Balancing the VA Backlog

Secretary Shinseki has set the goal: no claim over 125 days with 98% accuracy by the end of 2015. Photo Brendon Hoffman

Balancing the Record on the Claims Backlog

As we mark the 10th anniversary of the start of the Iraq war, people want to know how VA is taking care of our Veterans. There has been a lot of discussion recently about the compensation claims backlog and what the Department of Veterans Affairs (VA) is doing about it.

We at VA – many of us Veterans ourselves – know that Veterans, their families and survivors wait too long for the benefits they have earned and deserve. The fact is our average days-to-complete a claim currently sits at 273 days. All of us at VA agree this is unacceptable, and this is why we have been busy implementing a robust plan to fix the problem and end our reliance on paper-based claims.

Secretary Shinseki has set the goal: no claim over 125 days with 98% accuracy by the end of 2015. VA is aggressively building a strong foundation for a paperless, digital disability claims system – a lasting solution that will transform how we operate and eliminate the backlog. This new system will be installed in all 56 of our regional offices by the end of this year. Twenty-five offices have it now.

The backlog didn’t happen overnight, and it won’t end overnight. After ten years at war, the volume and complexity of claims is increasing as more servicemembers leave the military. Improved battlefield medicine has meant that more of our younger Veterans are coming home to their families, but with very complex injuries.

Claims submitted by Post-9/11 Veterans include more than double the number of conditions claimed by Veterans of the Vietnam era. To put this in perspective, in 2009 (the year Secretary Shinseki assumed office), VA processed claims for 2.7 million individual medical conditions. Last year, that number had grown to over 4 million.

At the same time, Veterans of previous wars are living longer and many have the opportunity to file for benefits for the first time, thanks to decisions made by Secretary Shinseki. These decisions to do right by Veterans were long overdue, and have dramatically increased access for many Veterans who would not otherwise been able to file for benefits. The decision to expand the number of illnesses presumed to be linked with Agent Orange exposure redirected over one third of VBA’s workforce to process 260,000 Agent Orange claims.

This grew the backlog, but it was the right decision to make for our Vietnam Veterans who, in some cases, were waiting over 40 years. In fact, Vietnam-era Veterans represent the largest group in the current claims inventory at 37%.

We also liberalized the rules for connecting PTSD to service, as well as adding nine diseases associated with service in the Gulf War to the list of presumptive conditions – again, long overdue. Over the last 4 years, over 940,000 Veterans were added to the compensation rolls — more Veterans than are on Active Duty in the Army and Navy combined today.

A tough economy and increased outreach efforts by VA to encourage Veterans to apply for earned benefits have also made our effort to tackle the backlog more challenging. Despite this, VA has completed a record-breaking 1 million claims per year the last three fiscal years, and completed 4.1 million claims the past four years.

In 2012 alone, VA provided $58.6 billion in disability compensation to 4.3 million Veterans and survivors.
In this challenging environment, there are several new initiatives – as part of the VA Transformation Plan – that Veterans and Veteran service representatives can take advantage of today to help VA process their claim as quickly as possible:

eBenefits is a joint VA-DoD client services portal with over 45 self-service options that allows users to file benefits claims online in an easy-to-use, prompt-based system, upload supporting claims information that feeds into VA’s paperless claims process, check the status of claims or appeals, review VA payment history, obtain military documents, and perform numerous other benefit actions.

Disability Benefits Questionnaires (DBQ) are designed to capture all the needed medical information relevant to a specific condition and give Veterans the option of having their private physician provide this information to VA, minimizing the need for a VA exam. More than 70 DBQs are available today for use by private medical physicians.

Fully Developed Claims (FDC) identify the claim-specific information and evidence needed to substantiate a claim at the time of application, and allow Veterans to certify that there is nothing further to give VA regarding the claim, preventing VA from undertaking a lengthy search for any missing information or evidence
Veterans and survivors who are able to do so, should submit as much evidence as they can at the time they submit their claims. Doing so allows VA to work claims much faster — meaning Veterans and survivors get accurate decisions sooner.

The backlog is a decades old problem. We have studied it carefully and engaged with Veterans Service Organizations and others to determine the right approach. Eliminating the backlog requires a radical overhaul of the way VA does business and that takes time. The good news is we are on the right path to succeed and deliver faster, more accurate results for Veterans.

Allison Hickey, a retired U.S. Air Force Brigadier General, is VA’s Under Secretary for Benefits.

Originally posted by the Department of Veterans Affairs blog, VAntage Point. All rights reserved.

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