VA claims: A question of accuracy?

Allison Hickey, under secretary of benefits for the Department of Veterans Affairs (VA), answered many questions put to her by senators at a Dec. 11 congressional hearing about progress being made in the department’s benefits claims system.

Recently, The American Legion challenged VA’s statistics for claims processing accuracy at its regional offices (VAROs), which stands at about 90 percent. The Legion testified to Congress on Dec. 4 that its own research indicated accuracy rates for claims processing at many VAROs were substantially lower.

For example, out of 75 claims files reviewed last March by the Legion at the Baltimore VARO, 48 of them were found to have errors or were improperly developed – an accuracy rate of only 36 percent. At the Oakland, Calif., VARO, 26 of 36 claims examined in May had similar problems – an accuracy rate of 27.8 percent.

Hickey, testifying before the Senate Committee on Veterans Affairs, was asked by its chairman, Sen. Bernie Sanders, I-Vt., if she was confident that VA could still meet its 2015 goal of processing benefits claims in less than 125 days with 98 percent accuracy. Barring any budgetary or funding problems – including full funding of the department’s fiscal 2014 information technology budget, the under secretary said that VA is “on track” to achieve that goal.

Hickey came under fire from Sen. Richard Burr, R-N.C., over VA’s data showing 90-percent accuracy in claims processing. He noted the discrepancy between VA and American Legion accuracy numbers.

Burr referred to last week’s testimony by The American Legion, which noted that claims accuracy percentages posted online in VA’s Monday Morning Workload Report did not reflect the Legion’s data, based on its recent examination of claims files at several VAROs nationwide. Of 260 cases examined, 55 percent had errors or were improperly developed, according to the Legion’s review.

“Are they wrong?” Burr asked Hickey.

“It’s an apples-and-orange(s) discussion, if I may have a moment to clarify that,” Hickey said. “First of all, let me just state for the record ... we will not trade production for quality ... but there is a very different way the (VA Office of Inspector General) and others are looking at issues than the way we do ....”

Before she could finish, Burr interrupted her. “Let me ask my question again. Are they wrong?”

“They are right for the way they look at it, we are right for the way we measure it, which is statistically valid,” Hickey said.

“I asked a very simple question,” Burr responded. “Are they wrong? And I guess the answer is yes, because you’re saying your statistics are different than what their review has been.”

“They have a different process, senator,” Hickey said.

Sanders  asked Hickey about how well VA was performing in Vermont. She told him the VARO in White River Junction has reduced its claims inventory by 25 percent and reduced its claims backlog by 34 percent. “The days that your veterans are waiting ... for their decisions, they’ve reduced it by 127 days,” she said.

Sen. John Boozman, R-Ark., told Hickey that “we really do appreciate (VA’s) efforts. This is a difficult situation. I know you’re working really hard.” He visited the VARO in Little Rock, Ark., last week “and they have a good story to tell. They’re working very, very hard. They mentioned the partnerships with the (veterans service organizations), the great job that they were doing ... and also our county veterans service officers.”