National Security, Homeland Defense & Foreign Operations
July 18, 2012
STATEMENT
OF
GERALD T.
MANAR, DEPUTY DIRECTOR
NATIONAL VETERANS SERVICE
VETERANS OF FOREIGN WARS OF THE UNITED STATES
BEFORE
THE
COMMITTEE
ON OVERSIGHT AND GOVERNMENT REFORM
SUBCOMMITTEE
ON NATIONAL SECURITY, HOMELAND DEFENSE
AND
FOREIGN OPERATIONS
UNITED
STATES HOUSE OF REPRESENTATIVES
WITH
RESPECT TO
Taking
Care of Our Veterans: What is the
Department of Veterans Affairs Doing to Eliminate the Claims Backlog
WASHINGTON, DC July
18, 2012
MR. CHAIRMAN AND MEMBERS OF THIS
COMMITTEE:
On behalf of the more than 2 million
members 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 on
the VBA claims transformation plan within the Veterans Benefits Administration
(VBA).
The
number of compensation, pension and education claims, award adjustments and
appeals currently pending before the Department of Veterans Affairs (VA) totals
2,075,272. The VA will tell you it is something
different, but that's the actual number.
There
are many "rules" in management, but one of the top rules has to be
this: You cannot fix a problem unless you know what it is. One wonders why VBA officials insist that the
number of claims it has is only its rating workload. However, the problem is not two million
pending claims. The problem is that VA
has yet to devise a work process that completes those claims in a timely manner
with high quality.
We
will discuss our views on VBMS and another transformation initiative shortly;
however, to understand the current problems it is important that we first examine
some of the reasons for the current backlog of pending claims and appeals.
What
we have here is a bipartisan multigenerational mess. It is a uniquely American problem.
The
American people, through their elected representatives in Congress, recognize
the contributions and sacrifice of the millions of men and women who have
served in her armed forces in both war and peace. They have come to understand that as horrific
as are some injuries received in combat, as many or more service members are
disabled from injuries or disease incurred while preparing for war. As a result of this understanding, Congress
created a unique set of programs designed to compensate veterans for their
service incurred disabilities, provide benefits to the survivors of those who
died as the result of that service and ensure that veterans have opportunities
to obtain housing and an education.
The
VA disability compensation program is complex.
It is the result of legislation dating back to at least the 1930s. It is a program which has been refined and
expanded, both legislatively and administratively, throughout its
existence. It is often cumbersome and
occasionally arcane. However, it has
served the needs of veterans, their survivors and the American people for over
80 years.
Today's
workload problems didn't happen overnight.
In fact, their origins date back decades. In the 1970s the VA agreed to VBA staffing
cuts in exchange for a budget which would allow it to place computers in its
regional offices for the first time. That the computer system it bought was
reportedly obsolete at the time it was installed is, perhaps, more an
indictment of purchasing practices than anything else. However, this action set the stage for
information technology (IT) miscues and missteps which plagued VA down to the
present.
Under
both internal and external pressures from the mid-1970s through 2000, VA failed
to adequately describe its real workload and consistently underestimated the
number of staff needed to process anticipated receipts and its existing backlog
of pending claims. This practice, through both Republican and
Democratic administrations, abdicated the responsibility of identifying and
funding VBA staffing needs to Congress. The result was, until the last decade,
significant shortages in critical claims processing FTE in VBA.
In
the last decade Congress has authorized substantial increases in FTE. This is a good thing. Unfortunately, no university or trade school
prepares students for a job of claims processing. Once hired, VA must train its employees in
the laws, regulations, processes and procedures they must follow in deciding
what evidence is needed, whether service connection can be granted, what
evaluation to assign and from which effective date. This training takes time and resources. While VBA has streamlined and refined the
training process, seeking to make its new employees productive in increasingly
shorter periods of time, the truth remains that it takes a year or more for a
Veterans Claims Representative (VSR) to learn and mature within their position,
and it takes two to three years for a Rating VSR to acquire the skills
necessary to make decisions with some speed and with a modicum of quality.
Adequacy
of VA budgets was only one of the reasons why VBA is in its current state. Even when Congress passed a budget for VA, it
was often months late. The chart, below,
shows the number of appropriation bills enacted by October 1st for Congresses
from 1977 through 2010. Note that in
only four years did Congress complete its work on time. This meant that those departments not blessed
with a budget were forced to work under continuing resolutions, often for
months. In several years, Congress used
continuing resolutions to fund the Executive Branch for the entire year.
The problem is that during a
continuing resolution VBA does not hire personnel to fill vacancies. Even when a budget is finally passed, it
routinely takes VA a substantial amount of time to crunch the numbers and allocate
staffing ceilings based on the budget.
Only then can managers in VA's regional offices begin the process of
recruiting, selecting and training new personnel. In those years when there was no budget,
there was no hiring. Consider a regional
office such as Los Angeles which, in the 1990s, had a 10-15 percent attrition
rate per year. The inability to hire
replacement FTE for extended periods contributed substantially to the increases
in workload during that decade at that and many VA regional offices. The problems created by these gaps cascaded
down through the years. For instance,
personnel were often unprepared to assume greater responsibilities when
vacancies above them arose because they had not been in their current position
long enough.
The administrations and Congresses
of the last several decades are not solely responsible for today's workload
crisis within VBA. VA and VBA leaders
and managers failed time and again to fully recognize and address problems
while they were still malleable.
The people not to blame for the
current state of affairs at VA are Secretary Shinseki and Under Secretary for
Benefits Hickey. On the day Secretary
Shinseki took office in 2009, VBA had about 850,000 pending claims and
appeals. There were 1,570,000 claims and
appeals pending when USB Hickey was sworn in on June 6, 2012.
Each year, since 2009, VBA has
completed more claims than it did the year before. However, with hundreds of thousands of men
and women returning from a decade of wars in Iraq and Afghanistan, many wounded
from both physical and psychological injuries; increased outreach efforts; over
230,000 fresh claims from veterans of the Vietnam war who were exposed to
herbicides; and thousands more seeking additional benefits in the worst
economic downturn since the Great Depression, to date, VBA has not yet been
able to overcome the burdens of its past.
Since Eric Shinseki became Secretary,
VA has had a set of goals. Since Allison
Hickey became USB, VBA has had a vision.
In our view, they are diligently working to overcome the problems of the
past and are driving VA forward more rapidly than any Secretary and Under
Secretary for Benefits in memory.
Congress has given VA the staffing sufficient to defeat the backlog and
the administration continues to voice its confidence that VA is turning the
corner and is on the road to success.
While we continue to have
significant concerns about VBA, we are working with them to identify problems
and make adjustments so that in the end veterans and their families receive
every benefit to which they are entitled under the law, in a timely manner and
with assurance that decisions are correct.
VBMS
Over the last 20 years we have
watched VBA struggle to determine how it would modernize its claims processing
systems. “Struggle to determine” because VBA has lacked a coherent vision
of what a 21st Century claims processing system should be. Lewis Carol,
author of Alice inWonderland, is often quoted as saying:
“If you don’t know where you’re going, any road will get you there.” To
the despair of many of us, VBA started down many roads, only to find that
nearly all got them precisely nowhere.
In our view, VBA is still struggling
to find its vision. Without a clear vision, an ultimate goal, it advances
in fits and starts, making some progress, but often at the cost of wasted time,
money and the energy of its people.
In the last year Allison Hickey,
Under Secretary for Benefits, has worked hard to bring that vision into
focus. Just a year ago this month she called 50 people to a Strategic
Planning and Implementation Workshop. Through two grueling, 12- hour days
she worked with them to define where VBA should be by 2015. By the end of
the workshop they had taken the vision from its murky, ethereal shape and had
developed the outline of goals and the start of a plan.
They started the process of paring
away the programs and pilots that weren’t working. They sought to
identify those things that were working but not delivering sufficient value to
continue. Then they began to examine which of the remaining initiatives
would help them get to their goals, and figure out what was required to further
the process.
In all of this there was recognition
that VBA could not overhaul its claims processing systems without first
overhauling its computer and software infrastructure.
How best to describe the computer
systems used by VBA to process claims? Imagine a house first built in the
late 1970s. The house was an old design, but because the plans and materials
were already out of date the price to build it was considered reasonable.
The house was modest at first, and because it was new, its owners thought that
it would serve them for many years to come.
Over the next 40 years many rooms
were added to the house. The rooms had funny names, such as BIRLS,
COVERS, RBA 2000, BDN and MAPD to name a few. Each room was added at different times. Some
doors failed to open onto hallways. Some had central air conditioning
while others had none. In some rooms the plumbing worked fine while there
were chronic problems in others. Visitors to this house often had to go
back outside and enter through a different door just to get to another
room. As a consequence of poor planning and design, the house was not
very efficient and it was difficult to live in.
This analogy describes the computer
systems VA uses today. While it is true that many changes and
improvements have been made, the basic foundation on which all these systems
are built is inadequate to support a functional claims system. It is
slow, inefficient, requires repetitive input and it is difficult to update and
repair.
VBMS is VBA’s attempt to build a
foundation for a new house. It’s not just designed to sustain the
software programs VBA envisions for the immediate future, it is intended to be
sufficiently flexible to allow the addition of programs not yet
contemplated.
It is important to understand that
VBMS is the foundation. VBMS is designed to facilitate the creation of
efficiencies. As such, we do not anticipate that the rollout of VBMS over the
next year will initially result in significant improvements in claims
processing timeliness or quality. In fact, if history is any guide, the
deployment of VBMS will actually slow claims processing during the first six
months as software problems are identified and fixes installed.
We do anticipate some efficiencies
from the start. For instance, information concerning individual veterans,
now scattered in multiple locations requiring separate input, will be stored in
one location. Whenever that information is required, VBMS is designed to
retrieve that centrally stored data.
For instance, right now a Veterans
Service Representative (VSR) must enter a veteran’s address in several
different programs to ensure that the address is current. Systems do not
automatically update. Similarly, a veteran’s Power of Attorney (POA) must be
entered in different programs to allow access by veterans
representatives. With VBMS, a VSR need update the system in one place
only and other programs will draw from that central data point to find the most
current address or POA.
There has been some discussion of
late that the deployment of VBMS may be delayed. There is a fine line
between rolling out a new program too soon and delaying rollout too long while
seeking to fix all the problems. VBA’s initial plans for rapid
development and deployment of VBMS were, in our view, unrealistic from the
start. It is our understanding that development and testing of VBMS was
to be conducted in rapid succession: collect the business requirements in Baltimore
for a few months, deploy the first version to Providence for six months, update
and deploy the second version to Salt Lake City for six months then roll it out
to the other regional offices. To date VBMS is in four regional offices
and, we are told, fewer than 800 cases have been processed to completion.
We believe that rolling out VBMS
prematurely, before it is fully stressed to identify the majority of issues and
problems it contains, is a bad business practice, bad for veterans and bad for
morale of an already demoralized VA workforce. Examples are replete in
the history of VBA claims processing of what happens when a new software
program is deployed before it is ready for prime time.
BIRLS has been a useful tool to aid
claims processors for many decades. It contains, among other things, data
on veterans’ military service. In an effort to clean up and verify the
data contained in this program, VBA undertook a project in the1980s called
BIRLS Redesign. This program was rolled out to the field without adequate
testing. As a result, tens of thousands of records had to be corrected or
updated by hand, costing VBA thousands of man-hours of lost productivity.
In the 1990s VBA developed a program
called RBA to assist rating specialists in the completion of rating
decisions. In 2000, VBA updated the program and deployed it to the field
without sufficient beta testing. As a consequence, creation of rating
decisions slowed to a crawl while thousands of VA’s most critical decision
makers spent months identifying software bugs and struggled with “workarounds”
while computer programmers fixed problems.
While it is counterproductive to
delay release of a computer program until all the bugs are identified, these
two examples are ample evidence of what happens when a new program is
inadequately tested and released too soon.
We encourage this Committee to
continue its oversight of VBA and VBMS while recognizing that it may be
necessary to accept modest delays in deployment of this major initiative in
order to avert the negative effects of rolling out a program with defects
simply to meet a deadline.
VBMS is just one of many initiatives
underway in VBA. A list of Transformation Initiatives on VA’s website offers a fascinating, though dated, summary of the dozens of
ideas tried, adopted or discarded in a quest to find the most efficient way to
develop and decide claims in a timely manner.
Simplified Notification Letters
(SNL) is an initiative thoroughly embraced by VBA leadership. An
examination of what this initiative does to veterans is illustrative of the
mindset of VBA in the last year.
The veteran service organizations
first became aware of this project in June 2011 when our service officers in
Atlanta notified us of its existence. Initially called Disability
Evaluation Narrative Text Tool (DENTT) and later Rating Redesign, a team
working in the Atlanta and St. Paul regional offices designed a process which
could best be described as “Back to the Future”. Instead of creating a
time machine in a DeLorean, this team reached back to a simpler pre-VCAA,
pre-veterans court era when ratings were simply conclusions with no discussion
of the evidence considered, nor the reasons and bases as to why the decisions
were made.
Instead, this initiative, now called
SNL, required the rating specialist to include a set of codes at the end of the
rating. The codes, in turn, were used by VSR’s to select standard
paragraphs for inclusion in the decision notice letters to veterans.
While these standard paragraphs were better written and more understandable
than those previously used by VA, they were generic and did not include the
minimum information needed by a veteran to decide whether the decision was
likely to be correct. With only general information provided by VA, veterans
are faced with the choice of blindly accepting the decision or filing a Notice
of Disagreement in
order to obtain the reasons for the decision.
In September 2011, the VFW conducted
an on-site review in Atlanta of rating decisions made under this initiative.
After reviewing 60 ratings and accompanying notice letters, we concluded that
the quality of the rating decisions was worse than that reported by VA through
its STAR quality review program, and that veterans were not receiving adequate
notice to satisfy legal and judicial requirements. Local management
bragged that production was increased by 40 percent when cases were rated under
this initiative.
Over the ensuing months we continued
to complain about the inadequate notice being provided to veterans. To be
fair, Under Secretary of Benefits Hickey listened to our concerns and changes
have been made in the SNL program in an attempt to address the problems we
noted.
Under the most recent changes,
rating specialists were given additional instructions on providing sufficient
details and discussion to explain their decisions. Restrictions on how
much “free text” narrative they could insert in a rating were removed. At
the time these changes were implemented in late February 2012, we concluded
that if field personnel followed the instructions it would be possible to
create barely adequate decisions and notice letters.
Since May 2012, the VFW has
conducted a review of SNL ratings and letters from several regional
offices. Fifty three (53) percent of the cases reviewed contained errors
in either the rating, decision letter or both. There were only a few
examples of where claimants were provided what we view as legally adequate
notice.
VBA’s apparent inability to compel
compliance by rating and authorization personnel with the most recent written
directives concerning the SNL program force us to renew our opposition to this
initiative. While we understand VBA’s desire to increase production, we
believe that this increased output is being done at the expense of veterans’
legal right to know why decisions have been made in their cases. No two
veterans, nor their disabilities, are alike. Canned generic paragraphs
are not sufficient to tell them why their claims were decided in a particular
way. VBA should suspend the SNL program until they can ensure that
veterans receive adequate notice as required by law.
Despite our concerns about some
elements of the transformation process, we believe that VBA is headed in the
right direction, with energetic leaders who have voiced the clearest set of
goals and possess the sharpest vision of any VA leadership team in
decades. We continue working with VA to
help ensure that the rights of veterans are not abridged in order to process
claims more quickly. We continue to
maintain that it is more important that VA make correct decisions rather than
fast wrong decisions.
We urge this Committee to continue
its oversight of VBA while it undergoes this journey from a 20th
century paper bound claims processing system to a 21st century model
which effectively utilizes IT to create efficiencies, significantly improve
quality and complete claims more timely.
Mr. Chairman, this concludes my
testimony, and I look forward to any questions you and the Committee may have
concerning these issues or other programs or pilots the VA is conducting to
improve the claims process
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.
"Monday
Morning Workload Report", Department of Veterans Affairs, July 9, 2012.
http://www.vba.va.gov/REPORTS/mmwr/index.asp
This total is the sum of all pending compensation, pension and education
actions found on the Final Aggregate spreadsheet. It also includes pending appeals shown for
compensation and pension programs since these appeal are under development in
the VA regional offices and processing centers.
VA officials frequently provide
lower numbers when discussing the workload and backlog. References to workload usually refer to
pending compensation and pension claims requiring rating action. The pending backlog usually refers to pending
rating claims requiring rating action pending longer than 125 days. On July 9, 2012, those numbers were 918,819
and 608,068, respectively. The VFW
counts all pending work, including appeals, since these actions must be
processed by VBA employees.
This practice is
not confined to VBA staffing levels.
Even today, VA repeatedly and substantially underestimates the amount of
major and minor construction funds it needs to maintain its extensive medical
infrastructure. The Independent Budget,
FY 2012. http://www.independentbudget.org/2012/6_new_construction.pdf
This was not an
insignificant or transient problem. In
the 1990's a good rating specialist could complete five (5) or more ratings per
day. In a year with 260 workdays, that
rating specialist could complete 1,300 ratings.
If Congress failed to fund, and VBA failed to staff, just 100 rating
specialist positions, 130,000 ratings would not be completed.
"Duration
of Continuing Resolutions in Recent Years", Congressional Research
Service, 2011,
http://assets.opencrs.com/rpts/RL32614_20110322.pdf
Benefits Identification and Records Locator System; Control
of Veterans Records System; Rating Board Automation 2000 was an updated version
of the original Rating Board Automation program; Benefits Delivery Network;
Modern Awards Processing - Development
Notice of Disagreement is the first step in the appeal
process. Upon receipt, VA is required to review the decision, determine
if additional development is required, and a new decision is warranted, if no
change is warranted, a Statement of the Case, which provides the reasons and
bases, as well as applicable citations of law and regulations supporting the
decision, is issued to the appellant. 38 CFR 19.26; 20.201.
VA regulations and Federal court decisions make it clear
that VA must provide claimants the reasons and bases for the decisions it
makes. “Every claimant has the right to written notice of the decision
made on his or her claim…” 38 CFR 3.103(a). “Claimants and their
representatives are entitled to notice of any decision made by VA affecting the
payment of benefits… Such notice shall clearly set forth the decision
made, any applicable effective date, the reasons for the decision…” 38
CFR 3.103(b). See also Gilbert v. Derwinski, 1 Vet.App. 49, 56-57
(1990) and Bolton v. Brown, 8 Vet.App. 185, 191 (1995).
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