Bills introduced to help VA reduce claims backlog

On April 25, the House Veterans’ Affairs Committee announced a coordinated legislative effort to help the Department of Veterans Affairs (VA) in its efforts to address the growing backlog of disability claims. The 10 pieces of legislation seek to help VA accomplish its goal to eliminate the backlog by 2015.

"We need to address the unacceptably large backlog of claims in order to get veterans the benefits they’ve earned faster," said Rep. Mike Michaud, D-Maine. "The VA has set an aggressive goal of ending the backlog by 2015, and our efforts are focused on helping them accomplish it. These bills represent a coordinated effort to put forth a pragmatic, solutions-oriented approach. A number of these initiatives already enjoy strong bipartisan support and are backed by veteran advocates."

The legislative package seeks to bolster VA’s current efforts to modernize and foster further innovation in order to get veterans’ claims and compensation settled faster. Some bills would have an immediate impact, while others would provide long-term remedies to prevent future backlogs. Goals of the legislative package include to:

Ensure that VA has the needed information to accurately process claims by requiring better interagency collaboration between VA and entities such as the Department of Defense (DoD),

Encourage VA to look at better ways to process claims in an electronic system, and

Strengthen accountability by requiring VA to track information in a more efficient and effective way that could be accessed by the public.

The following is a list of the 10 measures that have been, or will be, introduced and their impact.

VA Claims, Operations and Records Efficiency Act: Rrequires DoD to provide certified and complete electronic records to VA within 21 days.

The impact — Would substantially reduce the amount of time spent waiting for DoD to provide information in a timely manner.

Claims adjudication Centers of Excellence: Requires the Veterans Benefits Administration (VBA) to establish a pilot for Conditions Adjudication Centers of Excellence that would focus on the 10 most complex and time consuming medical conditions.

The impact — The pilot would utilize the highest-performing offices to adjudicate the most difficult medical conditions, such as post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), encouraging VA to specialize claims processing by condition, reduce the time it takes to adjudicate these conditions, and decrease the error rates on difficult claims.

Pay veterans as medical conditions are adjudicated: Requires VA to pay for medical conditions as they are adjudicated in an electronic system.

The impact — Currently, veterans receive payment when all medical conditions within a claim are fully adjudicated. This legislation will require VA to pay veterans as individual medical conditions are adjudicated, which will pay veterans at a faster rate.

Expedite claims processing by educating veterans on the quickest route to receive their decision: Provides veterans with information regarding VA’s timeliness for adjudicating claims in different formats, such as paper application or online, using the Fully Developed Claims program.

The impact — Would encourage and educate veterans to use methods that may increase the timeliness of their claims.

Encouraging the automation of certain VA claims: Requires VA to provide an annual report to list those medical conditions that are processed in an electronic automated fashion, the feasibility/consideration for adding additional medical conditions, and any barriers barring VA from adding those medical conditions that are not automated.

The impact — The reporting would require VA to consider whether and how any of the medical conditions it adjudicates could be automated or simplified. Any work that can be automated or simplified will allow VA to focus limited resources on the more challenging workload.

H.R. 1521: Extends VA’s authority to contract for medical disability examinations by five years.

The impact — VA’s ability to have contractors provide medical exams increases the availability and timeliness of those exams. VA needs the support of the contract exams to reach the goal of processing all claims within 125 days by 2015. Without this reauthorization, VA medical examinations would overwhelm the VA health-care system.

H.R. 1623: Requires VA to provide numerous data points in an online setting that would better detail the backlog, the timeliness and accuracy of VA regional offices, and timeliness and accuracy of adjudicating specific medical conditions.

The impact — The reporting would provide VA, the public and policy-makers with more clarity on the backlog and specific claims that are more challenging. VA indicates that such clarity should be available with the Veterans Benefits Management System (VBMS).

Require VA to maximize the use of private medical evidence: Amends title 38, United States Code, section 5103A(d)(1) to provide that, when a claimant submits private medical evidence, including a private medical opinion, that is competent, credible, probative, and otherwise adequate for rating purposes, the Secretary shall not request a VA medical examination.

The impact — Would conserve resources and enable quicker, more accurate rating decisions for veterans.

Require annual reports on VA regional offices that fail to meet backlog reduction goals: Requires annual reports on VA regional offices (VARO’s) that are not meeting their administrative goal of no claim taking longer than 125 days with 98 percent accuracy. Details would be required explaining why the office did not meet the goal, what they need to meet it, and how failure to meet the goal was considered with regard to a specific regional office director’s performance appraisal.

The impact — The reporting requirement would serve as a motivator for leadership to meet their administrative goals. It would also provide additional information on the claims backlog at VARO levels. Such information could assist policy-makers in considering additional solutions to reduce the backlog and provide better services to veterans.

Require detailed reporting on VA information requests to federal agencies: Requires VA to track all information requests to other federal entities.

The impact — Would require VA to provide quarterly updates to Congress on the timeliness of other agencies in fulfilling their information requests. Veterans’ claims decisions are often untimely because VA must wait for other agencies to provide information. By collecting more definitive data, VA and Congress can work to reduce these bottlenecks.