Friday, November 28th, 2014

The Obameter

Reduce the Veterans Benefits Administration claims backlog


"There are currently over 400,000 claims pending within the Veterans Benefits Administration, and over 800,000 claims receipts are expected in 2008 alone. … Obama will hire additional claims workers and convene our nation's leading veterans groups, employees and managers to develop an updated training and management model that will ensure that VA benefit decisions are rated fairly and consistently, and stem from adequate training and accountability for each claims adjudicator."


Updates

We note some progress, but the Veterans Benefits Administration claims backlog is still large

On the surface, President Barack Obama's promise to reduce the backlog in claims to the Veterans Benefits Administration appears a separate issue from the scandal that rocked the Veterans Affairs Department this summer.

The backlog refers to the number of claims — for disability compensation or pensions, or for compensation for veterans' surviving spouses and children — that have gone unanswered for more than 125 days. It's a long-standing problem that Obama promised to address during his 2008 campaign.

Meanwhile, the controversy that erupted this year started with a Phoenix VA office falsifying wait-time data to see a doctor. It turned out to be a system-wide problem in which VA employees lied about how quickly they saw patients to take advantage of a program that incentivized VA hospitals if they scheduled a primary care appointment within 14 days. The actual wait time at the Phoenix facility was 115 days.

While separate issues, the Phoenix scandal has shaken faith in the VA system and has left many wondering, veterans groups included, whether to trust other government data when it comes to veterans.

Here's what we know right now.

At the end of 2008, there were about 389,000 pending pension and compensation claims. About 87,000 had been pending for longer than 180 days (the benchmark was changed to 125 days during Obama's first term). In the years that followed, a decade of war ended and Iraq and Afghanistan veterans returned home. Additionally, some veterans who experienced complications from Agent Orange were now eligible for benefits. As a result, claims skyrocketed; 1.4 million claims were submitted in 2011 alone.

This flurry of new claims increased the backlog considerably. At the end of Obama's first year in office, there were 481,000 pending claims, of which 176,627, or 36.7 percent, were pending for more than 125 days and thus were considered part of the backlog.

Those numbers shot up as more claims were submitted. The backlog high came in March 2013 when 611,000 of the 884,000 claims were pending for longer than 125 days. It has since come down considerably. As of Nov. 8, about 240,000 of the 526,000 claims, or 46 percent, have been pending for longer than 125 days.

That number is still higher than what it was during Obama's first year in office, though it's down since the peak in 2013. The percentage of cases that have been pending longer than 125 days is also higher than it was in 2008, but again, it's an improvement from the worst of it.

So there's reason to believe things are heading in the right direction. However, veterans groups are concerned that the emphasis is on speed and not accuracy.

While the VA claims 95 percent of the claims are handled accurately, Zachary Hearn of the American Legion told Congress in December that 55 percent of cases they reviewed had errors. For example, Hearn noted that a regional office in Nashville had a 95 percent accuracy rating, but their own experts found errors in seven of 22 claims they reviewed.

"Our review paints a far dimmer picture of Nashville's accuracy than indicated in the Monday Morning Workload Report (from the Veterans Affairs Department)," Hearn said.

Hearn told the Washington Post in April that those concerns with accuracy still existed. Those complaints sound reminiscent of problems the VA experienced in Phoenix and elsewhere with wait times.

We'll be closely monitoring the numbers, and the result of new initiatives to better track and verify data reported by the various VA regional offices.

There are plenty of circumstances that explain the surge in new claims under this administration and the growth in the backlog. Significant progress has been demonstrated since claims hit their peak, and at the current pace it seems reasonable to believe that the administration will reach its goal of reducing the backlog before Obama leaves office.

However, right now the numbers say that the backlog remains higher than what it was during Obama's first year in office. That being the case, we're keeping this at Promise Broken.

Sources:

Email interview with Josh Taylor, spokesman for Veteran Affairs Department, Nov. 10, 2014

Washington Post, "Veterans Affairs' claims backlog down 44 percent since peaking one year ago," April 1, 2014

American Legion, "Legion challenges VA claims accuracy," Dec. 5, 2013

Email interview with Bob Norton, spokesman for the Military Officers Association of America, May 27, 2014

Veteran Affairs Department, "Claims Backlog," accessed Nov. 10, 2014

Veteran Affairs Department, "Claims Inventory," accessed Nov. 10, 2014

Veteran Affairs Department, "Detailed Claims Data," accessed Nov. 10, 2014

The Daily Beast, "Overtime, New Computer System Put Sizable Dent in VA Benefits Backlog," Nov. 11, 2013

Rated broken in 2012, wait times now back in the headlines

The last time we looked at this promise, in November 2012, we rated it Promise Broken.

The government has had a longstanding problem with handling benefits claims from veterans. We looked at documented wait times for disability compensation, pensions and compensation for surviving spouses or children of veterans who die because of their military service. While these aren't about waits to receive health care services, such claims are often health care-related.

We found a series of government oversight reports on the issue of wait times, which cited not only long lag times but also avoidable errors in rating claims. Officially, the backlog refers to benefit requests that go unaddressed by a government office within 125 days.    

We found that the backlog nearly doubled from roughly 36 percent in summer 2010 to 65 percent in June 2012. So not only did President Barack Obama not reduce the backlog, it grew after he took office.

Still, we noted then that Veterans Affairs was hiring more staff to rate claims and had shortened the average time to process a claim. Overall, though, the backlog got worse because there were more veterans coming home from Iraq and Afghanistan who were seeking benefits. For example, the number of claims jumped from 888,000 in 2008 to 1.4 million in 2011.

In 2014, journalists have uncovered stories about VA staff falsifying documentation about how long veterans are waiting for receiving health care in VA facilities. The story seems to be the same: A system overwhelmed by demand for services. Obama said on May 21 that he's waiting for findings from official investigations so he can take action.

Because of the allegations of falsifying information, we have questions about whether official numbers are trustworthy. In April, the Obama administration released numbers suggesting the backlog was shrinking, but veterans groups said they had serious concerns that the numbers weren't accurate.  

We'll be looking at this promise again in the coming months. For now, it remains Promise Broken.

Sources:

CNN, Veterans dying because of health care delays, Jan. 30, 2014

CNN, Phoenix VA officials put on leave after denial of secret wait list, May 1, 2014

Washington Post, As outrage over VA allegations grows, Obama and aides scramble to respond, May 20, 2014

Washington Post, A guide to the VA health care controversy, May 15, 2014

Washington Post, Veterans Affairs' backlog of claims down 44% since peaking a year ago, department says, April 1, 2014

U.S. House Committee on Veterans Affairs, Reclaiming the process: examining the VBA claims transformation plan as a means to effectively serve our veterans, Witness testimony of Gen. Allison Hickey, under secretary for benefits, U.S. Department of Veterans Affairs, June 19, 2012

Veterans Benefits Administration, Impact of VBA's new challenge training program, July 10, 2012

POLITICO, Veterans battle disability-claim backlog, Feb. 23, 2010

Federal News Radio, VA tackles claims backlog with new priority approach, July 11, 2012

U.S. Department of Veterans Affairs, VA report: new training model yields faster, more accurate claims processing, July 10, 2012

U.S. Department of Veterans Affairs, Strategic plan addendum fiscal year (FY) 2011‑2015, August 2012

The American Legion, VBMS: Silver bullet for claims backlog?, June 19, 2012

Government Accountability Office, Claims processing problems persist and major performance improvements may be difficult, May 26, 2005

Government Accountability Office, Preliminary Findings on Claims Processing Trends and Improvement Efforts, Statement of Daniel Bertoni, Director Education, Workforce, and Income Security, July 29, 2009

Veterans Benefits Administration, Understanding the disability claims process, (accessed Oct. 8, 2012)

Veterans claims backlog grew under Obama

During the 2008 election, Barack Obama courted veterans as a voting bloc. We've documented 14 campaign promises Obama made to them, from putting more money into U.S. Veterans Affairs to expanding housing vouchers for homeless veterans.

One such pledge was to reduce the benefits claims backlog.

The Veterans Benefits Administration, one of three branches of Veterans Affairs, reviews and grants requests for veterans to receive financial compensation, home loans, college tuition assistance and more through the federal government.

In a campaign document outlining his positions on veterans issues, Obama said he would reduce the backlog by hiring more staff to process benefits requests; he also pledged to convene the nation's veterans groups, employees and managers to improve the training those claims processors receive.

The process of reviewing claims has been the subject of repeated government oversight reports,  which inevitably cite long lag times and avoidable errors in rating claims. (Beyond deciding whether a veteran qualifies for a benefit, the processor must assign a rating that determines how big the benefit would be.)

The backlog refers to benefit requests that go unaddressed by a government office within 125 days. Although the Veterans Benefits Administration oversees an array of benefits, the backlog is shorthand for the bureaucratic bottleneck of claims for disability compensation, pensions and compensation for surviving spouses or children of veterans who die because of their military service.

The backlog nearly doubled from roughly 36 percent in summer 2010 to 65 percent in June 2012. In that sense, Obama has failed. The backlog grew after he took office.

Some context though: In the past four years, Veterans Affairs hired more than 2,500 new staff to rate claims and shortened the average time to process a claim by 16 percent since 2008. The backlog worsened because the expanded staff didn't keep pace with increased demand. A decade of war in Iraq and Afghanistan, new benefits made available to veterans and more medical conditions per veteran have resulted a dramatic increase in claims. The number of claims jumped from 888,000 in 2008 to 1.4 million in 2011.

Obama also promised improved training for staff that review claims. We found instances in 2010 and 2011 when the Veterans Benefits Administration revised its training program. Staff who received the new training seem to work quicker -- a July report from the administration said students of the new program finished more claims per day -- and with better accuracy -- compared with students of the older training model.

We did not find evidence of Obama convening a formal summit with the leaders of veterans groups to establish a new training and management model. However, the Veterans for Foreign Wars informed us that monthly meetings between the executive directors of six national veterans groups do occur, as do regular meetings between those groups and the under secretary for benefits at Veterans Affairs.

The progress on this promise is a mixed bag. Although he made modest improvements, he failed to keep up with the surge of applications. On the most important measurement of this promise -- the claims backlog -- things are worse. We rate this a Promise Broken.

Sources:

Email interview with Joshua Taylor, press secretary for Veterans Affairs, Sept. 28, 2012

Email interview with Terry Jemison, public affairs specialist for Veterans Affairs, Sept. 27, 2012

Interview with Gerald Manar, deputy director of the National Veterans Service at the Veterans of Foreign Wars (VFW), Oct. 2, 2012

U.S. House Committee on Veterans Affairs, Reclaiming the process: examining the VBA claims transformation plan as a means to effectively serve our veterans, Witness testimony of Gen. Allison Hickey, under secretary for benefits, U.S. Department of Veterans Affairs
June 19, 2012

Veterans Benefits Administration, Impact of VBA's new challenge training program, July 10, 2012

POLITICO, Veterans battle disability-claim backlog, Feb. 23, 2010

Federal News Radio, VA tackles claims backlog with new priority approach, July 11, 2012

U.S. Department of Veterans Affairs, VA report: new training model yields faster, more accurate claims processing, July 10, 2012

U.S. Department of Veterans Affairs, Strategic plan addendum fiscal year (FY) 2011‑2015, August 2012

The American Legion, VBMS: Silver bullet for claims backlog?, June 19, 2012

Government Accountability Office, Claims processing problems persist and major performance improvements may be difficult, May 26, 2005

Government Accountability Office, Preliminary Findings on Claims Processing Trends and Improvement Efforts, Statement of Daniel Bertoni, Director Education, Workforce, and Income Security, July 29, 2009

Veterans Benefits Administration, Understanding the disability claims process, (accessed Oct. 8, 2012)

Veterans Benefits Administration, VA claims transformation, (accessed Oct. 8, 2012)

The New York Times, Veterans wait for benefits as claims pile up, Sept. 27, 2012

The Bay Citizen, Disabled vets stuck in backlog limbo, accessed Aug. 29, 2012

BarackObama.com, Fulfilling a sacred trust with our veterans, Reduce the claims backlog

Shinseki says more claims workers will be hired this year


President Obama appointed retired U.S. Army Gen. Eric Shinseki as secretary of veterans affairs, and Shinseki was confirmed on Jan. 20, 2009.

He testified before the House Committee on Veterans Affairs on Feb. 4 and outlined several initiatives his office was tackling, including reducing the backlog in claims.

"Let me just give you a picture of what the disability claims process looks like," Shinseki said. "If you were to walk into one of our rooms where adjudication or decisions are being made about disability for veterans, you would see individuals sitting at a desk with stacks of paper that go up halfway to the ceiling. And as they finish one pile another pile comes in. There are 11,100 people doing this today for the Veterans Affairs Department, good people. Hard to do this rather challenging job in which they're trying to apply judgment to situations that occurred years ago and, in some cases, situations that they don't have the full appreciation for the context of combat. ... In the last two years we've hired 4,000 additional adjudicators. This year we're hiring another 1,100 to address the backlog problem.

"In my opinion, this is a brute force solution and we need to very quickly take this into an IT format that allows us to do timely, accurate, consistent decisionmaking on behalf of our veterans. And this is part of what the backlog is about," Shinseki said.

Shinseki then discussed in detail the challenges and logistics of improving the VA's electronic records system.

So reducing the claims backlog is on Shinseki's "to do" list, and his plans to hire 1,100 additional workers is enough for us to move the Obameter to In the Works.

Sources:

CQ.com, House Veterans Affairs Committee Holds Hearing to Organize for the 111th Congress and on the State of the Veterans Affairs Department, Feb. 4. 2009

House Committee on Veterans Affairs, Hearing , Feb. 4, 2009

Veterans Affairs, Shinseki biography , accessed Feb. 10, 2009