Veterans' Benefits: Lack of Timeliness, Poor Communication Cause Customer
Dissatisfaction (Letter Report, 09/20/94, GAO/HEHS-94-179).

In fiscal year 1993, the Department of Veterans Affairs (VA) provided
nearly $19 billion in nonmedical benefits to veterans and their
families. In 1993, GAO surveyed 1,400 recent applicants for VA
nonmedical benefits nationwide. Although most applicants were satisfied
with VA's services, more than one-third were unhappy with VA's handling
of their claims. The time it takes VA to process claims was by far the
greatest source of applicants' dissatisfaction. Communication with VA
was another major concern for applicants. Many customers said that they
were dissatisfied, whether the communications were by mail, by phone, or
in person. For example, 40 percent of those who visited a VA office said
that they did not get the information they needed. The need to resubmit
documents to VA also inconvenienced applicants. GAO's study pointed out
two other factors that may hold significant implication for VA's efforts
to improve customer satisfaction. First, applicants whose claims were
denied represented a significant portion--36 percent--of VA's customers.
VA knows very little about who those applicants are, why their claims
were denied, or what it could do to help these people. Second, 60
percent of VA customers received service from sources over which VA has
no authority, such as state and county veterans offices and veterans
service organizations.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  HEHS-94-179
     TITLE:  Veterans' Benefits: Lack of Timeliness, Poor Communication 
             Cause Customer Dissatisfaction
      DATE:  09/20/94
   SUBJECT:  Veterans benefits
             Claims processing
             Eligibility determinations
             Quality control
             Information processing operations
             Claims settlement
             Public relations
             Surveys
             Operations analysis
             Entitlement programs

             
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Cover
================================================================ COVER


Report to the Chairman, Committee on Veterans' Affairs, U.S.  Senate

September 1994

VETERANS' BENEFITS - LACK OF
TIMELINESS, POOR COMMUNICATION
CAUSE CUSTOMER DISSATISFACTION

GAO/HEHS-94-179

VA Customer Satisfaction


Abbreviations
=============================================================== ABBREV

  VA - Department of Veterans Affairs

Letter
=============================================================== LETTER


B-251769

September 20, 1994

The Honorable John D.  Rockefeller IV
Chairman, Committee on Veterans' Affairs
United States Senate

Dear Mr.  Chairman: 

Because of frequent complaints about the quality and timeliness of
the Department of Veterans Affairs' (VA) claims processing, you
expressed interest in improving the quality of service VA provides to
its customers.  In fiscal year 1993, VA provided nearly $19 billion
in nonmedical benefits to veterans and their families.  You asked
that we determine how applicants for benefits view the quality of
VA's services. 

This report summarizes the results of our 1993 national survey of
1,400 recent applicants for VA nonmedical benefits.  In addition to
assessing customers' overall satisfaction with VA's service, the
survey highlighted concerns in several key areas, including

  the time it takes to process claims,

  how VA communicates with veterans and their families, and

  the frequency with which applicants have to resubmit documents to
     VA in support of their claims. 

The survey also provided information about the extent to which (1) VA
denies claims and (2) organizations other than VA, such as veterans
service organizations, are involved in the claims process. 


   RESULTS IN BRIEF
------------------------------------------------------------ Letter :1

Although most applicants were satisfied, over a third were
dissatisfied with VA's handling of their claims.  (See fig.  1.) VA
has identified customer concerns and is developing approaches
designed to address them.  The concerns voiced by respondents to our
survey have important implications for those efforts to improve
customer satisfaction. 

   Figure 1:  Applicants' Opinions
   About How VA Handled Their
   Claims

   (See figure in printed
   edition.)

The time it takes VA to process claims was by far the greatest source
of applicants' dissatisfaction, according to our survey.  VA has
recognized the need to speed up its claims processing and has
established timeliness goals.  However, even if those goals are met,
many customers may remain dissatisfied because they believe
processing should be completed in less time than the goals call for. 
For example, initial compensation applicants thought claims should be
processed in an average of 9 weeks, but VA's goal for these claims is
15 weeks. 

Communication with VA was another major concern for applicants.  Many
customers said they were dissatisfied, whether the communication was
by mail, by phone, or in person.  For example, 40 percent of those
who visited a VA office reported they did not get the information
they needed.  One veteran's comment may have summed up the issue for
many:  "It's like you can't go to just one person and sit down and
have them explain to you step by step what you need to do for
whatever problem .  .  .  ." Applicants most often wanted information
about services and benefits available to them, the status of their
claims, and the reasons for the decisions on their claims. 

The need to resubmit documents to VA also inconvenienced applicants. 
Twenty-two percent of applicants had to resubmit documents at least
once.  Civilian documents such as marriage certificates were
resubmitted most often.  Resubmissions cost applicants time and money
and can increase VA's workload and processing time. 

Our study pointed out two other factors that may hold significant
implications for VA's efforts to improve customer satisfaction. 
First, applicants whose claims were denied represented a significant
portion--36 percent--of VA's customers.  VA knows very little about
who those applicants are, why their claims were denied, and what VA
could do to help these people.  Second, 60 percent of VA customers
received service from sources over which VA has no authority, such as
state and county veterans offices and veterans service organizations. 
The extent to which these other sources are involved highlights the
need for continued communication between VA and these sources as VA
seeks to improve customer satisfaction. 


   SCOPE AND METHODOLOGY
------------------------------------------------------------ Letter :2

To obtain the views of VA's customers, we surveyed a national random
sample of 1,400 applicants.  These applicants' claims were
representative of the claims completed at VA's regional offices
between April 1 and July 13, 1993, for nine types of benefit claims. 
Appendix I provides more details on our scope and methodology;
appendix II provides a copy of the questionnaire and customer
responses. 

We also conducted two focus groups, one with veterans who applied for
disability compensation and one with veterans' survivors who applied
for initial death pension benefits.  We spoke with representatives of
veterans service organizations, including the American Legion,
Blinded Veterans Association, Disabled American Veterans, Paralyzed
Veterans of America, and Veterans of Foreign Wars.  In addition, we
telephoned and visited state and county veterans offices in Alabama,
Florida, and Georgia. 

To obtain information about VA's current operations and efforts to
improve services, we reviewed VA's policies and procedures, data
relative to claims processing and timeliness standards and goals,
current customer survey efforts, and documentation outlining VA plans
and efforts to address customer and congressional concerns.  We also
met with VA officials at the Washington, D.C., headquarters and at
VA's regional offices in Atlanta, Georgia; Montgomery, Alabama; New
York City, New York; St.  Petersburg, Florida; and Washington, D.C. 

This report summarizes responses from applicants for nine types of
claims.  Appendix III provides more detailed information about, and
highlights some differences among, the nine types of claims.  Our
review was conducted from December 1992 to June 1994 and was
performed in accordance with generally accepted government auditing
standards. 


   BACKGROUND
------------------------------------------------------------ Letter :3

VA's Veterans Benefits Administration is responsible for
administering benefit programs, such as disability compensation and
pension.  Veterans and their families can apply for benefits through
any of VA's 58 regional offices.\1

Veterans and their families also may seek assistance with VA benefits
from a variety of sources, such as state and county veterans offices
and veterans service organizations.  Other sources provide assistance
with specific benefits, such as funeral home directors with burial
benefits and school officials with education benefits. 

VA has recognized the need to improve services to veterans and is
taking steps designed to do so.  Much of the emphasis has been on
improving timeliness of claims processing and reducing the backlog of
claims, which increased from 107,000 in 1988 to over 520,000 in 1993. 
VA has recognized, for example, that it does not efficiently obtain
documents necessary to decide claims, it does not effectively control
its records, and many staff are not sufficiently trained. 

VA has undertaken three long-term initiatives.  First, in December
1992, VA awarded a contract to implement a modernization plan
designed to improve operations through automation.\2 Second, VA is
implementing total quality management and is encouraging each
regional office to develop locally appropriate restructuring
initiatives to improve operations.  VA's third major effort focuses
on disability claims, which are usually the most difficult and time
consuming to process.  In November 1993, the Secretary of Veterans
Affairs approved a package of recommendations designed to improve
processing of those claims.  He gave regions until May 1995 to
develop plans to implement those recommendations and make other
changes to improve claims processing. 

To help it develop short- and long-term goals, VA conducted, by
telephone, a customer satisfaction survey between October and
November 1992.  In January 1994, VA published results for five
programs:  the Veterans Assistance Service, which is responsible for
answering customer inquiries by phone or in person; compensation
benefits; vocational rehabilitation; and two insurance programs.\3
Although the response rates for these surveys were relatively low,
the findings were in many ways similar to ours.  VA intends to use
survey findings to help establish priorities for future service
improvements and to develop goals and standards. 


--------------------
\1 VA regional offices are located in each state, the District of
Columbia, Puerto Rico, and the Republic of the Philippines.  New
York, Texas, and Pennsylvania have two regional offices each, and
California has three. 

\2 After we pointed to the need for improved planning and oversight
of VA's modernization efforts, VA signed an agreement with the Office
of Management and Budget to redirect its efforts.  See Veterans
Benefits:  Acquisition of Information Resources for Modernization Is
Premature (GAO/IMTEC-93-6, Nov.  4, 1992) and Veterans Benefits: 
Redirected Modernization Shows Promise (GAO/AIMD-94-26, Dec.  9,
1993). 

\3 VA surveyed customers about nine programs in all, but does not
anticipate publishing results for four of these programs because
response rates were too low or surveys could not be completed because
of technical difficulties. 


   PROCESSING TIME IS A CRITICAL
   CONCERN FOR APPLICANTS
------------------------------------------------------------ Letter :4

The time VA takes to process claims was the greatest complaint among
those customers we surveyed.\4 Fifty percent of customers indicated
timeliness should be improved.  This was the major concern regardless
of the type of claim, whether VA approved the claim, and the
applicants' gender, age, or education level. 

Processing time historically has been a problem for VA, and it is
getting worse.\5 VA officials acknowledged this and attributed
increased processing time to several factors that are unlikely to
change, such as the greater complexity of claims. 

In October 1992 VA officials set goals for how long it should take to
process claims for fiscal year 1993.  Those goals generally represent
improvement over actual processing times during a baseline period,
but the goals do not always meet customer expectations for reasonable
processing time.  VA's goals for four types of compensation and
pension claims were longer than the average time customers said was
reasonable for processing claims.  For example, VA's goal for
processing initial disability compensation claims is an average of 15
weeks.  But applicants reported that, on average, initial
compensation claims should be processed in 9 weeks.  (See fig.  2.)
VA's 1992 telephone survey of customers found similar expectations. 
On average, respondents in VA's survey said they should get a final
decision from VA regarding a compensation claim in 10 weeks. 

   Figure 2:  VA Not Meeting
   Customer Expectations

   (See figure in printed
   edition.)

Our survey also indicated that VA practices may affect applicants'
satisfaction level.  Those who were not given an estimate of how long
it would take to process their claims were generally less satisfied. 
They were more likely to indicate that VA's processing time was
unreasonable, that VA's decision was unfair, and that they were
dissatisfied with how VA handled their claims.  Over 40 percent of
applicants reported VA did not provide any estimate of when their
claims would be decided; VA policies do not require an estimate to be
given.  (See fig.  3.)

   Figure 3:  Satisfaction Levels
   of Those Who Received Estimates
   and Those Who Did Not

   (See figure in printed
   edition.)

However, giving an applicant an estimate of processing time can
backfire when the estimate is unrealistic.  In that case, applicants'
dissatisfaction levels can increase.  For example, one compensation
applicant said he had been told it would take 5 to 6 months to
process his claim, but instead it took about 12 or 13 months.  The
applicant said that had VA given him a realistic estimate of the
processing time, he would not have been so dissatisfied and would not
have repeatedly called VA to check on the status of his claim.  VA
officials agreed that providing realistic estimates may also reduce
VA's workload since customers would not telephone VA to ask about
claim status until the estimated time had elapsed.\6


--------------------
\4 Applicants for compensation claims were generally most
dissatisfied with timeliness and the other aspects of service
discussed in this report.  But, as the tables in appendix III show,
troublingly large portions of applicants for other types of benefits
expressed similar concerns about key aspects of service. 

\5 Compensation and pension claims present the biggest problem.  In
1989, we reported that VA took too long to process these claims (see
Veterans' Benefits:  Improvements Needed in Processing Disability
Claims, GAO/HRD-89-24, June 22, 1989).  In 1988, initial disability
compensation claims--generally considered the most complicated--on
average took 21 weeks to process.  In fiscal year 1993, they averaged
27 weeks. 

\6 Our data did not allow us to determine the reasonableness of the
estimates VA gave our respondents because we did not have the actual
processing time for each case. 


   CUSTOMERS OFTEN DISSATISFIED
   WITH COMMUNICATION WITH VA
------------------------------------------------------------ Letter :5

Many applicants were dissatisfied with their communication with VA. 
Some did not receive required communications from VA.  Others did not
get the information they needed whether the communication was by
letter, phone call, or personal visit.  Poor communication greatly
increases the potential for dissatisfaction among customers and
increases VA's workload. 

Many customers did not receive letters that VA is required to
provide.  Overall, about 34 percent of applicants did not indicate
that they were informed by letter that their application had been
received, and 38 percent of applicants whose claims had been
completed did not indicate they received a letter stating that from
VA. 

Of those who said they received letters from, phoned, or visited VA,
over one-third did not get most of the information they needed.  (See
fig.  4.) Applicants were most interested in VA (1) explaining the
services and benefits that are available, (2) keeping them informed
on the status of their claims, and (3) explaining the reasons for
decisions.  One applicant said it would have been helpful if VA had
told him what information they used to decide his claim.  "That way,"
he said, "when I appealed it, I would know what to send them--what
additional information I needed to send." Other applicants said they
would like "an indication of the amount of time it might reasonably
take for benefits to reach the person" or "more information on the
questions [the applicants] asked--not general information."

   Figure 4:  VA Often Does Not
   Provide Most of the Information
   Applicants Need

   (See figure in printed
   edition.)

For those who sought informational materials from VA, the results
were similar.  Of the 50 percent of our sample who requested
informational materials, more than one-quarter did not get them.  Of
those who received the informational materials they requested, about
one-quarter told us that these materials did not contain most of the
information they needed. 

Despite not getting what they needed, over 80 percent of applicants
said that VA employees were courteous.  And it appears courtesy helps
mitigate applicants' dissatisfaction.  One applicant said, "Their
phone service is fine.  They were helpful in telling me they knew
nothing about when my claim would be finished." Likewise, discussion
in our focus groups indicated many problems with VA service, but some
participants gave VA a high overall rating, citing courteous and
friendly employees as the reason.  Our survey results also point to
the positive effect of courtesy.  For example, applicants who
contacted VA by phone and reported that employees were courteous were
more likely to be satisfied (57 percent) overall with VA's handling
of their claims than dissatisfied (33 percent). 

The quality of VA communications with customers has been a
long-standing problem.\7 VA is developing approaches to address some
of the problems raised in our survey.  For example, VA is testing a
variety of software programs to allow written communications,
including decision letters, to be more informative and clearer.  VA
also is implementing a plan to change claims processing; in some
regions, changes allow applicants to directly contact the employees
most knowledgeable about their claims.  This is a significant
departure from the traditional way claims are processed. 
Furthermore, by February 1994 VA had begun sending form letters to
applicants every 90 days indicating that their claims were still in
process.  While these changes are potentially significant, they may
not address situations where customers did not get information
required or requested or where veterans and their families need to
understand benefits and services before they apply. 


--------------------
\7 Our 1989 report found several shortcomings in VA's communication
with customers.  For example, we found that VA decision notices did
not provide a clear and full explanation for VA actions and
decisions. 


   MANY APPLICANTS HAD TO RESUBMIT
   DOCUMENTS
------------------------------------------------------------ Letter :6

Having to resubmit documents to support a claim adds to customer
dissatisfaction and the time it takes to process a claim.  Twenty-two
percent of applicants had to resubmit a document.  Applicants who
resubmitted documents were more likely to be dissatisfied than those
who did not have to resubmit.  For example, 48 percent of those who
resubmitted records were dissatisfied, overall, with how VA handled
their claim, compared with 31 percent of those who did not have to
resubmit records. 

Sixteen percent of applicants had to resubmit civilian documents,
such as birth certificates or marriage licenses, rather than military
medical or service records.  Resubmitting civilian documents involves
time and expense on the part of the applicants.  The following
comments illustrate the frustration some applicants felt. 

     "I have received as many as six demands for marriage
     certificates and birth certificates all within days from each
     other .  .  .  .  I am afraid to call the regional office
     anymore because every time I do I get treated like it's my first
     contact with them, and the barrage of record requests starts all
     over again."

     "I hand-delivered records [DD214-personal medical records] and
     they took photostats and verified them only to have them say 19
     days later that they never received them .  .  .  .  The
     confusion in the system leaves something to be desired .  .  . 
     .  I feel I lost to a system and confusion."

VA officials recognize this problem and identified some reasons
applicants may need to resubmit documents.  One reason is that when
documents are submitted, they are not matched with the applicant's
claim file.  This can happen if the applicant does not provide the
right information, such as social security numbers, for VA to
determine which file the document goes with.  Or VA might not be able
to find the file.  VA's current processing procedures require a file
to be handled by many different employees in many different
locations, and files are misplaced.  VA is beginning to implement a
bar code system to allow regional offices to better track the
location of claim files within each region. 

Another reason applicants have to resubmit documents is that they do
not understand VA's document requirements.  Particularly, some
applicants do not understand that VA requires certified, not
photocopied, documents.  To confirm this, one VA regional official
telephoned 12 applicants who had been sent the usual form letter to
request documents.  Nine of the 12 applicants said that they had not
understood from the letter that VA wanted certified copies of those
documents, not photocopies.  All of those applicants then provided
certified copies of the documents.  If those applicants had not been
telephoned, at least some of them would have sent uncertified
documents.  If they had, VA's usual procedure would have been to send
the same form letter requesting the same documents.  Some VA regional
offices are changing procedures to allow employees to call applicants
to clarify what documents are needed.  Moreover, legislation has been
introduced to eliminate the requirement that documents be certified,
and even without such legislation, VA is revising its regulations to
allow photocopies, rather than certified copies, for some purposes,
such as showing marriage or death. 


   SURVEY INDICATES OTHER FACTORS
   TO CONSIDER IN IMPROVEMENT
   EFFORTS
------------------------------------------------------------ Letter :7

Our survey also highlighted two additional factors that could affect
VA's efforts to improve customer satisfaction.  First, applicants
whose claims are denied, about whom VA has little information,
constitute a large portion of VA's customer base.  And, second, many
people other than VA staff influence applicants' satisfaction with
the claims process. 


      INFORMATION ABOUT DENIED
      CLAIMS COULD BE VALUABLE FOR
      IMPROVING SERVICES
---------------------------------------------------------- Letter :7.1

Applicants whose claims were denied represent a substantial portion
of VA's customers, but VA knows little about them.  These applicants
were consistently less satisfied and had more difficulty with all
aspects of the process. 

Of those applicants who told us their claims were completed,\8

36 percent had been denied.  (See fig.  5.)

   Figure 5:  How Applicants'
   Claims Were Decided

   (See figure in printed
   edition.)

Note:  "Partially allowed" refers to those applicants who got some of
the benefits they asked for, but not all. 

Figure excludes the 20 percent of our respondents who said their
claims had not been completed. 

Those whose claims were denied represented 45 percent of all
applicants who were dissatisfied.  Their dissatisfaction levels with
timeliness, fairness, and overall processing of the claims were
higher than those of applicants whose claims were fully allowed. 
(See fig.  6.)

   Figure 6:  Applicants' Opinions
   About VA, by How Their Claims
   Were Decided

   (See figure in printed
   edition.)

Denied applicants had more trouble with the claims process than those
whose claims were fully allowed.  For example

  They were less likely to have gotten informational materials they
     requested (61 percent for denied claims versus 93 percent for
     fully allowed claims). 

  They were more likely to say informational materials did not
     include most of what they needed to know (33 percent versus 12
     percent). 

  They were more likely to indicate the letters from VA did not
     contain most of what they needed to know (55 percent versus 12
     percent). 

  They were more likely to state that telephone conversations with VA
     did not give them most of what they needed to know (64 percent
     versus 19 percent). 

  They were more likely to state that visits to VA offices did not
     give them most of what they needed to know (68 percent versus 14
     percent). 

The areas identified by applicants whose claims were denied as most
needing to be improved mirrored those identified by applicants
overall.  However, they were more concerned about improving
explanations of decisions and the helpfulness of employees.  (See
fig.  7.)

   Figure 7:  Ways Applicants Said
   VA Should Improve Service

   (See figure in printed
   edition.)

VA has little information about these denied applicants.  For
example, until our survey, VA did not know what portion of all
applications are denied and, until its most recent customer survey,
VA did not include the views and concerns of applicants whose claims
were denied in assessing customer satisfaction. 

VA does not keep data on denied claims that could allow it to assess
the implications of our survey's findings or the adequacy of services
it provides to these applicants.  Data could, for example, allow VA
to determine the following for denied applicants: 

  Did those who did not obtain help in filing their claim want such
     help?  The answer has implications for VA's outreach efforts. 

  Did they apply for benefits for which they clearly were not
     eligible?  The answer has implications for changes in VA's
     informational materials, as demonstrated by one respondent's
     comment:  "The information about eligibility was misleading. 
     More specific [information] would probably have resulted in my
     not filing a claim."

  Did those who received letters about denials understand them, and
     if not, why?  The answer has implications for what kinds of
     changes VA needs to make in those letters. 

  Were their claims frequently denied because records could not be
     found to support the claims?  The answer has implications for
     assessing, and possibly improving, VA's efforts to assist
     applicants in filing claims, including assistance in finding
     other sources of support. 


--------------------
\8 Eighty percent of respondents indicated that their claims had been
completed, that is, VA had fully allowed, partially allowed, or
denied their claims.  The other 20 percent reported that their claims
were still pending, they did not know if their claims had been
decided, or, for some other reason, their claims were not final. 


      MANY PEOPLE OTHER THAN VA
      STAFF ASSIST VA'S CUSTOMERS
---------------------------------------------------------- Letter :7.2

Many applicants receive assistance from sources not under VA's
authority.  VA is part of a network that supports veterans and their
families that includes state and county offices, veterans service
organizations, and others.  About 60 percent of applicants receive
services from these other sources, sometimes in addition to getting
help from VA.  VA officials said that applicants seek help from other
sources because these sources are more numerous and geographically
dispersed than the 58 VA regional offices. 

Over half of all applicants reported first learning about benefits
from someone other than VA or the military.  These sources most
frequently were veterans service organizations, state and county
veterans offices, and friends or relatives.  (See fig.  8.)

   Figure 8:  How Applicants First
   Learned About Benefits

   (See figure in printed
   edition.)

Notes:  Excludes those who answered, "I don't recall."

"Other" includes, for example, a friend or relative, funeral home or
cemetery staff, and school officials. 

These and other sources also helped with the claims process, usually
in filling out the application or filing the claim.  More than half
of respondents said someone other than VA was the most helpful.  (See
fig.  9.)

   Figure 9:  Sources Applicants
   Said Helped the Most

   (See figure in printed
   edition.)

Note:  "Other" includes, for example, a friend or relative, funeral
home or cemetery staff, and school officials. 

Applicants had high praise for these other sources. 

     "[The veterans service organization] representative crossed off
     the areas of the form I didn't have to complete.  Had he not
     done this, the form would have been very difficult."

     "I don't know what I would do without our state service officer
     to help me.  She handles all my VA material and questions."

     "I didn't fill out these forms.  The manager from the shelter
     care home either did them or had them done."

     "[The] assistant at school already knew how to fill out the
     forms."

     "[The] funeral director filled out all the information.  I just
     answered his questions and signed the papers."

Those who found someone other than VA to be most helpful to them were
less likely to be satisfied with VA's service overall.  On the other
hand, those who found VA most helpful generally were more satisfied
with various aspects of the process.  (See fig.  10.)

   Figure 10:  Applicants'
   Satisfaction Level, by Where
   They Obtained Help

   (See figure in printed
   edition.)

Note:  "Other" includes, for example, a friend or relative, funeral
home or cemetery staff, and school officials. 

The reasons satisfaction with VA's service was lower for those who
received the most help from non-VA sources are not clear.  Were these
applicants dissatisfied with VA before they contacted the other
sources?  Were there problems with the services these other sources
provided or with the expectations they gave applicants about VA's
service?  Did applicants seek help outside VA for the more complex,
difficult to support claims that are more likely to take longer and
raise frustration levels?  The answers to these questions would lead
to different actions to improve service and satisfaction.  The extent
to which these sources are involved highlights the need for VA to
fully understand who gets what help from them and why. 

VA recognizes the important role these organizations play, but some
VA officials expressed surprise at the extent of involvement we
found.  Officials said they make aggressive outreach efforts to these
other sources.  For example, representatives from some of these
sources were part of a panel charged with recommending improvements
in disability claims processing.  Additionally, VA sponsors
conferences attended by state and county officers; however, with
tighter budgets some local officers have not been able to attend
these meetings.  VA officials indicated that the quality of the
service provided by these other sources can vary and that sometimes
VA does not have enough informational materials to send other
sources. 


   CONCLUSIONS
------------------------------------------------------------ Letter :8

Our survey pointed to several key problems with the service VA
regional offices provide to veterans and their families.  VA has
recognized those key problems--its own customer survey highlighted
similar issues--and is attempting to find ways to address them.  But
some of these concerns are long-standing and only time will tell if
VA's efforts will be successful. 

Of major concern is that even if VA meets its new timeliness goals,
many veterans will not be satisfied.  While it may not be advisable
to set current goals based solely on customer expectations of what is
reasonable--if those expectations are not attainable in the
foreseeable future--VA's long-term efforts should be directed at
meeting customer expectations.  These efforts should include
determining what changes will be needed to meet customer
expectations.  In the short term, our survey suggests that VA may be
able to improve satisfaction by better communicating realistic time
estimates to applicants.  This and other efforts to improve
communication could have a major impact on customers' perceptions of
VA's service. 

The substantial extent to which claims are denied and to which
service is provided by non-VA sources was not previously known. 
Though it may not be surprising that applicants whose claims were
denied are less satisfied with VA's service, the fact that these
applicants constitute an estimated one-third of VA's customers
suggests more detailed information about them could be useful in
improving service.  Similarly, the extent to which other sources
provide assistance to applicants strongly suggests these sources can
have a substantial impact on customers' satisfaction with the claims
process and perceptions about VA.  As VA takes steps to change its
claims processing system, it will be important for VA to continue
communicating and coordinating with these sources, to know what
assistance these sources are giving, and to ensure that these sources
have the up-to-date information necessary to assist applicants. 


   RECOMMENDATIONS
------------------------------------------------------------ Letter :9

The Secretary of Veterans Affairs should direct the Under Secretary
for Benefits to

  set long-term goals to meet customer expectations for processing
     times, and prepare a plan describing the incremental steps
     necessary to meet them,

  provide applicants realistic estimates about how long it will take
     to complete their claims, and

  develop data on applicants whose claims are denied so VA can ensure
     that segment of its customers gets the best service possible. 


   AGENCY COMMENTS
----------------------------------------------------------- Letter :10

In a letter dated August 3, 1994, the Secretary of Veterans Affairs
commented on a draft of this report.  (See app.  IV.) He stated that
VA agreed with each of our recommendations and outlined some actions
VA is considering to implement them.  Absent more details and time
frames, however, we cannot assess the potential of the proposed
actions to improve customer satisfaction. 

The Secretary also pointed out that our report data on the failure of
customers to obtain needed information from federal VA employees may
be subject to misinterpretation.  He stated that his department's
customers do not always know when they are contacting a federal VA
office or a state or county VA office.  Consequently, he believes the
failure to provide information to a customer may not have been the
federal VA's fault, but rather one of the state and county offices. 
We agree that some respondents to our questionnaire may not have
differentiated between federal and state or county VA offices.  VA's
comment is particularly pertinent because it confirms the
significance of the concern we raised in this report about the extent
to which sources other than federal VA offices are involved in
providing services and their impact on quality of services and
customer satisfaction. 

Finally, the Secretary expressed concern that our sampling technique
overlooked claims that were closed quickly.  Our sample was drawn
from claims completed between April 1, 1993, and July 13, 1993.  VA
believes this sampling technique overlooked claims filed after April
1 and closed before July 13.  VA believes these applicants would be
among those most satisfied with VA's service because their claims
were completed so quickly.  However, because our sample was
representative of claims completed during this period and VA told us
this period was typical of other periods, our universe included
claims that were completed in a short time.  For example, if a claim
had been filed on March 30 and closed April 2, it would have been
included in our universe and could have been selected in our sample
for review. 


--------------------------------------------------------- Letter :10.1

We are sending copies of this report to interested congressional
committees, the Secretary of Veterans Affairs, and other interested
parties.  This work was done under the direction of Flora Milans,
Associate Director.  If you have any questions about this report,
please contact me at (202) 512-7101.  Other major contributors are
listed in appendix V. 

Sincerely yours,

David P.  Baine
Director, Federal Health Care
 Delivery Issues


SCOPE AND METHODOLOGY
=========================================================== Appendix I

To obtain the views of the Department of Veterans Affairs'
customers--veterans, their dependents, and survivors--we surveyed a
national random sample of 1,400 applicants.  These applicants' claims
were representative of the approximately 245,000 claims completed at
VA's regional offices between April 1 and July 13, 1993, for 9 types
of benefit claims.  We included claims for the following: 

  Initial Disability Compensation Benefits.  These benefits are paid
     to veterans who are disabled by injury or disease incurred or
     aggravated during active military service in the line of duty. 

  Disability and Death Dependency Benefits.  These include among
     others, increased benefits for children attending school after
     the age of 18, increases for additional dependents, or
     adjustments in benefits because of marriage, divorce, or death. 
     These actions can be initiated by VA or by the claimant. 

  Initial Dependency and Indemnity Compensation Benefits.  These
     benefits are awarded to the surviving spouses, certain dependent
     children, and in some cases the parents of veterans who died on
     active duty or from a disability that was service connected. 
     Surviving spouses and children may also receive dependency and
     indemnity compensation benefits when totally disabled veterans
     die from non-service-connected causes. 

  Burial Benefits.  These benefits include statutory burial
     allowances, plot allowances, and in some cases, reimbursement
     for expenses for headstones, markers, or engraving expenses. 

  Initial Disability Pension Benefits.  These needs-based benefits
     are provided to veterans with limited income who served during
     wartime and have become totally and permanently disabled from
     causes not connected to their military service. 

  Initial Death Pension Benefits.  These needs-based benefits are
     provided to the surviving spouses and children of wartime
     veterans who died from causes not connected to military service. 

  Education Benefits.  These benefits are provided to active duty and
     selected reserve personnel, veterans, and their eligible
     dependents. 

  Vocational Rehabilitation Benefits.  These benefits are provided to
     eligible disabled veterans who have demonstrated that
     service-connected disabilities make rehabilitation training
     necessary to overcome impairments in finding or retaining
     employment.  (Cases in our sample included two types of claims: 
     (1) those filed to determine eligibility for vocational
     rehabilitation benefits and (2) those filed to obtain actual
     benefits.)

We also included

  Reopened Claims for Compensation and Pension Benefits.  These
     include, among others, claims for benefits VA previously denied,
     increased disability compensation benefits, additional
     disabilities, and benefits granted through a successful appeal
     to the Board of Veterans Appeals. 

We did not include as part of our customer survey two other major
nonmedical benefit programs offered by VA.  The home loan guaranty
program was not selected because the national database of those who
take advantage of this benefit does not contain sufficient
information on each loan to allow us to draw a valid national sample. 
Veterans life insurance programs were not selected because claims
processing is limited to only two regional offices:  Philadelphia,
Pennsylvania, and St.  Paul, Minnesota. 

To determine our universe, we compared VA's work-in-progress
database\9 on April 1, 1993, with the same database on July 13, 1993. 
Claims that were in process in April that did not appear in July were
considered completed claims, and we drew our sample from these
claims.  VA told us that this period was representative of VA's
workload throughout the year. 

We sent questionnaires to random samples of applicants for each of
the nine types of benefit claims listed previously.\10 The survey was
administered anonymously, and individual responses could not be
linked to the actual respondent.  The questions we asked were based,
in part, on discussions with VA officials, veterans service
organizations, state officials, and veterans and their families.  The
final questionnaire was sent to VA for comments.  We tailored the
questionnaires only to enable us to ask the same questions to all
nine groups (for example, applicants for compensation benefits or
burial benefits).  A sample questionnaire showing aggregate responses
and percentages is included in appendix II.  Table I.1 shows the
universe of potential claims, the sample size, and the number of
questionnaires received by strata. 



                                    Table I.1
                     
                       Universe of Potential Claims, Sample
                       Size, and Questionnaires Received by
                                      Strata


                                                  Univer
Type of benefit claim                               se\a  Sample   Total  Recall
------------------------------------------------  ------  ------  ------  ------
Initial disability                                37,525     200     141     134
 compensation
Disability and death                              22,654     200     144     100
 dependency
Initial dependency and indemnity compensation      5,074     100      88      81
Burial                                            16,712     100      71      58
Initial disability pension                         9,967     200     145     132
Initial death pension                              6,887     100      78      71
Education                                         29,436     200     135     124
Vocational rehabilitation                         38,608     100      68      45
 eligibility and rehabilitation benefits
Reopened compensation and pension                 77,977     200     155     146
Total                                             244,84   1,400   1,025     891
                                                       0
--------------------------------------------------------------------------------
\a Universe:  Numbers reflect total number of claims completed by VA
during the period from April 1 through July 13, 1993, for the nine
types of benefit claims included in our review. 

\b Respondents:  "Total" represents the number of questionnaires
returned that were not blank or did not indicate the applicant had
died.  "Recall" is the number of questionnaires returned on which the
applicant recalled having had contact with VA concerning the claim in
our sample.  This represents the number of usable responses. 

We obtained an overall response rate across all nine strata of 73
percent.  Response rates for individual strata varied from a low of
67.5 percent for education claims to a high of 88 percent for initial
dependency and indemnity compensation claims.  Because these samples
are representative, the statistics we cite based on the survey are
estimates for the population of all veterans, their spouses, and
their dependents who had claims completed by VA from April 1 through
July 13, 1993.  We calculated sampling errors for estimates from this
survey at the 95-percent confidence level.  This means that the
chances are about 19 out of 20 that the actual percentage being
estimated falls within the range defined by our estimate, plus or
minus the sampling error.  Generally, the sampling errors did not
exceed 5 percentage points when addressing all strata combined. 

To determine if the nonrespondents were significantly different from
those who responded to our questionnaire, we obtained information
about those who did not respond.  First, we developed a geographic
profile and found that the geographic distribution of the
nonrespondents was similar to the distribution of the respondents. 
Second, because claim status (for example, approved or denied) was
strongly correlated with satisfaction, we determined the disposition
of the nonrespondents' claims.  We found that the percentage of
denied claims was similar to the percentage of denied claims for
those who responded.  Our limited analysis found nothing that would
indicate that their responses would be significantly different from
those who returned our questionnaire. 

Finally, about 10 percent of those who responded to our survey
indicated that their claims were still pending, even though VA's data
indicated that the claims had been completed.  We included their
responses because these applicants had been able to complete the
questionnaire and had opinions about VA's service.  Since our
questionnaire was administered anonymously, we could not follow up on
any individual cases.  However, we believe some of those who told us
that their cases were pending had in fact appealed VA's decision on
their original claim.  Other reasons for this response could be that
the VA data on the disposition were inaccurate, the claimant never
received a letter on the disposition of the claim, the disposition
letter was still in process, the claimant had received conditional or
partial approval of the claim, or the claimant had more than one
claim in process. 



(See figure in printed edition.)Appendix II

--------------------
\9 VA uses the work-in-progress subsystem to track all claims in
process at any given time.  In a recent report on claims processing,
the VA Inspector General commented that the subsystem's data are
generally reliable enough to be useful in controlling and monitoring
work flow.  Although the Inspector General's report found about
one-third of the records it reviewed were inaccurate in some way,
these inaccuracies did not affect the integrity of our sample. 

\10 If the same applicant was selected in more than one strata (that
is, the claimant had more than one type of claim in process), we
sought information on only one type of claim. 


SUMMARY OF RESPONSES TO GAO'S
SURVEY OF APPLICANTS FOR VA
BENEFITS
=========================================================== Appendix I



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)


ESTIMATES OF APPLICANTS' VIEWS BY
CLAIM TYPE
========================================================= Appendix III

The tables and figures in this appendix provide information by
individual types of claims included in our survey for the major
issues discussed in this report.  In many cases the differences
between claim types are not statistically significant.\11 However,
some clear patterns emerge.  Most notably, applicants for
compensation-related benefits were more likely to be dissatisfied and
had more difficulties with the claims process.  For example,
applicants for initial disability compensation or those who had
reopened compensation and pension claims

  were the most dissatisfied with VA timeliness, fairness, and
     overall handling of the claim (tables III.1, III.2, and III.3);

  had the largest difference between their expectations for
     timeliness and the goals VA set (table III.4); and

  were less likely to obtain the information they needed from VA
     through letters, telephone calls, and personal visits (tables
     III.8, III.9, and III.10). 

Conversely, applicants for burial and education benefits were
generally more satisfied and had fewer problems with the process. 

Our survey was not intended to provide a full explanation for why
applicants for some benefits are more satisfied than others. 
However, disability compensation claims tend to be more complicated
and take longer to resolve than other types of claims and, therefore,
may be more likely to cause frustration and dissatisfaction.  In
contrast, education and burial claims are relatively straightforward,
take less time to resolve, and may therefore be less likely to cause
frustration.  Furthermore, applicants for burial and education
benefits were the least likely to be denied and, as discussed in the
report, being denied is highly correlated with dissatisfaction. 

This appendix also provides information by individual types of claims
on whether applicants received estimated processing times, required
letters, and informational materials from VA (tables III.5, III.6,
and III.7).  Other tables cover the resubmission of civilian records
(table III.11); claims fully allowed, partially allowed, and denied
(table III.12); how applicants first learned about VA benefits (table
III.13); and sources applicants found to be the most helpful in
filing their claims (table III.14).  Figure III.1 highlights what
applicants said they would most like VA to improve. 



                         Table III.1
           
           Applicants' Opinions About Time VA Took
               to Process Claims (Question 58)

                        (Percentages)

                                      About as
                                    reasonable
                                            as
Type of claim         Reasonable  unreasonable  Unreasonable
--------------------  ----------  ------------  ------------
Initial disability            41            14            45
 compensation
Disability and death          44            11            44
 dependency
Initial dependency            51            19            30
 and indemnity
 compensation
Burial                      64\a             9            26
Initial disability            51             8            41
 pension
Initial death                 50            17            33
 pension
Education                     57            13            30
Reopened                      39            14            47
 compensation and
 pension
All claims                    47            12            41
------------------------------------------------------------
Note:  Percentages may not add to 100 due to rounding. 

\a Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                         Table III.2
           
            Applicants' Opinions About Fairness of
                        VA's Decisions
                        (Question 59)

                                            About as
                                             fair as
Type of claim                         Fair    unfair  Unfair
----------------------------------  ------  --------  ------
Initial disability compensation         40         8      52
Disability and death dependency         58         5      36
Initial dependency and indemnity        53        10      37
 compensation
Burial                                  78        12      10
Initial disability pension              44        12      45
Initial death pension                   51        14      35
Education                               77         6      18
Reopened compensation and pension       40         6      54
All claims                              53         7      40
------------------------------------------------------------
Note:  Percentages may not add to 100 due to rounding. 



                         Table III.3
           
              Applicants' Opinions About How VA
              Handled Their Claims (Question 60)

                                      About as
                          Satisf  satisfied as
Type of claim                ied  dissatisfied  Dissatisfied
------------------------  ------  ------------  ------------
Initial disability            47            12            40
 compensation
Disability and death          55            13            33
 dependency
Initial dependency and        55            11            34
 indemnity compensation
Burial                        79            10            12
Initial disability            58            10            32
 pension
Initial death pension         63             6            31
Education                     66            12            22
Reopened compensation         42            11            47
 and pension
All claims                    53            11            37
------------------------------------------------------------
Note:  Percentages may not add to 100 due to rounding. 



                         Table III.4
           
            How Applicants' Expectations Compared
            With Fiscal Year 1993 Processing Times
              and Timeliness Goals (Question 4)

                                    Averag           Average
                                         e      VA  applican
                                    proces  timeli         t
                                      sing    ness  expectat
Type of claim                         time   goals      ions
----------------------------------  ------  ------  --------
Initial disability compensation         27      15         9
Disability and death dependency          4       4         7
Initial dependency and indemnity        15      10         6
 compensation
Burial                                   5       4         6
Initial disability pension              17      11         7
Initial death pension                   10       6         7
Education (original)\a                   2       4         4
Reopened compensation and pension       18      12         7
------------------------------------------------------------
Note:  Timeliness goals do not meet customer expectations for four of
the eight types of claims shown above, but are shorter than
expectations for three types.  For one, the goal is longer than the
1993 actual time. 

\a The average processing time for education claims was calculated
for original claims completed between October 1993 and April 1994. 
VA's timeliness standard for original claims is completion of 80
percent of claims within 30 days and for subsequent changes,
completion of 90 percent within 30 days.  Applicant expectations
calculated from our survey include both original education claims and
subsequent changes. 



                         Table III.5
           
            Applicants Given Estimated Processing
                      Times (Question 2)

                        (Percentages)

                                                       Can't
Type of claim                            Yes      No  recall
------------------------------------  ------  ------  ------
Initial disability compensation           54      33      14
Disability and death dependency           34      50      16
Initial dependency and indemnity          50      35      15
 compensation
Burial                                  37\a    46\a      18
Initial disability pension                49      39      12
Initial death pension                     46      35      19
Education                                 57      30      13
Reopened compensation and pension         39      48      14
All claims                                44      41      15
------------------------------------------------------------
Note:  Percentages may not add to 100 due to rounding. 

\a Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                         Table III.6
           
            Applicants Who Did Not Receive Letters
           VA Is Required to Send (Questions 37 and
                             38)

                                                         Did
                                                         not
                                                 Did  receiv
                                                 not       e
                                              receiv  notice
                                                   e    that
                                              notice  applic
                                                that   ation
                                              applic     had
                                               ation    been
                                                 had  approv
                                                been   ed or
                                              receiv  denied
Type of claim                                   ed\a      \b
--------------------------------------------  ------  ------
Initial disability compensation                   29      23
Disability and death dependency                   31      29
Initial dependency and indemnity                  31      22
 compensation
Burial                                          34\c    39\c
Initial disability pension                        30      28
Initial death pension                             31      21
Education                                         37      34
Reopened compensation and pension                 38      46
All claims                                        34      35
------------------------------------------------------------
\a Excludes applicants who did not use an application form to apply
for benefits (question 16). 

\b Excludes applicants whose claims had not been finalized (question
5). 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                         Table III.7
           
            Applicants Who Requested and Received
               Informational Materials and Said
            Materials Did Not Tell Them What They
            Needed to Know (Questions 10, 11, and
                             14)

                                                         Did
                                                         not
                                                      contai
                                                      n most
                                              Receiv      of
                                                  ed    what
                                      Reques  reques    they
                                         ted     ted  needed
                                      materi  materi      to
Type of claim                            als   als\a  know\b
------------------------------------  ------  ------  ------
Initial disability compensation           57      85      22
Disability and death dependency           42    74\c    23\c
Initial dependency and indemnity          56    78\c    32\c
 compensation
Burial                                    28      94     7\c
Initial disability pension                46      64    35\c
Initial death pension                     57    83\c    29\c
Education                                 51      86      26
Reopened compensation and pension         45      61    23\c
All claims                                50      74      23
------------------------------------------------------------
Note:  VA officials indicated that specific informational materials
address education and vocational rehabilitation claims, but all other
claim types are discussed in brochures that cover multiple benefits. 

\a Percentages are of those applicants who requested materials. 

\b Percentages are of those applicants who received materials. 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                         Table III.8
           
           Applicants Who Said VA's Letters Did Not
               Contain What They Needed to Know
                    (Questions 37 and 40)

                        (Percentages)

                                                         Did
                                                         not
                                                      contai
                                                      n most
                                                          of
                                                        what
                                              Receiv    they
                                                  ed  needed
                                              letter      to
Type of claim                                     \a  know\b
--------------------------------------------  ------  ------
Initial disability compensation                   92      40
Disability and death dependency                   90      28
Initial dependency and indemnity                  89      33
 compensation
Burial                                            84      17
Initial disability pension                        93      30
Initial death pension                             93      31
Education                                         90      16
Reopened compensation and pension                 79      44
All claims                                        84      34
------------------------------------------------------------
\a Percentages are of all applicants. 

\b Percentages are of those applicants who received letters. 



                         Table III.9
           
           Applicants Who Called VA but Did Not Get
            Information They Needed (Questions 43
                           and 49)

                                                         Did
                                                         not
                                                      obtain
                                                        most
                                              Contac      of
                                              ted VA    what
                                                  by    they
                                              phone\  needed
Type of claim                                      a      \b
--------------------------------------------  ------  ------
Initial disability compensation                   49    44\c
Disability and death dependency                   61      35
Initial dependency and indemnity                  59    39\c
 compensation
Burial                                            27      \d
Initial disability pension                        40    44\c
Initial death pension                             51    34\c
Education                                         72      33
Reopened compensation and pension                 50    52\c
All claims                                        52      41
------------------------------------------------------------
\a Percentages are of all applicants. 

\b Percentages are of those applicants who contacted VA by phone. 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 

\d Too few respondents to allow meaningful analysis. 



                         Table III.10
           
            Applicants Who Visited VA but Did Not
            Get Information They Needed (Questions
                          51 and 56)

                                                         Did
                                                         not
                                                      obtain
                                              Visite    most
                                                d VA      of
                                              region    what
                                                  al    they
                                              office  needed
Type of claim                                     \a      \b
--------------------------------------------  ------  ------
Initial disability compensation                   33    36\c
Disability and death dependency                   37    49\c
Initial dependency and indemnity                  40    37\c
 compensation
Burial                                            11       0
Initial disability pension                        39    38\c
Initial death pension                             31      \d
Education                                         23    18\c
Reopened compensation and pension                 44    54\c
All claims                                        37      40
------------------------------------------------------------
\a Percentages are of all applicants. 

\b Percentages are of those applicants who visited VA offices. 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 

\d Too few respondents to allow meaningful analysis. 



                         Table III.11
           
           Applicants Who Had to Resubmit Civilian
                Records (Questions 33 and 35)

                                   Submitted     Resubmitted
Type of claim                      records\a       records\b
--------------------------------  ----------  --------------
Initial disability compensation           44              22
Disability and death dependency           59            39\c
Initial dependency and indemnity          82              27
 compensation
Burial                                  48\c              \d
Initial disability pension                74              21
Initial death pension                     80            35\c
Education                                 34            35\c
Reopened compensation and                 46              38
 pension
All claims                                49              33
------------------------------------------------------------
\a Percentages are of all applicants.  Some applicants did not need
civilian records to support their claims. 

\b Percentages are of those applicants who submitted civilian records
to VA. 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 

\d Too few respondents to allow meaningful analysis. 



                         Table III.12
           
           Claims Fully Allowed, Partially Allowed,
                   and Denied (Question 5)

                                              Partia
                                       Fully     lly
                                      allowe  allowe
Type of claim                              d       d  Denied
------------------------------------  ------  ------  ------
Initial disability compensation           19      37      44
Disability and death dependency           55      23      22
Initial dependency and indemnity          38      11      51
 compensation
Burial                                    78       9      13
Initial disability pension                37      15      49
Initial death pension                   44\a      16    40\a
Education                                 77      14       9
Reopened compensation and pension         34      19      47
All claims                                44      20      36
------------------------------------------------------------
Notes:  Percentages may not add to 100 due to rounding.

Excludes 20 percent of all applicants whose claims were not
finalized. 

\a Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                                   Table III.13
                     
                      How Applicants First Learned About VA
                              Benefits (Question 6)

                               State/
                               county  Friend
                        VA or  vetera      or   Veterans
                       milita      ns  relati  organizat  Someon  Other\   Don't
Type of claim            ry\a  office      ve        ion  e else       b  recall
---------------------  ------  ------  ------  ---------  ------  ------  ------
Initial disability         61       9      10         13       3       2       1
 compensation
Disability and death       40       9      11         23       8       1       7
 dependency
Initial dependency         29      11      13         18      25       1       3
 and indemnity
 compensation
Burial                   34\c      12       4          4       8      36       2
Initial disability         27      13      20         17      20       1       2
 pension
Initial death pension      20      14      25         19      11      12       0
Education                  84       3       7          1       3       2       1
Reopened compensation      29      16       9         25      13       2       6
 and pension
All claims                 45      11      10         17       9       4       4
--------------------------------------------------------------------------------
Note:  Percentages may not add to 100 due to rounding. 

\a Includes VA literature, VA employees, and military. 

\b Includes radio or television advertisements, funeral home or
cemetery staff, or school officials. 

\c Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 



                         Table III.14
           
            Sources That Helped Applicants Most in
               Filing Their Claims (Question 9)

                State/                                    No
                county                                   one
                vetera    Friend                         was
Type of             ns        or      Veterans  Othe  helpfu
claim       VA  office  relative  organization   r\a       l
--------  ----  ------  --------  ------------  ----  ------
Initial     31      36         3            22     2       7
 disabil
 ity
 compens
 ation
Disabili    19      31         7            28     7       9
 ty and
 death
 depende
 ncy
Initial     18      28        15            28     3       9
 depende
 ncy and
 indemni
 ty
 compens
 ation
Burial    21\b    21\b         5             5  41\b       7
Initial     32      41         7            14     2       5
 disabil
 ity
 pension
Initial     21      33        19            12     7       7
 death
 pension
Educatio    18       9         6             3    60       5
 n
Reopened    20      38         4            25     4      10
 compens
 ation
 and
 pension
All         24      30         5            20    14       8
 claims
------------------------------------------------------------
Notes:  Percentages may not add to 100 due to rounding.

Although, as shown on table III.13, VA or the military are cited as
the single most frequent first sources of benefits information,
applicants most often cited one of three key sources as most helpful: 
VA, state or county offices, and veterans service organizations. 
Notable exceptions include applicants for burial benefits, who often
cited funeral home or cemetery officials as the most helpful, and
applicants for education benefits, who often cited school officials. 

\a Includes radio or television advertisements, funeral home or
cemetery staff, or school officials. 

\b Sampling error exceeds plus or minus 12 percentage points.  See
figure III.2. 

   Figure III.1:  What Applicants
   Would Most Like VA to Improve

   (See figure in printed
   edition.)

Note:  Shaded areas are the top three service issues that applicants
want VA to improve. 

\a Sampling errors for burial and initial death pension claims exceed
plus or minus 12 percentage points.  See figure III.2. 

\b Sampling error for burial claims exceeds plus or minus 12
percentage points.  See figure III.2. 

   Figure III.2:  Maximum Sampling
   Errors by Type of Claim

   (See figure in printed
   edition.)



(See figure in printed edition.)Appendix IV

--------------------
\11 As discussed in appendix I, the sampling errors when discussing
all types of claims generally did not exceed plus or minus 5
percentage points.  However, sampling errors for individual types of
claims differed.  (See fig.  III.2).  Data for vocational
rehabilitation claims are not shown in the tables and figures in this
appendix because generally there were too few usable responses to
allow meaningful analysis. 


COMMENTS FROM THE SECRETARY OF
VETERANS AFFAIRS
========================================================= Appendix III



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)


MAJOR CONTRIBUTORS TO THIS REPORT
=========================================================== Appendix V

Ruth Ann Heck, Assistant Director, (202) 512-7007
Cynthia Forbes, Evaluator-in-Charge
Frank M.  Guido
Michael J.  O'Dell
Pamela A.  Scott
Charles Taylor
Joan K.  Vogel
Zachary White

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