[House Hearing, 112 Congress]
[From the U.S. Government Publishing Office]
BREAKING THROUGH THE BACKLOG:
EVALUATING THE EFFECTIVENESS OF THE
NEW STATE STRIKE FORCE TEAM
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DISABILITY ASSISTANCE
AND MEMORIAL AFFAIRS
of the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED TWELFTH CONGRESS
SECOND SESSION
__________
FRIDAY, SEPTEMBER 21, 2012
__________
Serial No. 112-78
__________
Printed for the use of the Committee on Veterans' Affairs
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COMMITTEE ON VETERANS' AFFAIRS
JEFF MILLER, Florida, Chairman
CLIFF STEARNS, Florida BOB FILNER, California, Ranking
DOUG LAMBORN, Colorado CORRINE BROWN, Florida
GUS M. BILIRAKIS, Florida SILVESTRE REYES, Texas
DAVID P. ROE, Tennessee MICHAEL H. MICHAUD, Maine
MARLIN A. STUTZMAN, Indiana LINDA T. SANCHEZ, California
BILL FLORES, Texas BRUCE L. BRALEY, Iowa
BILL JOHNSON, Ohio JERRY McNERNEY, California
JEFF DENHAM, California JOE DONNELLY, Indiana
JON RUNYAN, New Jersey TIMOTHY J. WALZ, Minnesota
DAN BENISHEK, Michigan JOHN BARROW, Georgia
ANN MARIE BUERKLE, New York RUSS CARNAHAN, Missouri
TIM HUELSKAMP, Kansas
MARK E. AMODEI, Nevada
ROBERT L. TURNER, New York
Helen W. Tolar, Staff Director and Chief Counsel
______
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
JON RUNYAN, New Jersey, Chairman
DOUG LAMBORN, Colorado JERRY McNERNEY, California,
ANN MARIE BUERKLE, New York Ranking
MARLIN A. STUTZMAN, Indiana JOHN BARROW, Georgia
ROBERT L. TURNER, New York MICHAEL H. MICHAUD, Maine
TIMOTHY J. WALZ, Minnesota
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
__________
September 21, 2012
Page
Breaking Through The Backlog: Evaluating The Effectiveness of The
New State Strike Force Team.................................... 1
OPENING STATEMENTS
Chairman Jon Runyan.............................................. 1
Prepared Statement of Chairman Runyan........................ 22
Hon. Jerry McNerney, Ranking Democratic Member................... 2
Hon. Bill Flores................................................. 4
WITNESSES
Mr. Eliseo ``Al'' Cantu, Jr., Chair, Texas Veterans Commission... 5
Prepared Statement of Mr. Cantu, Jr.......................... 22
Mr. James O. Richman, Director, Claims Representation and
Counseling, Texas Veterans Commission.......................... 7
Prepared Statement of Mr. Richman............................ 24
Mr. Steve Hernandez, County Veterans Service Officer, McLennan
County, Texas.................................................. 8
Prepared Statement of Mr. Hernandez.......................... 26
Ms. Diana Rubens, Deputy Under Secretary for Field Operations,
Veterans Benefits Administration, United States Department of
Veterans Affairs............................................... 15
Prepared Statement of Mrs. Rubens............................ 27
Accompanied by:
Mr. John Limpose, Director, Waco Regional Office, Veterans
Benefits Administration, United States Department of
Veterans Affairs
QUESTIONS FOR THE RECORD
Hon. Jon Runyan, Chairman, Subcommittee on Disability Assistance
and Memorial Affairs to Ms. Diana Rubens, Deputy Under
Secretary for Field Operations:................................ 30
BREAKING THROUGH THE BACKLOG:
EVALUATING THE EFFECTIVENESS OF THE NEW STATE STRIKE FORCE TEAM
----------
Friday, September 21, 2012
U.S. House of Representatives,
Committee on Veterans' Affairs,
Subcommittee on Disability Assistance
and Memorial Affairs,
Washington, D.C.
The Subcommittee met, pursuant to notice, at 10:00 a.m., in
Room 334, Cannon House Office Building, Hon. Jon Runyan
[Chairman of the Subcommittee] presiding.
Present: Representatives Runyan, McNerney, Barrow, and
Waltz.
Also Present: Representative Flores.
OPENING STATEMENT OF CHAIRMAN JON RUNYAN
Mr. Runyan. Good morning and welcome, everyone. This
oversight hearing of the Subcommittee on Disability Assistance
and Memorial Affairs will now come to order.
As is often the case when this Subcommittee convenes, we
are here to discuss the backlog of veterans disability benefits
claims. Unfortunately, when such a discussion takes place, we
often find ourselves having the same discussion over and over.
Frustrated veterans want to know why it takes so long to
process their claim; frustrated lawmakers want to know why the
backlog keeps increasing; and frustrated VA employees want
everyone to know what the folks on the front lines are doing,
that they are doing the best they can to try to keep up with
the increasing amount of claims. However, every so often we
have an idea that is interjected into the discussion, and we
are here today to discuss one such idea.
In 2009, the State of Texas created a Claims Processing
Assistance Team that helped reduce pending claims at the
State's two regional offices, or ROs, in Waco and Houston. Four
hundred thousand dollars was allocated toward a dozen employees
over several months. Those employees reduced the number of
pending claims in Waco and Houston by 17,000. Despite this
success, the situation has since worsened for veterans not only
in Texas but across the country as the amount of pending claims
has doubled since that time.
As a recent Center for Investigative Reporting study
reveals, the impact of the backlog varies by region. The study
finds that veterans in sparsely populated States often have
their benefit claims processed faster than those in more
populated States. In addition to this study, the media has also
been paying close attention to veterans who must wait the
longest to receive their benefits, which are veterans in Texas,
and, as is well-known to the Ranking Member Mr. McNerney,
veterans in California. But the fact remains no matter where
the veteran is located, more often than not the veteran is
waiting too long to receive their benefits decision.
Once again, taking action into their own hands in late July
of this year, the Texas State legislature created a State
Strike Force Team led by the Texas Veterans Commission. This
time they have allocated $1.5 million and 16 full-time
employees. The goal of the State Strike Force Team is to assist
veterans and their families in receiving disability
compensation and pension payments earlier than expected.
Specifically, eight claims counselors will be located at
both the Waco and Houston regional offices to help process
claims. There will also be fully developed claims teams located
throughout the State to improve access to and assist veterans
with fully developed claims. By examining this process today we
are hoping that the State Strike Force Team will serve as a
model to other States and perhaps even lead to the creation of
a similar Federal Strike Force Team.
I want to thank the VA, the Texas Veterans Commission, and
Mr. Hernandez for their valuable input as we work together to
find important solutions to the growing backlogs of claims. I
welcome today's witnesses to continue this ongoing discussion
and offer their own specific recommendations on how to improve
the current system of processing veterans' disability claims.
At this time I would like to welcome Mr. Flores to our
hearing. Although he is not a member of the Subcommittee, he is
a member of the full Committee.
At this time I would like to yield to Ranking Member, Mr.
McNerney, for any opening statement he might have.
[The statement of Jon Runyan appears in the Appendix]
OPENING STATEMENT OF HON. JERRY MCNERNEY, RANKING DEMOCRATIC
MEMBER
Mr. McNerney. Well, thank you, Mr. Chairman, for holding
today's hearing on possible ways to address the VA's mounting
backlog of claims and appeals. Today over 1.3 million claims
and appeals are jammed in a flawed processing system and in an
organization with a current management culture that often
overemphasizes production over quality. It is our collective
quest to vanquish BVA's backlog of claims and appeals, which as
I mentioned previously, currently exceeds 1 million. It is my
hope that we can improve the performance of the system as a
whole while ensuring accurate and accountable claims outcomes
for our veterans.
Since 2007, the VBA has added over 10,000 claims processing
personnel and Congress has funded these requests. Yet the
backlog still climbs. Merely adding more people to the same
broken system does not expedite benefits to veterans and their
families. We need to continue to look at the system with fresh
eyes to help the VA with managing its claims processing
mission.
As the VA OIG recently concluded in its report after
inspection reviews of 16 VA ROs, the VBA is processing 23
percent of its claims erroneously. To change this, the VA OIG
recommended that VA needs to enhance policy guidance,
compliance, workload management, training and supervisory
review in order to improve claims processing operations.
These conclusions echo many of the provisions of the
Veterans Benefits Improvement Act of 2008, P.L. 110-389, as
well as the continued course from Congress and other
stakeholders that say time and again that the backlog is just a
symptom of a much larger problem. The current system is broken
and in need of a major overhaul. We need to focus on getting
the claims right the first time.
Today we have representatives here from the Texas Veterans
Commission (TVC), and I welcome you here this morning. TVC has
hired employees to create strike force teams out of the monies
from State coffers. These teams are working side-by-side with
VA employees to help process claims. The Waco and Houston Texas
regional offices that serve these veterans are considered
underperforming by the VA's own standards, where wait times
exceed the national averages.
I know that in California, particularly in the Oakland and
Los Angeles regional offices, we are experiencing similar
extraordinary wait times for claims decisions, including
lengthy work stoppages, which means delays will only increase.
As a Representative from the State with the most veterans per
capita, I agree that we need to come up with solutions that put
veterans first, and this is what the VA is not doing enough of.
There is no shortage of getting around the basics of having
well-trained employees who are empowered with the right tools
and the right systems to get the job done the first time. We
need claims done right the first time, as if a do-over was not
an option, and that is why I still remain concerned that the
work credit system may not keep the focus on the veterans but
rather on churning out more work.
We have veterans committing suicide in shameful numbers.
The most recent figure is 18 veterans per day. That is one
veteran every 80 minutes, over 6,500 a year. That means that
before this hearing is over, a veteran may take his or her
life. That breaks my heart. Having a system like the current
claims processing system where over 65 percent of claims are in
backlog also breaks my heart, with many veterans and families
suffering while waiting for a decision.
We need to get this right so that no claims are languishing
and veterans, their families and survivors get the benefits
that they have earned and deserve without delay.
With this in mind, I look forward to the hearing, I thank
the Chairman and I yield back.
Mr. Runyan. I thank the gentleman. At this time I would
like to ask unanimous consent that Mr. Flores be able to sit in
on the Committee and participate and ask questions. Hearing no
objection, so ordered.
I would also at this time like to ask any of the members, I
know Mr. Flores has an opening statement he would like to make,
but do any of the other members wish to?
If not, with that, Mr. Flores, you are now recognized.
OPENING STATEMENT OF HON. BILL FLORES
Mr. Flores. Thank you, Chairman Runyan and Ranking Member
McNerney, for allowing me to be part of this important hearing
today.
I think it is important that we hold this hearing so that
we can take a closer look at this issue, which is important not
only to veterans living in Texas, but also to veterans across
this country. The growing problem with processing disability
claims that the Department of Veterans Affairs faces in serving
Texas veterans is merely a microcosm of a problem at large that
our veterans face around the country today.
Unfortunately, Mr. Chairman, Texas is only one example of
the glaring problems and service trials our veterans are facing
throughout the country. It is also important that we work
through the problems within our VA and implement a flawless
claims processing system for our Nation's veterans.
I am concerned about the VA claims issue, particularly
those at the Waco VARO, which is in my district. I appreciate
the fact that the VA has appointed a new director to the Waco
VARO to address this issue. I have met with Director Limpose
and I am pleased with his efforts thus far and his commitment
in particular to address the Waco backlog claims. He and I have
agreed to meet again in late November or early December to
follow up on his progress.
I applaud Texas Governor Rick Perry, Texas Lieutenant
Governor David Dewhurst, Speaker Joe Straus and the leadership
of the Texas Veterans Commission for committing valuable State
resources to help address this issue by creating the Texas
State Strike Force--that is a lot of vowels to say at one
time--Texas State Strike Force Team and for being proactive to
help our Nation's veterans. I appreciate Mr. Cantu and Mr.
Richman for agreeing to testify today.
I suggested that Mr. Hernandez be allowed to speak at this
hearing. The reason for that is we are going to hear a lot of
numbers today. We are going to hear about claims backlogs and
the claims delays and the time to process claims. But behind
every one of those numbers is the face of a veteran and Mr.
Hernandez can help put a face on each of those numbers. So I
think his testimony will be valuable.
In my district in McLennan County, which is the home of the
Waco VARO, we have tens of thousands of veterans, given that we
are a neighbor to Fort Hood, the largest Army base in the
country.
Mr. Hernandez has a quote in his testimony that I think is
particularly poignant, and it says this: ``The effects of the
prolonged backlog are affecting the veteran in the most adverse
way. If the data is possible, I am certain it would be a
travesty to know how the backlog has affected veteran
homelessness, relationships, crime, addiction, mental health,
and suicides. The prolonged wait on claims decisions cannot be
productive on our society and unfortunately will continue to
lead to social problems at the national level. A sad and
embarrassing end to the dedicated patriots who have braved
austere conditions, family separation, traumatic experiences,
and multiple deployments to provide us with the freedom and the
liberty as a free society.''
That is what we need to think about. Behind every number
that we talk about today is the face of a veteran.
Before I close I think it is important that we as a
Committee and we as a Congress think outside the box and think
about solutions. I personally could care less about the
bureaucracy. I care about the veterans. Our goal ought to be as
a Congress and as a Nation to deliver the benefits to the
veterans. So whatever it takes, and if it takes thinking
outside the box, let's think about how we do that to take care
of the veterans versus taking care of the bureaucracy.
Thank you, Mr. Chairman. I yield back.
Mr. Runyan. I thank the gentleman.
At this time I would like to welcome our first panel to the
witness table. We will be hearing from Al Cantu, the Chair of
the Texas Veterans Commission. Next we will hear from James
Richman, the Director of Claims Representation and Counseling
with the Texas Veterans Commission. And our final witness on
this panel will be Mr. Steve Hernandez, the McLennan County
Veterans Service Officer.
Your complete and written statements will be entered into
the hearing record. Mr. Cantu, you are now recognized for 5
minutes for your oral statement.
STATEMENTS OF ELISEO ``AL'' CANTU, JR., CHAIR, TEXAS VETERANS
COMMISSION; JAMES O. RICHARDSON, DIRECTOR, CLAIMS
REPRESENTATION AND COUNSELING, TEXAS VETERANS COMMISSION; AND
STEVE HERNANDEZ, COUNTY VETERANS SERVICE OFFICER, MCLENNAN
COUNTY, TEXAS
STATEMENT OF ELISEO ``AL'' CANTU, JR.
Mr. Cantu. Good morning, Mr. Chairman Runyan, Ranking
Member McNerney, and members of the Subcommittee. For the
record, my name is Eliseo ``Al'' Cantu, Jr., Chair of the Texas
Veterans Commission. I am humbled by the invitation to testify
before you today on behalf of the Texas Veterans Commission. I
would like to thank the Subcommittee for this opportunity and
for your interest in the efforts the State of Texas has
undertaken to serve its 1.7 million veterans.
I am accompanied today by Mr. Jim Richman, Director of the
Texas Veterans Commission's Claims Representation and
Counseling Program. Mr. Richman has been with the agency for
over 25 years.
My testimony today will provide you with some background
information regarding Texas' State Strike Force and Fully
Developed Claims Teams Initiative directed by the State leaders
this past July. Mr. Richman's testimony will provide you with
the details of the initiative and an update on our progress and
our keys to success.
The Texas Veterans Commission is the veterans advocacy
agency for the State of Texas. Our mission is to advocate for
and provide superior service to veterans through four programs:
Claims representation and counseling; veterans employment
services; veterans education; and the Fund For Veterans'
Assistance that will significantly improve the quality of life
for all Texas veterans, their families, survivors and spouses.
No other State has centralized all of these program areas
within their State's veterans agency. Texas is becoming
recognized for aggressively leading on veterans issues.
National leaders have referred to the Texas model when
advocating for the integration of veterans services.
Texas Veterans Commission's Claims Representation and
Counseling Program assists veterans prepare compensation and
pension claims with the United States Department of Veterans
Affairs. In 2011, our claims counselors handled 179,981 benefit
claims on behalf of our veterans and dependents, filed 125,000-
plus monetary claims and 16,000-plus new appeals.
In November 2009, Governor Rick Perry and the State
Veterans Commission launched a special Claims Processing
Assistance Team to assist veterans who had their claims for
monetary benefits pending with our two VA regional offices in
Waco and Houston, Texas. This project built upon the succession
of a pilot project between the Texas Veterans Commission and
the VA in 2008.
At the time the CPAT project was announced, a total pending
caseload of 39,000 Federal benefit claims existed in Texas' two
VA regional offices. These CPAT teams consisted of 12
additional claims counselors, six at each office. They targeted
specific areas within the claims process, doing all development
needed on the individual's claim and working directly with the
claimants in identifying and acquiring necessary evidence. The
project was funded for the period November 2009 to July 2011.
In that time, the special CPAT teams returned to the VA 17,000-
plus cases ready for decision or award action.
Since that time, the situation has become worse. On July
16, 2012, the Commission testified before the State Senate
Veterans Affairs and Military Installation Committee regarding
the state of backlog in Texas. According to the VA, in January
2010 the total pending caseload in Texas was 59,000 plus claims
and 15,000 plus appeals. The number of cases that had been
pending for over 125 days, which is what the VA considers
backlog, was 16,800 claims. On July 14, 2012, the total pending
caseload in Texas was 107,000-plus claims and 28,000-plus
appeals. The number of cases that have been pending for over
125 days was 68,612 claims. The backlog has more than
quadrupled from 2010 to present. Presently the real world
average for getting a decision from VA is 18 to 24 months.
Following the hearing, the Governor, Lieutenant Governor
and House Speaker Straus directed the Texas Veterans Commission
to implement a team and a force to get behind eliminating the
backlog. The State of Texas committed over $100,000 from the
first pass and $1.5 million in 2012-2013 biennium to address
the backlog of claims. The teams will be working on both ends
of the claim process to ensure that the backlog is removed or
brought down. We make sure that all the claims are processed
and all the information is available. We work directly with the
claimant. And we hope to be able to reduce the backlog in Texas
by 17,000 claims.
Mr. Richman is going to share with you how his team will
make that goal a reality.
Again I want to thank you for the opportunity to testify
before you today. Thank you for the work the Committee is doing
and will do on behalf of the Texas veterans and all veterans of
this Nation's Armed Forces.
Thank you, sir.
[The statement of Eliseo ``Al'' Cantu appears in the
Appendix]
Mr. Runyan. Thank you, Mr. Cantu.
Mr. Richman, you are now recognized.
STATEMENT OF JAMES O. RICHMAN
Mr. Richman. Good morning, Chairman Runyan, Ranking Member
McNerney, and members of the Subcommittee. I am Jim Richman. I
am the Texas Veterans Commission Director of Claims
Representation and Counseling and it is truly a privilege to
serve in that capacity. This morning I will provide you with
the details of the Texas Veterans Strike Force Team and the
Fully Developed Claims Team and provide an update at only one
month into the project and highlight some keys to successful
implementation.
As soon as the direction came this past July from Governor
Rick Perry, Lieutenant Governor David Dewhurst, and House
Speaker Joe Straus to reinstate a form of this initiative, we
began building two separate teams. We expanded on the old
method.
First, there are two State Strike Force Teams, one in Waco
and one in Houston. Rather than talk about what we have already
said, I am going to tell you what they are going to do. These
16 members will take cases that are over 125 days old and not
only identify the development that still needs to be done, but
actually accomplish that development with the intention of
handing it back to the VA completely ready to rate.
The Fully Developed Claims Teams, if you consider the
Strike Force Team working on cases over 125 days old and the
Fully Developed Teams working at the front end of the process
to make sure that every claim that can possibly fit the Fully
Developed Claim Initiative is done so, then we are working both
ends against the middle. We feel like this is a very needed
addition to what we have done in the past in certain projects.
The update, within days of the State leaders' authorization
of the teams, we posted the positions. We now have filled all
of those positions in the initiative, and those hires include
personnel with significant VA claims experience, including
former and retired VA and TVC employees with a total combined
experience with the VA claims process of over 700 years. This
is critical in the success of this program. We have returning
to work a former TVC Waco regional director, we have a VA
former assistant service manager, a hearing officer, numerous
decision review officers, VSRs, RVSRs and coaches.
During this initial period lead TVC and VA personnel have
been working together very closely to create a standard
operating procedure. I would like to point out with no
absolute, with all certainty, that Area Director Beth McCoy,
Houston Director Pritz Navaratnasingam and Waco Director John
Limpose and their staffs have completely bought into what we
can accomplish with this endeavor. Both VA regional offices in
Waco and Houston have provided TVC with additional space,
training materials and the logistical support that we need to
cooperate in this endeavor and make it truly successful.
Are we cooperating with the VA or coordinating with the VA
and assisting the VA, helping the VA? Absolutely, yes we are.
But our mission in this endeavor is to improve the timeliness
and get veterans and their families the benefits they have
earned and very desperately need, especially in this economy.
As of Monday, September 17th, members of the State Strike
Force Teams have reviewed 2,525 cases. I would like to bring to
your attention, this is in the first month of operation while
we are even hiring up. Of those backlogged claims, identifying
and executing all required additional development, they have
already delivered to the VA 852 claims fully developed and
ready to rate.
Mr. Chairman, we have identified the keys to success,
because to coin a phrase, this ain't our first rodeo based on
those two previous projects, and there are several essential
elements required for the successful implementation of these or
like initiatives: Complete support from the VA regional offices
involved, which we have all the way from upper management down.
The individuals hired to staff such an initiative must be
experienced with the VA's claim process. This is imperative.
Any initiative should utilize identified best practices for
claims development and dedicated funding to support the
initiative for a set period of time in order to realize
meaningful reduction of the backlog.
In closing, I would like to thank the Subcommittee for the
opportunity to share this information with you, the State
leaders that have provided TVC with the opportunity to make a
tangible difference in the lives of veterans in the State of
Texas, and TVC has demonstrated the capability to have a
positive impact on this issue twice before.
I mean absolutely no disrespect by what I am fixing to say,
because the VA is full of hard-working, dedicated, well-
intentioned people, but the backlog has been talked about for
so long and has continued to grow that the VA has become
institutionally desensitized to the backlog. Make no mistake,
the veterans are not desensitized to the backlog and to the
timeliness of claims.
We hope with the support of this Subcommittee and Federal
funding, we believe that Texas and other States have the
capability to successfully replicate and implement similar
initiatives. Like those famous Texans who drew a line in the
sand at the Alamo, Governor Perry, Lieutenant Governor
Dewhurst, and Speaker Straus have drawn a line in the sand
regarding the backlog of claims in Texas and say ``no more.''
The Texas Veterans Commission is making a difference now
because the veterans we serve already did.
Thank you for your time, sir.
[The statement of James O. Richman appears in the Appendix]
Mr. Runyan. Thank you, Mr. Richman.
I now recognize Mr. Hernandez for his statement.
STATEMENT OF STEVE HERNANDEZ
Mr. Hernandez. Thank you, sir.
Mr. Chairman, Ranking Member McNerney, members of the
Subcommittee, my name is Steve Hernandez. I am the McLennan
County Veterans Service Officer located in Waco, Texas. On
behalf of the Veteran Community of Texas, the Veteran Community
of Central Texas, the citizens of McLennan County, the
Commissioner's Court of McLennan County and the McLennan County
Veterans Service Office, thank you for allowing me to provide
testimony on this very important issue that is affecting the
Nation, the chronic backlog of benefit claims form our Nation's
veterans.
As you are well aware, nationally benefit claims submitted
to the Veterans Affairs Regional Office have increased
dramatically. We attribute the influx to an increased average
of single digit to double digit individual disability claim
submittals, economic stagnation, employment difficulties,
issues involving social reintegration, and a continued stream
of past era veterans submitting claims for the first time or
resubmitting previously denied claims, just to mention a few.
Unfortunately, from the regional perspective, the Waco VA
Regional Office has been identified as the worst of the 57
regional offices under the ASPIRE database. Because of this
dubious distinction the Waco Regional Office is under intense
scrutiny for the backlog and discussions continue on how the
Federal Government can resolve this dilemma.
Realizing the economic benefit in breaking through the
backlog and the catastrophic condition under the current
Federal system, State leaders have authorized the State veteran
component of the Texas Veterans Commission to dedicate State
assets to assist with the backlog claims with a commitment of
$1.5 million Teams--for the State Strike Force Teams. I am
having the same trouble you were, Congressman--a team of
counselors who will assist in fully developed claims as well as
assisting in claims assistance and development.
To fully understand the Waco VA Regional Office's dismal
performance requires an in-depth evaluation on the causes for
such a backlog. The major cause for the spike in the backlog
has been the Nehmer claims as well as the most recent
presumptive Agent Orange illnesses, illnesses that have been
long overdue in recognition.
The Federal directive posed on the VA regional office as a
responsible party on Nehmer death claims has proved to be a
daunting task. Not only were there 40,000 more claims added to
the operation for decision, but the award distribution became
extremely complex as these claims involved estate succession
that proved unprecedented like never before in deciding the
rightful beneficiaries.
In evaluating the backlog at the grassroots level,
eliminating the claims backlog will require what hopefully will
be a short-term commitment from States that have the ability to
supplement State assets to assist in claims processing. The
investment should yield an equitable rate of return for the
State economy. Also the local private sector could become more
involved as community partners in creating one-stop shops
utilizing Federal, State and private funds and grants in
assisting in the diagnosis of certain specialized claims that
could relieve the decision process and the backlog also being
experienced by the VA's health care system. The Veterans
Benefit Management System must also be a priority in the
development of advancing into the 21st century with new
technology. The continued review of evaluating the
effectiveness of the rating schedule diagnostics codes also
should be considered.
As a local Veterans Service Officer, I am the recipient of
direct public contact from the veterans who are being
confronted with life challenges as they await word on the
status of their claim. The level of frustration, the coded
threatened innuendoes, some uncontrolled anger outbursts,
misunderstanding and the system confusion on the process, and
dire economic need are the most common and frantic interactions
that I have with the veteran while waiting on the decision. The
most disheartening part of the prolonged process is that they
could potentially be denied, which is a reality. Many have
invested their future on the decision while waiting, leaving
many with few alternatives but to become further dependent on
other VA programs.
The effects of prolonged backlog are affecting the veteran
in the most adverse way. If the data is possible, I am certain
it would be a travesty to know how the backlog has affected
veteran homelessness, relationships, crime, addiction and
mental health and suicides. The prolonged wait on claim
decisions cannot be productive on our society, and,
unfortunately, will continue to lead us into social problems at
the national level. A sad and embarrassing end to the dedicated
patriots who have braved austere conditions, family separation,
traumatic experiences and multiple deployments to provide us
the freedom and liberty as a free society.
Thank you.
[The statement of Steve Hernandez appears in the Appendix]
Mr. Runyan. Thank you, Mr. Hernandez. With that, I will
begin the first round of questions.
Touching on what you, Mr. Hernandez, and Mr. Richman
alluded to, I forget the exact words you used, but you are
talking about the institution in general being callous to what
is going on. I just wanted to really give you the opportunity--
I would think you would say the Strike Force has truly done a
good job in assisting veterans. Could you put a personal face
to that, a faster decision or more accurate decision and the
outcome of that that the Strike Force has really accomplished
and put a personal face to it?
Mr. Richman. Yes, sir. When the vets come back and they are
discharged, they are facing some of the most important times of
their lives. They are trying to come back home, resocialize
into civilian society, care for their families, get jobs, get
education or training. No reasonable thinking individual being
the vet coming back and filing for injuries that were incurred
in service, taking 2 years to get an answer and their
compensation for those conditions. This is making the life
struggle more and more difficult every day. So that is what we
want to work on with the Fully Developed Teams, is to get every
possible claim that is fully developed into the fully developed
claims process and then my staff, the team will work with
keeping it in the track to make sure that the time period of
processing is as short as possible.
Then with the Strike Force Teams, they are reviewing the
older cases that are 125 days old or more, and many of them, in
Waco for example, because of the Nehmer cases, hundreds if not
thousands of cases are 730 days old. They have a flash on them.
And they are working those as feverishly as possible. But that
is a long time to wait for an answer on monetary benefits, sir.
Mr. Runyan. Talking about part of the problem, do you
really think lack of access to the records slows down the
process? I know Congressman Walz and myself had a piece of
legislation just on the floor the other day actually to really
address that. But do you see that as a hurdle, just lack of
access to the information?
Mr. Richman. Sir, development is one of the toughest parts
of the entire claim process and anything we can do to get the
VA quicker access to whatever records and documents from DOD,
their service treatment records, all of those things can do
nothing but improve the situation.
Mr. Runyan. Do you have any suggestions through your
experience as to how to make that process a little faster?
Mr. Richman. Sir, the bureaucracy is substantial.
Mr. Runyan. Understood.
Mr. Richman. That is too long of an answer to address in
this setting.
Mr. Runyan. Thank you. Mr. Cantu, can you talk about the
level of cooperation you have received from the VA employees
and the RO, do you see the same level of cooperation with the
Strike Force Team to the VA central office? Talk about each
level and if there is uniform cooperation.
Mr. Cantu. Well, the cooperation has been great. They do
cooperate. They have given us space and access to information
that we would not have gotten had we not developed a strong
relationship with them in the past with our CPAT teams. They
continue to do well. However, the problem is, as Mr. Richman
says, is the bureaucracy. I mean, it is just ridiculous to have
to wait that long before we can get action.
Earlier you mentioned about a story. In the Texas Veterans
Commission we had a letter from a daughter of a World War II
veteran a while back that said her father had applied for
benefits and it had been over a year and still no result, then
a year-and-a-half and what have you. And then finally about 2
years after that she wrote us a letter and said, I certainly
appreciate that my father's rating finally came in service-
connected. I am sorry to inform you that he passed away 3 weeks
ago.
So this is America's greatest generation warrior that put
his life on the line for our country and did not get the proper
compensation that he was entitled to.
Again, something has to be done at this level, at the
congressional level. Something has to be done to ensure that
our regional offices understand the need that is out there. Mr.
Hernandez said many veterans are dying every day because of
suicides and what have you. And what does that tell us? It
tells us that we need to think outside the box, as Congressman
Flores said, go after those that control the situation and
demand answers and ensure that we get them done.
Mr. Runyan. Thank you very much for that. With that I will
recognize the Ranking Member, Mr. McNerney, for his questions.
Mr. McNerney. Thank you, Mr. Chairman.
We all want the same thing here. We want the VA claims
processing to be fast and right. I know the people in the VA
are working hard. They have got a big program in place. I
appreciate what the State of Texas is doing and trying to do.
My problem with this hearing is that it is kind of
premature in my opinion to really make any conclusions about
the program based on a fairly short implementation. But,
nonetheless, you clearly learn some things. The underlying
thing is here, and whoever wants to take this, what do you
think would be the best thing the VA could do to address this
backlog? What would be the single most important thing you
could think of to help us get the VA steered in the direction
that would reduce this backlog?
Mr. Cantu. Well, I certainly believe that one of the most
important things is to ensure that there is timely
communications between the ROs and the claimant, because
sometimes there are no communications. When you call a number,
it takes forever to answer. You do not get clear answers.
Sometimes it takes a while before mail gets to you to say we
need additional information. I think communications is very,
very important. They try. Their call centers are taking too,
too many calls. They call our Texas Veterans Commission to find
the status of their claims. That takes away from us working
claims and doing that.
So I think that communications, implementation, and
ensuring that we are on board with the sensitivity of the
individuals in the awards that we are dealing with. I mean, it
is not something that we can turn our back on and say, well,
you know, they can wait another 6 months or whatever. I am not
saying they are doing that.
But I would certainly encourage communications, constant
communications from the RO office to the claimant and some of
the State agencies to let them know what is going on. At our
conference the other day we had Ms. McCoy from the Central
Region of the VA came to our conference and spoke.
Mr. McNerney. We are really limited. We have been called to
vote. So if Mr. Richman or Mr. Hernandez has a fairly quick
response.
Mr. Richman. Congressman, the VA has over the years
instigated numerous wonderful ideas, wonderful processes, but
it gets over regulated to the point of non-functionality. The
first example that comes to my mind is the QR review, the
quality review, where every organization needs quality review,
quality control. But they take a case, the quality review team
reviews it, and then another quality review member reviews that
quality review member's work, and it has created a paralysis of
people being afraid to make a decision.
Mr. McNerney. That is a definition of bureaucracy.
Mr. Richman. Yes, sir. Yes, sir. And one thing, the reason
our teams have always been so successful is we speed up the
development process by using every possible venue to contact
the veteran; telephone, email, family members, whatever, third
party providers, doctors, hospitals. In the DAT program that
the VA came to us and asked us to participate in, we concluded
our development, full development in cases in 10.71 days. The
VA's control cases that were the same types of cases and number
of indications was 131 days, sir.
Mr. McNerney. Mr. Hernandez?
Mr. Hernandez. Yes, sir, real quick, just a knee-jerk
reaction to your question there. I would say easing
restrictions. I do know on a lot of packages that are sent to
the veteran there are probably 15 pages, and out of those 15
pages there are probably 12 that do not necessarily pertain
specifically to their claim. How you can eliminate that or what
you need to do, I can't answer that. But I will tell you----
Mr. McNerney. I see heads shaking behind you, so you are on
to something here.
Mr. Hernandez. Well, I will be the first to tell you as a
knee-jerk reaction, just answering your question directly as a
direct question, I would say if we could maybe visit that
first, along with some others. But that would be my first reply
to you.
Mr. McNerney. Thank you. I yield back.
Mr. Runyan. I thank the gentleman. With that I recognize
Mr. Flores. I am watching the floor very closely, so we do have
time.
Mr. Flores. Thank you, Mr. Chairman.
Mr. Cantu, one of the statements you said is that something
has to be done. Mr. Richman, you said that the bureaucracy has
become desensitized. So I would ask you this: We have people in
this world that process millions of claims a day in the private
sector and they do it with very high accuracy. So what do you
think about a potential pilot program where we pick a private
contractor to process claims in a particular VARO and see how
they do?
Again, if you remember what I said at the beginning, I care
about taking care of veterans. I really don't care as much
about the bureaucracy. I want the bureaucracy to do their job.
So we have given them lots of money, we have given them more
people, but as you guys said, it hasn't worked.
So what would you think about a pilot program, thinking
outside the box again, to have a private contractor process
claims in a particular area?
Mr. Cantu. I would certainly concur that that is a step in
the right direction, because a contractor will be loyal to the
veterans, to ensure that they do their work. They don't have a
bureaucracy that ties one of the quality assurance guys to be
inspected or reviewed by someone else, by someone else, by
someone else. They ought to have the authority to review that
claim, and if all the evidence is there, make an award.
Mr. Flores. Mr. Richman, any comments?
Mr. Richman. Yes, sir. Let the State of Texas be the
contractor.
Mr. Flores. Okay. You know what you could do.
Mr. Richman. We have proven it twice. The legalities, the
VA is an administrative law process that takes years to
understand. That is one of the problems. It takes years to
understand. The people that we are hiring for these teams have
700 years of experience, but they are also highly motivated.
They are the people that when they worked for the VA wanted to
be turned loose to accomplish the mission.
Mr. Flores. I am going to try to get to Mr. Hernandez in a
minute so I am going to try to keep the answers short. For
instance, let's say we hired the State of Texas to do this, we
subcontracted with the State of Texas. You have done processing
on each end of the claims process. Could you do it from A to Z,
do you think?
Mr. Richman. Yes, sir.
Mr. Flores. Mr. Hernandez, what are your thoughts about a
pilot process like this?
Mr. Hernandez. Sir, I think at this present time anything
that could help the veteran would be very well received. In
regards to a private contractor, I do agree with my colleagues
here that it would be good to cut some of the bureaucracy and
some of the red tape, have a focus more on the claim itself and
either denying or approving the claim with that emphasis and
not necessarily regulations. And I don't want to make that
sound in a bad way, but naturally I just feel like it has
become so complex that that particular part, the claim itself,
is, like I said earlier, two pages of a 15-page disclosure.
Mr. Flores. Mr. Hernandez, in your written testimony you
had a couple of examples you wanted to share with us, real
world examples. Can you share one of those examples in a minute
and 46 seconds?
Mr. Hernandez. Yes, sir. The first example is that of a 40-
year-old Gulf War I veteran. He submitted a new claim for PTSD
and an increased evaluation for a recognized back condition.
Once submitted, the letter received indicated that his claim
had been received by the VA and the claim process had begun.
Approximately 6 months later he received a VARO letter stating
more information was requested to prove the nexus of his claim
which, of course, is the relationship between his service and
his claim condition. He provided a personal narrative with
information on his experience and his current diagnosis. He
also stated that he had service treatment--only had service
treatment records from the VA health care system for medical
records on his medical evidence.
Approximately 3 months later he came in to inquire about
his claim again--I am sorry, I thought my microphone had cut
off--he came in to inquire about his claim again because he was
experiencing some life challenges. His wife had been diagnosed
with breast cancer and was losing her job and he had no other
source of income. After the inquiry, he was told that he still
needed additional information pertaining to the nexus. He then
resubmitted the original narrative with a follow-up letter
explaining his HTRs in VA medical treatment files as the sole
basis of medical evidence once again.
Another 3 months passed and no correspondence from the VA.
We then called the VA again to be told that they had located
the original information and he would be receiving a C&P exam
in the near future. The C&P schedule did come in 6 weeks later
and he was told when to report, which he did. At this time he
was becoming agitated and anxious because his wife was
receiving chemo treatment and the travel and expense was taking
a toll on his overall mental and physical health.
After taking the C&P, he waited another 3 months before
coming to inquire again. He was then told that his exams had
not been received from the VA health care system. He then
decided to go talk to the RO and explain his plight so the
public contact staff could put a face with the claim. He was
distraught at this time.
Apparently his demeanor concerned the RO because he was
then advised to go to the VA hospital in Waco. Upon arrival at
the hospital, he was admitted for a psychological exam and held
for 72 hours because he appeared unstable. He was then
counseled and released instead of concentrating on his claim
for decision. He then did receive an award from Social Security
disability which helped with his finances.
He inquired once again approximately 2 weeks later only to
be told that he would have to take another C&P exam on both
claims. He was told the C&Ps were in August of 2012 and is now
scheduled for both in October of this year. His wife's cancer
is in remission but he continues to have financial
difficulties, mental anguish and depression over the overall
experience. His file is still pending and the decision has not
been rendered. He is in his 18th month of the claim process.
Mr. Flores. Thank you, Mr. Hernandez. As I said in my
opening testimony, my opening comments, every number has a
face.
Thank you, Mr. Chairman. I yield back.
Mr. Runyan. I thank the gentleman.
Gentleman, on behalf of the Subcommittee, I would like to
thank you for your testimony and look forward to working with
you on these important matters and continuing to have updates
from your progress as you tackle this issue. With that, you are
now excused.
That being said, the Committee will stand in recess until
approximately 12 noon as we go vote.
[Recess.]
Mr. Runyan. At this time the Committee will come to order,
and we will welcome the second panel to the table. First, we
will have Ms. Diana Rubens, Deputy Under Secretary for Field
Operations, Veterans Benefits Administration, U.S. Department
of Veterans Affairs. Ms. Rubens is accompanied by Mr. John
Limpose, the Director of Waco's Regional Office at the U.S.
Department of Veterans Affairs. We appreciate your attendance
today. Your complete and written statements will be entered
into the hearing record. And Ms. Rubens, you are now recognized
for 5 minutes for your opening statement.
STATEMENT OF DIANA RUBENS, DEPUTY UNDER SECRETARY FOR FIELD
OPERATIONS, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT
OF VETERANS AFFAIRS; ACCOMPANIED BY JOHN LIMPOSE, DIRECTOR,
WACO REGIONAL OFFICE, VETERANS BENEFITS ADMINISTRATION, U.S.
DEPARTMENT OF VETERANS AFFAIRS
STATEMENT OF DIANA RUBENS
Ms. Rubens. Thank you, Mr. Chairman. Good afternoon,
Ranking Member McNerney, and members of the Subcommittee. Thank
you for the opportunity to discuss the Veterans Benefits
Administration's work with the Texas Veterans Commission. I am
accompanied today by Mr. John Limpose, the Waco Regional Office
Director.
VA is committed to achieving our goal of processing all
claims within 125 days with 98 percent quality by 2015, and
assistance from stakeholders like TVC is critical to our
success in improving the claims process.
As you know, VBA is in the midst of implementing its
transformation plan and is relying on support from stakeholders
to implement this transformation which changes interactions
with our employees, other Federal agencies, veteran service
organizations, and State and county service officers such as
TVC.
VBA's transformation is demanded by a new era of emerging
technologies, the latest demographic realities, and our renewed
commitment to today's family, veterans, family members, and
their survivors. In the face of dramatically increasing
workloads, VBA must deliver first-rate and timely benefits and
service and they must be delivered with greater efficiency.
I would like to touch on several components of our
transformation plan. eBenefits: Veterans now have the access to
benefit information from multiple channels, on the phone,
online, or through DOD and VA shared portal called eBenefits.
This eBenefits portal provides 45 self-service features to
check the status of a claim, or an appeal, review a history of
payments, access military personnel records, numerous other
benefit actions. eBenefit enrollment now exceeds 1.8 million
users. Also, disability benefits questionnaires. DBQs are a
template that solicit the medical information necessary to
evaluate veterans' medical conditions. VA has made 71 DBQs
available to the public so that veterans can take them to their
private physicians for completion. Ten additional DBQs for
specialized medical examinations and opinions are used by VA
physicians, bringing the total number of DBQs to 81.
Also, our fully-developed claim, it is a veteran's
disability benefit claim that consists of a complete
application, all military and civilian treatment records, and
relevant military personal records, to include the DD-214.
Veterans participating in the FDC program are often supported
by their VSOs, would send in all of the required evidence with
their claims, and certify that they have nothing left to
provide. The more claims that we receive that are fully
developed, the faster that we can make decisions.
In fact, today, claims submitted under the FDC program are
processed in an average of 115 days; however, only 3 percent of
claims from VSOs and State and county service officers are
currently submitted through the FDC program. VBA's target for
2013 is to increase this percentage to 20 percent participation
rate.
TVC and the Waco RO first conducted a pilot, the
Development Assistant Pilot Program. In this partnership four
TVC employees assisted with review and development of cases
needing rating decisions. A second pilot with TVC, the Claims
Processing Assistance Team, was conducted with Waco and Houston
regional offices where TVC dedicated 12 full-time counselors to
contact claimants by telephone, email, or other means to
facilitate completion of required development.
The Texas State Legislature 2013 biennial budget includes
$1.5 million to create Task Strike Force Teams to work side by
side with Houston and Waco regional offices to reduce the
number of pending claims and appeals. On August 15, a planning
meeting was conducted between TVC and Houston and Waco where
TVC committed counselors to the strike force teams. Counselors
will be stationed at each RO, will concentrate both on
gathering evidence and working with veterans to submit fully-
developed claims, as well as focus on pending appeals and
claims.
The TVC counselors on the strike force teams will assist by
gathering evidence from veterans and securing health care
records to expedite claims processing. However, the new
partnership will do much more to support submission of fully
developed claims as well as the disability benefits
questionnaires.
VBA hopes that with the assistance of TVC's strike force
team we will far exceed our goal of receiving 20 percent of the
claims from veterans represented by TVC by the end of 2013.
Other partnerships across the States with FDC include the
Chicago regional office having provided a pilot of the FDC
initiative confirming that the FDC allows employees to spend
less time developing gathering evidence, and spend more time
rating claims, reducing the backlog. VBA also would like to
especially recognize the Maine Department of Veterans Services,
for their outstanding assistance as they today are providing up
to 42 percent of their claims as fully developed.
In July of this year, an FDC workshop was held here in
Washington with representatives from 10 different VSOs. The
goal was to emphasize the positive impact of filing FDCs and
emphasized receipt of FDCs with disability benefits
questionnaires would further improve processing time.
VSO and State and county service officers are important
partners in our transformation to better serve veterans, their
families, and survivors. In our pilot projects with TVC, we
experience positive outcomes. We believe there are greater
opportunities to improve service and productivity in the new
partnership and the broader scope from the new strike force
teams will assist VBA in decreasing the backlog in Houston and
Waco. VA will carefully track and monitor the strike force
teams and assess the potential for future partnerships or
pilots to be expanded at our ROs.
Mr. Chairman, this concludes my statement. I am pleased to
answer any questions you or any other members may have.
[The statement of Diana Rubens appears in the Appendix]
Mr. Runyan. Thank you, Ms. Rubens, I appreciate that.
Actually, passing the Ranking Member in the hallway on the way
here I had a question. We know it is early in what the strike
force is doing, but can you give a sense of if you feel it is
working, and it is benefiting and helping you actually be able
to execute what you are supposed to do at the regional office?
Ms. Rubens. I would tell you, sir, that in fact we are
building on the benefits that we have seen in the past and as
they help us provide review of claims and make things, if you
will, ready for decision, it will speed the process by which a
claim is able to move through the system and enhance the
timeliness of the decision we provide to the veteran.
Mr. Runyan. Are you finding statistically that they are
done correctly?
Ms. Rubens. Mr. Chairman, I am going to tell you I am going
to defer that one to Mr. Limpose, who is on the ground with the
folks in Waco.
Mr. Limpose. Sir, TVC is working very, very well with the
Waco Regional Office and also the Houston Regional Office.
Currently, they are, one of every three cases they are
reviewing, for about a 33 percent gathering of information, or
making the case ready for decision is helping us make those
cases work in a more timely fashion. So they are helping and I
think it is a very, very positive story that we can branch out
into just not only TVC, but all of our stakeholders.
Mr. Runyan. Is there a metric of following a claim's
processing by the strike force through the whole process and a
comparison at the end between the traditional realm ?
Mr. Limpose. Sir, we are early in the stages currently
working with Mr. Richman on a standard operating procedure
between both eastern Waco and Texas Veterans Commission. We
have some metrics we will be putting in place to be able to
aggregate some data in the future.
Mr. Runyan. Ms. Rubens, given the statistics on claims
processing in Waco, why was this RO chosen for the Nehmer
claims after the new Agent Orange presumptives were added?
Ms. Rubens. Chairman Runyan, as we identified locations to
aggregate the previously denied Nehmer conditions, Waco had a
day-one brokering center already in place. They were the focus
for where we would process the reviews of those things that had
been previously denied. Frankly, it was a function of the fact
that they had the resources, if you will, to capacity, that as
we looked at it was in addition to what was already in the
service center, whose focus was on the Waco jurisdiction
claims.
Mr. Runyan. Was it more of an issue of expertise than
anything else?
Ms. Rubens. I would say that for all of the day-one
brokering centers that we moved the roughly 93,000 claims that
needed review, we did actually extensive training around the
conditions for those three new presumptives that were added and
as those folks worked those claims, I would tell you that many
of them with the volume of ischemic heart disease claims that
they worked, became true experts in those issues, and frankly,
as a function of moving away from once they completed the
review of those claims, it was an opportunity and a requirement
that we, if you will, refresh everybody that was doing that
work so that they would then be able to move back to general
rating claims.
Mr. Runyan. Moving on to, what I think most of us think is
going to help another part of the backlog is VBMS. Do you know
where we are when Waco and Houston are scheduled to start using
VBMS?
Ms. Rubens. Yes, sir, as part of our transformation, one of
the things that VBA is doing is first implementing, if you
will, the people and the process components of the
transformation plan. Houston has actually already implemented
the people and the process components, with Waco coming
somewhere down the line. The expectation would be then that
VBMS, as it continues to, I will say mature, will then follow
that same path with an expectation that that being the case,
Houston will see VBMS first and Waco shortly thereafter,
recognizing that retraining your entire workforce on a new
technology all at once might not be the right way to go, but we
are moving out smartly working to get both people and process
and the VBMS, the technology component for the processors
rolled out as quickly as we can.
Mr. Runyan. Mr. Limpose, what is the average processing
time for fully developed claims versus non-fully developed
claims in the Waco--between the Waco and Houston offices?
Mr. Limpose. The fully developed claims are being processed
on average of about 100 days sooner than our normal workload is
right now. We fully expect to improve upon that. Obviously, I
am not happy with that, and we are going to do everything we
can to fully, fully take advantage of the work with our
stakeholders to make sure that we deliver timely services and
that overall the normal workload has had an impact due to,
obviously, some of our Agent Orange work that we have completed
under the national mission. We are proud to say that the office
completed an extraordinary number of cases. We finished up last
August and it had some impact and we are feverishly working
some of our oldest cases out there which has a negative impact
on the way our claims are aggregated.
So I fully expect that we will continue to trend in a more
positive direction, and that I am happy to say that last month
the Waco Regional Office successfully completed 4,400 cases in
service output to veterans, which is a 50 percent increase over
the strategic target that we had for last month.
Mr. Runyan. That all being said and simply put, would you
agree that fully developed claims not only help the process
move faster, but also, ease the strain on the veteran just as a
general statement?
Mr. Limpose. Absolutely, sir. Those claims that we will be
working with all of our stakeholders to bring in the front door
as fully developed will help us in that market of evidence
gathering during our claims process timeliness, should shorten
that, and then in the long run give us better timeliness and
service and output to veterans.
Mr. Runyan. Do you believe, between VSRs, RVSRs, DROs, that
both of the offices are adequately staffed or do they need
additional adjudicators required to help us tackle this?
Mr. Limpose. Sir, I cannot answer for Houston. However, at
the Waco Regional Office I feel that in my veteran service
center with approximately 470 employees that I am adequately
staffed and that we are fully focused and feverishly processing
cases as fast as we can, sir.
Mr. Runyan. Are you diverting any appeals staff to do the
work on the initial claims at all?
Mr. Limpose. Sir, that is a very delicate balance. We are
working all facets of the claims process to include the
appellate work.
Mr. Runyan. On July 10, 2012, VBA released a report on
challenge training showing an increased productivity among VBA
rating specialists after receiving the training. How many of
your Waco staff have received the challenge training?
Mr. Limpose. All of our new employees, sir, go through
challenge training. I have only been there 5 months. Every new
VSR and RVSR goes through our challenge curriculum, and I would
have to ask to get the exact number back to you on the entire
staff of the Waco Regional Office.
Mr. Runyan. I would appreciate that because my next
question was, were you measuring it. So I would appreciate
those numbers if you would get them to the Committee.
Mr. Limpose. Yes, sir.
Mr. Runyan. Were there any employees at the Waco RO held
accountable for the office's dismal performance in claims
processing?
Mr. Limpose. Sir, we hold people accountable for their
individual performance standards and we will take appropriate
action, when deemed necessary, for poor performance in serving
our veterans. We have done so in the past and will continue to
do so in the future. I am always looking to have the best and
brightest individuals serving our veterans and our claimants,
and I will continue to raise the bar to make sure we meet all
expectations out of the Waco Regional Office.
Mr. Runyan. I appreciate that. I don't have anything
further, but like the conversation I had with the Ranking
Member earlier today, we know we are early in this process, and
I think we all agree that fully developed claims make it a lot
easier on everybody. And I think we all have a hand in that,
whether it is from my personal congressional office helping a
veteran, whether it is our county VSO officers doing the same
thing, and I think that the team approach to doing this, which
the State of Texas has taken an honest attempt at it to truly,
take care of our veterans. We have to be open-eyed to this, and
know there is multiple solutions and multiple ways to get
there. As the Ranking Member said, we are still early in this
process, but I think we can see some uptick from it and some
positives.
So I look forward to hopefully continuing this discussion
down the road as we can get some more statistical analysis,
some more, I would say, comforting stories from our veterans
that we are serving. This is the one biggest thing where they
can see the light because, specifically in this room let alone
up on the Hill, bureaucracy is a word that just makes the back
of your neck tingle sometimes because of the uphill battles we
have to climb to not give our men and women what we promised
them, especially our warriors, is something I think most of us
would not sleep well at night thinking about.
So I thank you for coming and doing this, and also
everybody from the State of Texas with the strike force, and
thank you for your testimony.
And with that being said, I want to thank everyone for
being here this day. I would like to again emphasize that the
fact that all veterans in central Texas face the longest time
for claims processing is an issue. The backlog for claims
processing is one that affects veterans nationwide, including
many in my home State of New Jersey. Therefore, I applaud the
State strike force in their efforts at addressing the issue,
and thank the VA for being here today to participate in a
discussion on the new approaches, and there probably will be
many more to come on this very long-standing problem.
I ask unanimous consent that all Members have 5 legislative
days to revise and extend their remarks and include any
extraneous materials. Hearing no objection, so ordered. I thank
the members that were in attendance today, and this hearing is
now adjourned.
[Whereupon, at 12:41 p.m., the Subcommittee was adjourned.]
A P P E N D I X
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Prepared Statement of Hon. Jon Runyan, Chairman
Good morning and welcome everyone. This oversight hearing of the
Subcommittee on Disability Assistance and Memorial Affairs will now
come to order.
As is often the case when this Subcommittee convenes, we are here
to discuss the backlog of veterans' disability benefits claims.
Unfortunately, when such discussions take place, we often find
ourselves having the same discussion over and over.
Frustrated veterans want to know why it takes so long to process
their claim. Frustrated lawmakers want to know why the backlog keeps
increasing. And frustrated VA employees want everyone to know that the
folks on the front lines are doing the best they can to try to keep up
with an increasing amount of claims.
However, every so often a new idea is interjected into the
discussion, and we are here today to discuss one such idea.
In 2009, the State of Texas created a ``Claims Processing
Assistance Team'' that helped reduce pending claims at the State's two
Regional Offices, or ``ROs'', in Waco and Houston. $400,000 was
allocated toward about a dozen employees over several months, and those
employees reduced the number of pending claims in Waco and Houston by
17,000. Despite this success, the situation has since worsened for
veterans not only in Texas but across the country, as the amount of
pending claims has doubled since that time.
As a recent Center for Investigative Reporting study reveals, the
impact of the backlog varies by region. The study finds that: veterans
in sparsely populated states often have their benefits claims processed
faster than those in more populous states.
In addition to this study, the media has also been paying close
attention to veterans who must wait the longest to receive their
benefits - which are veterans in Texas and, as is well-known to the
Ranking Member Mr. McNerney, California.
But, the fact remains that no matter where a veteran is located,
more often than not, that veteran is waiting too long to receive their
benefits decision.
Once again taking action into their own hands, in late July of this
year, the Texas State Legislature created a ``State Strike Force
Team,'' led by the Texas Veterans Commission. This time around, they
have allocated $1.5 million dollars and 16 full time employees. The
goal of the State Strike Force Team is to assist veterans and their
families in receiving disability compensation and pension payments
earlier than expected.
Specifically, eight claims counselors will be located at both the
Houston and Waco Regional Offices to help process claims. There will
also be ``Fully Developed Claims'' Teams located throughout the state
to improve access and assist veterans in filing fully developed claims.
By examining this process today, we are hoping that this State
Strike Force Team will serve as a model to other states and perhaps
even lead to the creation of a similar Federal Strike Force Team.
I want to thank the VA, the Texas Veterans Commission, and Mr.
Hernandez for their valuable input as we work together to find
important solutions to the growing backlog of claims.
I welcome today's witnesses to continue this ongoing discussion and
offer their own specific recommendations on how to improve the current
system of processing veterans' disability claims.
Prepared Statement of Mr. Cantu, Jr.
GREETING
Good morning, Chairman Runyan, Ranking Member McNerney, and Members
of the Subcommittee. For the record, my name is Eliseo ``Al'' Cantu,
Jr., Chair of the Texas Veterans Commission. I am humbled by the
invitation to testify before you today. On behalf of the Texas Veterans
Commission, I would like to thank the Subcommittee for this opportunity
and for your interest in the efforts the state of Texas has undertaken
in order to better serve the 1.7 million veterans in our state.
I am accompanied today by Mr. Jim Richman, Director of Texas
Veterans Commission's Claims Representation and Counseling program. Mr.
Richman has been with the agency for over 25 years, working his way up
from entry-level claims counselor to becoming the program director in
2006.
My testimony will provide you with some background information
regarding Texas' State Strike Force and Fully Developed Claims Teams
Initiative, directed by state leaders this past July. Mr. Richman's
testimony will provide you with the details of the initiative, and an
update of our progress, keys to its success.
TEXAS VETERANS COMMISSION
The Texas Veterans Commission is the veterans advocacy agency for
the state of Texas. Our mission is to advocate for and provide superior
service to Veterans in the areas of claims assistance, employment
services, education, and grant funding that will significantly improve
the quality of life for all Texas Veterans, their families and
survivors. The Texas Veterans Commission provides these services
through four program areas: Claims Representation and Counseling,
Veterans Employment Services, Veterans Education Program, and the Fund
for Veterans' Assistance.
No other state has centralized all of these program areas within
their state's veterans agency. Texas is becoming recognized for
aggressively leading on veteran issues. National leaders have referred
to the ``Texas-model'' when advocating for the integration of veterans
services.
Texas Veterans Commission's Claims Representation and Counseling
Program assists veterans prepare compensation and pension claims with
the U.S. Department of Veterans Affairs (VA). In 2011, Mr. Richman's
claims counselors handled 179,981 benefit cases on behalf of veterans
and dependants, filed 125,179 new monetary claims, and 16,101 new
appeals.
CLAIMS PROCCESSING ASSISTANCE TEAMS (CPAT)
In November 2009, Governor Rick Perry and the Texas Veterans
Commission launched the special Claims Processing Assistance Team
(CPAT) project to assist Texas Veterans who had their claims for
monetary benefits pending with the two VA regional offices in Texas
(Waco and Houston). This project built upon the success of a pilot
project between the Texas Veterans Commission and VA in 2008. At the
time the CPAT project was announced, a total pending caseload of 39,000
federal benefit claims existed in Texas' two VA regional offices. These
CPAT Teams consisted of 12 additional claims counselors (6 at each
regional office). They targeted specific areas within the claims
process, doing all development needed on the individual claims and
working directly with the claimants in identifying and acquiring
necessary evidence. The project was funded for the period from November
2009 to July 2011. In that time, these special CPAT teams returned to
the VA 17,325 cases ready for decision or award action.
STATE STRIKE FORCE AND FULLY DEVELOPED CLAIMS TEAMS INITIATIVE
Since that time, the situation has become measurably worse. On July
16, 2012, the Commission testified before the State Senate's Veterans
Affairs and Military Installations Committee regarding the state of the
backlog in Texas. According to the VA, in January 2010, the total
pending caseload in Texas was 50,934 claims and 15,644 appeals. The
number of cases that had been pending over 125 days, what the VA
considers backlogged, was 16,803 claims. On July 14, 2012, the total
pending caseload in Texas was 107,279 claims, and 28,183 appeals. The
number of cases that had been pending over 125 days, what the VA
considers backlogged, was 68,612 claims. In essence, in Texas, the
total pending caseload has more than doubled while the backlog has more
than quadrupled from 2010 to present. Presently, the real world average
for getting a decision on a VA claim is 18 to 24 months.
Following that hearing, on July 19, 2012, Lieutenant Governor David
Dewhurst, working with Governor Rick Perry and State House Speaker Joe
Straus, directed the Texas Veterans Commission to reinstitute the
``State Strike Force Teams'' that were implemented in 2009 to help
reduce this federal backlog of veterans' claims for disability
benefits. The state leadership also directed the Texas Veterans
Commission to help the backlog by assisting veterans in filing fully
developed claims, which are processed faster by the VA, and to address
critical staffing needs in areas where Veterans need additional access
to Texas Veterans Commission Claims Counselors. On July 25, 2012,
Governor Perry provided $100,000 to the Texas Veterans Commission to
immediately implement these teams. On July 26, 2012, Governor Perry,
Lieutenant Governor Dewhurst, and Speaker Straus authorized the Texas
Veterans Commission to utilize $1,511,267 in the 2012-2013 biennium to
address the backlog of federal disability claims.
These teams will be working on both ends of the claims process to
ensure that the backlogged claims and new claims have all the
information and evidence needed in order to allow a more timely
decision. The goal of this initiative, with the single year of funding
we have been authorized, is to reduce the current backlog of claims in
Texas by 17,000 claims.
Mr. Richman is going to share with you how he and his teams will
make that goal a reality, momentarily. Again, I want to thank you for
the opportunity to testify before you today. Thank you for the work are
doing, and will do, on behalf of Texas veterans, and all veterans, of
this Nation's Armed Forces.
Prepared Statement of Mr. Richman
INTRODUCTION
Good Morning, Chairman Runyan, Ranking Member McNerney, and Members
of the Subcommittee. My name is Jim Richman and I have the privilege of
serving as the Director of Claims Representation and Counseling at the
Texas Veterans Commission. As the Chairman mentioned, I have been with
the agency for over 25 years. I am a veteran myself and come from a
family where military service was expected, as is the case with
countless families across this Nation and across the great State of
Texas. My father and uncles were members of the greatest generation and
participated in some of the toughest combat in WWII. By the grace of
God, they all came home and they taught me to be a part of something
bigger than myself. I instill that virtue in my Claims Counselors, all
of whom are veterans, many of them disabled veterans. Serving the
veterans of Texas, their families and survivors is not only our
mission, it is our duty, as veterans serving fellow veterans.
This morning, I will provide you with the details of Texas' State
Strike Force and Fully Developed Claims Team Initiative, provide an
update, one month in to the initiative, and highlight some keys to
successful implementation.
In his remarks, Chairman Cantu outlined the gravity of the
situation for us in Texas, that in the years from 2010 to 2012, the
total pending caseload of claims has doubled and the number claims
pending longer than 125 days, backlogged, has quadrupled. I will only
emphasize that the end of combat operations in Iraq, a decreased
military presence in Afghanistan, and force shaping measures announced
by the Department of Defense in January 2012 are expected to greatly
increase the demand and need for these services. This influx, coupled
with the increasing demand of an aging population of WWII, Korea,
Vietnam, and Gulf War I Era veterans threatens to compound the workload
of a system already operating beyond capacity.
As I am confident that this Subcommittee has received prior
testimony from the U.S. Department of Veterans Affairs (VA) and others
regarding the overwhelming backlog of claims and the unacceptable
current timelines of 18-24 months associated with claims processing, I
will not belabor the point any further. What I will add is that this
situation exists, despite the fact that, in Texas, the VA is full of
dedicated, hard-working people who are trying to do the right thing for
the veterans they serve. The problem is the complexity of the process.
The information that follows is how we propose to assist the VA in
Texas with regard to reducing the backlog and improving processing
timeliness of current claims.
DETAILS OF THE INITIATIVE
The concept for the State Strike Force and Fully Developed Claims
Teams was developed as the result of best practices and lessons learned
from two previous cooperative projects with the VA in Texas. The first,
in 2008, was the Development Assistance Pilot Project (DAPP) wherein
the VA Central Office requested a TVC team to conduct claims
development parallel to a team from the VA. In the final analysis of
this project, development of the claims processed by the TVC Claims
Counselors was accomplished in 10.73 days compared to the VA's 131
days. At the time, VA Undersecretary for Benefits Patrick Dunn
commended the results and the VA Office of Field Operations provided
all of its regional offices with a copy of the final report, and
encouraged them to implement the best practices identified by the
project.
The second, the Claims Processing Assistance Teams (CPAT), Chairman
Cantu covered in his remarks. CPAT was a state project, funded by the
Governor's Office from November 2009 to July 2011. Twelve (12) TVC
Claims Counselors targeted specific areas within the claims process,
doing all development needed on the individual claims and working
directly with the claimants in identifying and acquiring necessary
evidence. By the end of the project, TVC had handed back to the VA
17,325 cases ready for decision or award action.
As soon as the direction came this past July from the Governor Rick
Perry, Lieutenant Governor David Dewhurst, and House Speaker Joe Straus
to reinstate a form of this initiative, we began building two separate
teams.
STATE STRIKE FORCE TEAMS
First, there are two (2) State Strike Force Teams, each consisting
of eight (8) members located at each of the two VA Regional Offices in
Texas (Houston and Waco). The purpose is to assist the VA by
accomplishing all necessary development on cases that have been pending
for over 125 days (backlogged) and return to the VA ready for decision.
These teams will review cases and not only determine what development
needs to be done, but to actually accomplish that development utilizing
best practices identified in previous projects, which include:
Utilizing every resource available (telephone, email,
fax, family members, and mail as a last resort) to contact the veteran,
clarify or get additional information on his or her claim.
Contacting private physicians, hospitals or any other
party or entity that has information to give the Veteran the highest
possibility of a favorable decision on the claim.
Expediting claims and appeals through submission of
waivers, as appropriate.
Contacting claimants with Decision Review Officer (DRO)
hearing requests.
Contacting claimants with Board of Veteran Appeals (BVA)
partial grants for resolution of appeal.
Identifying inadequate exams.
In our review, if we find ``directed development'' or
things that have been overlooked or not finalized, we will make
recommendations regarding what is needed.
FULLY DEVELOPED CLAIMS TEAMS
The Fully Developed Claims Teams were the critical missing piece of
our previous projects to assist the VA with reducing the backlog of
claims. While the State Strike Force Teams are attacking cases already
caught in the backlog, the Fully Developed Claims Teams will work on
the front end of the process to ensure that qualifying new cases being
filed by TVC Claims Counselors (an average of 500 claims and appeals
per day) are filed in a fully-developed status. They will work with the
TVC field counselors and Veterans County Service Officers (VCSO's) to
assist them in making every claim possible a fully developed claim, and
work with the VA Regional Offices to expedite their ratings.
There are two (2) Fully Developed Claims Teams of five (5) members
in each of the two VA Regional Offices in Texas (Houston and Waco). The
five Fully Developed Claims Team members inside the VA Regional Offices
will be working with our TVC field staff to:
Provide additional training, resources, and assistance in
properly preparing fully developed claims prior to submission.
Utilize ``Informal Claims'' whenever necessary to insure
the Veterans date of claim is protected.
Review incoming claims to identify those which could be
made fully developed claims.
Review existing claims and determining if they could be
``re-filed'' as fully developed claims.
There are an additional eight (8) Fully Developed Claims Team
members in the field will be utilized to augment the staff of field
office locations that have the highest daily volumes of veteran
clientele, thereby allowing the counselors in those offices to have
more time to develop the claims they file, ensuring they meet the
threshold of fully developed.
UPDATE
Within days of state leaders' authorization of the teams, we posted
the positions and began hiring. As of September 1, we filled all 34
positions created as a result of the initiative. Those hires include
personnel with significant VA claims experience, including former and
retired TVC and VA professionals with a total combined experience with
the VA claims process of over 700 years.
During this initial period, lead TVC and VA personnel have been
working together to create the Standard Operating Procedures (SOP). I
would like to point out that VA Area Director, Beth McCoy, Houston
Regional Office Director, Pritz Navaratnasingam, Waco Regional Office
Director, John Limpose, and their staffs have completely bought in to
what we can accomplish with this endeavor. Both VA Regional Offices
have provided TVC with the additional space, computers, training
materials and support we need to make this a truly successful endeavor.
We have already devised workflow and workload tracking because we must
be able to track all of our production from both teams. The VA has
provided us with specific people and/or locations to receive the files,
use of the ``Covers'' computer program to track our work, and to
locations to deliver our work. Of course, everything we do is subject
to adjustments and improvements as we progress into the project.
As of Monday, September 17, members of the State Strike Force Teams
have reviewed 2,525 case files of backlogged claims, identifying and
executing all required additional development. They have already
delivered 852 claims to the VA, fully developed and ready to rate.
KEYS TO SUCCESS
Based on experience gleaned from previous projects and with Texas'
State Strike Force and Fully Developed Claims Teams initiative, there
are several essential elements required for the successful
implementation of these, or like, initiatives.
1. Complete support from the VA Regional Offices involved.
No state level initiative can succeed without the complete support
of the VA Regional Offices involved, in particular the Regional Office
Directors. The need for additional workspace, computers, training
materials, and access to VA systems and applications, necessitates the
need for a solid working relationship between the state agency and VA
personnel. VA Regional Office Directors need to direct their entire
staff to recognize the experience of the team members and be accepting
of their suggestions when devising workflow and workload tracking. As
with any cooperative effort, transparency and feedback from both
parties regarding the effectiveness of efforts is critical to refining
processes and procedures.
2. The individuals hired to staff such an initiative must be
experienced with the VA claims process.
Based on our previous experience with the projects referenced, an
experienced workforce is critical to the success of a project like
this.
3. Any initiative should utilize identified best practices for
claims development.
As previously discussed, our prior cooperative projects (DAPP and
CPAT) have identified best practices for claims development. The
effective implementation of these practices has demonstrated that they
can drastically reduce the time required to get claims through the
development process to a rating decision.
4. Dedicated funding to support the initiative for a set period of
time in order to realize meaningful reduction in the backlog of claims.
The value of federal funding such initiatives is obvious. The
specific situation faced by the particular state veteran agency or VA
Regional Office will dictate the funding requirement and length of time
such funding would be required in order to affect reduction in the
claims backlog. In Texas, state leaders have currently authorized $1.5
million in state funds for the State Strike Force and Fully Developed
Claims Teams initiative for one fiscal year. TVC's goal for this
initiative, for this single year, is to reduce the backlog of claims in
Texas by 17,000 claims.
CLOSING
In closing, I would like to thank the Subcommittee for the
opportunity to share this information with you today. State leaders
have provided TVC with the opportunity to make a tangible difference in
the lives of veterans of the state of Texas. TVC has demonstrated the
capability to have a positive impact on this issue twice before. With
the support of this Subcommittee and federal funding, we believe that
Texas and other states have the capability to successfully replicate
and implement similar initiatives. Like those famous Texans who drew a
line in the sand at the Alamo, Governor Rick Perry, Lieutenant Governor
David Dewhurst, and House Speaker Joe Straus have drawn a line in the
sand regarding the backlog of claims in Texas to say ``No More''. The
Texas Veterans Commission is making a difference now, because the
veterans we serve already did.
Prepared Statement of Mr. Hernandez
Mr. Chairman and Members of the Subcommittee,
My name is Steve Hernandez. I am the McLennan County Veterans
Service Officer, located in Waco, Texas. On behalf of the veteran
community of Central Texas, the citizens of McLennan County, the
Commissioners Court of McLennan County, and the McLennan County
Veterans Service Office thank you for allowing me to provide testimony
on a very important issue that is affecting the Nation: The Chronic
Backlog of Benefit Claims for our Nations' veterans.
As you are all aware, nationally, benefit claims submitted to the
Veterans Affairs Regional Office (VARO) have increased dramatically. We
attribute the influx to an increased average of single digit to double
digit individual disability claim submittals, economic stagnation,
employment difficulties, issues involving social reintegration, and a
continued stream of past era veterans submitting claims for the first
time or resubmitting previously denied claims, just to mention a few.
Unfortunately, from a regional perspective, the Waco VARO has been
identified as the worst of the 57 RO's under the ASPIRE database.
Because of this dubious distinction, the Waco RO is under intense
scrutiny for the backlog and discussion continues on how the federal
government can resolve this dilemma. Realizing the economic benefit in
breaking through the backlog and the catastrophic condition of the
current federal system, state leaders have authorized the state veteran
component of the Texas Veterans Commission to dedicate state assets to
assist with the backlogged claims with a commitment of $1.5 million
dollars for the State Strike Force Teams, a team of counselors who will
assist in fully developed claims as well assisting in claims assistance
and development.
To fully understand the Waco VARO's dismal performance requires an
in-depth evaluation on the causes for such a backlog. The major cause
for the spike in the backlog has been the Nehmer claims as well as the
most recent presumptive Agent Orange illnesses. Illnesses that have
been long overdue in recognition. The federal directive posed on the
Waco RO as a responsible party to Nehmer death claims proved to be a
daunting task. Not only were there 40,000 more claims added to the
operation for decisions but the award distribution became extremely
complex as these claims involved estate succession that proved
unprecedented like never before in deciding the rightful beneficiaries.
In evaluating the backlog at the grass root level, eliminating the
claims backlog will require what hopefully will be a short term
commitment from states that have the ability to supplement state assets
to assist in claims processing. The investment should yield an
equitable rate of return for the state economy. Also, the local private
sector could become more involved as community partners in creating
``one stop'' shops utilizing federal, state, or private funds and
grants in assisting in the diagnosis of certain specialized claims that
could relieve the decision process and the backlog also being
experienced by the VA's health care system. The Veterans Benefit
Management System must also be a priority in the development of
advancing into the 21st century with new technology. The continued
review of evaluating the effectiveness of the rating schedule
diagnostics codes should also be considered.
As the local veterans service officer, I am the recipient of direct
public contact from the veterans who are being confronted with life
challenges as they await word of the status of their claim. The level
of frustration, coded threatening innuendos, some uncontrolled anger
outbursts, misunderstanding and system confusion on the process, and
dire economic need are the common and frantic interactions with the
veteran while waiting for a decision. The most disheartening part of
the prolonged process is if they are denied, which is a reality. Many
have invested their future on the decision while waiting, leaving many
with few alternatives but to become further dependent on other VA
programs.
The effects of the prolonged backlog are affecting the veteran in
the most adverse way. If the data is possible, I am certain it would be
a travesty to know how the backlog has affected veteran homelessness,
relationships, crime, addiction, mental health, and suicides. The
prolonged wait on claim decisions cannot be productive on our society
and unfortunately will continue to lead to social problems at the
national level. A sad and embarrassing end to the dedicated patriots
who have braved austere conditions, family separation, traumatic
experiences, and multiple deployments to provide us the freedom and
liberty as a free society.
Prepared Statement of Mrs. Rubens
Good morning Chairman Runyan, Ranking Member McNerney, and Members
of the Subcommittee. Thank you for the opportunity to discuss the
Veterans Benefits Administration's (VBA's) work with the Texas Veterans
Commission (TVC) to expedite claims processing for Texas Veterans. I am
accompanied today by Mr. John Limpose, Director of VBA's Waco Regional
Office (RO). VA is committed to achieving our goal of processing all
claims within 125 days with 98 percent accuracy in 2015, and assistance
from stakeholders like TVC is critical to our success in improving the
timeliness and accuracy of the claims process.
VBA Transformation
VBA is in the midst of implementing its Transformation Plan and is
relying on support from stakeholders to better serve our Veterans,
Servicemembers, and their families. This transformation changes
interactions with our employees, other Federal agencies, Veterans
Service Organizations (VSOs), and state and county service officers,
such as TVC.
VBA's transformation is demanded by a new era, emerging
technologies, the latest demographic realities, and our renewed
commitment to today's Veterans, family members, and survivors. In the
face of dramatically increasing workloads, VBA must deliver first-rate
and timely benefits and services - and they must be delivered with
greater efficiency. VBA is aggressively pursuing its Transformation
Plan, a series of tightly integrated people, process, and technology
initiatives designed to eliminate the claims backlog and achieve our
goal of processing all claims within 125 days with 98 percent quality
in 2015.
VBA is working to simplify processes and reduce the burden of
paperwork for both Veterans and our workforce. Many of our
transformation initiatives will improve efficiency and customer
service. While stakeholder engagement is important to nearly all of
VBA's transformation initiatives, I would like to highlight three
initiatives, the eBenefits web portal, disability benefit
questionnaires (DBQs) and the fully developed claims (FDC) program, in
which Veterans service officers play a vital role.
eBenefits: Veterans now have access to benefit information from
multiple channels--on the phone, online, or through the Department of
Defense (DoD) and Department of Veterans Affairs (VA) shared portal
called eBenefits. The eBenefits portal provides over 45 self-service
features to check the status of a claim or appeal; review the history
of VA payments; request and download military personnel records; secure
a certificate of eligibility for a VA home loan; and numerous other
benefit actions. eBenefits enrollment now exceeds 1.8 million users,
and VA expects enrollment to exceed 2.5 million by the end of 2013. VA
is engaging our VSO, state and county partners in registering Veterans
for eBenefits accounts.
DBQs: DBQs are templates that solicit the medical information
necessary to evaluate Veterans' medical conditions. VA has made 71 DBQs
available to the public, so that Veterans can take them to their
private physicians for completion. Ten additional DBQs for specialized
medical examinations and opinions are used by VA physicians, bringing
the total number of DBQs to 81. DBQs facilitate submission of a fully
developed claim, the fastest means of getting a claim processed. VBA is
informing stakeholders, particularly VSOs and state and county
partners, about DBQs so they can encourage Veterans to utilize these
templates and receive more timely and accurate rating decisions.
FDC: A Fully- Developed Claim (FDC) is a Veterans disability
benefit claim that consists of a complete application, all Military and
civilian medical treatment records, and relevant Military personnel
records to include the DD 214. Veterans participating in the FDC
program, often supported by their VSO representatives, send all the
required evidence with their claims and certify that they have nothing
further to provide. By doing this, they dramatically reduce the
processing time of their claim. The more claims we receive that are
fully developed, the faster we can make decisions. Currently, claims
submitted under the FDC program are processed in an average of 115
days. However, only three percent of claims from VSOs and state and
county service officers are currently submitted through the FDC
Program. VBA's target for FY 2013 is to increase this percentage to 20
percent - meaning VBA will have the ability, if this goal is reached,
to complete 153,000 more claims before they can become backlogged. VBA
is exploring both monetary and nonmonetary incentives for its VSO
partners to increase FDC submission because of the impact this would
have on claims-decision timeliness.
Initial TVC Pilots
The Waco RO first conducted a pilot, the Development Assistant
Pilot Project (DAPP), from June 2008 through January 2009. In this
partnership, four TVC employees assisted with the review and
development of cases needing rating decisions. VA gave TVC counselors
32 hours of training in claims processing. Follow-up training was also
given to counselors on an ``as needed'' basis. A VBA first-line
supervisor was assigned to provide subject matter expertise, oversight,
guidance, and review of the work each counselor completed. TVC touched
over 1,600 claims, 33 percent of those claims were made ready for
decision. Evidence was received in an average of 11 days during our
initial partnership with TVC.
An additional pilot, the Claims Processing Assistance Team (CPAT),
was conducted with TVC and the Waco and Houston ROs from November 2009
through July 2011. TVC had funding available to support CPAT. TVC
dedicated 12 full-time counselors to contact claimants by telephone, e-
mail, or other means to facilitate completion of required development.
CPAT members also worked with health care providers and DoD to expedite
receipt of requested information needed to complete claims.
TVC's review was limited to claims where TVC was designated as the
claimant's accredited representative. They were and are unable to
assist with the entirety of the Waco and Houston ROs' workload. Claims
determined to be ready-for-decision were forwarded to the ROs' decision
makers for expedited action.
TVC Strike Force Teams
The Texas State Legislature's 2012-2013 biennial budget includes
$1.5 million to create TVC Strike Force Teams to work side-by-side with
the Houston and Waco ROs to reduce the number of pending claims and
appeals. On August 15, 2012, a planning meeting was conducted between
leadership of TVC and the Houston and Waco ROs. At the meeting, TVC
committed to assign 34 counselors to the Strike Force Team. Thirteen
TVC counselors will be stationed at each RO, five of whom will
concentrate on gathering evidence and working with Veterans to submit
FDCs, and the other eight will focus on pending claims and appeals. The
remaining eight counselors will be stationed at key field locations
around the state.
Similar to the previous pilots, TVC counselors on the Strike Force
Teams will assist by gathering evidence from Veterans and securing
health-care records to expedite claims processing. However, the new
partnership will do much more than the CPAT pilot to support submission
of FDCs as well as DBQs. VBA hopes that with the assistance of TVC's
Strike Force Team, we will far exceed our goal of receiving 20 percent
of claims from Veterans represented by TVC through the FDC program by
the end of fiscal year 2013.
As of September 11, 2012, the Houston RO's inventory of pending
disability claims included 38,088 claims, of which 27,981 or 75 percent
were pending longer than 125 days and are considered to be part of VA's
backlog. The Waco RO's inventory included 50,039 claims, of which
38,217 or 76 percent were pending over 125 days. The ultimate goal of
our partnership with TVC is to impact these numbers in a positive
manner, and provide the Veterans in Texas with fast and accurate
service.
In addition to FDC claims, TVC will also assist the Houston and
Waco ROs with their appeals inventory by working with appellants to
identify cases in which appealed issues may be resolved through written
submissions or informal conferences without the need for a hearing and
to determine whether a partial grant of benefits by VA resolved the
appeal to the appellant's satisfaction.
VBA has provided desk space in the in both Houston and Waco ROs for
all TVC employees. They will be provided training with a special focus
on FDC. The TVC Strike Force Teams will also have VBA tools and
training materials at their disposal and may consult with members of
the ROs' Quality Review and Training Teams on an as-needed basis. RO
staff will provide regular feedback regarding the quality of the cases
deemed ready-for-decision by TVC.
FDC Partnerships in Other States
Since our last partnership with TVC, VA has been reviewing and
reengineering our business processes in collaboration with both
internal and external stakeholders, including VSOs, state and county
service officers, and Congress, to constantly improve our claims
process using best practices and ideas. There are approximately 8,000
Veterans service officers nationwide, and they are an integral part of
our transformation initiatives, particularly the FDC program.
In December 2009, the Chicago RO was selected to pilot the FDC
initiative. Since the beginning of the FDC program, open and continual
communication has occurred between the Chicago RO and the collocated
VSOs. Through this pilot, VBA confirmed that the FDCs allow employees
to spend less time developing and gathering evidence for claims and
spend more time rating claims and reducing the backlog.
The Togus Regional Office has also established a robust FDC program
by forming a strong relationship with VSOs in the Maine. VBA especially
recognizes the Maine Department of Veterans Services for the
outstanding assistance they are providing to the Veterans they
represent, submitting 42 percent of their claims as FDCs.
On July 31, 2012, an FDC workshop was held in Washington, DC, for
representatives from 10 VSOs. The goal of the workshop was to emphasize
the positive impact of filing FDCs, and VBA emphasized that the receipt
of DBQs with FDCs would further improve processing time. A presentation
on the technical process of submitting a FDC was provided, and the
Director of the Chicago Regional Office led a discussion on how ROs and
VSOs can work together to increase participation in the FDC program.
Conclusion
VSOs and state and county service officers, such as TVC, are
important partners in VBA's transformation to better serve Veterans,
their families, and survivors. In our pilot projects with TVC, VBA
experienced positive outcomes; we believe there are greater
opportunities to improve service and productivity in the new
partnership with TVC. The broader scope from the new Strike Force Teams
can assist VBA in decreasing the backlog in the Houston and Waco RO's.
VA is working on a standard operating procedure that will clearly
outline the responsibilities of both VA and TVC and assist the agencies
in ensuring a smooth process. VA will carefully track and monitor the
Strike Force Teams and assess the potential for future partnerships or
pilots to be expanded to other ROs.
Mr. Chairman, this concludes my statement. I would be pleased to
answer any questions you or other Members of the Subcommittee may have.
Questions for the Record
Questions from Honorable Jon Runyan, Chairman, Subcommittee on
Disability Assistance and Memorial Affairs to Ms. Diana Rubens, Deputy
Under Secretary for Field Operations:
(1) How many employees at the Waco Regional Office have gone
through VA's new Challenge training?
(2) How is VA measuring the progress of those going through the
Challenge training against those who have not been through the
training?
(3) What have the results been so far?
Responses from Ms. Diana Rubens, Deputy Under Secretary for Field
Operations to Honorable Jon Runyan, Chairman, Subcommittee on
Disability Assistance and Memorial Affairs:
1. Answer: Deliverables: The number of Waco and Houston VARO
employees that have received the new eight week Challenge Training.
The number of Waco and Houston Regional Office employees that
received the new eight week Challenge training is provided below. Also
included is the number of VSRs that attended the four week Challenge
session. The eight week VSR Challenge session included both Pre- and
Post-Determination training, allowing employees to work on either team.
The four week VSR training session provided training on either Pre-or
Post-Determination, but not both.
Challenge Sessions 2011-6 through 2012-5
----------------------------------------------------------------------------------------------------------------
Regional Office RVSR (8 Week) VSR (8 Week) VSR (4 Week)
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Houston......................................................... 23 6 10
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Waco............................................................ 103 49 31
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2. Answer: Comparing a current cohort to employees to a previous
Challenge cohort is not feasible. Beginning in FY 2012, Compensation
Service modified the employee performance tracking system (ASPEN) so
VBA could begin tracking Challenge students' production. Before we
implemented that modification, comparing the aggregate performance of
previous cohorts of Challenge students or existing journey-level
employees who have not been through Challenge would have been extremely
time consuming and difficult, requiring manual generation and timely
aggregation of hundreds of individual reports.
3. Answer: THe first group of VSRs who completed the revised
Challenge curriculum in September 2011 produced an average of 5.58
weighted cases per day during September 2012. The national production
standard for a VSR GS-9 (typically the grade after 12 months) is 5
weighted cases per day. The September 2011 cohort of Challenge-trained
VSRs is exceeding its aggregated performance expectation by more than
10 percent.
The first group of RVSRs who completed the revised Challenge
curriculum in September 2011 produced 2.92 weighted cases per day
during September 2012. The production standard for RVSRs on the job for
12 months is typically between 1.5 and 2 weighted cases per day. (There
are no national production standards for non-journey level RVSRs at
this time. Each office negotiates locally). The September 2011 cohort
of Challenge-trained RVSRs is exceeding its aggregated performance
expectation by approximately 50 percent.