After Legion testimony, VBA plans changes

After Legion testimony, VBA plans changes
National Commander Clarence Hill says that a big part of the claims backlog problem is caused by VBA claims processors who make mistakes on the original claims, which are then often appealed.

Four days after The American Legion testified to Congress on problems with VA's work-credit system for processing veterans' disability claims, the Veterans Benefits Administration (VBA) announced it will take new steps to improve the quality and timeliness of work performed by its benefit claims staff.

Ian de Planque, The American Legion's deputy director for operations and legislative action, told a House subcommittee on May 6 that VBA's work-credit and management systems are still geared toward "quantity over quality," a mindset that contributes to initial errors in processing disability claims and adds to an already enormous backlog.

"We've heard many outrageous stories from veterans about how their disability claims appeals have languished months or even years within VBA's processing system," American Legion National Commander Clarence Hill said. "If those claims had been properly adjudicated in the first place - if enough time had been taken to make the right decision the first time around - they wouldn't have been delayed and veterans would not have been denied their benefits."

Referring to de Planque's May 6 testimony before the House Veterans' Affairs Subcommittee on Disability Assistance and Memorial Affairs, Hill said that VBA's plan to improve the performance of its claims processors "has to begin with the quality component, just like (de Planque) said to the House subcommittee last week.

"If VBA doesn't properly evaluate a claim the first time around, then The American Legion or some other veterans service organization has to submit an appeal on behalf of the veteran. That appeals process can take a long time, it adds to the claims backlog, and it stops veterans from getting benefit payments they've already earned from their service," Hill said.

Last week, de Planque told the subcommittee, chaired by Rep. John Hall, D-N.Y., that VA has projected an accuracy rate of 87 percent for more than one million disability claims being processed this year - a figure deemed overly optimistic by its own Office of the Inspector General. So it is reasonable to assume that VBA will inaccurately process about 130,000 disability claims this year alone.

"Errors affect lives. It is essential that the removal of errors from the system be the highest priority of reform," de Planque told the subcommittee on May 6. "Errors take years - not hours - to correct."

"I hope the VBA has finally gotten the message from veterans groups that their work-credit system produces bad outcomes for veterans," Hall said in a news release from the House Committee on Veterans' Affairs. "The VBA needs to re-engineer from the ground up how it incentivizes employees to make absolutely sure claims are decided correctly the first time."

Under current policy, according to de Planque, VBA claims processors must earn a fixed number of production credits per day; this creates an incentive to work quickly, but not necessarily accurately.

"So a lot of these claims get decided prematurely - mistakes are made," Hill said. "So while we do welcome the news that VBA wants to address this problem, we're still waiting for details on how, exactly, they intend to do it. Will the changes produce meaningful results, or will they be cosmetic?"

Fixing the inaccuracy of VBA claims processing has become even more critical because the number of disability claims continues to increase. In 2009, VA received more than one million claims - a 14-percent jump from the number filed in 2008. Given the ongoing wars in Iraq and Afghanistan, as well as the aging of Vietnam-era veterans, the number of claims for compensation and pension benefits should go even higher.

"VBA has yet to officially publish the proposed changes for its work-credit system," Hill said. "We are anxiously waiting to see the substance of those changes, and whether they are likely to make claims processors more accurate in their work - every mistake they make affects the quality of a veteran's life."

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jdseippel

May 15, 2010 - 1:19am

It has been over 3 years that I have been getting the run around and lied to, hung up on and insulted from the claims center in St. Louis, Mo. I finally had to contact Congressman Sam Grave to get some help with my claim, now they have cetified it to the VBA. I am now waiting to see what kind of Justice that I get from the VBA !

JWUROL

May 14, 2010 - 10:36am

THE RATE LIMITING STEP IN CLAIMS PROCESSING BEGINS WITH THE VARO. IN THE DISTANT PAST, PHYSICIANS AND SURGEONS WERE USED TO EVALUATE THE MEDICAL CLAIMS AS PART OF A 3 PERSON BOARD. IN ORDER TO "SAVE MONEY", THE VA CUT OUT THE PHYSICIANS. NOW, MANY, MANY MISTAKES ARE MADE BECAUSE OF A LACK OF OVERALL UNDERSTANDING OF MEDICINE. THE ERRORS AT THIS LEVEL CLOG THE SYSTEM FOR YEARS. THE ONLY WAY THE PRESENT SYSTEM SAVES MONEY NOW--IF IT DOES AT ALL--- IS BY TYING CLAIMS UP FOR YEARS, THUS DEPRIVING VETS OF THEIR LEGITIMATE BENEFITS. THERE WILL BE MANY PHYSICIANS AND SURGEONS WILLING TO SERVE IN THIS CAPACITY. PHYSICIANS SHOULD BE REPRESENTED AT EVERY STEP ALONG THE ADJUDICATION PROCESS. THE MEDICINE IS TOO COMPLEX FOR LAYMEN TO MAKE THESE DETERMINATIONS. THE ONLY PEOPLE WHO SUFFER FROM THIS GLARING OMISSION ARE THE VETERANS. THE SYSTEM CAN'T BE CORRECTED UNTIL THIS ERROR IN THE PROCESS IS CORRECTED.

flpayne

May 13, 2010 - 6:56pm

Certainly the Legion can personally contact me for the details, but I am one of those cases the legion is talking about. My initial claim for benefits dated July 1992 is still open and finally reached the US Court of Appeals for Veterans Claims in January of 2009, yes that is 16.5 years for part of the claim. My initial back injury claim has not been adjudicated by the Appeals Management Center 17.5 years after the initial claim and is on the second Remand from the Veteran Board of Appeals. The Hampster Wheel of Appeals is alive and well, and I have been on it since my original claim. The work credit system is the foundation of the yearly performane appraisal and awards at the expense of the very veterans thay are there to serve.

jonathan morris

May 11, 2010 - 9:33am

This is hopefully just the first of many steps in the right direction to support our current and past service members that have worked hard to tirelessly support our country

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