Strategic Goal: Provide One VA world-class service to veterans and their families through the effective management of people, technology, processes, and financial resources. VA will operate as a veteran-focused organization that provides high quality, accessible, and timely information and service through the development and maintenance of a high-performing workforce, the application of state-of-the-art technologies, the continuous improvement of processes, and the effective allocation of dollars.

Objective: Improve VA’s overall governance and operational management, and access to benefits and services to meet or exceed the expectations of veterans and their families, while ensuring full compliance with applicable laws, regulations, and financial commitments.

Performance Goal: Complete rating-related actions on compensation and pension claims in an average of 142 days.

Timeliness of claims processing, especially of rating-related actions, continues to be an important issue for the Department. Prior to FY 1999, information about claims processing timeliness probably understates actual performance by a substantial margin. An Inspector General audit of three end products revealed that timeliness reported by regional offices was in error by as much as 34 percent. Core rating actions include original compensation claims, original DIC claims, original pension claims, reopened compensation claims, reopened pension claims, routine examinations, and reviews due to hospitalization.

We will pursue several initiatives during the fiscal year that will significantly improve claims processing performance. The most important ones are briefly described below.

• Additional FTE Resources – VBA will redirect 183 existing FTE and hire 243 new FTE to claims adjudication to improve accuracy and timeliness of processing.

• Benefits Delivery at Discharge – VBA will continue to expand its initiative to develop claims, conduct disability examinations, and prepare rating decisions for service persons awaiting discharge from active duty.

• Personnel Information Exchange System (PIES) – Through this initiative, VBA will implement enhancements to the system, which has been operational since December 1998. We will identify options for exporting the application beyond the National Personnel Records Center (NPRC) allowing for electronic information requests to all military records centers (that is, Defense Finance and Accounting Services, Cleveland, OH; Naval Reserve Personnel Records Center, New Orleans, LA). VBA and VHA continue to develop the component that will allow for the exchange of service data between VHA and NPRC.

• Virtual VBA – This project will launch VA into the 21^st Century by allowing us to process veterans claims in an electric environment. Since many of our stakeholders, including DoD and other government agencies, are beginning to use digital imaging technology, we must be in an environment that will facilitate the exchange of information with them.

• VETSNET Migration (C&P Benefits Payment Replacement System) – VA will pursue an incremental strategy as the most effective means to complete the development of the C&P payment system. A key component of the strategy is the completion of the award, payment, and accounting subsystem. Completion of this forms the basis for replacing the finance and accounting code with a standardized, on-line accounting and payment system that will interface with the Financial Management System.

VBA will consult with VHA and appropriate DoD officials to formulate proposals supporting claims development and the physical examinations process prior to separation with a disability rating at or near separation from active duty. National, state, and county veterans service organizations are encouraged to be an integral part of the planning and execution of this project.

VBA will work with DoD and NPRC to create a local area network that will allow electronic control and exchange of military medical records and service verification. VBA will also work with VHA to streamline the exchange of beneficiary information.

GAO and IG report that the timeliness of adjudication decisions and slow appellate decisions continue to be a major challenge in VA’s compensation and pension programs. They also report that the timeliness and quality of medical examinations conducted for the purposes of deciding C&P claims need to be improved. VA has taken several steps to address these challenges.

Claims Processing Timeliness. VBA continues to pursue the redefined claims processing concepts outlined in its Roadmap to Excellence. Nine SDNs have been established which align regional offices geographically so that the offices in each network can share resources and provide support to one another.

Also among the outlined concepts is the continued merger of veterans services functions with adjudication functions into Veterans Service Centers where veterans service representatives will use a case manager approach to complete claims for veterans benefits. Although this merging of functions adversely affects our ability to complete claims in the short term, the long-term effect will be the ability to provide more timely and accurate service to our veteran customers.

This revised process will be supported by initiatives that affect specific points in the claims adjudication process. Such initiatives include Benefits Delivery at Discharge, PIES, and Electronic Burial Claims.

Appeals Processing. For a one-year period ending November 30, 1998, we tested the viability of the Decision Review Officer (DRO) position as an enhancement to the appeal process. The results of the test indicated significant improvements in the appellate process. Timeliness of decisions, from the date of the formal appeal to the date of the final decision, was reduced from an average of 421 days to 316 days while the number of appeals continuing to the Board of Veterans’ Appeals (BVA) was reduced by 10 percent. Cases reviewed by DRO achieved an accuracy rate of 81 percent, compared to the national accuracy rate of 64 percent. The data also suggested that the recommended process would enable BVA to issue a final decision, thereby reducing the number of remanded decisions. The process has been refined and will be implemented nationwide in the near future.

The expansion of video-conferencing offers claimants the opportunity to have a hearing with BVA decision-makers without waiting for more than a year for a Travel Board hearing or undergoing the expense and inconvenience of a trip to Washington.

VBA and BVA have adopted a joint performance indicator called Appeals Resolution Time, which represents the average number of days it takes VA to resolve an appeal, from the date of the Notice of Disagreement to the date of resolution.

A joint VBA/BVA work group has been formed to develop a methodology to improve overall claims processing timeliness. The work group developed a common definition of the term "issue." In June 1999, the Veterans Appeals Control and Locator System (VACOLS) became the only tracking system for appeals, covering all stages from the receipt of the Notice of Disagreement through final disposition by BVA or the Court of Appeals for Veterans Claims (CAVC). This version implements the tracking of individual issues being appealed and will allow for statistical analysis of the types of disabilities which are most commonly appealed, remanded, and reversed after the regional office’s decision.

Timeliness and Quality of Compensation and Pension Medical Examinations. VBA and VHA continue to work together to improve the timeliness and quality of medical examination reports done for disability evaluation purposes. VBA and VHA have jointly designed improved worksheets for every system of the body to guide physicians in performing examinations that meet VBA’s needs. In addition, VBA has provided training to VHA physicians.

In March 1998, the Under Secretaries for Benefits and Health jointly issued a memorandum to VHA VISN Directors, and Directors of VBA regional offices and VHA medical facilities, advising them that VBA regional offices and VHA medical facilities were expected to work in cooperation to reduce the number of incomplete examinations and to initiate all reasonable efforts at the local level to address the issue of incomplete examinations.

In January 1999, under the joint Disability Examination Steering Committee, VBA and VHA established a work group with a goal of significantly reducing the number of incomplete examinations. The work group has been asked to analyze the reasons for the high rate of incomplete examinations and to offer recommendations for reduction.

Public Law 104-275 authorized VBA to conduct a pilot project to measure the effectiveness of contracting with a non-VA medical source and its impact on veterans. Data are being collected in conjunction with the Contract Disability Examination Pilot.

The timeliness of rating-related actions is measured using data captured automatically by the Benefits Delivery Network as part of claims processing.

In its September 1998 report, the IG found that three key compensation and pension timeliness measures lacked integrity. They reported that the information system was vulnerable both to reporting errors and to manipulation by regional office personnel to show better performance than was actually achieved. VA has taken several steps to ensure it has accurate and reliable data. Since October 1997, we have maintained a database of all end-product transactions that are analyzed, on a weekly basis, to identify questionable actions by regional offices. The C&P Service reports quarterly on its findings and calls in cases for review from stations with the highest rates of questionable practices.

(For additional information on this performance goal, refer to General Operating Expenses, Volume 4, Chapter 2B.)