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Full HVAC Investigation of VA”s Two Year Old Claims Initiative

The full House Committee on Veterans’ Affairs (HVAC) addressed a new Department of Veterans Affairs (VA) initiative to help tackle the backlog in a hearing Wednesday morning, May 22, to determine the effectiveness of the new strategy. The heavily attended hearing focused the attention of over a dozen members of the committee on a single panel consisting solely of Under Secretary for Benefits Alison Hickey and Deputy Under Secretary for Field Operations Diana Rubens. As the hearing was entitled “Expediting Claims or Exploiting Statistics?: An Examination of VA’s Special Initiative to Process Rating Claims Pending Over Two Years” the committee was clearly skeptical of the plan; however some positive indications are emerging about the work.

Under Secretary Hickey pointed out that at the halfway point of the two month initiative, VA is on track, having completed approximately 51 percent of the more than 42,000 claims identified as pending over two years and delivered decisions to the affected veterans. Addressing one of the concerns, how VA would handle “provisional ratings” issued as part of the initiative, Hickey proudly noted that “approximately 95 percent of these decisions are being issued as ‘final ratings’ because we have all the evidence needed to grant the maximum benefit sought.”

Committee Chairman Jeff Miller (FL) seized on this, noting one of the concerns raised by The American Legion and other Veteran Service Organizations (VSOs) and asked, “If these claims had everything needed to issue a final decision, why had they been sitting on the shelf for two years? What do you say to the veteran who asks ‘Why did my claim sit for two years and now you are able to handle it in under a month?’” Hickey could only reply that VA was “sorry” but that they were trying to “lean forward” and make sure it didn’t happen in the future.

Ranking Member Mike Michaud (ME) was more measured, noting he was happy VA was finally taking drastic steps to address the growing backlog problem, but acknowledging he too was skeptical and did not want this to simply be a way to shift numbers around on paper.

Many of the members present expressed concern about manipulation of numbers. If VA issues faulty decisions, they are essentially restarting the clock on the claims, while providing themselves with a public excuse for why their numbers for average days to complete a claim are soaring. Chairman Miller made it clear he was tired of the same litany of VA excuses for their backlog problems, particularly when Hickey noted many backlog issues arose from dealing with the Nehmer-related claims for Agent Orange conditions stemming from a VA decision two years ago to add three new disorders to the list of conditions presumptively associated with the pesticide exposure.

Because of a previous class action lawsuit entitled Nehmer v. U.S. Department of Veterans Affairs, VA is required to, whenever it recognizes that the emerging scientific evidence shows that a positive relationship exists between Agent Orange exposure and a new disease, to (a) identify all claims based on the newly recognized disease that were previously denied and then (b) pay disability and death benefits to these claimants, retroactive to the initial date of claim. Because this process can take time, and over 40,000 claims had to be reviewed under this provision, VA has stated for the past two years that the backlog was because they did the right thing and added new presumptive conditions based on the scientific evidence.

However, as Miller was quick to point out, the Nehmer cases were all processed through a small number of hubs in only a couple of offices. It could not possibly provide an excuse for a failure to perform in all 54 Regional Offices. Hickey countered that the Agent Orange claims had prevented VA from surging forces to deal with additional problems. But, now that the resources had been freed up, VA was free to aggressively tackle pieces of the backlog with initiatives such as the Two Year Old Claims project. After the 42,000 claims have been dealt with next month, VA plans to direct their attention to the over 200,000 claims pending over a year, eventually working down to the claims considered in backlog – those pending over 125 days. As of Monday morning, May 20, VA had over 584,000 claims pending over 125 days, nearly 67 percent of their total inventory. Interestingly, VA recently changed the way they count claims towards their backlog numbers, reducing the claims counted to those fulfilling eight end product claim codes in addition to Agent Orange claims, excluding some types of claims including Vocational Rehabilitation, claims from children of Agent Orange veterans who suffer from spina bifida and other birth defects, and other types of claims.

At the hearing’s conclusion, the main thing that was clear was the uneasy tension between VA officials and the committee that monitors them in the House of Representatives. Nearly every committee member present expressed skepticism and a “watch and wait” attitude towards VA’s new initiatives. While some were happy to finally see progress in reducing the backlog of claims, most were familiar with a long-standing VA culture of excuses and were wary of another round of promises with little results for the veterans.

House VA Subcommittee on Health Receives Testimony on Legislation

On Tuesday, May 21, the House Veterans’ Affairs Subcommittee on Health held a hearing to examine six pieces of legislation. The American Legion submitted testimony for the record, and took a supportive position on three of them. The bills supported by The American Legion were:

·   A draft bill entitled the Veterans Integrated Mental Health Care Act of 2013;

·A second draft measure entitled Demanding Accountability for Veterans Act of 2013; and

·   H.R. 241, the Veterans Timely Access to Health Care Act.

The remaining three bills were not opposed by The American Legion, but, due to lack of resolution support, The American Legion refrained from taking a position.

The Veterans Integrated Mental Health Care Act of 2013 would direct the Secretary of Veterans Affairs to provide certain veterans with an integrated delivery model for mental health care through care-coordination contracts. Essentially, this bill aims to ensure that veterans who live in areas which do not have ready access to VA health care facilities would receive the health care they need – specifically with regard to mental health – by ensuring that the contracts between VA and local medical facilities are maintained. 

The Demanding Accountability for Veterans Act of 2013 aims to improve the accountability of the VA Secretary to the VA’s Inspector General. Specifically, this legislation would establish particular performance standards for VA executives, and would tie the bonuses they receive to the extent to which they meet these standards. This is in line with The American Legion’s Resolution No. 99 from National Convention 2012 which states that “bonuses for VA senior executive staff [should] be tied to qualitative and quantitative performance measures developed by VA.” 

H.R. 241, the Veterans Timely Access to Health Care Act, directs the VA Secretary to ensure that the standard for access to care for a veteran seeking hospital care and medical services from the VA is 30 days from the date the veteran contacts the VA; directs the Secretary to periodically review the performance of VA medical facilities in meeting such standard; and requires quarterly reports from the Secretary to the congressional veterans' committees on the VA's experience with respect to appointment waiting times. This is an issue in which The American Legion has a long-standing interest. Our organization’s System Worth Saving Reports, dating back to 2002, have highlighted this issue, and The American Legion has been an advocate for addressing it. 


Letters of Support

The American Legion on May 17 sent a letter of support to Rep. Phil Roe (TN) giving our organization’s support for H.R. 2055, the Integrated Electronic Health Records for Military and Veterans Act. This measure would help marshal American innovation to accomplish the creation of a single, inter-operable system of medical records for veterans, from the moment they swear their oath of enlistment through their military service and on to the entirety of their civilian life after service. It would help leverage the private sector to support a working group committed to expediting delivery of a truly seamless medical record, which our nation’s veterans have been promised time and again for years. [Resolution 42-2012]

Update on Flag Amendment Bill

On January 18, House Joint Resolution (H.J. Res.) 19 was introduced by Representative Jo Ann Emerson (MO). This legislation is a proposed constitutional amendment to protect the American flag from physical desecration. Its text states simply: “The Congress shall have power to prohibit the physical desecration of the flag of the United States.”

The next task is finding cosponsors for this legislation. Please contact the offices of your representative and senators, and ask them to become cosponsors of the flag amendment in their respective chambers. [Resolution 272-2012]

Action Alert: Veterans Health Care in Jeopardy

On Friday, May 17, we sent out a legislative action alert to everyone on our alert email list. If you didn’t receive it or act upon it yet, please do so now. The alert comes with a prepared message ready to send to your members of Congress, which can be done in literally a minute. You can find the action alert at the following link:

The alert calls for decisive action by House and Senate leadership on whether Congress will continue to authorize new construction of local VA community-based outpatient clinics and other needed facilities. Without decisive action by House and Senate leadership, the VA warns existing leases will expire, clinics will close, and costs will increase as veterans travel further and wait longer for needed treatment.

We would appreciate if you use the link above. If you do, it puts together a nice table showing us how many people sent emails and who they sent them to. This is instrumental in our legislative reports as well as our communication to members telling them how many emails we generated with our legislative action alert. Some of you have personal email addresses for key staffers in the office. If that’s the case, please send a copy of your email (and hopefully their response) to our Grassroots Guru Jeff Steele ( Thanks for your important efforts on this front.