Veterans' Benefits

Better Assessments Needed to Guide Claims Processing Improvements Gao ID: HEHS-95-25 January 13, 1995

Slow claims processing and poor customer service have long been recognized as serious problems for the Department of Veterans Affairs (VA). As early as 1990, VA began encouraging its regional offices to improve their claims processing system, but processing times and backlogs have increased rather than decreased. At the end of fiscal year 1994, nearly 500,000 claims awaited a VA decision. About 65,000 of these were initial disability compensation claims. On average during fiscal year 1994, veterans waited more than seven months for their initial disability claims to be decided and, if approved, payments to begin; some waited much longer. This report discusses VA's current plans to change regional office claims processing and assesses VA's plans to determine the effectiveness of those changes.

GAO found that: (1) VA has taken steps to ensure that VARO implement the changes necessary to improve overall service to veterans; (2) VA needs to implement the Blue Ribbon Panel's recommendations to improve disability claims processing; (3) VA has developed several model claims processing structures designed to reorganize staff so that fewer resources are devoted to clerical functions; (4) the models will serve as a framework for implementing other initiatives such as improving claims folder management and the use of evidence received by telephone or fax; (5) VA is also developing regulations and training materials to encourage VARO to adopt these improvement initiatives; (6) VARO have been given significant flexibility to implement initiatives in ways they believe are appropriate; (7) VA may not have a sound basis for determining what additional changes need to be made for guiding future improvements because it has not developed adequate plans for evaluating the merits of the various initiatives; and (8) VA does not have a formal mechanism to disseminate information about the effectiveness of regional initiatives and other VARO experiences with these initiatives.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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