Going through the motions: Claims processing at the VBA

Going through the motions: Claims processing at the VBA
Posted by Tom Tarantino [1] on December 5 [2] 2008

The disability claims backlog is about more than numbers. It is all too familiar to hear that VA disability claims are endlessly backlogged.  With the national average of claims pending over 6 months hovering consistently at around 20% [3], it is clear that the problem is system wide with no easy solutions.  In 2007 and 2008 Congress increased the VA budget to allow for the hiring of over 4000 new claims processors.  This was a major step forward, but it did not address the underlying problem that nobody talks about.  It's easy to throw money at the system and simply hire more hands to process the claims, but what happens when the backlog remains, or the numbers simply shift from claims processing to claims appeals? This is where we get to the heart of the problem.  The biggest issue is not with the number of claims processed, but with the quality of the processed claims.  Quality is the key to timeliness. Timeliness follows from quality because poor record development, failure to accurately process claims and erroneous decisions require the claims to continually cycle through the process, which adds to the load of an already overburdened system. An article in newsday.com this week [4] outlines many of the issues surrounding VA disability claims development in the New York office:

The VA became so concerned that employees had misplaced key documents such as marriage certificates and medical records that they offered amnesty to encourage their return. Some 700 documents were recovered anonymously, Walcoff said. The massive agency has already been pummeled by accusations that employees have lost, misplaced or shredded documents across the country.

While systematic boneheaded mistakes [5] are certainly alarming and gaining national attention [6], there is a deeper issue involved that speaks to a culture at the Veterans Benefits Administration (VBA) that places premiums on easily quantifiable statistics, a work credit system that focuses on quantity, and poor methods of training VBA employees and managers. VBA's current work credit system does not take into account the correct or incorrect outcome of the claim, but rather focuses on the number of tasks completed by the individuals rating the claim. This ultimately leads to very little individual accountability within the VBA.  Employees receive credit for the work they do, regardless of whether they did the work correctly. Under this system, there is little incentive for any employee to do the work correctly the first time. According to a recent GAO report [7] the VBAs methods of training are also sorely lacking in both accountability and proper methodology.

Currently, claims processors at the VA regional offices must conduct 80 hours of annual standardized training as part of the VA's performance management system.  Yet VBA officials could not identify the criteria or analysis that was used in determining the 80 hour requirement.

Additionally, the agency does not hold claims processors or managers accountable for meeting the annual training requirement. Furthermore, the training programs are not based on feedback from processors, nor do they take in to account the most common errors found in processing over the last fiscal year. What this all adds up to is a passive and apathetic VBA that did not prepare for the influx of veterans from the wars in Iraq and Afghanistan, nor is jumping to reform its current broken practices.  I hope that the new administration and the new VA Secretary will replace the current crop of managers in the VBA with leaders who are not afraid ask tough questions and implement reforms.  Until then, it's up to all of us to keep watching and ensure that the VA is ultimately accountable to those that it is supposed to serve.