Veterans' Disability Benefits: Long-Standing Claims Processing	 
Challenges Persist (07-MAR-07, GAO-07-512T).			 
                                                                 
The Senate Veterans' Affairs Committee asked GAO to discuss its  
recent work related to the Department of Veterans Affairs' (VA)  
disability claims and appeals processing. GAO has reported and	 
testified on this subject on numerous occasions. GAO's work has  
addressed VA's efforts to improve the timeliness and accuracy of 
decisions on claims and appeals, VA's efforts to reduce backlogs,
and concerns about decisional consistency.			 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-07-512T					        
    ACCNO:   A66546						        
  TITLE:     Veterans' Disability Benefits: Long-Standing Claims      
Processing Challenges Persist					 
     DATE:   03/07/2007 
  SUBJECT:   Appeals						 
	     Claims processing					 
	     Claims settlement					 
	     Disability benefits				 
	     Performance management				 
	     Persons with disabilities				 
	     Program evaluation 				 
	     Veterans						 
	     Veterans benefits					 
	     Veterans disability compensation			 

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GAO-07-512T

   

     * [1]Background
     * [2]VA Continues to Face Service Delivery Challenges
     * [3]Despite VA's Continuing Steps, a Number of Factors May Limit
     * [4]Opportunities for Improvement May Lie in More Fundamental Re
     * [5]GAO Contact and Acknowledgments
     * [6]GAO's Mission
     * [7]Obtaining Copies of GAO Reports and Testimony

          * [8]Order by Mail or Phone

     * [9]To Report Fraud, Waste, and Abuse in Federal Programs
     * [10]Congressional Relations
     * [11]Public Affairs

Testimony
 
Before the Committee on Veterans' Affairs, United States Senate

United States Government Accountability Office

GAO

For Release on Delivery Expected at 9:30 a.m. EST
Wednesday, March 7, 2007

VETERANS'DISABILITY BENEFITS

Long-Standing Claims Processing Challenges Persist

Statement of Daniel Bertoni, Acting Director
Education, Workforce and Income Security

GAO-07-512T

Mr. Chairman and Members of the Committee:

I am pleased to have the opportunity to comment on the claims processing
challenges and opportunities facing the Department of Veterans Affairs'
(VA) disability compensation and pension programs. Through these programs,
VA provided about $34.5 billion in cash disability benefits to more than
3.5 million veterans and their survivors in fiscal year 2006. For years,
the claims process has been the subject of concern and attention by VA,
the Congress, and veterans service organizations. Many of their concerns
have focused on long waits for decisions, large claims backlogs, and
inaccurate decisions. Our work, and media reports of significant
discrepancies in average disability payments from state to state have also
highlighted concerns about the consistency of decision-making within VA.
In January 2003, we designated modernizing VA and other federal disability
programs as a high-risk area, because of these service delivery challenges
and because our work over the past decade found that these programs are
based on outmoded concepts from the past.

You asked us to discuss our recent work on VA's disability claims process.
My statement draws on a number of prior GAO reports and testimonies. (See
related GAO products.) We updated information as appropriate to reflect
the current status of VA claims processing and initiatives.

In summary, VA continues to face challenges in improving service delivery
to veterans, specifically in speeding up the process of adjudication and
appeal, reducing the existing backlog of claims, and improving the
accuracy and consistency of decisions. For example, between fiscal years
2003 and 2006, the inventory of rating-related claims grew by almost half
to a total of about 378,000, due in part to increased filing of claims,
including those filed by veterans of the Iraq and Afghanistan conflicts.^1
During the same period, the average number of days these claims were
pending increased by 16 days, to an average of 127 days. While VA has
improved the accuracy of its compensation decisions to 88 percent in
fiscal year 2006, it is still well short of its established goal of 98
percent. Meanwhile, appeals resolution remains a lengthy process. In
fiscal year 2006, it took an average of 657 days to resolve appeals.
Further, we and VA's Inspector General have identified concerns about the
consistency of decisions across regional offices and at the Board of
Veterans' Appeals.

^1 Rating-related claims are primarily original claims for disability
compensation and pension benefits, and reopened claims. For example,
veterans may file reopened claims if they believe their service-connected
conditions have worsened.

VA is taking steps to address service delivery problems, but improvements
may be limited by several factors. The President's fiscal year 2008 budget
requests an increase of over 450 full-time equivalent employees to process
compensation claims. Through training and information sharing, VA is also
working to reduce appeals processing times by decreasing the number of
cases sent back from the appeals level for further development. Further,
VA has taken actions to improve consistency, including developing a plan
to monitor decisions and identify unacceptable variations, and
commissioning a study of the major influences on compensation decisions.
However, several factors may limit VA's ability to make and sustain
significant improvements in its claims processing performance. These
include the potential impacts of laws and court decisions, continued
increases in the number and complexity of claims being filed, and
difficulties in obtaining the evidence needed to adjudicate claims in a
timely and accurate manner, such as military service records.

Opportunities for significant performance improvement may lie in more
fundamental reform of VA's disability compensation program. This would
include reexamining program design as well as the structure and division
of labor among field offices. For example, we found that VA and other
federal disability programs have not been updated to reflect the current
state of science, medicine, technology, and labor market conditions.
Specifically, the criteria for disability decisions are based primarily on
estimates made in 1945 about the effect of service-connected impairments
on the average individual's ability to perform jobs requiring manual
labor. In addition, our work has shown that about one-third of newly
compensated veterans could be interested in receiving lump sum payments,
which could potentially save VA time and money associated with reopening
cases over time and could be beneficial to veterans. In addition, VA and
other organizations have identified potential changes to field operations
that could enhance productivity and accuracy in processing disability
claims. While major reexamination may be daunting, there are mechanisms
for undertaking such an effort. For example, the congressionally chartered
commission on veterans' disability benefits has been studying a number of
program design issues, and will report to the Congress later this year.

Background

VA pays monthly disability compensation benefits to veterans with
service-connected disabilities (injuries or diseases incurred or
aggravated while on active military duty) according to the severity of the
disability. VA also pays compensation to some spouses, children, and
parents of deceased veterans and service members. VA's pension program
pays monthly benefits based on financial need to certain wartime veterans
or their survivors.^2

When a veteran submits a claim to any of the Veterans Benefits
Administration's 57 regional offices, a veterans service representative is
responsible for obtaining the relevant evidence to evaluate the claim.
Such evidence includes veterans' military service records, medical
examinations, and treatment records from VA medical facilities and private
medical service providers. Once a claim has all the necessary evidence, a
rating specialist evaluates the claim and determines whether the claimant
is eligible for benefits. If the veteran is eligible for disability
compensation, the rating specialist assigns a percentage rating based on
degree of disability. A veteran who disagrees with the regional office's
decision can appeal to VA's Board of Veterans' Appeals and then to U.S.
federal courts. If the Board finds that a case needs additional work such
as obtaining additional evidence or contains procedural errors, it is sent
back to the Veterans Benefits Administration, which is responsible for
initial decisions on disability claims.

In November 2003, the Congress established the Veterans' Disability
Benefits Commission to study the appropriateness of VA disability
benefits, including disability criteria and benefit levels. The commission
is scheduled to report to the Congress by October 1, 2007.

VA Continues to Face Service Delivery Challenges

VA continues to experience significant service delivery challenges
including lengthy processing times and inaccurate and inconsistent
decisions. While VA made progress in fiscal years 2002 and 2003 reducing
the size and age of its pending claims inventory, it has lost ground since
then. This is due in part to increased filing of claims, including those
filed by veterans of the Iraq and Afghanistan conflicts. Moreover,
questions remain about consistency of VA's decisions across regional
offices and at the Board of Veterans' Appeals.

^2 Veterans qualify for pensions if they have low income, served in a
period of war, and are permanently and totally disabled for reasons not
service-connected (or are age 65 or older).

VA's inventory of pending claims and their average time pending have
increased significantly in the last 3 years. The number of pending claims
increased by almost one-half from the end of fiscal year 2003 to the end
of fiscal year 2006, from about 254,000 to about 378,000. During the same
period, the number of claims pending longer than 6 months increased by
more than three-fourths, from about 47,000 to about 83,000 (see fig.1).

Figure 1: Rating-Related Claims Pending at End of Period, Fiscal Years
2000-2006

Similarly, as shown in figure 2, VA reduced the average age of its pending
claims from 182 days at the end of fiscal year 2001 to 111 days at the end
of fiscal year 2003. However, by the end of fiscal year 2006 average days
pending had increased to 127 days. Meanwhile, the time required to resolve
appeals remains too long. The average time to resolve an appeal rose from
529 days in fiscal year 2004 to 657 days in fiscal year 2006.

Figure 2: Average Days Pending for VA Compensation and Pension
Rating-Related Claims, Fiscal Years 2000-2006

The increase in VA's inventory of pending claims, and their average time
pending is due in part to an increase in claims receipts. Rating-related
claims, including those filed by veterans of the Iraq and Afghanistan
conflicts, increased steadily from about 579,000 in fiscal year 2000 to
about 806,000 in fiscal year 2006, an increase of about 39 percent.

In addition to problems with deciding claims in a timely manner, VA
acknowledges that regional office decision accuracy needs further
improvement. VA reports that it has improved the accuracy of decisions on
rating related compensation claims from 80 percent in fiscal year 2002 to
88 percent in fiscal year 2006.^3 However, this figure remains well short
of its strategic goal of 98 percent.

VA also continues to face questions about its ability to ensure that
veterans receive consistent decisions across regional offices. We have
identified the need for VA to systematically address this issue to achieve
acceptable levels of variation.^4 VA's Inspector General has studied one
indicator of possible inconsistency, the wide variations in average
payments per veteran from state to state. In May 2005, the Inspector
General^5 reported that compensation payments are affected by many factors
and that some disabilities are inherently more susceptible to variations
in rating determinations. Further, we reported in May 2005 that the Board
of Veterans' Appeals had taken actions to strengthen its system for
reviewing the quality of its decisions, but VA still lacked a systematic
method for ensuring the consistency of decision making within VA as a
whole.

^3 Actual data through July 2006.

Despite VA's Continuing Steps, a Number of Factors May Limit Its Ability to
Improve Claims Processing

VA has recently taken several steps to improve service delivery, but their
potential to lead to significant improvements may be limited by several
factors. These steps include requesting funding for additional staff,
initiatives to reduce appeal remands, and initiatives to assess and
monitor decision consistency. However, limitations on potential
improvements include increases in claims volume and complexity, and
challenges in acquiring needed evidence in a timely manner.

In its fiscal year 2008 budget justification, VA identified an increase in
claims processing staff as essential to reducing the pending claims
inventory and improving timeliness. According to VA, with a workforce that
is sufficiently large and correctly balanced, it can successfully meet the
veterans' needs while ensuring good stewardship of taxpayer funds. The
fiscal year 2008 request would fund 8,320 full-time equivalent employees
working on compensation and pension, which would represent an increase of
about 6 percent over fiscal year 2006. In addition, the budget
justification cites near-term initiatives to increase the number of claims
completed, such as using retired VA employees to provide training, and the
increased use of overtime.

^4 GAO, Veterans' Benefits: Quality Assurance for Disability Claims and
Appeals Processing Can Be Further Improved, [12]GAO-02-806 (Washington,
D.C.: Aug. 16, 2002); and Veterans Benefits: VA Needs Plan for Assessing
Consistency of Decisions, [13]GAO-05-99 (Washington, D.C.: Nov. 19, 2004).

^5 Department of Veterans Affairs Office of Inspector General, Review of
State Variances in VA Disability Compensation Payments, Report No.
05-00765-137 (Washington, D.C.: May 19, 2005).

Even as staffing levels increase, however, VA acknowledges that it still
must take other actions to improve productivity.^6 VA's budget
justification provides information on actual and planned productivity, in
terms of claims decided per full-time equivalent employee. While VA
expects a temporary decline in productivity as new staff are trained and
become more experienced, it expects productivity to increase in the longer
term. Also, VA has identified additional initiatives to help improve
productivity. For example, VA plans to pilot paperless Benefits Delivery
at Discharge, where service members' disability claim applications,
service medical records, and other evidence would be captured
electronically prior to discharge. VA expects that this new process will
reduce the time needed to obtain the evidence needed to decide claims.

To resolve appeals faster, VA has been working to reduce the number of
appeals sent back by the Board of Veterans' Appeals for further work such
as obtaining additional evidence and correcting procedural errors. To do
so, VA has established joint training and information sharing between
field staff and the Board. VA reports that it has reduced the percentage
of decisions remanded from about 57 percent in fiscal year 2004 to about
32 percent in fiscal year 2006, and expects its efforts to lead to further
reductions. Also, VA reports that it has improved the productivity of the
Board's judges from an average of 604 appeals decided in fiscal year 2003
to 698 in fiscal year 2006. The Board attributes this improvement to
training and mentoring programs and expects productivity to improve to 752
decisions in fiscal year 2008.

To improve decision consistency, VA has contracted for a study of the
major influences on compensation payments, to develop baseline data for
monitoring and managing decision variances. Also, VA is in the process of
testing templates for compensation and pension medical examinations for
specific types of disabilities to ensure that medical evidence from these
examinations will enable consistent evaluations of disabilities. Further,
VA formed a workgroup to study variances in the rates of benefit grants
and denials, and in assigned disability evaluations, leading to
development of plans to monitor consistency on an ongoing basis.

Despite these efforts, VA may be limited in its ability to make and
sustain significant claims processing performance improvements. Recent
history has shown that VA's claims processing workload and performance are
affected by several factors, including the impacts of laws and court
decisions, increasing numbers and complexity of claims, and difficulties
in obtaining accurate and timely information to adjudicate claims. Since
1999, several court decisions and laws related to VA's responsibilities to
assist veterans in developing their benefit claims have significantly
affected VA's ability to process claims in a timely manner. VA attributes
some of the increase in the number of claims pending and the average days
pending to a September 2003 court decision that required over 62,000
claims to be deferred, many for 90 days or longer. Also, VA notes that
legislation and VA regulations have expanded benefit entitlement and added
to the volume of claims. For example, in recent years, laws and
regulations have created new presumptions of service-connected
disabilities for many Vietnam veterans and former prisoners of war. Also,
VA expects additional claims receipts based on the enactment of
legislation allowing certain military retirees to receive both military
retirement pay and VA disability compensation.

^6See GAO, Veterans' Benefits: More Transparency Needed to Improve
Oversight of VBA's Compensation and Pension Staffing Levels, [14]GAO-05-47
(Washington, D.C.: Nov. 15, 2004).

In addition, rating-related claims continue to increase, from about
579,000 in fiscal year 2000 to about 806,000 in fiscal year 2006, an
increase of about 39 percent. While VA projects relatively flat claim
receipts in fiscal years 2007 and 2008, it cautions that ongoing
hostilities in Iraq and Afghanistan, and the Global War on Terrorism in
general, may increase the workload beyond current levels. VA has also
noted that claims have increased in part because older veterans are filing
disability claims for the first time. Moreover, according to VA, the
complexity of claims is also increasing. For example, some veterans are
citing more disabilities in their claims than in the past. Because each
disability needs to be evaluated separately, these claims can take longer
to complete. Additionally, VA notes that they are receiving more
disability claims, such as those related to mental health issues including
post-traumatic stress disorder, which are generally harder to evaluate.

Additionally, claims processing timeliness and decisional accuracy can be
hampered if VA cannot obtain the evidence it needs in a timely manner. For
example, to obtain information needed to fully develop some post-traumatic
stress disorder claims, VBA must obtain records from the U.S. Army and
Joint Services Records Research Center (JSRRC), whose average response
time to VBA regional office requests is about 1 year. This can
significantly increase the time it takes to decide a claim. In December
2006, we recommended that VBA assess whether it could systematically
utilize an electronic library of historical military records rather than
submitting all research requests to the JSRRC. VBA agreed to determine the
feasibility of regional offices using an alternative resource prior to
sending some requests to the JSRRC. We also reported that while VBA
quality reviewers found few decision errors due to failure to obtain
military service records, VBA does not know the extent to which the
information that is provided to regional offices is reliable and accurate.
Regional offices rely on a VBA unit at the National Personnel Records
Center, where service records of many veterans are stored, to do thorough
and reliable searches and analyses of records and provide accurate reports
on the results. However, we noted that VBA does not systematically
evaluate the quality of these searches and analyses. Incomplete and
inaccurate reports could affect decisional accuracy.

Opportunities for Improvement May Lie in More Fundamental Reform

While VA is taking actions to address its claims processing challenges,
there are opportunities for more fundamental reform that could
dramatically improve decision making and processing. These include
reexamining program design, as well as the structure and division of labor
among field offices.

After more than a decade of research, we have determined that federal
disability programs are in urgent need of attention and transformation and
placed modernizing federal disability programs on our high-risk list in
January 2003. Specifically, our research showed that the disability
programs administered by VA and the Social Security Administration lagged
behind the scientific advances and economic and social changes that have
redefined the relationship between impairments and work. For example,
advances in medicine and technology have reduced the severity of some
medical conditions and have allowed individuals to live with greater
independence and function in work settings. Moreover, the nature of work
has changed in recent decades as the national economy has moved away from
manufacturing-based jobs to service- and knowledge-based employment. Yet
VA's and SSA's disability programs remain mired in concepts from the
past--particularly the concept that impairment equates to an inability to
work--and as such, we found that these programs are poorly positioned to
provide meaningful and timely support for Americans with disabilities.

In August 2002, we recommended that VA use its annual performance plan to
delineate strategies for and progress in periodically updating labor
market data used in its disability determination process. We also
recommended that VA study and report to the Congress on the effects that a
comprehensive consideration of medical treatment and assistive
technologies would have on its disability programs' eligibility criteria
and benefits package. This study would include estimates of the effects on
the size, cost, and management of VA's disability programs and other
relevant VA programs and would identify any legislative actions needed to
initiate and fund such changes.

Another area of program design that could be examined is the option of
providing a lump sum payment in lieu of monthly disability compensation.
In 1996, the Veterans' Claims Adjudication Commission noted that most
disability compensation claims are repeat claims--such as claims for
increased disability percentage--and most repeat claims were from veterans
with less severe disabilities.^7 According to VA, about 65 percent of
veterans who began receiving disability compensation in fiscal year 2003
had disabilities rated 30 percent or less. The commission questioned
whether concentrating claims processing resources on these claims, rather
than on claims by more severely disabled veterans, was consistent with
program intent. The commission asked Congress to consider paying less
severely disabled veterans compensation in a lump sum. According to the
commission, the lump sum option could have a number of benefits for VA as
well as veterans. Specifically, the lump sum option could reduce the
number of claims submitted and allow VA to process claims more
quickly--especially those of more seriously disabled veterans. Moreover, a
lump sum option could be more useful to some veterans as they make the
transition from military to civilian life. In December 2000, we reported
that about one-third of newly compensated veterans could be interested in
a lump sum option.

In addition to program design, VA's regional office claims processing
structure may be disadvantageous to efficient operations. VBA and others
who have studied claims processing have suggested that consolidating
claims processing into fewer regional offices could help improve claims
processing efficiency, save overhead costs, and improve decisional
accuracy and consistency. We noted in December 2005 that VA had made
piecemeal changes to its claims processing field structure. VA
consolidated some of its pension income and eligibility verifications at
three regional offices. Further, VA consolidated decision making on
Benefits Delivery at Discharge claims, which are generally original claims
for disability compensation, at the Salt Lake City and Winston-Salem
regional offices. However, VA has not changed its basic field structure
for processing compensation and pension claims at 57 regional offices,
which experience large performance variations and questions about decision
consistency. Unless more comprehensive and strategic changes are made to
its field structure, VBA is likely to miss opportunities to substantially
improve productivity, accuracy, and consistency, especially in the face of
future workload increases. We have recommended that the VA undertake a
comprehensive review of its field structure for processing disability
compensation and pension claims.

^7 Veterans' Claims Adjudication Commission, Report to Congress
(Washington D.C.: December 1996).

While reexamining claims processing challenges may be daunting, there are
mechanisms for undertaking such an effort, including the congressionally
chartered commission currently studying veterans' disability benefits. In
November 2003, the Congress established the Veterans' Disability Benefits
Commission to study the appropriateness of VA disability benefits,
including disability criteria and benefit levels. The commission is to
examine and provide recommendations on (1) the appropriateness of the
benefits, (2) the appropriateness of the benefit amounts, and (3) the
appropriate standard or standards for determining whether a disability or
death of a veteran should be compensated. The commission held its first
public hearing in May 2005 and in October 2005, established 31 research
questions for study. These questions address such issues as how well
disability benefits meet the congressional intent of replacing average
impairment in earnings capacity, whether lump sum payments should be made
for certain disabilities or level of severity of disability, and how VA's
claims processing operation compares to other disability programs,
including the location and number of processing centers. These issues and
others have been raised by previous studies of VBA's disability claims
process. The commission is scheduled to report to the Congress by October
1, 2007.

Mr. Chairman, this concludes my remarks. I would be happy to answer any
questions that you or other members of the committee may have.

GAO Contact and Acknowledgments

For further information, please contact Daniel Bertoni at (202) 512-7215
or [email protected]. Also contributing to this statement were Shelia
Drake, Martin Scire, Greg Whitney, and Charles Willson.

Related GAO Products

High Risk Series: An Update. [15]GAO-07-310 . Washington, D.C.: January
31, 2007.

Veterans' Disability Benefits: VA Can Improve Its Procedures for Obtaining
Military Service Records. [16]GAO-07-98 . Washington, D.C.: December 12,
2006.

Veterans' Benefits: Further Changes in VBA's Field Office Structure Could
Help Improve Disability Claims Processing. [17]GAO-06-149 . Washington,
D.C.: December 9, 2005.

Veterans' Disability Benefits: Claims Processing Challenges and
Opportunities for Improvements. [18]GAO-06-283T . Washington, D.C.:
December 7, 2005.

Veterans' Disability Benefits: Improved Transparency Needed to Facilitate
Oversight of VBA's Compensation and Pension Staffing Levels.
[19]GAO-06-225T . Washington, D.C.: November 3, 2005.

VA Benefits: Other Programs May Provide Lessons for Improving Individual
Unemployability Assessments. [20]GAO-06-207T . Washington, D.C.: October
27, 2005.

Veterans' Disability Benefits: Claims Processing Problems Persist and
Major Performance Improvements May Be Difficult. [21]GAO-05-749T .
Washington, DC.: May 26, 2005.

VA Disability Benefits: Board of Veterans' Appeals Has Made Improvements
in Quality Assurance, but Challenges Remain for VA in Assuring
Consistency. [22]GAO-05-655T . Washington, D.C.: May 5, 2005.

Veterans Benefits: VA Needs Plan for Assessing Consistency of Decisions.
[23]GAO-05-99 . Washington, D.C.: November 19, 2004.

Veterans' Benefits: More Transparency Needed to Improve Oversight of VBA's
Compensation and Pension Staffing Levels. [24]GAO-05-47 . Washington,
D.C.: November 15, 2004.

Veterans' Benefits: Improvements Needed in the Reporting and Use of Data
on the Accuracy of Disability Claims Decisions. [25]GAO-03-1045 .
Washington, D.C.: September 30, 2003.

Department of Veterans Affairs: Key Management Challenges in Health and
Disability Programs. [26]GAO-03-756T . Washington, D.C.: May 8, 2003.

Veterans Benefits Administration: Better Collection and Analysis of
Attrition Data Needed to Enhance Workforce Planning. [27]GAO-03-491 .
Washington, D.C.: April 28, 2003.

Veterans' Benefits: Claims Processing Timeliness Performance Measures
Could Be Improved. [28]GAO-03-282 . Washington, D.C.: December 19, 2002.

Veterans' Benefits: Quality Assurance for Disability Claims and Appeals
Processing Can Be Further Improved. [29]GAO-02-806 . Washington, D.C.:
August 16, 2002.

Veterans' Benefits: VBA's Efforts to Implement the Veterans Claims
Assistance Act Need Further Monitoring. [30]GAO-02-412 . Washington, D.C.:
July 1, 2002.

Veterans' Benefits: Despite Recent Improvements, Meeting Claims Processing
Goals Will Be Challenging. [31]GAO-02-645T . Washington, D.C.: April 26,
2002.

Veterans Benefits Administration: Problems and Challenges Facing
Disability Claims Processing. [32]GAO/T-HEHS/AIMD-00-146 . Washington,
D.C.: May 18, 2000.

(130644)

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Highlights of [40]GAO-07-512T , a testimony before the Committee on
Veterans' Affairs, United States Senate

March 7, 2007

VETERANS' DISABILITY BENEFITS

Long-Standing Claims Processing Challenges Persist

The Senate Veterans' Affairs Committee asked GAO to discuss its recent
work related to the Department of Veterans Affairs' (VA) disability claims
and appeals processing.

GAO has reported and testified on this subject on numerous occasions.
GAO's work has addressed VA's efforts to improve the timeliness and
accuracy of decisions on claims and appeals, VA's efforts to reduce
backlogs, and concerns about decisional consistency.

VA continues to face challenges in improving service delivery to veterans,
specifically in speeding up the process of adjudication and appeal,
reducing the existing backlog of claims, and improving the accuracy and
consistency of decisions. For example, as of the end of fiscal year 2006,
rating-related compensation claims were pending an average of 127 days, 16
days more than at the end of fiscal year 2003. During the same period, the
inventory of rating-related claims grew by almost half, due in part to
increased filing of claims, including those filed by veterans of the Iraq
and Afghanistan conflicts. Meanwhile, appeals resolution remains a lengthy
process, taking an average of 657 days in fiscal year 2006. Further, we
and VA's Inspector General have identified concerns about the consistency
of decisions by VA's regional offices and the Board of Veterans' Appeals
(BVA).

Rating-Related Claims Pending at End of Period, Fiscal Years 2000-2006

VA is taking steps to address these problems. For example, the President's
fiscal year 2008 budget requests an increase of over 450 full-time
equivalent employees to process compensation claims. VA is working to
improve appeals timeliness by reducing appeals remanded for further work.
VA is also developing a plan to monitor consistency across regional
offices. However, several factors may limit VA's ability to make and
sustain significant improvements in its claims processing performance,
including the potential impacts of laws and court decisions, continued
increases in the number and complexity of claims being filed, and
difficulties in obtaining the evidence needed to decide claims in a timely
and accurate manner, such as military service records.

Opportunities for significant performance improvement may lie in more
fundamental reform of VA's disability compensation program. This could
include reexamining program design such as updating the disability
criteria to reflect the current state of science, medicine, technology,
and labor market conditions. It could also include examining the structure
and division of labor among field offices.

References

Visible links
  12. http://www.gao.gov/cgi-bin/getrpt?GAO-02-806
  13. http://www.gao.gov/cgi-bin/getrpt?GAO-05-99
  14. http://www.gao.gov/cgi-bin/getrpt?GAO-05-47
  15. http://www.gao.gov/cgi-bin/getrpt?GAO-07-310
  16. http://www.gao.gov/cgi-bin/getrpt?GAO-07-98
  17. http://www.gao.gov/cgi-bin/getrpt?GAO-06-149
  18. http://www.gao.gov/cgi-bin/getrpt?GAO-06-283T
  19. http://www.gao.gov/cgi-bin/getrpt?GAO-06-225T
  20. http://www.gao.gov/cgi-bin/getrpt?GAO-06-207T
  21. http://www.gao.gov/cgi-bin/getrpt?GAO-05-749T
  22. http://www.gao.gov/cgi-bin/getrpt?GAO-05-655T
  23. http://www.gao.gov/cgi-bin/getrpt?GAO-05-99
  24. http://www.gao.gov/cgi-bin/getrpt?GAO-05-47
  25. http://www.gao.gov/cgi-bin/getrpt?GAO-03-1045
  26. http://www.gao.gov/cgi-bin/getrpt?GAO-03-756T
  27. http://www.gao.gov/cgi-bin/getrpt?GAO-03-491
  28. http://www.gao.gov/cgi-bin/getrpt?GAO-03-282
  29. http://www.gao.gov/cgi-bin/getrpt?GAO-02-806
  30. http://www.gao.gov/cgi-bin/getrpt?GAO-02-412
  31. http://www.gao.gov/cgi-bin/getrpt?GAO-02-645T
  32. http://www.gao.gov/cgi-bin/getrpt?GAO/T-HEHS/AIMD-00-146
  40. http://www.gao.gov/cgi-bin/getrpt?GAO-07-512T
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