At The American Legion's request, the House Veterans' Affairs Committee (HVAC) held a hearing April 18 to hear the views of veterans service officers (VSOs) on how the Department of Veterans Affairs (VA) handles disability claims for veterans.
Committee Chair Jeff Miller, R-Fla., opened the hearing by thanking the Legion for calling his attention to the often unheralded role of VSOs in the claims process. He cited a letter written to him on March 5 by American Legion National Commander Fang Wong, who wrote that several of the Legion's own VSOs "expressed their concern that an ever-increasing workload due to changing VA policies, high denial rates, and other factors were beginning to hamper the ability to provide adequate and timely service to veterans."
Wong pointed out in his letter that VSOs are in a unique position to offer insight into how the claims backlog might be reduced. "Congress must hear from those who work with veterans on claims each day to better understand ways that VA and veterans service organizations can work effectively to improve representation, decrease the backlog, and provide veterans with their earned benefits."
Randall Fisher, a VSO for the Legion's Department of Kentucky, testified to the committee that VA claims processors often lacked sufficient training to tackle the "staggering" problem of nearly 900,000 backlogged claims — over 65 percent of them pending for more than 165 days.
Questioned by the committee on how VA could improve its training, Fisher noted VA employees often lack basic medical understanding. As an example, he cited one claims examiner insisting that a doctor who mentioned that a patient "neuropathy in all extremities" had made no mention of "hands and feet."
In its written testimony submitted to the committee, The American Legion noted, "Too often in speaking to VA employees, we hear of training as an afterthought, something that gets in the way of working.... We hear VA employees at the regional offices dismiss cases by the CAVC (Court of Appeals for Veterans Claims) as ‘something the Board (of Veterans Appeals) deals with, not the RO,' when, unfortunately, that is far from the truth. If regional offices better implemented the (precedent-setting) decisions from the CAVC at the local level, claims wouldn't have to go to the Board."
Tom Murphy, VA's director of compensation service, also testified at the hearing. He noted that well-trained VSOs "provide invaluable guidance to veterans filing claims" and work with the Veterans Benefits Administration (VBA) to "ensure that complete and accurate information is available to facilitate correct disability and compensation decisions."
Since 2008, VSOs have been able to participate in VA's Training, Responsibility, Involvement and Preparation of Claims (TRIP) program. The program was developed to improve overall service to veterans by training VSOs in claims processing and familiarizing them with VBA computer systems. So far, more than 4,100 VSOs have registered for TRIP, with 3,385 passing TRIP's final exam.
"TRIP training is a critical part of VBA's goals to improve access and transparency to the disability claims process, and thereby improve efficiency," Murphy told the committee.
VBA is also implementing its Transformation Plan, a series of initiatives designed to eliminate the claims backlog and achieve VA's goal of processing all claims within 125 days, with 98 percent accuracy, by 2015. "We are confident that we are on the right path to deliver more timely and accurate benefits decisions to our nation's veterans," Murphy said. "VSO involvement in our Transformation Plan is extremely important, especially as we shift from a paper-based to a paperless electronic process system."
Another initiative VA is working with VSOs to fully implement is the Fully Developed Claims (FDC) Initiative, which aims to process claims within 90 days of their receipt. FDC's one-year pilot program was so successful that VA decided to expand it across all regional offices. "Claims representatives are critical to the FDC initiative, as they assist in gathering supporting evidence for a disability claim and helping the veteran to certify that no additional evidence is necessary to make a decision on the claim," Murphy said.
The Legion's testimony also looked at VA's work-credit system for its claims processors: "Much of the inherent culture at VA revolves around the number of claims completed. Unfortunately, it is somewhat lacking in the critical accuracy component of getting the claim done right.... Accuracy and training just don't merit the same consideration as meeting the quotas and getting the right number of claims done each week."
The VA claims process could also benefit greatly by hiring more veterans to get the job done. Their military experience and training gives them an automatic advantage over non-veterans in understanding the context and details of disability claims. "Whether we are understanding abbreviations used on a DD-214 discharge document or understanding the nature of noise exposure suffered by a lance corporal assigned to an artillery unit, we know how to read a veteran's file because the language of the military subculture is our native language," the Legion testified.
To reduce the VA claims backlog and improve the claims adjudication process, the Legion offered three recommendations: Hire more veterans, make training a priority and re-evaluate the work-credit system.
Fisher, a former nurse manager who retired from VA, said after the hearing that claims processors "do have quotas and that really puts a lot of pressure on them at the end of the month. A lot of times, they adjudicate claims that probably need further development. This causes a lot of appeals and delays the claims process."
As to whether the work-credit system for claims processors is necessary as an incentive, Fisher said, "The (VA) pay is good and people would love to have jobs at the VA, especially the veterans coming back. We think they need to hire more veterans because they have that knowledge about what it means to be on a firing line, a flight line, or being a combat engineer. A lot of the kids they're hiring are straight out of college, and they don't have that kind of experience."