Here’s what caused the enormous claims backlog at VA

With the backlog of compensation claims at the Department of Veterans Affairs having ballooned in recent years, one would expect major veterans service organizations to be among the VA’s harshest critics.

If so, they would join a rising chorus. Recently network news programs have turned cameras and commentary on the mountain of 598,000 overdue claim decisions pending, suggesting bureaucratic neglect of returning ill and injured vets from Iraq and Afghanistan. Time magazine columnist Joe Klein even asked VA Secretary Eric Shinseki to resign.

One veteran association, Iraq and Afghanistan Veterans of America (IAVA), says the administration isn’t doing near enough to end the backlog, with an average wait, from filing to decision, now at 273 days and some veterans in the largest cities reportedly waiting more than 600 days.

But most veteran service organizations aren’t joining that chorus, for perhaps two major reasons. One, they believe they understand better than the loudest critics why the backlog has grown so: some contributing factors these veterans’ groups actually fought for.

Two, criticism of Shinseki and his team rings hollow to many veteran groups given the administration’s support over the past four years for robust funding of VA, unprecedented cooperation with vet advocates and the depth of its commitment to reform a 20th century paper-driven claims process.

That’s why groups including Veterans of Foreign Wars and the American Legion came to Shinseki’s defense after Klein’s call to resign. That’s why Joseph Violante, legislative director of Disabled American Veterans, told the Senate Veterans Affairs Committee that VA is moving “down the right path” with many of its reform plans even while “processing over a million claims annually, which in my mind is something phenomenal.”

Violante described VA leadership as the most open he has seen in almost 30 years of working veterans issues in Washington, D.C. He had particular praise for Allison A. Hickey, under secretary for benefits.

At the same hearing, Bart Stichman, executive director of the National Veterans Legal Services Program, praised Shinseki. The NVLSP successfully has sued VA, initially more than 20 years ago, to compensate Vietnam veterans for diseases presumed caused by wartime exposure to herbicides including Agent Orange. Stichman said Shinseki showed courage when, facing a rising claims backlog in 2009, he added three new diseases to VA’s list of diseases for which compensation can be granted to Vietnam veterans due to Agent Orange.

This required VA to re-adjudicate 150,000 claims previously denied and to process more than 100,000 fresh claims from Vietnam veterans, including for most anyone with heart disease who ever served in Vietnam. The Veterans Benefits Administration put more than 2300 experienced claims staff — 37 percent of its workforce — on the effort for two and a half years, paying out more than $4.5 billion in retroactive benefits.

“While the decision was absolutely the right thing to do,” Hickey said, “it did have an impact on our ability to keep up with news claims coming in and on aging claims already in the system.”

One of Klein’s criticisms is that VA should be giving priority to claims from returning Iraq and Afghanistan veterans versus the steady stream of “supplemental” claims from older generations seeking to upgrade ratings.

One factor encouraging supplemental claims from military retirees is Congress’ decision to lift the ban on concurrent receipt of both retired pay and VA disability compensation for retirees with ratings of 50 percent or higher. That threshold encourages some to file again and again for reconsideration given the financial stakes. Until a retiree is rated 50 percent disabled, their retired pay is offset dollar for dollar by VA disability compensation.

VA claims data give some credence to Klein’s argument because 52 percent of the current backlog is veterans who had an earlier claim decided in the past five years. But critics also should note only 20 percent of backlogged claims are from Iraq and Afghanistan vets. Vietnam veterans represent 37 percent, 1991 Gulf War veterans 23 percent and 20 percent are claims from World War II, Korean War and peacetime-era veterans.

Hickey pointed to several developments that should allow VA to reach its two goals of eliminating the backlog by 2015 and raising the quality of claim decisions to an average accuracy rate of 98 percent, up from 86 percent in 2012. One is electronic claim processing through the Veterans Benefits Management System (VBMS), which will be operating at all 56 regional offices by December. Hickey said this will result in faster and more accurate claim decisions, in the same way automation was used to end long waits for payments under the new Post-9/11 GI Bill.

Also, military services now have teams collecting for the VA service and medical records, including from Tricare civilian physicians, for former service members filing claims. And these teams are certifying to VA that filed are complete and accurate. “That is a game changer,” Hickey said.

VA continues a massive project of scanning into computers all paper claims so that adjudicators can use Google-like searches rather than physically flipping pages, to verify information. And VA also has established quality review teams at every regional office to monitor claims processing in real time to catch and correct errors before decisions become final.

All of this is encouraging the support of most veteran groups. But the political pressure on VA remains intense, and the generational rift among advocates likely won’t ease until the backlog is in full retreat.

Joseph Thompson, who formerly held Hickey’s job as VA benefits chief, told senators that, for VA to meet its ambitious goals for 2015, every one its many initiatives must succeed, which is an unlikely outcome. The quantity of claims, the unproven technology solutions and the vast number of other initiatives working, Thompson said, “is the heaviest lift I can imagine.”

What VA needs most, Thompson said, “are more people … thousands more.” That is one initiative that Hickey said VA isn’t yet ready to embrace.

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