opportunity to submit this statement for the record on ways the
Department of Veterans Affairs (VA) worked to address its disability
claims backlog.
The VFW is a veterans service organization (VSO) recognized by
Department of Veterans Affairs for the preparation, presentation, and
prosecution of VA benefit claims before the agency under 38 U.S.C.
Chapter 59. At the end of Fiscal Year 2025, the VFW held power of
attorney in this process for more than 700,000 veterans and eligible
dependents, with more than 600,000 active awards, totaling more than
$16.2 billion in benefits delivered to veterans in Fiscal Year 2025.
Our global network of more than 2,000 accredited representatives
assists claimants daily in navigating the complex VA benefits system.
As such, the VFW offers a unique, ground-level perspective on both the
progress and persistent challenges within the Veterans Benefits
Administration (VBA).
VA recently announced that it has reduced its disability claims
backlog below 100,000 claims pending for more than 125 days. The VFW
applauded VA Secretary Doug Collins and the VA workforce for this
achievement. However, this should also serve as an inflection point for
the Department as it seeks better ways to deliver timely benefits to
veterans who have earned them.
The backlog of VA disability claims first started to tick up during
the COVID-19 pandemic when VA paused examinations but then accelerated
after the implementation of the Honoring our PACT Act of 2022, when VA
started to process an influx of presumptive toxic exposure claims from
veterans across multiple generations.
VA initially projected that its PACT Act claims inventory would
peak around March 2024 with an estimated 600,000 backlogged claims. VA
outperformed this projection. The backlog peaked instead in January
2024 at about 400,000 claims, while total receipts for claims far
exceeded VA's initial projections. By increasing ratings output and
automating certain back-end processes, VA more effectively managed its
claims workload, despite the persistent influx of benefit claims. In
fact, for the preceding three fiscal years, VA adjudicated more claims
than ever before. Moreover, VA learned a strong lesson from 2013 and
ensured it did not ignore its non-PACT Act workload, continuing to
deliver non-PACT Act rating decisions in a timely manner.
The VFW has not viewed this claims backlog in the same way as past
backlogs because the veterans we represent did not view it the same
way. In fact, we told VA officials over the years that we would no
longer use the term ``backlog'' to talk about VA's pending workload
because this old way of talking about the process did not accurately
capture the expectations or experiences of veterans navigating this
complex system.
Instead, we recommended that VA provide a more transparent
assessment of how a claim proceeded from the time of filing,
establishing the claim, initial processing, development (gathering
evidence and completing exams), building the rating, and processing the
award. Each of these phases is instructive to where bottlenecks persist
and should be viewed as individual pain points - or ``backlogs.''
Looking at an arbitrary 125 days from start to finish fails to account
for variance in number of conditions claimed, complexity of the claim,
and difficulty in acquiring records or exams. For example, the backlog
of military sexual trauma claims, which required specialized
processing, was fundamentally different from the backlog of PACT Act
claims related to gastrointestinal conditions when VA updated the
regulations and required rework of many pending claims. These problems
demanded very different solutions and different ways to manage
expectations for veterans. However, VA does not offer this granular
level of information publicly to veterans, which leaves accredited
representatives to manage expectations, hoping that our clients trust
the explanation.
This backlog was fundamentally different from 2013 because today's
bottlenecks were almost exclusive to development, evidence gathering,
and examinations. Thanks to innovations that VA implemented to resolve
last decade's backlog, the processes that VA controls directly -
initial processing, rating, and processing awards - are either
automated or take days to complete instead of weeks for most rating
bundle actions.
During the 2013 backlog, development lagged as well, but VA's
internal processes could also take weeks because the system was paper-
based and often handled by a single VA regional office. This also meant
that processing timelines varied wildly across the enterprise, with
busier offices facing backlogs far exceeding one full year.
The situation was so bad in 2013 that VA's average days to complete
a claim at the end of Fiscal Year 2013 was 378 days. At the peak of the
current backlog in Fiscal Year 2024, VA's average days to complete was
152 days and continued to fall throughout Fiscal Year 2025 (121 days),
currently standing at 81 days through this fiscal year.
Several advancements make today's situation drastically different:
Technology Advancements
VA's investment in modernized claims processing systems and digital
tools has significantly improved efficiency. VA's national work queue -
while imperfect -allows VA to cross-level work across its enterprise to
avoid regional surges. VA has also automated many initial intake
processes, such as VA ``flagging'' PACT Act-eligible claimant files to
accelerate development. Automation, improved workflow management
systems, and expanded digital records access have enabled faster
decision-making. Additionally, enhanced tools for accredited
representatives have helped streamline the submission and tracking of
claims. The evolution of artificial intelligence (AI) offers VA
opportunities to improve development, but AI has flaws. VFW continues
to insist on human intervention to enhance implementation of AI to
ensure accuracy.
Workforce Dedication and Increased Output
The productivity and dedication of VBA employees cannot be
overstated. VA increased hiring, implemented mandatory overtime, and
drove record-level output to address incoming claims and backlog
inventory. These efforts reflect a workforce committed to serving
veterans under challenging conditions. VFW believes VA's workforce must
be fully staffed and fully funded. Reductions in the workload cannot be
sustained at an operational tempo that leads to burnout. Moreover, new
hires must continue to receive high quality training that promotes
proficiency and growth. It is impractical to expect VA's workforce to
``do more with less.'' VA must work just as diligently at workforce
development and retention as it has in inventory reduction.
Fully Developed Claims and Complete Submissions
When claims are submitted as complete packages--with all necessary
medical evidence and documentation--they can be rated in a matter of
days. This demonstrates that the system can operate efficiently when
development requirements are minimized. However, this efficiency
underscores a central challenge: Assembling a complete claim remains
difficult for many veterans. VFW accredited representatives often
report that in meeting with veterans to file claims, veterans
experience challenges with VA physicians who are unwilling to complete
disability benefit questionnaires (DBQs) related to their claim.
Service members who are separating from active duty often experience
delays with the military providing them with a copy of their service
treatment records in a timely manner, and many report that private
medical providers are unwilling to take the time to respond to requests
for records that would meet the requirement to rate the claim without
further delay. VA and Department of Defense (DoD) have made efforts to
produce a single record that would eliminate some of these
complications and VFW will continue to collaborate with both
departments to identify a solution.
Declining Decision Quality
A reduction in decision quality leads directly to increased
supplemental claims, higher--level reviews (HLRs), appeals, and
remands. When veterans must continuously re-engage the system to
correct errors, it creates additional workload and delays for all
claimants. VFW has testified multiple times that quality must be
treated more substantially than speed. As processing has sped up during
this backlog, quality has lagged. If a claim ends up in the cycle of
remands and appeals because of poor quality, nothing is gained.
Development as the Primary Bottleneck
The most significant driver of delays is not the rating process
itself, but the development phase. Challenges include delays in
obtaining service records, scheduling medical examinations, and
requesting additional unnecessary evidence. These inefficiencies slow
the entire system and prevent timely adjudication. VFW has consistently
urged that VA review the veteran's record in its entirety before
ordering exams. Far too often, VFW's accredited representatives report
that VA overlooks evidence, leaving the veteran inconvenienced by
erroneous requests for material that is already in the record.
Unnecessary Examinations and Rework
The VFW has consistently raised concerns about the overuse of
medical examinations and the rigidity of the contract medical exam
system that frustrates veterans and advocates alike. Ordering exams
when sufficient evidence already exists creates unnecessary delays,
increases costs, and burdens veterans. Rework--caused by inadequate
initial development, poor-quality exams, or rushed exams--further
compounds the problem. VFW applauds VA for working toward giving the
veteran agency over their exams with the development of enhanced
scheduling tools and we urge their continued development. Additionally,
consistent training and development of claims processors and raters
will lead to more consistent ratings and reduce rework.
Non-Rating Claims Require Greater Attention
Claims related to dependency, pension adjustments, and other
administrative matters often receive less attention but can
significantly impact veterans' financial stability. These claims must
not be overlooked in the pursuit of reducing the compensation backlog.
Specialized Processing Models
While specialized processing teams may improve short-term
consistency, they do little to build long-term workforce expertise
across the system. Over-specialization can create bottlenecks and
reduce flexibility. The backlog of Military Sexual Trauma (MST) claims
is one example of how specialization, without sufficient capacity, can
lead to delays.
To ensure that recent progress leads to lasting reform, the VFW
offers the following recommendations:
Continue Investment in Modern IT Systems
The primary driver to reducing the 2013 backlog was the
introduction of electronic tools to digitize the claims process. VA
must prioritize the development of a modern, user-friendly claims
submission portal for accredited representatives alongside efforts to
modernize internal information systems, like Veteran Benefits
Management System. Current reliance on legacy systems, such as the
Stakeholder Enterprise Portal (SEP), limits efficiency and innovation.
A modern platform would improve submission accuracy, reduce errors, and
accelerate processing.
Improve Record Sharing Between DOD and VA
Seamless transfer of service and medical records from the
Department of Defense (DOD) to VA remains essential. VA's ongoing
efforts in this area are encouraging, but further improvements are
needed. The Benefits Delivery at Discharge (BDD) program demonstrates
how timely access to records can dramatically improve processing speed.
Expanding similar capabilities across all claims would yield
significant benefits.
Limit Examinations to When They Are Truly Necessary
The VFW supports VA leadership's goal of ordering medical
examinations only when required. Clearer guidance, improved training,
and stronger oversight are needed to ensure this principle is
consistently applied. However, as VA seeks to change this business
process, we must ensure that medical evidence is valid. The rise in
pay-to-play actors submitting potentially fraudulent evidence means
that VA raters must exercise discretion in weighing the validity of
evidence.
Improve Scheduling and Accessibility of Examinations
When examinations are necessary, VA and its contractors must work
collaboratively with veterans to schedule appointments at reasonable
times and locations. Current practices often impose unrealistic
timelines and require excessive travel, leading to missed appointments,
inadequate exams, and further delays.
Strengthen Quality Assurance Measures
VA must invest in quality control at every stage of the claims
process. Reducing errors at the initial decision point will decrease
the volume of supplemental claims and appeals, ultimately improving
efficiency and veteran satisfaction.
Address Development Bottlenecks Directly
Targeted solutions are needed to streamline evidence gathering,
reduce redundant requests, and accelerate record acquisition. This
includes leveraging technology, improving interagency coordination, and
empowering claims processors to make timely decisions based on
available evidence.
Balance Specialization with Workforce Development
While specialized teams may be necessary in certain contexts, VA
must ensure that all claims processors receive comprehensive training
and experience. A flexible, well-trained workforce is essential for
long-term success.
The VFW commends VA for its progress in reducing the claims backlog
and preventing the kinds of outlandish wait times veterans experienced
in 2013. This achievement reflects meaningful improvements in
technology, workforce capacity, and operational focus.
However, backlog reduction alone cannot be the sole measure of
success. The goal must be a system that delivers accurate, timely, and
fair decisions for every veteran through a transparent and nimble
process.
The VFW stands ready to work with Congress, VA, DoD, and their
partners to ensure that recent gains lead to lasting reform. We urge
the Committee to continue its oversight and to ask critical questions
about not just how the backlog has been reduced, but whether the system
is truly improving for veterans.
Chairman Bost and Ranking Member Takano, thank you for the
opportunity to submit this statement for the record and we look forward
to further dialog with the committee and responding to any questions
members of the Committee may have.
Prepared Statement of the American Federation of Government Employees,
AFL-CIO
Chairman Bost, Ranking Member Takano, and Members of the House
Committee on Veterans' Affairs:
The American Federation of Government Employees, AFL-CIO (AFGE) and
its National Veterans Affairs Council (NVAC) appreciate the opportunity
to submit a statement for the record for today's hearing titled
``Faster Decisions, Stronger Outcomes: VA's Work to Streamline the
Disability Claims Backlog.'' On behalf of the 325,000 Department of
Veterans Affairs (VA) employees AFGE represents, approximately a third
of whom are veterans themselves, including approximately 50 percent of
frontline workers at the Veterans Benefits Administration (VBA), it is
a privilege to offer AFGE's view on the current state of the claims
process and its ability to meet veterans' needs. In its examination,
AFGE will focus on the logistics of the claims process, and the
internal metrics VBA uses to measure its own success. In each of these
categories, AFGE will highlight current problems and offer commonsense
solutions that would enable claims processors to better serve veterans,
as well as demonstrate the vital role employees and AFGE play in
ensuring veterans receive their benefits in an accurate and effective
manner.
Logistics of the Claims Process
The National Work Queue (NWQ) was created in part to maximize VBA's
claims processing capacity between Regional Offices (RO). 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, which 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. This model better enabled claims
processors including Veteran Service Representatives (VSRs) and Rating
Veteran Service Representatives (RVSRs) to work on claims. 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
seven plus years since this report, VBA has heeded some of this advice
as it tries to reestablish what it did for specialty claims. Now
certain ROs have Special Operations centers within them where certain
claims are processed, including MST claims at the San Juan, PR RO and
the Roanoke, VA 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
specific and more challenging claims, with veterans benefiting from
these employees' expertise. As 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. AFGE also notes that while this
specialization is critical, to ensure that claims processors can
transition to other claims in the future and do not burn out from
issues like ``compassion fatigue'' by exclusively developing MST
claims, claims processors on specialty missions also work on other
claims while serving in these special missions.
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 grocery shopping for the week, veterans who have simpler
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 also 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 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 VBA to modify the
NWQ so that claims 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 a
claim's duration would avoid these inconsistencies and delays. This is
also true for secondary claims arising out of the original claim.
Keeping those secondary claims in the same RO would help with
efficiency, as claims processors are already familiar with the original
claim.
Additionally, keeping the claim within the same RO improves
communication and collaboration. 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 email 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 and avoid repeating the mistake. 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.
Furthermore, VBA has implemented a return to the office, despite
well-documented improvements in claims processor production since
telework and remote work became necessary during the COVID-19 Pandemic.
If VBA does not also require that claims stay in the same RO for the
duration of their processing to allow for collaboration and efficiency,
what is the merit of requiring claims processors to work anonymously
with one another from across the country?
Unlocking the NWQ
Despite a claims backlog that VA states is ``below 90,000'' as of
March 18, 2026, 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 placed on the NWQ. VBA assigns each 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 queue 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 time 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 that claim 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 may 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 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 efficiently and prevent a different claims processor from
having to spend time familiarizing themselves with an entirely new
claim unnecessarily.
Examining Internal VBA Regional Office Performance Metrics
AFGE notes that, in addition to individual claims processor
performance standards, each RO must meet VBA-imposed performance
metrics. These metrics drive the priorities and behavior of Regional
Office executives and greatly influence the claims process. While VBA
has a responsibility to measure the success of individual claims
processors and ROs, AFGE believes that at least three RO-level metrics
do not serve veterans' best interest: ``Time in Queue,'' VBA's lack of
credit for partial rating of claims, and mandatory overtime.
``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 within 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.
Lack of Credit for Rating of Partial Claims
Each veteran's claim can have as few as one contention or as many
as dozens of contentions, not all of 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; as a result, a single outstanding contention can hold up a
veteran's entire claim: 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. While
not all ROs follow this practice and some do rate partial claims, on
balance, the metric creates perverse incentives for ROs that slows down
the claims process. Veterans deserve to be treated like warriors and
not widgets. AFGE therefore calls on VBA to eliminate these
counterproductive metrics and instead create metrics that facilitate
and expedite the accurate delivery of benefits to qualifying veterans.
Mandatory Overtime
For years, VBA has used and relied upon mandatory overtime to
achieve its own internal production metrics. The problem with its use
is, as its name suggests, that it is mandatory. Not all VBA claims
processors desire to work extra hours and would prefer to spend
additional time with their family and friends. While not denying those
who choose to work overtime, giving employees an option would help
avoid burnout, improve claims quality, and prevent extra attrition, all
in the best interests of veterans.
Conclusion
AFGE thanks the House Committee on Veterans' Affairs for the
opportunity to submit a statement for the record for today's hearing.
AFGE stands ready to work with the committee and VBA to address
problems and better allow VBA employees to perform their duties and
serve veterans.
Prepared Statement of Abe Hamadeh
Thank you, Mr. Chairman.
I want to start by saying something that does not get said enough
in these hearings. The men and women at the Veterans Benefits
Administration (VBA) who are processing these claims every day deserve
recognition. Three million claims were completed last fiscal year. A
record. Not because of some new program or some consultant's
recommendation, but because the people doing the work were finally
given the leadership and the tools to do it right.
So let's be direct about where we are.
Since President Trump took office 15 months ago, the VA disability
claims backlog has dropped 67 percent--from nearly 265,000 claims on
Inauguration Day to roughly 87,000 today. Last fiscal year, VBA
processed a record 3 million claims. By contrast, the backlog grew 24
percent over the prior 4 years. President Biden inherited the lowest
backlog in modern history (64,738 claims in December 2019) and left
office with 265,000. The PACT Act increased volume, but leadership
means managing that volume--not being overwhelmed by it.
I'm cautiously optimistic about this direction. The real question
for this Committee is whether this progress--and the surge capacity
behind it--is sustainable. That's what I want to explore today.
Questions for the Record Submitted by Mark Takano
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U.S. Department of Veterans Affairs Response to Questions for the
Record
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