VA's plan to clear claim glut is given slim odds

By CARL PRINE | The Pittsburgh Tribune-Review | Published: May 13, 2013

PITTSBURGH — The Department of Veterans Affairs, buried in disability claims and appeals, plans to push through by slashing its high rate of processing errors and using technology.

Yet critics contend the overdue reforms likely won't drastically cut by 2015 the glut of nearly 1 million initial claims filed by honorably discharged GIs, much less speed up an appellate process that makes veterans wait years for decisions.

A Tribune-Review investigation found that, on average, veterans wait nine months for VA field offices to take up an initial claim. If a veteran disputes the government's finding, he or she faces delays 3½ times longer from the Board of Veterans Appeals.

That internal agency court in Washington recorded a record 45,959 ap-peals at the beginning of the fiscal year, up from only 7,731 filed 11 years ago.

With that ballooning appellate backlog and longer waits, an increasing number of veterans are dying before their cases are resolved. Of the nearly 160,000 appeals before the board between 2009 and early 2013, the Trib found 2,936 cases in which veterans and sometimes surviving family members died before VA reached decisions.

In nine of every 10 appeals, the claims died with the veterans because no eligible family member came forward within a year to substitute for them.

VA officials declined to talk to the Trib about appeals that, in some cases, go back decades because of agency inaction or errors. However, VA officials have issued prepared statements about backlogs.

Alison Hickey, a retired Air Force general who is the VA undersecretary for benefits, has called agency delays “unacceptable” and vows to fix the system with lasting reforms. In her first move to trim the nearly 1 million initial or supplemental claims to zero by 2015, she has ordered the Pittsburgh review office and other field stations to issue decisions during the next two months on all initial claims pending for more than two years.

Hickey predicts that VA raters deciding the cases can achieve a 98 percent error-free rate, eventually trimming the growing stack of cases before the appeals board in Washington.

That would be a reduction of seven times the rate of errors VA says it now posts, and critics doubt the agency is capable of hitting that target.

Hickey believes that a critical factor in VA reforms is digitizing claim records so that field offices aren't swamped by paperwork and appellate judges can survey claims on computers.

Going paperless would streamline the initial claims process, but it won't touch the nearly 46,000 cases before the appeals board. Last year, the agency estimated that for every completely digitized appeal the board handled, 450 of the files were still on paper, leading to much longer delays.

Fixing the system

“The best word I'd use to describe the VA system is ‘inertia,' ” said Tom Tarantino, an Army combat veteran of the Iraq War and legislative strategist for the nonprofit Iraq and Afghanistan Veterans of America. “The agency can be resistant to change. But it's not so much that the system as a whole is bad. It's an antiquated and overly complicated process, but it can be fixed.”

Tarantino noted an easy fix that could trim months off appellate delays: Send an appeal form with the field office's written decision on initial claims so that veterans can immediately ask the agency to reconsider.

Of bigger concern to Tarantino is what he believes are the VA's projections for how quickly and efficiently the agency will clean up the backlog. He noted VA promises to add 3,700 compensation claim raters at field offices nationwide, an initiative that fizzled when 3,400 of them quit the agency after training — leaving a net gain of “only 300 raters,” he said.

For their part, VA officials blame Congress for some of the backlog because lawmakers liberalized the rules that guide the compensation of Vietnam veterans potentially sickened by defoliants sprayed on jungle canopy. That led to a third of VA's workforce having to process 260,000 new Agent Orange claims.

Stung by criticism that VA too often blocked claims by veterans alleging post-traumatic stress disorder, or PTSD, and brain injuries, Congress softened rules mandating firm proof of combat-induced mental anguish. That added more than 940,000 men and women to VA rolls, the agency estimates, further delaying the processing time for initial claims and leading to appeals from those previously denied compensation for such disabilities.

Management is ‘broken'

VA officials say claims cases filed by today's veterans are complex. Iraq and Afghanistan vets are returning home after longer periods of wartime service and with more complicated injuries tied to “hidden wounds of war,” such as PTSD. They claim more than twice the number of disabling conditions as did their peers after the Vietnam War.

That's partly why VA processed claims for 4 million individual medical conditions last year, up from 2.7 million in 2009, the agency estimates.

Shrugging off partisan politics that often divide Capitol Hill, 67 senators sent a letter on April 29 to President Obama urging him to “take direct action” to end the disability claims backlog. White House officials retorted that the president ordered an “all of government effort” to fix the agency.

Critics contend that dumping more cash and manpower on VA probably won't help resolve claims and appeals. With more than 280,000 workers, VA is second only to the Department of Defense in size and was largely protected from sequestration budget cuts.

“VA has plenty of resources, plenty of money and plenty of workers,” said Darin Selnick, a retired Air Force officer and high-ranking political appointee at VA between 2001 and 2009. “There are good people at VA, and they know what needs to get done to right the ship. But they're failed by their leadership. Management is broken at all levels of VA.”

Now an independent consultant with the nonprofit Concerned Veterans for America, Selnick said he believes that only removal of “deadwood” management at VA could fix a culture that at times seems to be almost anti-veteran.

“Band-Aid type stuff,” he said, won't work. He and other critics have urged Congress to radically remake VA into a “performance-based” agency that replicates efficient private-sector companies.

“Could you imagine what would happen if a medical insurance company had a backlog of a million claims? They'd go out of business,” he said.



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