HVAC Disability Claims Process Hearing
April 18, 2012
JAMES D. WEAR, ASSISTANT DIRECTOR, VETERANS BENEFITS POLICY
NATIONAL VETERANS SERVICE
VETERANS OF FOREIGN WARS OF THE UNITED STATES
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES HOUSE OF REPRESENTATIVES
WITH RESPECT TO
REPRESENTATIVES’ ROLE IN THE DISABILITY CLAIMS PROCESS
WASHINGTON, D.C. April 18, 2012
MR. CHAIRMAN AND
MEMBERS OF THE COMMITTEE:
On behalf of the more
than 2 million men and women of the Veterans of Foreign Wars of the United
States (VFW) and our Auxiliaries, I would like to thank you for the opportunity
to testify today regarding the Veterans Service Organizations’ role in the
disability claims process.
2011, the Veterans of Foreign Wars (VFW) helped more than 97,000 veterans and
survivors receive over $2 billion in compensation and pension benefits. In addition, in FY 2011 the VFW represented more
than 3,700 appellants at the Board of Veterans Appeals. Our allowed rate (one or more issues granted
on appeal) of 30.7 percent was second highest among the major veteran service
organizations. Our allowed rate was
higher than that achieved by attorneys.
It was fully eight percentage points higher than veterans who had no
are proud of these achievements. They
show that representation by our service officers and appeals consultants clearly helps veterans and other claimants perfect their claims and obtain the
benefits to which they are entitled under the law.
we are not alone in this work. The
American Legion, Disabled American Veterans and the Veterans of Foreign Wars
represent nearly 1.6 million veterans and survivors already receiving
compensation, pension or DIC from VA. Together,
we represent tens of thousands more with claims and appeals awaiting decisions
part of this process, we answer millions of telephone calls and emails a
year. We interview hundreds of thousands
of individuals annually, explaining what benefits they may or may not be entitled
to, help them complete forms, assist in developing claims, review VA decisions,
identify errors, and work with VA to get them corrected.
provide all these services to veterans and the VA for free. We do not take a dollar in grants or payment
from the Federal government to provide these services. We do these things because we recognize that
the laws and regulations dealing with veterans benefits are often complex; the
claims process is often treacherous to navigate. We do these things because veterans have
already sacrificed for our country and whatever assistance they receive from
our government should not require additional struggle and turmoil.
readily acknowledge that nearly all VA employees are dedicated to doing the
very best they can for veterans, we also realize that they are, at present,
overwhelmed with over 1.5 million pending compensation, pension and education
claims, and over a quarter of a million pending appeals. They are people working within an
extraordinarily complicated and frequently archaic claims processing
system. Since there are few automated
quality controls, they are dependent on both how much they know and how well
they apply it to their work. In short,
VA decision makers are human; they make mistakes.
of decision making is problematic. A
review of the latest quality data for ratings indicates that the best regional
office (Lincoln, NB) has a four percent error rate. The national average has remained nearly
stationary at 16 percent for months.
Recent changes in the Baltimore regional office, still the worst in the
nation, have resulted in significant improvement (for it); errors occur in
“only” 29 percent of its rating decisions, down from a 33 percent error rate
just a few months ago.
VFW has nearly 1,300 accredited individuals.
Most of these are county and state employees who provide assistance to
veterans and survivors who have given the VFW their power of attorney
(POA). Service officers employed by the
VFW and work within VA regional offices number 245. This is the group that receives specialized
training and routine information dissemination from our national office in
Washington concerning changes in law, regulations, VA procedures or court
VFW service officers are given a 40 hour classroom “boot camp” where they receive
intense training in all VA benefit programs, with a special emphasis on
compensation and pension. They are also taught
representational skills; they learn about the appeal process. We give them the basic knowledge they need to
intelligently discuss disability and survivor benefit programs with claimants,
help them fill out appropriate forms, tell them what evidence is needed to
complete their claim, outline the claims process within VA and other
does not stop there. Every VFW service
officer who works within a VA regional office is required to attend training
each year. This training is very
technical in nature, with a heavy emphasis on topics related to the rating
schedule. Most of our trainers are
recently retired VA subject matter experts who provide instruction as good as
or better than that received by VA employees.
Our goal is to ensure our service officers know VA laws and regulations
as well as or better than the VA employees with whom they deal with in their
offices. Once a problem with a decision
has been identified, we expect our service officers to use the facts, laws and
regulations to convince VA to change the decision in favor of the
all, we provide approximately 80 hours of classroom training each year to VFW
service officers who work within VA regional offices.
does not stop between training conferences.
The Veterans Benefits Administration (VBA) frequently adds or modifies
regulations and policies dealing with its benefit programs. The VA Office of General Counsel, the Court
of Appeals for Veteran Claims, the Court of Appeals for the Federal Circuit and
others publish decisions which change how VA works. Our national staff is constantly monitoring
the various sources of change to identify those things which may affect
veterans. We analyze these changes,
discern how they might impact veterans benefit programs and then notify our
service officers of the change and what it means to them. These Updates are distributed several times
each month. This is how we keep our
service officers up to date.
service officers offer a host of services to veterans, dependents and survivors. While each claimant is different and has
different needs, the veteran service officer performs the following roles:
dissemination – Generally, the first contact a service officer has with a
claimant is either in person or on the telephone. The veteran has questions, concerns or
problems. The service officer must
identify each issue and provide the most accurate information available. Veteran service officers often perform
outreach, meeting groups wherever they might gather. This typically involves talking about the
things which are likely to interest the group, then taking specific questions
after the conclusion of his remarks.
intake and preparation – This can be done either in person or on the
phone. It is most effective when the
claimant can sit down with the service officer. This allows the service officer
to review available records as the application for benefits is being
completed. The service officer asks
questions and helps the claimant focus the issues. It is also an opportunity to begin to
discussing what evidence is needed to perfect the veterans claim.
in development – A well trained service officer will usually know what evidence
the VA needs to favorably consider the claim.
He/she should tell the veteran what that evidence is and explore with
him just how that evidence can be obtained.
This is also an opportunity to begin to manage expectations of the
resolution – informal intermediary to clarify issues, obtain evidence – VA
employees know who the good service officers are, and they use them to help
expedite claims. It is not unusual for a
VA employee to alert a service officer of the need for a particular piece of
evidence in order to make a decision (e.g., “If you obtain this piece of
evidence, I think I can grant the claim.”)
This type of communication acts as an incentive for both the service
officer and the veteran to obtain that evidence and submit it quickly. This type of informal interaction becomes a
win-win for VA and veterans.
quality control of VA decisions – Long established VBA policy requires that
proposed rating decisions be provided to service officers holding veterans
power of attorney for at least two business days. During that period service officers have an
opportunity to review not just the rating, but also the record on which the
rating was based. Any errors identified
during this review are brought to the attention of either the rater who made
the decision or a designated supervisor.
This process is designed so that errors can be corrected before the
rating is sent to the veteran. While
some local VA managers occasionally try to reduce or eliminate this review
period, VBA leadership has always recognized the importance of this step and
have taken corrective action when necessary.
of VA decisions – Not every decision made by VA is favorable to veterans. There are times when the evidence and the law
do not allow VA to grant the benefit sought.
One of the jobs of a service officer is to explain decisions to
claimants in ways that they will understand.
They discuss the problem which forced VA to deny the benefit sought and
explain what evidence is necessary to obtain a different decision in the
counselor – Sometimes the VA just makes a wrong decision. When that happens the service officer
discusses appellate options with the claimant and helps him/her file a notice
of disagreement when appropriate. During
the appeal process the service officer may discuss the case with a Decision
Review Officer, represent the veteran on appeal and write an argument on behalf
of the claimant to the Board of Veterans Appeals.
at the BVA – The national Veterans of Foreign Wars maintains a staff of highly
trained appeals consultants at the Board of Veterans Appeals. Their job is to review the case when it comes
to the Board, formulate the best possible argument on behalf of the appellant. They also represent appellants in personal
hearings before Veteran Law Judges at the Board. As mentioned above, we helped appellants
obtain reversals by the Board in 31.7 percent of the appeals considered in
is in the midst of tremendous change.
Historically, technological advances in VA have been done in fits and
starts. Three phase plans often failed
to move beyond the second phase. Even
when new programs were rolled out in the last two decades, they were often deployed
long before adequate testing was completed, leaving users in the field with
programs which required thousands of man-hours to fix.
VBA appears to be moving forward today with IT programs which promise to speed
processing while finally introducing tools which promise to improve
quality. We welcome this progress. We hope that VA has learned lessons from its
past and from private industry which will allow it to implement change with
minimal negative impact on its employees, service officers and veterans.
is important to understand that veteran service organizations are both
advocates for veterans and partners, or stakeholders, with VA. In order for us to do our job effectively, we
must have access to VA computer systems, records, facilities and
personnel. Without this access, we might
as well stand on the curb and shout at regional office buildings.
relationship with Secretary Shinseki and VBA leaders has steadily improved over
the last four years. VA has shown
progressively greater transparency in many of the things it does. We have tried to demonstrate to VA that while
we are advocates for veterans and will hold VA accountable for doing its many
and varied jobs, we are also willing to work with VA to help ensure that
change, when it occurs, is at least neutral in its effect on veterans. More importantly, we seek to identify win-win
opportunities: opportunities for improvement which help both VA and veterans. A
recent development within VBA illustrates both the difficulties and benefits of
working closely together to achieve win-win situations.
summer VBA deployed elements of what has now become known as the Simplified
Notification Letter. In its earliest
manifestation, VA rolled back the clock to 1945 and began issuing rating
decisions which looked remarkably like those written at the end of WWII. Decisions did not contain a discussion of the
evidence considered or an explanation of the reasons for the decision made – commonly
referred to as “reasons and bases.”
Decisions granting an evaluation did not contain a summary of the rating
criteria used to assign the evaluation nor an explanation of what was needed to
obtain the next higher evaluation. These
elements are required by VA regulations and court decisions. The explanation for these changes was that it
allowed raters to increase production by 30-40 percent.
service organizations were not consulted on these changes. When we became aware of them, the VFW went to
the VA regional office in Atlanta to review both the ratings and notification
letters to veterans. We discussed our
findings with project managers who made a few changes to the program which
provided additional, but very generic, explanations to veterans.
changes did not, in our view, meet regulatory and court mandated requirements
for explaining VA decisions to veterans.
In order for a veteran to understand a decision and determine whether it
was correct or not the law requires that he/she be provided certain
information. We believed this program
failed to provide veterans with the information required by law. We continued to press VA on this program.
their credit, VA made additional modifications and information was added. Both the VFW and DAV continued to object to
this program because notice remained inadequate. It was only in the last few months that we
were all able to arrive at a point where the notice provided by VA, when
properly done, was adequate to satisfy our concerns, while allowing VA to
achieve increased production without further degradation of quality.
work with VBA at the national level almost daily. The VFW and representatives from the largest
veteran service organizations have been meeting with VBA on a number of
initiatives, including eBenefits (working on ways to improve functionality and
customer satisfaction for veterans) and the Veterans Benefits Management System
(VBMS) (to ensure the needs of veterans representatives are addressed in VA’s
next generation claims processing system).
recognize and support VBA’s plans on expanding customer and service
organization interaction with VA. VA has
plans to allow claimants and service officers to submit information and claims
electronically. VA indicates that it
embraces the idea of permitting veterans to change their contact information,
such as an address or to report changes in income (for pension) and add or
subtract dependents by computer. Any
initiatives which allow claimants and their representatives to submit data
electronically or to effect minor changes to awards based on user input,
portends great savings in time and money to VA, while offering enhanced service
to veterans. The VFW looks forward to continuing and improving our working
relationship with VA to find common sense solutions to reducing the claims
backlog, while improving rating decision outcomes.
Chairman, this concludes my testimony. I
would be happy to answer any questions that you or the members of the Committee
Information Required by Rule XI2(g)(4) of the House of Representatives
Pursuant to Rule XI2(g)(4) of the House of
Representatives, VFW has not received any federal grants in Fiscal Year 2012,
nor has it received any federal grants in the two previous Fiscal Years.
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