Veterans' Disability Benefits
Claims Processing Challenges Persist, while VA Continues to Take Steps to Address Them Gao ID: GAO-08-473T February 14, 2008The Subcommittee on Disability Assistance and Memorial Affairs, House Veterans' Affairs Committee, asked GAO to present its views on the Department of Veterans Affairs' (VA) disability claims process. This statement discusses (1) claims processing challenges VA faces, (2) steps VA is taking to address these challenges, and (3) opportunities for more fundamental reform. GAO has reported and testified on this subject on numerous occasions. GAO's work has addressed VA's efforts to improve the timeliness and accuracy of decisions on claims, VA's efforts to reduce pending claims levels, and concerns about decisional consistency. This testimony is based on a body of past work, updated as appropriate to reflect the current workload and initiatives.
Despite taking steps to improve its disability claims process, VA continues to face challenges, specifically in reducing the number of claims pending, speeding up the process of deciding claims, and improving accuracy and consistency of decisions across regional offices. For example, between fiscal years 2003 and 2007, the inventory of claims awaiting a decision by VA grew by more than 50 percent to a total of about 392,000, and the average number of days claims were pending increased by 3 weeks to 132 days. Further, GAO and VA's Inspector General have identified concerns about the consistency of decisions across regional offices. Factors affecting VA's claims-processing performance may include increases in the number and complexity of claims being filed and the potential impacts of laws and court decisions. VA continues to take steps to help improve claims-processing performance, including requesting funding for additional staff. The President's fiscal year 2009 budget request funds an increase of more than 2,600 additional full-time equivalent employees over fiscal year 2007 levels to process claims. Beyond the steps VA is taking to address its claims processing challenges, opportunities for significant performance improvement may lie in more fundamental reform of VA's disability compensation program. Such reforms could include reexamining program design such as updating the disability criteria to reflect the current state of science, medicine, technology, and labor market conditions. It could also include examining the structure and division of labor among field offices. Recent studies conducted by presidential and congressionally appointed commissions have recommended some fundamental changes, including updating VA's rating schedule, which provides the basis for decisions about eligibility for benefits.
GAO-08-473T, Veterans' Disability Benefits: Claims Processing Challenges Persist, while VA Continues to Take Steps to Address Them
This is the accessible text file for GAO report number GAO-08-473T
entitled 'Veterans' Disability Benefits: Claims Processing Challenges
Persist, while VA Continues to Take Steps to Address Them' which was
released on February 14, 2008.
This text file was formatted by the U.S. Government Accountability
Office (GAO) to be accessible to users with visual impairments, as part
of a longer term project to improve GAO products' accessibility. Every
attempt has been made to maintain the structural and data integrity of
the original printed product. Accessibility features, such as text
descriptions of tables, consecutively numbered footnotes placed at the
end of the file, and the text of agency comment letters, are provided
but may not exactly duplicate the presentation or format of the printed
version. The portable document format (PDF) file is an exact electronic
replica of the printed version. We welcome your feedback. Please E-mail
your comments regarding the contents or accessibility features of this
document to Webmaster@gao.gov.
This is a work of the U.S. government and is not subject to copyright
protection in the United States. It may be reproduced and distributed
in its entirety without further permission from GAO. Because this work
may contain copyrighted images or other material, permission from the
copyright holder may be necessary if you wish to reproduce this
material separately.
Testimony:
Before the Subcommittee on Disability Assistance and Memorial Affairs,
Committee on Veterans' Affairs, House of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery:
Expected at 2:00 p.m. EST Thursday, February 14, 2008:
Veterans' Disability Benefits:
Claims Processing Challenges Persist, while VA Continues to Take Steps
to Address Them:
Statement of Daniel Bertoni, Director:
Education, Workforce, and Income Security:
GAO-08-473T:
GAO Highlights:
Highlights of GAO-08-473T, a testimony before the Subcommittee on
Disability Assistance and Memorial Affairs, Committee on Veterans'
Affairs, House of Representatives.
Why GAO Did This Study:
The Subcommittee on Disability Assistance and Memorial Affairs, House
Veterans‘ Affairs Committee, asked GAO to present its views on the
Department of Veterans Affairs‘ (VA) disability claims process. This
statement discusses (1) claims processing challenges VA faces, (2)
steps VA is taking to address these challenges, and (3) opportunities
for more fundamental reform.
GAO has reported and testified on this subject on numerous occasions.
GAO‘s work has addressed VA‘s efforts to improve the timeliness and
accuracy of decisions on claims, VA‘s efforts to reduce pending claims
levels, and concerns about decisional consistency. This testimony is
based on a body of past work, updated as appropriate to reflect the
current workload and initiatives.
What GAO Found:
Despite taking steps to improve its disability claims process, VA
continues to face challenges, specifically in reducing the number of
claims pending, speeding up the process of deciding claims, and
improving accuracy and consistency of decisions across regional
offices. For example, between fiscal years 2003 and 2007, the inventory
of claims awaiting a decision by VA grew by more than 50 percent to a
total of about 392,000, and the average number of days claims were
pending increased by 3 weeks to 132 days. Further, GAO and VA‘s
Inspector General have identified concerns about the consistency of
decisions across regional offices. Factors affecting VA‘s claims-
processing performance may include increases in the number and
complexity of claims being filed and the potential impacts of laws and
court decisions.
VA continues to take steps to help improve claims-processing
performance, including requesting funding for additional staff. The
President‘s fiscal year 2009 budget request funds an increase of more
than 2,600 additional full-time equivalent employees over fiscal year
2007 levels to process claims.
Figure: Rating-Related Claims Pending at End of Period, Fiscal Years
2000-2007:
This figure is a combination bar chart showing rating-related claims
pending at end of period, fiscal years 2000-2007. The X axis represents
the fiscal year, and the Y axis represents the claims pending (in
thousands). One bar represents pending over 6 months, and the other bar
represents the total pending.
Fiscal year: 2000;
Pending over 6 months: 2000: 57;
Total pending: 228.
Fiscal year: 2001;
Pending over 6 months: 2001: 172;
Total pending: 2001: 421.
Fiscal year: 2002;
Pending over 6 months: 2002: 122;
Total pending: 2002: 346.
Fiscal year: 2003;
Pending over 6 months: 2003: 47;
Total pending: 2003: 254.
Fiscal year: 2004;
Pending over 6 months: 2004: 67;
Total pending: 2004: 321.
Fiscal year: 2005;
Pending over 6 months: 2005: 72;
Total pending: 2005: 346.
Fiscal year: 2006;
Pending over 6 months: 2006: 83;
Total pending: 2006: 378.
Fiscal year: 2007;
Pending over 6 months: 2007: 101;
Total pending: 2005: 392.
[See PDF for image]
Source: VA data.
[End of figure]
Beyond the steps VA is taking to address its claims processing
challenges, opportunities for significant performance improvement may
lie in more fundamental reform of VA‘s disability compensation program.
Such reforms could include reexamining program design such as updating
the disability criteria to reflect the current state of science,
medicine, technology, and labor market conditions. It could also
include examining the structure and division of labor among field
offices. Recent studies conducted by presidential and congressionally
appointed commissions have recommended some fundamental changes,
including updating VA‘s rating schedule, which provides the basis for
decisions about eligibility for benefits.
To view the full product, including the scope and methodology, click on
[hyperlink, http://www.GAO-08-473T. For more information, contact
Daniel Bertoni at (202) 512-7215 or bertonid@gao.gov.
[End of section]
Mr. Chairman and Members of the Committee:
I am pleased to have the opportunity to comment on the claims-
processing challenges and opportunities facing the Department of
Veterans Affairs' (VA) disability compensation and pension programs.
Through these programs, VA provided about $37.5 billion in cash
disability benefits to more than 3.6 million veterans and their
survivors in fiscal year 2007. For years, the claims process has been
the subject of concern and attention by VA, Congress, and veterans
service organizations, due in large part to long waits for decisions
and large numbers of claims pending a decision. Further, we and VA's
Inspector General have identified concerns about the consistency of
decisions across regional offices. These concerns have continued and
been magnified as veterans of the conflicts in Iraq and Afghanistan,
and survivors of service members who have died in those conflicts face
similar issues as they seek VA disability benefits. In January 2003, we
designated modernizing VA and other federal disability programs as a
high-risk area, because of these service delivery challenges, and
because our work over the past decade has found that these programs are
based on outmoded concepts from the past. More recently, the President
and Congress established commissions to study VA's disability
compensation system.
You asked us to discuss our views on VA's disability claims process.
Specifically, my statement today addresses (1) claims processing
challenges VA faces, (2) steps VA is taking to address these challenges
and (3) opportunities for more fundamental reform. My statement draws
on a number of prior GAO reports and testimonies that were conducted in
accordance with generally accepted government auditing standards. (See
related GAO products.) We updated information as appropriate to reflect
the current status of VA claims processing workload and initiatives.
In summary, despite taking steps to improve its processing of
disability claims, VA continues to face challenges, specifically in
speeding up the process of deciding claims, reducing the number of
claims pending, and improving the accuracy and consistency of decisions
across regional offices. For example, between fiscal years 2003 and
2007, the inventory of claims awaiting a decision grew by more than 50
percent to a total of about 392,000, in part because of increased
filing of claims, including those filed by veterans of the Iraq and
Afghanistan conflicts and from VA's increased outreach to
veterans.[Footnote 1] During the same period, the average number of
days these claims were pending increased by 21 days, to an average of
132 days. Further, we and VA's Inspector General have identified
concerns about the consistency of decisions across regional offices.
Some of the factors affecting VA's claims processing performance may
include increases in the number and complexity of claims being filed
such as those for post-traumatic stress disorder (PTSD), reopening of
existing claims, and the potential impacts of laws and court decisions.
VA has taken a number of steps to help improve claims processing
performance, including requesting funding for additional staff,
establishing "tiger teams" to help process certain claims, and
expediting the processing of claims filed by veterans of Operation
Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The
President's fiscal year 2009 budget request funds an increase of over
2,600 full-time equivalent employees from actual fiscal year 2007
levels to process compensation claims. While the infusion of a large
number of staff has the potential of increasing VA's claims processing
capacity, quickly absorbing these many staff will likely present human
capital challenges for VA such as how to develop, train, and deploy
them.
Beyond the steps VA is taking, opportunities for significant
performance improvement may lie in more fundamental reform of VA's
disability compensation program. This would include reexamining program
design as well as the structure and division of labor among field
offices. For example, after more than a decade of research, we have
found that VA's and other federal disability programs have not been
updated to reflect the current state of science, medicine, technology,
and labor market conditions. More specifically, VA's rating schedule,
upon which disability decisions are made, is based primarily on
estimates made in 1945 about the effect of service-connected
impairments on the average individual's ability to perform jobs
requiring manual labor. We and at least two recent commissions--the
President's Commission on Care for America's Returning Wounded
Warriors, commonly referred to as the Dole-Shalala Commission, and the
Veterans' Disability Benefits Commission--appointed to study VA's
disability compensation system, have recommended updating VA's rating
schedule, among other fundamental reforms.
Background:
VA pays monthly disability compensation benefits to veterans with
service-connected disabilities (injuries or diseases incurred or
aggravated while on active military duty) according to the severity of
the disability. VA also pays additional compensation for some
dependents--spouses, children, and parents-of veterans.[Footnote 2]
VA's pension program pays monthly benefits based on financial need to
certain wartime veterans or their survivors.[Footnote 3]
When a veteran submits a claim to any of the Veterans Benefits
Administration's (VBA) 57 regional offices, a veterans service
representative is responsible for obtaining the relevant evidence to
evaluate the claim. Such evidence includes veterans' military service
records, medical examinations, and treatment records from VA medical
facilities and private medical service providers. Once a claim has all
the necessary evidence, a rating specialist evaluates the claim and
determines whether the claimant is eligible for benefits. If the
veteran is eligible for disability compensation, the rating specialist
assigns a percentage rating based on degree of disability. A veteran
who disagrees with the regional office's decision can appeal to VA's
Board of Veterans' Appeals and then to U.S. federal courts.[Footnote 4]
VA Continues to Face Challenges in Improving Its Claims Processing:
VA continues to experience significant service delivery challenges--
large pending workloads, lengthy processing times, and inaccurate and
inconsistent decisions. A number of factors contribute to these
challenges, such as an increase in the numbers and complexity of the
claims veterans are filing and the effects of recent laws and court
decisions. These factors have eroded some of the earlier gains VA made
in reducing claims backlogs. For example, VA made progress in fiscal
years 2002 and 2003 reducing the size and age of its pending claims
inventory, but it has lost ground since then.
VA's inventory of claims awaiting a decision and their average time
pending has increased significantly in the last 4 years, in part
because of an increase in the number of claims received. The number of
pending claims increased by more than 50 percent from the end of fiscal
year 2003 to the end of fiscal year 2007 to about 392,000. During the
same period, the number of claims pending longer than 6 months more
than doubled from about 47,000 to about 101,000 (see fig. 1).
Figure 1: Rating-Related Claims Pending at End of Period, Fiscal Years
2000-2007:
This figure is a combination bar chart showing rating-related claims
pending at end of period, fiscal years 2000-2007. The X axis represents
the fiscal year, and the Y axis represents the claims pending (in
thousands). One bar represents pending over 6 months, and the other bar
represents the total pending.
Fiscal year: 2000;
Pending over 6 months: 2000: 57;
Total pending: 228.
Fiscal year: 2001;
Pending over 6 months: 2001: 172;
Total pending: 2001: 421.
Fiscal year: 2002;
Pending over 6 months: 2002: 122;
Total pending: 2002: 346.
Fiscal year: 2003;
Pending over 6 months: 2003: 47;
Total pending: 2003: 254.
Fiscal year: 2004;
Pending over 6 months: 2004: 67;
Total pending: 2004: 321.
Fiscal year: 2005;
Pending over 6 months: 2005: 72;
Total pending: 2005: 346.
Fiscal year: 2006;
Pending over 6 months: 2006: 83;
Total pending: 2006: 378.
Fiscal year: 2007;
Pending over 6 months: 2007: 101;
Total pending: 2005: 392.
[See PDF for image]
Source: VA data.
[End of figure]
Similarly, while VA reduced the average number of days claims were
pending from a high of 182 days at the end of fiscal year 2001 to 111
days at the end of fiscal year 2003, the average age of pending claims
crept back up to 132 days by the end of fiscal year 2007, as shown in
figure 2.
Figure 2: Average Days Pending for VA Compensation and Pension Rating-
Related Claims, Fiscal Years 2000-2007:
This figure is a bar chart showing average days pending for VA
compensation and pension rating-related claims, fiscal years 2000
through 2007.
2000: 138;
2001: 182;
2002: 174;
2003: 111;
2004: 118;
2005: 120;
2006: 127;
2007: 132.
[See PDF for image]
Source: VA data.
[End of figure]
A number of factors are contributing to this increase in VA's inventory
of pending claims, and their average time pending. First, there has
been a steady increase in the number of claims filed--including those
filed by veterans of the Iraq and Afghanistan conflicts--from about
579,000 in fiscal year 2000 to about 838,000 in fiscal year 2007, an
increase of about 45 percent. VA projects claims receipts to increase
to about 872,000 in fiscal year 2009 and cautions that ongoing
hostilities in Iraq and Afghanistan, and the Global War on Terror in
general, may further increase its workload. VA also attributes
increased claims receipts to its efforts to increase outreach to
veterans and service members. For example, VA reports that in fiscal
year 2006, it provided benefits briefings to about 393,000 separating
service members, up from about 210,000 in fiscal year 2003. VA has also
noted that the number of veterans receiving compensation has increased
by about a half million from fiscal years 2000 to 2007. VA anticipates
the number of reopened claims will increase as compensation recipients-
-many of whom suffer from chronic progressive disabilities such as
diabetes, mental illness, and cardiovascular disabilities--reopen
claims for increased benefits as they age and their conditions worsen.
Another factor affecting processing times is the complexity of cases,
in both terms of numbers and types of disabilities veterans are
claiming. According to VA, some veterans are citing more disabilities
in their claims than in the past and these claims can take longer to
complete because each disability needs to be evaluated separately. VA
reported that the number of cases with eight or more disabilities
claimed increased by 168 percent--from about 21,800 to about 58,500--
from 2000 to 2007. Additionally, VA notes that it is receiving claims
for new and complex disabilities related to combat and deployments
overseas, including those based on environmental and infectious disease
risks and traumatic brain injuries. Further, VA reports receiving
increasing numbers of claims for compensation for PTSD, which is
generally more difficult to evaluate, in part because of the evidence
required to link the disorder to a particular event. According to VA,
from 1999 through 2007, the number of veterans receiving compensation
benefits for PTSD increased from 120,000 to nearly 300,000.
Further, a number of statutes[Footnote 5] and court decisions[Footnote
6] related to VA's disability claims process have affected VA's ability
to process claims in a timely manner. For example, VA stated that the
Veterans Claims Assistance Act of 2000 significantly increased the
length and complexity of claims development by adding more steps to the
process and lengthening the time it takes to develop and decide a
claim. VA also notes that legislation and VA regulations have expanded
benefit entitlement, adding to the volume of claims. In recent years,
statutes have created new presumptions of service-connected
disabilities for many Vietnam veterans and former prisoners of
war.[Footnote 7] Also, VA expects additional claims receipts following
enactment of legislation that allows certain military retirees to
receive both military retirement pay and VA disability
compensation.[Footnote 8]
VA Continues to Take Steps to Improve Claims Processing:
VA is taking several steps to improve claims processing. Some near-term
initiatives include the increased use of overtime and use of retired VA
employees to provide training and to assist in processing claims. VA
reported it currently employs 70 rehired annuitants. VA expects these
annuitants to complete 23,000 rating decisions in 2008. VA has also
used other initiatives such as brokering claims between offices to help
manage its claims inventory and establishing special teams to assist in
the processing of claims. For example, VA established teams to process
disability claims for veterans 70 years and older and for expediting
claims of OIF and OEF veterans. In 2007, VA announced an initiative to
provide priority processing of disability claims for all OIF and OEF
veterans', including active duty, National Guard, and reservists.
In VA's fiscal year 2009 budget justification, an increase in claims
processing staff was identified as essential to reducing the pending
claims inventory and improving timeliness. The fiscal year 2009 request
would fund 10,998 full-time equivalent employees working on
compensation and pension claims, and represents an increase of about
2,600 positions, or 32 percent over fiscal year 2007. In keeping with
our prior recommendation, VA's budget justification provides
information on actual and planned productivity, in terms of claims
decided per full-time equivalent employee. While VA expects a temporary
decline in productivity in fiscal year 2008 as new staff are trained
and become more experienced, it expects productivity to increase in the
longer term. VA is modifying its centralized training program to focus
newly hired employees on processing burial and dependency claims. VA
reports this will allow them to become productive more quickly, while
enabling more experienced staff to focus on disability claims
processing. However, incorporating the large number of new employees
into the disability claims process will likely present human capital
challenges for VA. For example, VA would have to adequately train them.
For staff who decide claims, it is estimated that this could take 1 to
2 years. VA would also have to determine where these staff should be
deployed.
Even as staffing levels increase, however, VA acknowledges that it
still must take other actions to improve productivity.[Footnote 9] For
example, VA added more locations where service members can initiate the
VA disability claims process up to 180 days prior to separating from
the service. VA reports that these locations, known as Benefits
Delivery at Discharge sites, now total 140. The goal of the program is
to provide benefits within 60 days following discharge. In addition, VA
also plans to pilot paperless Benefits Delivery at Discharge, where
service members' disability claim applications, service medical
records, and other evidence would be captured electronically prior to
discharge. VA expects this new process will reduce the time needed to
gather evidence for deciding claims. GAO currently has work underway
looking at the Benefits Delivery at Discharge program.
Another step to improve claims processing is a pilot program by VA and
the Department of Defense (DOD) in which VA completes disability
ratings for service members who have been found unfit for duty due to
disability by the military services. The goal of the pilot program is
to deliver faster and more consistent disability evaluations and
compensation to service members and veterans. Because VA rates
disabilities while the service member is still in the military service,
disability benefits can be awarded soon after the service member is
discharged. GAO is currently studying this pilot.
In addition to challenges with managing pending claims inventories and
deciding claims in a timely manner, VA acknowledges that regional
office decisional accuracy needs further improvement. VA reports that
it improved the accuracy of decisions on rating-related compensation
claims from 80 percent in fiscal year 2002 to 88 percent in fiscal year
2007. However, this figure remains short of its current strategic goal
of 98 percent. In March 2007, VA stated it had established an
aggressive quality assurance program to assess rating, authorization,
and fiduciary program accuracy. Additionally, VA plans to begin routine
quarterly monitoring of compensation and pension cases by diagnostic
code and to expand quality review staff to complete additional reviews.
VA also continues to face questions about its ability to ensure that
veterans receive consistent decisions across regional offices. We have
identified the need for VA to systematically address this issue to
achieve acceptable levels of variation.[Footnote 10] VA's Inspector
General has studied one indicator of possible inconsistency, which is a
wide variation in average payments per veteran from state to state. In
May 2005, the Inspector General reported that variation in rating
decisions was more likely to occur for some disabilities like PTSD than
for others, where much of the information needed to make a
determination is susceptible to interpretation and judgment. To improve
decision consistency, VA conducted a pilot project to monitor
consistency of rating-related claims decisions. VA also conducted a
consistency review of post-traumatic stress disorder claims. Finally,
VA deployed 58 computerized exam templates for each type of
compensation and pension exam to each Veterans Health Administration
compensation and pension exam site to improve the quality of medical
exams used to make rating decisions.
Opportunities for Improvement May Lie in More Fundamental Reform:
While VA is taking actions to address its claims processing challenges,
there are opportunities for more fundamental program reform such as
reexamining program design and the structure and division of labor
among field offices.
After more than a decade of research, we have determined that federal
disability programs, including VA's disability program, are in urgent
need of attention and transformation and placed modernizing federal
disability programs on our high-risk list in January 2003.[Footnote 11]
Specifically, our research showed that the disability programs
administered by VA and the Social Security Administration (SSA) lag
behind the scientific advances and economic and social changes that
have redefined the relationship between impairments and work. For
instance, advances in medicine and technology have reduced the severity
of some medical conditions and have allowed individuals to live with
greater independence and function in work settings. Moreover, the
nature of work has changed in recent decades as the national economy
has moved away from manufacturing-based jobs to service-and knowledge-
based employment. At the same time, impairments such as traumatic brain
injury have become more prevalent. Yet VA's and SSA's disability
programs remain mired in concepts from the past--particularly the
concept that impairment equates to an inability to work--and as such,
we found that these programs are poorly positioned to provide
meaningful and timely support for Americans with disabilities. We
currently are assessing the challenges VA faces in providing vocational
rehabilitation and employment services to current beneficiaries as well
as the large number of service members returning from the OIF and OEF
conflicts in need of such services.
In prior work, we recommended that VA use its annual performance plan
to delineate strategies for and progress in periodically updating labor
market data used in its disability determination process.[Footnote 12]
We also recommended that VA study and report to Congress on the effects
that a comprehensive consideration of medical treatment and assistive
technologies would have on its disability programs' eligibility
criteria and benefits package. This study would include estimates of
the effects on the size, cost, and management of VA's disability
programs and other relevant VA programs and would identify any
legislative actions needed to initiate and fund such changes.
In its October 2007 report, the Veterans' Disability Benefits
Commission (VDBC)--established by Congress in 2003 to study the
appropriateness of VA disability benefits[Footnote 13]--also pointed
out that VA's eligibility criteria were outdated and recommended that
the VA Rating Schedule be reviewed and updated. The commission further
recommended the schedule be reviewed and updated on a frequent basis
and that first priority be given to revising the mental health and
neurological body systems to expeditiously address post traumatic
stress disorder, other mental disorders, and traumatic brain injury.
In its July 2007 report, the Dole-Shalala Commission also recommended
updating VA's rating schedule. The commission reported that VA's rating
schedule is outdated and does not include diagnostic criteria for
injuries that are new or for which diagnostic criteria are changing
rapidly, such as traumatic brain injury. Further, the commission
pointed out that VA's rating schedule fails to acknowledge the
disabling impact of conditions such as PTSD, and the effect medical
advances have on the prognosis for certain conditions such as serious
burns and amputations.
VA is in the process of addressing some of our and the commission's
concerns. For example, VA is modifying the rating schedule to provide
detailed and updated criteria for evaluating traumatic brain injury and
the potential effect of medical advances on certain conditions. In
January 2008, VA announced that it had contracted for a study of the
appropriate level of compensation for any loss of earnings capacity
caused by service-incurred or service aggravated conditions.
In addition to program design, VA's regional office claims processing
structure may be disadvantageous to efficient operations. VBA and
others who have studied claims processing have suggested that
consolidating claims processing into fewer regional offices could help
improve claims-processing efficiency and save overhead costs. We noted
in December 2005 that VA had made piecemeal changes to its claims-
processing field structure. For example, VA consolidated decision
making on certain claims--Benefits Delivery at Discharge claims, which
are generally original claims for disability compensation--at two
regional offices (Salt Lake City, Utah and Winston-Salem, North
Carolina). VA also consolidated in-service dependency and indemnity
compensation claims at the Philadelphia regional office. These claims
are filed by survivors of service members who die while in military
service.[Footnote 14] VA consolidated these claims as part of its
efforts to provide expedited service to survivors, including service
members who died in Operations Iraqi Freedom and Enduring Freedom.
Despite these initiatives, VA has not changed its basic field structure
for processing disability claims at 57 regional offices, which have
large variations in performance. Unless more comprehensive and
strategic changes are made to its field structure, VBA is likely to
miss opportunities to substantially improve productivity, especially in
the face of future workload increases. We have recommended that VA
undertake a comprehensive review of its field structure for processing
disability compensation and pension claims.[Footnote 15] Undertaking
such a review is especially critical, since VA will need to determine
how and where to deploy the 2,600 new staff that may be coming on board
between fiscal years 2007 to 2009 to address its claims processing
challenges.
In conclusion, reexamining claims-processing challenges and finding
viable solutions are daunting tasks. While VA has taken a number of
steps to improve its disability claims process, challenges persist.
Opportunities may lie in more fundamental reform. A number of recent
studies by commissions, GAO, and others have laid the groundwork and
made many recommendations for addressing current workload challenges
and redesigning the current program to better align it with modern
concepts of disability and support services. However, as we move
forward, it is imperative that VA adequately assess its options for
improving its disability compensation program and their potential
effects. It is also important that VA continue to look for other
fundamental reforms that may be needed to improve its disability
program for the longer term.
Mr. Chairman, this concludes my remarks. I would be happy to answer any
questions that you or other members of the subcommittee may have.
GAO Contact and Acknowledgments:
For further information, please contact Daniel Bertoni at (202) 512-
7215 or Bertonid@gao.gov. Also contributing to this statement were
Shelia Drake, Martin Scire, Kate van Gelder, and Rachael Valliere.
[End of section]
Related GAO Products:
DOD and VA: Preliminary Observations on Efforts to Improve Health Care
and Disability Evaluations for Returning Servicemembers. GAO-07-1256T.
Washington, D.C.: September 26, 2007.
Veterans' Disability Benefits: Processing of Claims Continues to
Present Challenges. GAO-07-562T. Washington, D.C.: March 13, 2007.
Veterans' Disability Benefits: Long-Standing Claims Processing Problems
Persist. GAO-07-512T. Washington, D.C.: March 7, 2007.
High Risk Series: An Update. GAO-07-310. Washington, D.C.: January 31,
2007.
Veterans' Disability Benefits: VA Can Improve Its Procedures for
Obtaining Military Service Records. GAO-07-98. Washington, D.C.:
December 12, 2006.
Veterans' Benefits: Further Changes in VBA's Field Office Structure
Could Help Improve Disability Claims Processing. GAO-06-149.
Washington, D.C.: December 9, 2005.
Veterans' Disability Benefits: Claims Processing Challenges and
Opportunities for Improvements. GAO-06-283T. Washington, D.C.: December
7, 2005.
Veterans' Disability Benefits: Improved Transparency Needed to
Facilitate Oversight of VBA's Compensation and Pension Staffing Levels.
GAO-06-225T. Washington, D.C.: November 3, 2005.
VA Benefits: Other Programs May Provide Lessons for Improving
Individual Unemployability Assessments. GAO-06-207T. Washington, D.C.:
October 27, 2005.
Veterans' Disability Benefits: Claims Processing Problems Persist and
Major Performance Improvements May Be Difficult. GAO-05-749T.
Washington, DC.: May 26, 2005.
VA Disability Benefits: Board of Veterans' Appeals Has Made
Improvements in Quality Assurance, but Challenges Remain for VA in
Assuring Consistency. GAO-05-655T. Washington, D.C.: May 5, 2005.
Veterans Benefits: VA Needs Plan for Assessing Consistency of
Decisions. GAO-05-99. Washington, D.C.: November 19, 2004.
Veterans' Benefits: More Transparency Needed to Improve Oversight of
VBA's Compensation and Pension Staffing Levels. GAO-05-47. Washington,
D.C.: November 15, 2004.
Veterans' Benefits: Improvements Needed in the Reporting and Use of
Data on the Accuracy of Disability Claims Decisions. GAO-03-1045.
Washington, D.C.: September 30, 2003.
Department of Veterans Affairs: Key Management Challenges in Health and
Disability Programs. GAO-03-756T. Washington, D.C.: May 8, 2003.
Veterans Benefits Administration: Better Collection and Analysis of
Attrition Data Needed to Enhance Workforce Planning. GAO-03-491.
Washington, D.C.: April 28, 2003.
Veterans' Benefits: Claims Processing Timeliness Performance Measures
Could Be Improved. GAO-03-282. Washington, D.C.: December 19, 2002.
Veterans' Benefits: Quality Assurance for Disability Claims and Appeals
Processing Can Be Further Improved. GAO-02-806. Washington, D.C.:
August 16, 2002.
Veterans' Benefits: VBA's Efforts to Implement the Veterans Claims
Assistance Act Need Further Monitoring. GAO-02-412. Washington, D.C.:
July 1, 2002.
Veterans' Benefits: Despite Recent Improvements, Meeting Claims
Processing Goals Will Be Challenging. GAO-02-645T. Washington, D.C.:
April 26, 2002.
Veterans Benefits Administration: Problems and Challenges Facing
Disability Claims Processing. GAO/T-HEHS/AIMD-00-146. Washington, D.C.:
May 18, 2000.
[End of section]
Footnotes:
[1] Rating-related claims are primarily original claims for disability
compensation and pension benefits, and reopened claims. For example,
veterans may file reopened claims if they believe their service-
connected conditions have worsened.
[2] 38 U.S.C. § 1115 provides for payment of additional benefits for
qualifying dependents of veterans whose disability is rated not less
than 30 percent.
[3] Veterans qualify for pensions for non-service connected disability
if they have low income, served in a period of war, and are permanently
and totally disabled for reasons not service-connected (or are aged 65
or older). 38 U.S.C. § 1521 and 38 U.S.C. § 1513.
[4] Appeals from the Board of Veterans Appeals go to the U.S. Court of
Appeals for Veterans Claims, and finally to the U.S. Court of Appeals
for the Federal Circuit, under certain circumstances.
[5] Veterans Benefits Improvement Act of 2004, Pub. L. No.108-454;
Veterans Benefits Act of 2003, Pub. L. No. 108-183; Veterans Claims
Assistance Act of 2000, Pub. L. No. 106-475.
[6] See e.g., Moody v. Principi, 360 F.3d. 1306 (Fed. Cir. 2004);
Szemraj v. Principi, 357 F.3d 1370 (Fed. Cir. 2004); Disabled American
Veterans v. Secretary of Veterans Affairs, 327 F.3d 1339 (Fed. Cir.
2003).
[7] For example, the Agent Orange Act of 1991, Pub. L. No. 102-4,
broadens the presumption of exposure to herbicides in Vietnam. See
also, 38 C.F.R. § 3.309 (diseases subject to a presumptive service
connection).
[8] National Defense Authorization Act for Fiscal Year 2004, Pub. L.
No. 108-136, Div. A. tit VI, § 641, amending 10 U.S.C. § 1414.
[9] See GAO, Veterans' Benefits: More Transparency Needed to Improve
Oversight of VBA's Compensation and Pension Staffing Levels, GAO-05-47
(Washington, D.C.: Nov. 15, 2004).
[10] GAO, Veterans' Benefits: Quality Assurance for Disability Claims
and Appeals Processing Can Be Further Improved, GAO-02-806 (Washington,
D.C.: Aug. 16, 2002); and Veterans Benefits: VA Needs Plan for
Assessing Consistency of Decisions, GAO-05-99 (Washington, D.C.: Nov.
19, 2004).
[11] GAO, High Risk Series: An Update, GAO-03-119 (Washington, D.C.:
Jan. 2003).
[12] GAO, SSA and VA Disability Programs: Re-examination of Disability
Criteria Needed to Help Ensure Program Integrity, GAO-02-597
(Washington D.C.: Aug. 9, 2002).
[13] National Defense Authorization Act for Fiscal Year 2004.
[14] VBA also provides dependency and indemnity compensation to
survivors of certain deceased disability compensation beneficiaries. 38
U.S.C. §§ 1541,1542.
[15] GAO, Veterans' Benefits: Further Changes in VBA's Field Office
Structure Could Help Improve Disability Claims Processing. GAO-06-149
(Washington, D.C.: Dec. 9, 2005).
[End of section]
GAO's Mission:
The Government Accountability Office, the audit, evaluation and
investigative arm of Congress, exists to support Congress in meeting
its constitutional responsibilities and to help improve the performance
and accountability of the federal government for the American people.
GAO examines the use of public funds; evaluates federal programs and
policies; and provides analyses, recommendations, and other assistance
to help Congress make informed oversight, policy, and funding
decisions. GAO's commitment to good government is reflected in its core
values of accountability, integrity, and reliability.
Obtaining Copies of GAO Reports and Testimony:
The fastest and easiest way to obtain copies of GAO documents at no
cost is through GAO's Web site [hyperlink, http://www.gao.gov]. Each
weekday, GAO posts newly released reports, testimony, and
correspondence on its Web site. To have GAO e-mail you a list of newly
posted products every afternoon, go to [hyperlink, http://www.gao.gov]
and select "Subscribe to Updates."
Order by Mail or Phone:
The first copy of each printed report is free. Additional copies are $2
each. A check or money order should be made out to the Superintendent
of Documents. GAO also accepts VISA and Mastercard. Orders for 100 or
more copies mailed to a single address are discounted 25 percent.
Orders should be sent to:
U.S. Government Accountability Office:
441 G Street NW, Room LM:
Washington, D.C. 20548:
To order by Phone:
Voice: (202) 512-6000:
TDD: (202) 512-2537:
Fax: (202) 512-6061:
To Report Fraud, Waste, and Abuse in Federal Programs:
Contact:
Web site: [hyperlink, http://www.gao.gov/fraudnet/fraudnet.htm]:
E-mail: fraudnet@gao.gov:
Automated answering system: (800) 424-5454 or (202) 512-7470:
Congressional Relations:
Ralph Dawn, Managing Director, dawnr@gao.gov:
(202) 512-4400:
U.S. Government Accountability Office:
441 G Street NW, Room 7125:
Washington, D.C. 20548:
Public Affairs:
Chuck Young, Managing Director, youngc1@gao.gov:
(202) 512-4800:
U.S. Government Accountability Office:
441 G Street NW, Room 7149:
Washington, D.C. 20548:
