THE HONORABLE DANIEL L. COOPER
UNDER SECRETARY FOR BENEFITS
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE HOUSE COMMITTEE ON VETERANS' AFFAIRS
SUBCOMMITTEE ON BENEFITS
June 6, 2002
Mr. Chairman and members of the Subcommittee, thank you for the opportunity to testify today on the status of the Department's implementation of the VA Claims Processing Task Force's recommendations and to explore the potential for expanded partnerships with the Veterans Service Organizations.
On November 6, 2001, I testified before the House Committee on Veterans' Affairs as Chairman of the VA Claims Processing Task Force. At that hearing, I provided the Committee with an overview of the Task Force's findings and conclusions and outlined a series of recommendations for tackling the claims backlog and improving claims processing. About that time, Mr. Guy McMichael and Mr. Stan Sinclair were appointed as acting Under Secretary for Benefits and Deputy Under Secretary, respectively. Both had been members of the Claims Processing Task Force. They immediately initiated actions that laid the groundwork for our success to date. On April 2, I had the honor of being sworn in as the VA Under Secretary for Benefits, and Mr. Sinclair has been appointed Deputy on a permanent basis. I am appearing before you to report on the progress that VBA has made in carrying out the Task Force recommendations. And, although we have only begun to see the effect of implementing the easiest recommendations, the trends are in the proper direction and productivity is greater at every regional office.
Subsequent to the hearing in November, VBA developed an Implementation Plan that converted the Task Force recommendations into a series of short-, medium- and long-term tasks for achieving the claims processing objectives. Since becoming Under Secretary, I have continued the implementation of a number of the recommendations identified by the Task Force and contained in the Implementation Plan. Today I will highlight those initiatives that were identified as short-term. Obviously, we would never implement all 20 of the short-term changes immediately. Each could individually be completed in six months, but the accomplishment of all of them must take longer. I have attached to this testimony a summary of all the recommendations contained in the Plan. Note that the Task Force Report outlined 34 recommendations (20 short-term and 14 medium-term). For implementation purposes, VBA has defined 62 actions we can take to fully accomplish the 34 recommendations. We have aggressively pursued implementation of the recommendations: 10 of the action items are already completed.
The three priority areas where we are focusing our attention are: 1) reducing the size of the backlog and the time veterans must wait for decisions on their claims; 2) ensuring high quality decisions while producing large numbers of claims; and 3) establishing greater accountability and consistency in regional office operations.
When I assumed the challenge of guiding VBA, I knew that reducing and controlling the claims processing backlog would be the primary undertaking. While we have only just started on the path to success, I believe that we are on the right track. A number of initiatives have been put into place to help accomplish our goal.
One of our most successful initiatives has been the Tiger Team, which is located at the Cleveland Regional Office. The Secretary implemented the Tiger Team in November 2001 in order to process the oldest claims in VBA and to focus on claims from veterans age 70 and older that have been pending over one year. The emphasis was to be on War World II and Korean War veterans whose claims were mired in the system. Through the end of May, the Tiger Team has completed 10,162 claims, and of these completed claims, the majority of which were for veterans over the age of 70. Working in tandem with the Tiger Team are nine Resource Centers. These Centers have completed 21,548 claims. By the end of calendar year 2002, we hope they will have completed 65,000 claims.
We have also taken action to significantly reduce the time required to obtain military records needed to resolve these long-pending claims. The VA Liaison Office at the National Personnel Records Center responds to Tiger Team requests within an average of 48 hours. Procedures have also been established to screen all records requests based on date of claim and to process the oldest claims on a priority basis. The number of requests related to these older claims has been reduced by almost 4,000 since October 2001.
We have also made great strides in improving the way annual income adjustments are made for pension recipients. The processing of all of the eligibility verification reports ( EVRs) was consolidated to three Pension Maintenance Centers this year. Utilizing three sites across the country exclusively for processing EVRs has allowed the regional offices to focus on VA's backlog of rating claims. This dramatic change was accomplished with no disruption in the pension benefit program.
The Task Force also recommended that the Board of Veterans' Appeals develop for additional evidence rather than remanding all cases back to the regional offices. Regulations to effect this recommendation have been implemented. By allowing the Board to develop for evidence, VA has virtually eliminated the time-consuming requirement of sending cases back to the local offices for additional development. This will free up resources in the regional offices to spend more time on previously remanded cases still pending at the regional offices and new claims. The Board of Veterans' Appeals has also augmented the Tiger Team in Cleveland where staff counsel drafted 3,651 Statements of the Case. In addition, the Board sent staff counsels to 19 regional offices where they reviewed the oldest pending appeals to assist in expediting the appellate workload.
To help VBA achieve uniformity of process, consistency of results across all regional offices, as well as sustain higher levels of productivity, the Task Force recommended that VBA establish specialized processing teams within each Veterans Service Center. This organization will narrow the focus and reduce the complexities of each employee's work. The result will be more efficiency in the claims process. This processing model requires six separate and distinct teams - Triage, Pre Determination, Rating, Post Determination, Appeals, and Public Contact. These new processing teams have been prototyped in four regional offices, and in July through September we will implement this organization nationwide. We are doing this at every regional office because lack of accountability and inconsistent processes between and among offices were major contributors to our inability to attack and overcome the problems of changing rules and increasing claims demands.
This model will help us to more quickly and critically examine our results and develop the talented new people that we are now hiring. We must demand timeliness, consistency, and higher quality of decisions, so that veterans' claims are treated in a prompt, appropriate, and dependable manner no matter where the claim is adjudicated. As a result of the Task Force's focus on accountability, national performance plans have been developed for rating veterans service representatives ( RVSRs) and veterans service representatives ( VSRs) that establish both production and accuracy standards.
VBA has also established performance requirements for every Director that are tied directly to the Secretary's priorities. Specific service delivery goals have been set for monthly rating production, improvements in processing times, reductions in the numbers of cases pending over six months, reductions in the total pending inventory, reductions in the number of pending appeals, improvements in remand timeliness, and timeliness of placing claims under control in VBA's processing systems. "Wellness plans" have already been requested of some Directors who have, thus far, failed to achieve the goals specified in the performance plan. These plans include an analysis of the causes of the performance deficiencies and identification of countermeasures to correct the situation.
I unequivocally share the concern for the requirement to maintain quality, especially with the higher output levels expected of employees. There are several recommendations in the Task Force Report designed to help VBA achieve this objective.
One of these is a refinement to our compensation and pension quality assurance process, known as STAR (Systematic Technical Accuracy Review). STAR was originally designed as a "zero defects" process, measuring all aspects of the claims process: complete development of evidence, evaluation of all issues, correctness of evaluations, and proper decision notifications.
The Task Force recommended that the STAR protocol be clarified to highlight determinations that directly affect entitlement, including statutory duty-to-assist requirements, and monetary payments. Those refinements have been made. We continue to address the full range of issues, but now give greater focus to the areas of entitlement and monetary payments. This in turn helps us gear improvement efforts where they can have the greatest impact.
The Task Force also identified the quality of medical examinations as a critical component of decision accuracy. The Compensation and Pension Examination Project ( CPEP) Office in Nashville, Tennessee is a joint VBA/ VHA initiative designed to improve examination report quality.
VBA has moved a portion of its C&P claims processing quality assurance ( STAR) staff to Nashville to support the efforts of the CPEP office. The STAR staff conducts quality assurance reviews of examination reports based on quality protocols developed by the CPEP team with concurrence of a joint VHA/ VBA Clinical Advisory Panel. In addition to conducting a baseline review to provide more detailed information concerning examination report quality and areas requiring improvement, CPEP supports a "Collaborative Examination Improvement Breakthrough" quality improvement series, focusing attention on cooperative efforts between medical centers and regional offices to establish effective communication, identify problems, and resolve examination problems.
One very important area addressed in the Task Force Report is the working partnership between VA and the Veterans Service Organizations (VSOs) to support veterans in the development of ratable claims. In 1998 VA began the "Training, Responsibility, Involvement, and Preparation of Claims," or TRIP program. The goal of TRIP is to help VSO representatives submit fully developed claims so that VA can decide veterans' claims more expeditiously. To achieve this objective, VSOs would be allowed access to VA's computer systems, up to the point the claim is adjudicated. TRIP also included the provision of extensive training in claims development to participating VSOs.
All VBA regional offices have successfully provided both Levels 1 and 2 of TRIP Training to their VSO representatives. A consolidated TRIP training package (Levels 1 & 2 combined into a 32-hour program) is on schedule for national rollout in the fourth quarter of FY 2002. The consolidated package will be used by all regional offices for training beginning the first quarter of FY 2003. The consolidated program was pilot tested at the Washington Regional Office in February with participants from the Veterans of Foreign Wars and the Paralyzed Veterans of America. Three additional regional offices (St. Petersburg, Louisville, and Buffalo) are testing the program during the third quarter of FY 2002. Remote access of VBA computer applications by VSOs who have completed TRIP training is currently being tested. Our Claims Automated Processing System (CAPS) remote access test began on May 20. Plans are to incrementally expand the test to 49 additional out-based users over the next two months.
Looking to the future of this working partnership between VA and the VSOs, we see a number of opportunities and a number of issues. We are having ongoing discussions with VHA regarding electronic access by VSOs to VAMC treatment records. We are working with several regional offices (Buffalo, Louisville, Seattle, & Montgomery) to devise a method to measure how well VSOs are developing TRIP claims before they are submitted ("ready to rate" or "ready for action").
We have also increased VSO involvement in development of regulatory and procedural changes. We consult with them on major issues and solicit their advice and input prior to drafting changes. This increased collaboration promises to improve our policy development and our responsiveness to veterans' needs.
There may be or may have been several ways to attack VBA's claims processing problems. However, I am convinced that the Task Force Report offers the best plan for dramatically decreasing the backlog and providing VA with a viable long-term claims process. The attributes of the plan are accountability, integrity, and professionalism. The results that we are looking for are quality, uniformity, consistency, efficiency, and effectiveness. With all of VA and the VSOs working together as a team, I believe we can make a difference for veterans.
Mr. Chairman, this concludes my prepared testimony. I will be pleased to answer any questions you or the members of the Committee might have.