VA debuts new model for claims process

The Department of Veterans Affairs (VA) announced July 11 it is deploying a new model for processing compensation benefits claims at 16 of its regional offices. The new model is part of a comprehensive transformation plan designed to yield an estimated 150,000 to 200,000 additional compensation claim decisions annually, while ensuring that veterans who are most in need get high priority.

"This new model is a part of our comprehensive plan to eliminate the compensation claims backlog," said Allison Hickey, VA’s undersecretary for benefits. "Our redesigned model follows comprehensive planning and testing to ensure we have the right recipe for success."

As of July 11, VA reported a total number of 883,914 pending disability claims in its system; 588,447 of those are in backlog (pending more than 125 days).

For the past two fiscal years, VA has completed more than 1 million claims; Hickey said the department is on target to hit the same benchmark for fiscal 2012. In the past four months, the accuracy rate for VA claims processors has risen from 83 to 87 percent.

Recently, VA has been focusing on completing the disability claims for Vietnam War-era veterans. Last year, 260,000 claims for Agent Orange-related illnesses were completed.

"We are done with that, and redirecting more than 2,300 claims experts to handle the remaining backlog," Hickey said, adding that 83 percent of veterans from the global war on terrorism who filed disability claims are already receiving benefits.

The new organizational model involves the special handling of claims from veterans with the most serious injuries or illnesses, experiencing financial hardships, or are homelessness, and need immediate attention. Through a new "intake processing center," claims are routed to one of three segmented lanes:

• Express: claims that have only one or two medical conditions, or have all the supporting documentation, medical evidence and service records needed for an expeditious rating decision (referred to as fully developed claims).

• Special Operations: claims requiring special handling because of the unique circumstances of the veterans. These include financial hardship, homelessness, serious wounds, injuries or illnesses, post-traumatic stress disorder associated with military sexual trauma, and former prisoner-of-war status.

• Core: claims with more than two medical conditions, or those that will need additional evidence to make a compensation decision.

The segmented-lanes approach helps to increase speed and accuracy because the claims specialists are processing claims with similar levels of complexity. Hickey said that VA expects 20 percent of claims to be handled in the express lane, 20 percent in special operations, and 60 percent in the core lane.

 Veterans and their veterans service organization representatives are encouraged to provide all the needed evidence along with their application in a "fully developed claim" in order to expedite the process. Hickey said that any veteran who wants to file a claim should work with their VSOs, who know how to thoroughly develop claims and, secondly, be sure to use VA’s disability benefits questionnaires.

Sixteen regional offices have received the new segmented-lanes model, including Huntington, W.Va.; Hartford, Conn.; Portland, Ore.; Houston, Cleveland, Des Moines, Iowa; Boise, Idaho; Phoenix, New Orleans, San Juan, Puerto Rico; Atlanta, Indianapolis, Wichita, Kan.; Milwaukee, Newark, N.J.; and Fort Harrison, Mont. These offices will also receive new technology systems and software upgrades over the next three months.

All of the people, processes, and technology initiatives in VA’s transformation plan should be fully implemented at all 56 VA regional offices by the end of 2013. To learn more about how to file fully developed claims, using VA’s new DBQs, click here.