Most everyone in the veterans community agrees that the current disability claims process is complex, confusing and poorly understood by veterans and even VA employees. With the backlog of unprocessed claims expected to top the 1 million mark by year’s end, the situation has reached the crisis point. VA’s current inventory includes more than 400,000 rating claims, more than 200,000 non-rating claims and 170,000 appeals pending adjudication.
So, the DAV has crafted a plan for a more efficient claims processing system that is faster and better meets the needs of our nation’s disabled veterans and their families and survivors.
VA Deputy Under Secretary for Benefits Michael Walcoff testified at a recent House Veterans’ Affairs Committee hearing that rating-related claims received through May 2009 are up 13.5 percent over the same period in 2008. Despite a 9.3 percent increase in claims completed, the rating-related inventory increased from 379,842 at the end of fiscal year 2008 to 402,047 at the end of May 2009. Rating claims increased by approximately 22,000 this year.
During a Feb. 11 Senate Veterans’ Affairs Committee hearing, Sen. Richard Burr (R-N.C.) challenged DAV and other witnesses to create a draft model for a new VA disability claims process. “We took this worthy challenge very seriously and have crafted the DAV’s 21st Century Claims Process,” said National Legislative Director Joseph A. Violante.
“The DAV’s package is the first comprehensive set of legislative and administrative recommendations to make the disability benefits system more efficient, reduce the initial claims-processing time and make the appeals process faster and more efficient,” said National Adjutant Arthur H. Wilson.
“Our recommendations are designed to improve the accuracy and timeliness of the claims adjudication system, simplify procedures to make the best use of government resources and, at the same time, safeguard the rights of claimants,” said Washington Headquarters Executive Director David W. Gorman. “After all, making sure our government lives up to its responsibilities to disabled veterans and their families is one of the DAV’s most important jobs.”
“With the exception of the initial startup for the information technology component, our plan does not require large government spending, not even increased VA staffing. Over time, the cost savings of this proposal would be significant,” said National Service Director Randy Reese. “If all of the legislative/administrative recommendations are implemented immediately, it would bring long-needed efficiency to the claims process.”
It is estimated that the recommendations would save VA more than 100,000 hours of work each year and cut the initial average claims-processing time by 30-90 days. The appeals process also would be faster and more efficient.
“Essentially, our proposal consists of three major components — a legislative package, an information technology package and a claims process reorganization,” Violante said. “While all three of the components complement each other, any of the three components will individually enhance the efficiency of the claims process. The benefit to this approach is that all three portions are not required to be implemented simultaneously, as would be the case in an ‘all-or-nothing’ approach.”
A key recommendation for revamping the adjudication system is creating and maintaining a centralized database of electronic claims files. Under the DAV’s plan, paper forms and other documents in support of claims would be scanned to create an electronic image that would be viewable in the official record the following day. It currently takes several days, or even weeks, for VA to incorporate new evidence into a claims folder. Lost or incorrectly destroyed records would be a problem of the past.
Another recommendation would require legislation to amend the VA’s duty to assist and notification requirements. Claims received by VA would first be analyzed by a rating team to determine the type of benefit sought and what type of notification and assistance VA would need to provide the claimant in developing the case. Under this recommendation, VA would not be required to undertake needless development.
This determination and notification process would require 1-3 days, but should never require more than one week, DAV testified before a House Veterans’ Affairs subcommittee on Disability Assistance and Memorial Affairs. Under the current disability timeline, these same functions take 44 days on average.
“In instances where the evidence of record is sufficient to award all benefits sought, VA would be allowed to waive current notice and assistance requirements,” said Reese. “Many such straight-forward cases could be reviewed and rated in less than two weeks.”
The streamlined analysis and pre-determination process outlined in DAV’s plan also would cut processing time and allow rating specialists to do a more thorough job on cases requiring information verification and further development. “The result would be better decisions in less time and fewer appeals,” Reese said.
A proposed change in law would allow claimants wishing to appeal a decision 180 days in which to do so. Claimants also would have the right to request an initial six-month extension. Even more time would be allowed if mental or physical disability prevented a claimant from responding within the specified time.
“Shortening the current 1-year time period for appeals should have a minimum impact on claimants,” Reese said. “The average time it took the VA to receive a notice of disagreement (NOD) in 2008 was 41 days. In fact, 92 percent of NODs were received within the first six months of the rating decision.”
Among other important changes proposed by DAV is disbanding the VA Appeals Management Center, generally viewed as a failure because of its poor record of performance.
Finally, an administrative team would handle most functions not necessarily part of the claims process. This would free up resources that could be used specifically for claims processing, resulting in increased efficiency.
“Congress is now considering legislation to implement DAV’s claims processing initiative, and some people in key VA management positions have unofficially indicated a willingness to explore our recommendations,” said Washington Headquarters Executive Director David W. Gorman. “These recommendations are carefully aimed at making the claims process more efficient and dramatically reduce undue delays without sacrificing a single earned benefit.”
Editor’s Note: The DAV is organizing the first-ever Virtual March on Washington for Veterans. This online event has also been dubbed the “Million Claims March.” To learn how you can help advance the DAV’s 21st Century Claims Process and raise awareness of this issue and the many other issues now affecting veterans, join the march today at http://www.dav.org/VirtualMarch.
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