VA chipping away at oldest disability claims in backlog

The Department of Veterans Affairs, struggling with an intractable backlog of disability payment claims, which currently stands at 559,000, has focused its resources within the past month on veterans who have been waiting the longest — two years or more. VA officials say the approach is working, and that in a month, the oldest part of the backlog will be completely eliminated.

VA made the decision April 19 to take an all-hands-on-deck approach to its oldest claims and process each and every one within 60 days. A little more than halfway through that time period, things are on track, said Allison Hickey, VA’s Under Secretary for Benefits.

She said the department started with nearly 68,000 extremely old claims, the oldest of which dates back 20 years. As of this week, it’s reached a decision on 51 percent of them.

“I’m encouraged that this initiative is working,” she said. “The grant rate for this category of claims is 70 percent, and it’s on par with our historical average. These are quality decisions for our veterans. Our national claim-level quality for April was 90.57 percent, an all-time high for VA.”

Hickey said VA is also taking steps to start sending payments to veterans who have been waiting the longest, even in cases where it still needs more evidence to make a final decision.

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“We made an important policy decision that allows for a provisional rating based on the current evidence that VA has obtained, provided that it meets the minimum legal requirements,” she said. “The goal of the provisional rating is to provide veterans with benefits more quickly, but at the same time, it gives them a safety net.”

Mixed reactions

VA also cut its overall number of backlogged claims — those that have been pending for more than 125 days — by about 50,000 over the last two months, Hickey told the House Veterans Affairs Committee, where lawmakers had mixed reactions to the figures.

Rep. Jeff Miller (R-Fla.), the committee chairman, said it’s good news that veterans who have been waiting multiple years for an answer now have one. But VA’s ability to now process those claims begs an obvious question.

“What do you tell a veteran who’s been waiting for two or three years? All of a sudden, within 30 days, you’ve been able to give a permanent decision. How does it happen that a file can sit for that long without a permanent decision being made?” he asked during Thursday’s hearing.

Hickey said the department doesn’t consider years-long waits to be acceptable. But the largest contributing factor, she said, was VA Secretary Eric Shinseki’s 2010 decision to make it easier for Vietnam-era veterans who were exposed to Agent Orange to apply for and receive benefits, which she said led to a sudden surge of 260,000 new claims. For the ensuing two-and-a-half years, VA’s top priority was to process those Agent Orange claims.

“We took 37 percent of our workforce out of our main body of claims so they could focus on Agent Orange,” she said. “Yes, claims got old. They did, and we are sorry about that and we are working hard. We took that manpower who had been pointed at those claims and pointed them toward this issue. It took a little additional training because they had only been working on three presumptive medical conditions, but we got them up to speed, and that’s why we’ve been able to focus now on getting these old claims done.”

VA officials say they are still committed to completely eliminating the backlog by 2015 and to processing all claims within 125 days.

It’s seen scant progress so far, with the backlog fluctuation up and down week-by- week, but the department believes its transition away from all-paper records and into the completely electronic Veterans Benefits Management System will let it meet the goal.

Vets who submit their claims though VA’s online portal, eBenefits, are getting their claims processed within about 80 days, Hickey said, as long as they also upload all the necessary supporting documentation.

DoD records still a problem

The shift away from paper and toward automation only eliminates one part of the bottleneck. For example, VA still is having trouble getting comprehensive medical records from DoD when a servicemember is first discharged from the military.

“In some cases they transfer things relatively quickly, but part of my issue is it’s not complete,” Hickey said. “Part of my requirement is to make the very best decision for that veteran with all the evidence there is in the DoD system, and not have to recycle back in and ask again for a piece of data. That piece of medical information may not seem important in the grand scheme of all the data DoD gives us, but it can make all the difference in the world to us when it comes to saying yes or no to that veteran.”

Hickey said DoD has agreed to provide VA with exhaustive medical records for every discharged servicemember by June 1. After that date, if a record is not complete, VA will send it back to DoD and document that the Pentagon is to blame for any resulting delays on an individual compensation case.

Once VA has finished processing all of its two-year old claims cases, it will move on to claims that are more than one-year old, and it aims to process all of those within the succeeding five months.

But lawmakers are worried that the new attention to old claims will mean that new ones will fall further behind than they ordinarily would.

“Every veteran deserves a thorough, fair and timely evaluation of their claims regardless of when that claim might have been filed,” Miller said. “This policy should not interfere with that, and I hope that this policy will not continue for a long period of time.”

Incentivizing behavior

The department says it intends to dig out of the backlog and never return to it. Last week, Shinseki ordered the claims processing staff in all 56 of the Veterans Benefits Administration’s regional offices to work mandatory overtime for 20 hours per month to chip away at the backlog.

Hickey did not guarantee that no new claims would suffer from the new attention to old ones, but she said VA would still move right away on certain high priority claims, including those from veterans who are in severe medical or financial distress, are Medal of Honor recipients, or who are terminally ill.

VA also is prioritizing claims that arrive at its front door as “fully-developed,” meaning that a veteran already has submitted all of his or her medical evidence and other supporting documentation, and certifies that there’s nothing else to add to the record.

“It’s an incentive. We want to incentivize new behavior that drives us to this faster process, so we are prioritizing these fully-developed claims, and they can be brand new ones that just came in the door,” she said.

Such claims are usually submitted with the help of veterans service organizations whose caseworkers work one-on-one with individual veterans. This week, VA signed a formal agreement with the American Legion and Disabled American Veterans on best practices for those claims, which VA says it can process in half the time it takes to work through “traditional” claims.

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