Transcripts For CSPAN Veterans Affairs Officials Testify On VA Claims Processing 20170215

Subcommittee, and im grateful to chairman row for the opportunity. I want to explain that although working withd to our new Ranking Member from connecticut, under committee ises, ms. Julia brownley still the subcommittees acting Ranking Member. My understanding is the full committee will schedule a business meeting to formalize the subcommittee assignment and our new subcommittee Ranking Members soon, but since we have to see ifat, i need we have also we also need to make sure that we know we have been joined by the ranking walsh, mr. Tim walz and thank him for being here. I would like to ask that he be andwed to sit at the dais ask questions and also that ms. Esty be allowed to serve as Ranking Member pending her affirmation. By way of short introduction, this is my second term in congress on this subcommittee. I am a father of three and a grandfather of 11, and before coming to congress, i worked in small business, a trucking business, and my wife and i now own a beauty salon with a firefighter and state representative with over 20 years in the state of illinois. Im also honored to say that my family has a tradition of service. Im not only a murray and, im a marine and a father of a marine. Im enlisted, and he is an forcer, so it kind of makes unique conversation around our home. The House Veterans Affairs committee is known for working in a bipartisan manner for making sure that the department of Veterans Affairs provides our former military members with the best service possible. Our nations heroes deserve no less. The subcommittee specifically addresses how to best provide for the needs of veterans who have medical conditions relating to their service. We also Work Together to ensure that veterans who have asked are treated with dignity and respect. I look forward to continuing this tradition and with working members of thend subcommittee on issues that are critically important to the veterans and our nation as a whole. The first meeting of the subcommittee oversight hearing will focus on how or the nwqrk q o has impacted the ability to process claims. Before it, the practice was to process claims that the Region Office and state where the veteran lived. The challenge is that some Regional Offices had large in those and veterans states were often left in limbo. The Regional Offices in other states would have been able to process claims faster because of not being so busy. Is supposed to increase the effectiveness and efficiency by automatically assigning the claim to the Regional Office with the most capacity. On its face, this is a commonsense idea. It allows the v. A. To distribute its workload evenly across the , but there are some concerns about if it is actually performing as it should. Unfortunately, the v. A. Claims backlogs have increased from about 76,000 claims on may 2, 2016 before it was fully up limited to now as of february 4 101,000. One has to question if the disbursement distribution work is in fact more effective. Than assigning a claim to a specific employee to work the entire claim, the nwq breaks up the claim into different tasks. After one claim, the processor reviews a file and completes an action, it will likely assign another claim processor for the next step. The second claim processor also has to become familiar with the file to determine if additional action is needed for the v. A. To make it decision. Ondoes not make sense to me how having multiple claim process is completely review the same file can possibly save time. We will hear from our second panel as well comprised of Veterans Service organizations. They used to receive an advanced ratings decisions before it was sent to the veteran. This practice gave 48 hours to review a proposed decision and raise objections before a decision was finalized, but now, q has been deployed, they complain they no longer have a chance to review a decision and try to resolve errors before any incorrect decision is sent to the veteran. I hope the v. A. Will explain what steps it is taking to decisions are accurate. Im also looking forward to learning more about how the v. A. Intends to monitor employee production and quality standards has beenthe nwq limited. I also hope the v. A. Will tell us more about what the department intends to do to tackle the current backlog of appeals and how it plans to to do so. Wq again, i want to thank the witnesses for being here today and with that, i want to call on the distinguished Ranking Member for her opening statement. Esty thank you very much, mr. Chairman, and i appreciate your warm welcome, and im delighted to join the committee. Im happy to be here is the Ranking Member designate, and i look forward to working with all of you to ensure that the veterans that we are honored to represent our receiving all the quality of care and the Rapid Service that they and their families deserve. A bit about my background i am in my third term in congress. I and the daughter of a navy man, daughterinlaw of air force, and my knees and nephew are army. So we need a marine. Were working on getting a marine in the next generation. My district in connecticut is proud home to over 40,000 veterans, a long service tradition. In my office, it is always issue number 1, 2, or three for constituent services. We have made it a core part of our mission. I hire veterans proudly in my office, and im committed to ensuring that everyone who serves this country is served in turn by all of us who enjoy the freedoms that they secured. I want to thank mr. Murphy and the deputies of the v. A. For appearing today to help us understand how the National Work to programs functioning now that it has been rolled out in all 56 Regional Offices. In speaking with connecticut veterans, its my impression that the claims have made progress and i went to congratulate all of you. You are providing assurance to veterans as they navigate the disability process. I thank you for your commitment to veterans and making sure things get done right. We are here for the same enjoy thee want to speed and accuracy of our nation but we want to make sure that personal touch is an short and our veterans are treated with that care. Forward to hearing from you today. How we get the best of both worlds, the hightech and the hightouch. Tonow everyone is committed getting us where we need to be and i look forward to the testimony and working together collaboratively. We have been joined by the current raking, my good friend, colleague and classmate and my work buddy. Thank you. I ask all members waiver the remark as per this committees custom. I welcome our first two panels. Thank you for taking the time to be here today. Our first witnesses mr. Thomas murphy, the acting under secretary for benefits. He is accompanied by mr. Willie clark. Undersecretary for Field Operations and mr. Ronald burke, assistant secretary, undersecretary Field Operations. Into the be entered hearing record. Mr. Murphy, you are recognized for five minutes. Good morning. Thank you for the opportunity to discuss the implementation of the the aelated to workload. It is designed to match claims and capabilities with me a capacity regardless of geographical boundary. This provides the means necessary to make sure veterans receive a more timely decision. It uses sophisticated capabilities for electronic claim inventory and models for and allows for efficiency and areas for improvement and this new environment allows the va the capability to move claims around the country and has the capacity to take the next step and assign work to the right person in each facility. One of the principals is doing is to ensure veterans are treated in goalie regardless to where they live. In 2015, in many instances the timeliness of the decision was impacted based solely on the state of which the veteran received lived. Some took more than 213 days, double the time of others. This variance demonstrates the inefficiency of the model where he each receives claims based on geography rather than capacity to complete work. The average and spending for veteran disability claims was 94 days. It was reduced to 84. A 10 reduction. Upon receipt of a claim, the v8 develops revenues. It was reduced from 56,000 to of januaryo the end 2017. The average number of days has dropped from almost 25 to less than 10 in 2017. Following the initial development actions, veterans way totration develops a related. It has dropped from 29 days to 16 days. Once a rating decision is report is prepared. It has dropped from eight days to four days. The Veterans Administration continues to work on reducing the time. Weird knowledge some claims will take longer but we have made improvements. As of january 2017, 66 were completed within 125 days. In was a component and one the vllows the v8 v. A. Features, weese can now measure feedback from employees. Approximately 6500 claims returned for been correction. Systematically tracking errors and enables us to increase accountability in the claims process. Large, theeavor this va efforts had a myriad of calls and briefings. New levels and created standard reports. Additionally, it brought 1001 hundred than 64 supervisors for training on tools and breast part best practices. The feedback was taken to heart. We acknowledge there is more work to be done but it is important to recognize these efforts have been continue to generate positive results for myerans this concludes statement. Pleased to answer any questions. Thank you. I would like to yield five minutes for questions. And w q was fully implemented, there were over 76,000 backlogged claims. Yet last week there were more 100,000 claims. The increase is about dirty assertion the is about 30 percent. Does the v. A. Think it is improving . Yes. We have the ability to look at what needs to be worked. Today in the work we are sending out every claim it every single day and working back to the earliest claims. Ability toraging the see what needs to be done and sending it out at the right time. See, whatat we can specific factors are contributing to that increase. That all of usrn want to see a process as soon as possible. What would be agency say the reasons are for that. Good morning. It is my pleasure to respond. The first thing i would like to say is our receipts have gone up since last year. One of the things we know it is as we get more efficient and more veterans are aware of what is available to them, they come in and submit more claims. We are taking a more balanced approach to the work we are doing. One of the things we have done in the past and we did great backlog downng the in past years, we focused probably too much on the backlog. We have this old saying in the v. A. That if you work only the thelog than only you work backlog. So we have improved in answering phones. Ofhad a blocked call rate 60 a couple years ago and now we are right 0 blocked calls. Not great, dependency claims, we have claims we are working. Are doing is taking a more balanced approach but we do understand. We do keep an eye on our backlog to make sure we dont have veterans waiting to look. That would be the concern. Another part of my question is what claims to have we should not work up the backlog. I agree with that alone. But that is still a major factor we can use to say, ok, how quick are we getting these process through. I am sure it is a concern when you see this pileup. What do we see out there we can do to speed the process up . That one. Take about six months ago i took a look at where we were spending money in terms of overtime dollars and a number of people we had, the number of vacancies. Authorized and strength. If you look at it today, the hiring freeze, we have 200 50 people above authorized headcount. Dollarsi cost over time and we converted it into fulltime labor. It takes about one year to get a bsr up to speed. Two years for ian r svr. Better processing, more leaders in place within next six months. , and i will concern finish quickly because my time is running out, the concern i have is relative then one person dealing with a particular claim in having it handed off over and over again, it can cause confusion. My concern, and you have that same concern that maybe one person is not focusing on one claim and by passing through multiple hands, do you see a problem with that . I will ask why into time about this one. I have been concerned that the changes we made was much smaller than it was. Mr. Chairman, thank you for t question and simplify semper fi. Were still learning. We wanted to make sure our claims distribution was much too capacity. As we get more data from the end of week you system we are ways to optimize. One of the things were going to do is maximize the amount of work that goes to the home station. We believe it will do several things. It will most likely a sign a claim back to an employee that has seen a before and as one of two former on the panel to hand one of three veterans, we also received that stakeholder vsos. K from our we have heard that feedback. We have created a request that will allow us to almost reverse the amount of claims of being assigned to the same station. We hope that will help. Real quickly if you can, because i know my time is expired, how many on average handleou think employees one claim as it processes through under the existing system . When i can tell you sir right now is that the amount of work being assigned to the home station is about 3035 of each daily distribution. With the march release, we believe that will allow us to increase it to about 50 , maybe as high as the mid50s. That will at least reduce the amount of instances where employees are seeing the same. You have an average of how many people touch claims as they go through . The certain, it depends on claimants up. 3, 6, 8 . Normally, five or six touches from initial development to completion to begin with. We would like to add that number to the record will stop i would like to turn it over to the Ranking Member. Thank you mr. Chairman and thank you all for your service and commitment to Work Together with us to serve veterans better. I want to pick up where they chairman left off on this issue of ownership. I have a lot of manufacturing territory. N my i am the granddaughter of a manufacturer. This depends on ownership. Not ownership. N in so, think we need to figure at how we ensure we are reducing the number of touches. Have very complex claims into those require and should go to the people best able to do specializedre are claims we know are much more fairly and rapidly processed in specialized settings but i think we do need to work for the typical claim to keep a closer to home. Engaged. Vsos reduce the number of touches we need to 11 so if you could talk in a little bit in addition, mr. Burr, about in march issuing a directive to reduce that number nro more so it stays in the s. So what are you hearing that will just not reduce the a time improve the engagement necessary to keep our veterans feeling served as well is being served. Thank you for that question. Let me start with the latest part of your question about quality. One of the things were all building into our processes and automating is the diagnostic tool. This is purely based to improve and focus on the quality of our claims processing at all steps. This is an automated feature that will run in the background as an employee is processing a claim and before the claim boost to the next step, the employee will have the opportunity to have a diagnostic check and it is designed to catch some of the major trend we see now with missed steps or confusion in the claims process. We believe that will help. I am actually leading an endeavor to we bring 1100 and we are still in this process ringing 1100 of our division processors and chiefs to eight location for trading. This is to talk about trends, new reports, and we have created a standard suite of report so our supervisors can lead better. They can see issues with the claims process. On the issue of ownership, what we are stressing the importance of is that we have to treat this National Work queue environment like an ecosystem. Every action we take on a veterans claim has a subsequent reaction. We are stressing we want pride in ownership from our employees in every action they take on a veterans claim whether it is the entire claim or pieces of the claim but to that point what we to routevalued need for work to local stations in what we have been doing since implementation. That feedback comes not only from our employees but from our dsl employees and other stakeholders. Thank you i want to follow up on the backlog. We are in a freeze right now. So lets be clear. The committee has been told that an hundred 60im vacancies. Mr. Murphy talked about how you are redirecting money to try to more appropriately try to cover. It you still have those they can seize. It is our understanding those will not be exempted from the hiring ban at this point so when you are looking at the final role of establishing a new related to diseases contaminated water at camp lejeune, that will affect march 14. You will see intake go up obviously. We have vacancies. You talk a little bit about what you expect to happen to backlog when those cases come online . This are overstaffed at time. The intent right up front six months ago was where one to hire ahead because we always have 1000 positions vacant. We authorized the strength 100 . Waiting for a vacancy, starting the fill presses, 45 months later in person would show up and start training. I bumped up across the nation for5 and told everybody you could hire up to one hundred 5 . They followed the normal procedure which took them to 100 . We spent 130 million last year on overtime. Overtime is very expensive. Why not convert some of that to permanent employees and keep the rest of this overtime and use the overtime money for so just we have. So in addition to the 105 , we converted the 50 of overtime dollars to higher individuals and those folks now are working through our challenge process today. So again, i am 250 bodies over our strength for the president ial budget. We lose approximately 140 people ap. Now its so i could be ahead for the next three months because of the attrition rate impact. The next step as we start moving positions. Direct the delivery of service. Not a next her person at the headquarters. So we do have a hiring freeze in place, we also have a Movement Trees and place where people could not promoted into other positions which leaves me trying to figure out how to deliver services. I see my time has expired, thank you all very much. The district i present has double that of others. We have new challenges. As far as the questions im going to ask, am not going to ask a person specifically so whomever wishes to respond, please feel free. What about the delay of implementation within and the q nwq . And w additionally planned, we were testing. That is different than actuality. Everything was successful. As we went to go into the production environment, we attended to do it over the course of a weekend and we notice the actual production , 256pride toward ties in Regional Offices took too long. A Regional Office and an employee skew before they start their day, we dont want any employee waiting for work to do. It is important for our and tired distribution job will stop it starts around midnight and needs to finish at 4 00 in the morning. We noticed it took too long. We decided to go back and read tool and reconfigure said the processing time could be reduced. That caused the additional delay in a did not put ourselves position where employees did not have work available to them at the start of a work day. The testingel like of the testing you employed as you implemented in an sought work in realtime, the problems did not resolve to your satisfaction . Yes, it was resolved. It was the key feature that allowed it to successfully deploy it may have 2016. Yes, sir. And onthejob learning . Yes, sir. We were told this system needs to he either replaced or updated. Have the ability to be compatible with new or updated benefits Management Systems Going Forward . Tracks what i would say sir was when we designed and developed and built the National Work you it was under the auspices of dbms. We do go through the process for any enhancements, new features, etc. Right now we are connected vbms and we are operate. On vbms to you are connected . I am sure as part of our doing that it would be incorporated. We have to integrate nwq with vbms. Ng if we replace why does it take one year for adequacy standards . Why so long . I will start with that one. We went for the partial rollout. We started it in maine. We did not completed until summer. We ran it from somewhere up until two months ago and looked at live production data using 100 of the population in presented standards to the union. They go live on march one. In the past we have used sampling of a couple people but this time we used 100 percent of the population over a time of six months. So arguing what individuals can produce is no longer an issue because we are using what you will actually produced. So all of the discussions weve had in years past about what the numbers should be is gone. Related it process, out, used standard deviation. So, it took longer. It took six months of life passes but now we have numbers that are live a end right based on what our individuals are producing on a daily basis. Thank you. I see my time is up. Thank you, mr. Chairman. Thank you mr. Chairman. I want to add my voice and thank all of you for your service to our country into her service to our veterans. Think, mr. Murphy, in your opening comments you talked about there is still more work to be done and there has already been discussions on where improvements can be made. Are there other areas we have not discussed so far that you are looking at to improve the system . To hit this at a high level in and given to rhonda in about 20 seconds. We are getting so much stayed right now we are still trying to figure out how to use some of the data. An example is what we did with performance standards and using statistics to say, wow, look at what we have air. This every day. I spend a lifetime in his office. He may be able to verify that. Yes. A couple things were doing right now, while very short lived in this environment, we have started to a ton of data that was not available before. We are focusing on the reduction of our rework. We have an automated process that allows us to see whenever an employee indicates a backwards movement is necessary. We can determine if that backwards movement was necessary or if it could have been avoided. This allows us to improve training, a improve gaps in policy or procedure and tailoring our training to meet the trend we see. This has allowed us to do this, by the implementation of automated referral, is to capture the data we did not have before and that speaks to making sure we have the right performance standards. Making sure we have the right training tools. Making sure that as we create new reports for supervisors to manage workload in employee performance that we bring them together. Get on the same page. Provide consistency that was not that was not there before. Did i understand you right to say we lose approximately 40 period. S per pay crankshaft. Some moved to other agencies. Yes. Some moved to other agencies. Is an advancement . Are they leaving . This is not turnover. This is people who are leaving the agency. Percent. Test, 20 , 28 we typically run in the low percentages. So 40 people with a population base of 22,000 is Just Retirement or taking an opportunity someplace else. Thats when we were first discussing this transaction and i do believe this transition has plenty of indications that has been successful, so i want to congratulate you all in that endeavor. Obviously i agree there is more work to be done but one of the things we talked about was the fact that for those people who are doing this processing, what could emerge from this system are people who are experts across the country in a particular type of claim and inhaps with that expertise and of itself, it would streamline and make the system more efficient. Is that happening . Do you see that kind of trend . We have the data to give us a takenf trend, we have not action on it to actually physically realign. Forare talking about instance, st. Paul, minnesota, becomes experts at ptsd so we route those there because they are good at that. We do that a little bit now. We do that with camp lejeune related claims. You were talking about a center of excellence where we would. Oncentrate available for future improvements. The los angeles Regional Office which is a service my veterans, the average day is 105, while it is only 81 days in fargo, north dakota. I presume the v. A. Is tracking these numbers but are you adding more people in areas where you know they are going to have more claims . Maam we are. Recall going back i oversaw the Western Region of which l. A. Was one of those offices and there was a point in time where the average claim was over six months. Yes. So one of the things we did previously was we would take cases out physically and move them the ups or we would just ship cases. Things are able to do electronically. Ending and day is complete have lowered significantly. We keep track of our claims that are pending. One of the great things about and is we could target or send that work to places where we have capacity. Sometimes proportionally, claims or radiation claims or what have you maybe pending but on the aggregate, we sent cases where we have a need to send work and where there is capacity. That is where it goes everyday at 4 00 a. M. Mr. Burke and his team of folks move that work around. Thank you very much. I apologize in deal back, mr. Chairman. Mr. Chairman, mr. Murphy, out of the claims backlog, what percentage would you say are ptsd only . I would have to go back and get you a detailed number. I would not want to venture a guess. Let me just ask you this, is it the largest right now in terms of pending claims . Inin isolation, no, but combination with others, yes. What are some of the i mean, i am concerned that we are not focused enough on our combat veterans in terms of the times claims process. Can you give me again, just a very rough breakdown of just what i would call agerelated issues in terms of the claims processed. Nother it is hearing loss necessarily associated in terms of being, you know, around explosions or around Aviation Assets and things like that. I can tell you what we have in the terms of the most 57 conditions. Traumatic brain injury, ptsd, but more than that, hearing loss and muska skeletal injuries for the knees, ankles, back. Those are the most frequently occurring conditions. Your shift to tell me about your shift to a more electronic system. I know that is controversial. Some have fought to maintain a paper system because it is simply easier for more of the veterans who are not sophisticated in terms of Electronic Committee occasions to be able to utilize but where are we at in the process . Bags we do not work cases on paper anymore. A small percentage is existing on paper. It is all a paperless environment. In fact, a week ago we completely emptied philadelphia. There is paper in philadelphia anymore. Now st. Petersburg, and a couple weeks there will be no paper there. Addendum next fiscal year we will be completely done with all of the paper and all offices. You are down to about 18,000 on the claims backlog . Backlog is down to 100, 200. 99,000. Tell me where you want to be one year from now. I would like you to be as close to zero as we can get. 25,000,that is probably 35,000, 40,000. Depending on the work flow. Some will never be under 125 days because you are shortchanging the veteran. Radiation claim, to say we are is noto get 20 that going to happen. It is not the right thing to do. And certainly it can be smaller. Any system you have got can get better. Including ours. Are we just pushing this to the appeals process, in other words kicking them upstairs by trying to expedite and shrink the volume in terms of the claims backlog . No. That just creates more problems. We actually stop the growth of inventory in the appeals process. We have been on an eight year steady growth and in the last three months weve turned in and started reducing the repeals buses. Because seven months ago i looked in the appeals people and nobody could work on anything other than appeals if you are assigned to that. So that dedicated workforce, 495 people working only on appeals on their primetime, overtime, anytime they were working, extra pressure and a few modifications and changeup process have resulted in us flattening and theting to bring down overall number of appeals. Inside of that, the number of is growing because we are producing faster and pushing them across which leads us into the legislation pending in congress about appeals reform. I yield back. Mr. Walsh, you are recognized. Thank you. I appreciate it. Mr. Murphy, a special thank you to you. I know you have been through this as it reached its peak. You adjusted fire and fired for affect and reduce them, as we expected. I am grateful you chose not to take your talents elsewhere were you could probably get paid more and have less problems. Work is a passion for you and i think im veterans deserve that. It is important to us. I know you have come here on numerous occasions. With a goal of working together. I am appreciative of that. A couple things. This came from our vso who i know you are a good partner with. A special thank you to your employees, too. I literally watch this folks out at the st. Paul sro burn the midnight oil. I applaud them. We are paying a lot of money for overtime and that needed to be keepbut to smooth this and that going, that makes sense. When we talk about hiring freezes, we do need to talk about in the long run, hiring and entertaining that people could not only do the good thing for veterans but can help us in the long run. Our vsos express concern that they cannot find the Contact Information when they need to reach out to an employee in the make changes. And thank you. We have tried to ensure no orradation of Service Relationship between our vsos at the local Regional Offices and the stuff there. We are learning from the process. It has post challenges. We are adjusting fire as you reference. We have designated personnel in each Regional Office. The same Regional Office the the us so resides in that have been ancillary rolea if you will. They conserve is a direct liaison between that vso and that office no matter where they are they have ap or they reach out to two kind of facilitate the process. I think we are good in some areas and in some we get a reminder from our partners it may not be working as intended. We want to make sure there is that local flavor. Both the high technology, high touch thing that was referenced the other. These are your partners. Is a force multiplier. I will end with one, and you brought it up, mr. Murphy, with camp lejeune. We are coming up with the on the 14th. I said this at the time and i continue to say it, a lot of the backlog came out of the claims which i am glad they were approved. That we were there. I feel like i added a lot of work for you. I understand that. I do not think we give you the necessary upfront resources once those claims went through. That is not an excuse but it is certainly eight reason. Are we going to be ok this time . I know the numbers are probably far less. I am certain of that. Will be handled. Are you talking specifically about camp lejeune . March 14. Thats the date is coming up quickly. Was thee up before review. That does not apply in this case. These are claims that were filed since we did the notice. A completely different kind of work. The fact we put the presumptive and there, it will bring more volume of the door but it speeds up the process. Are you going to follow those or handle it as a normal prices . Were going to keep them at one are oh. If they cant handle the volume we will have to train another and expanded. Well keep an eye on it. There, you are concerned, youre focused on a but you do not anticipate anything near the disruption caused . Name or claims i am rightful. I appreciate you being here is always ended us about service to this veterans and it is clear watching you over the last half decade or so that you have done what you are expected to do. And you back. We thank you for your testimony. We appreciate you being here today. If you have any followup we will send those your way. They queue for being here and for what you do. We need to move on to our next panel. If the second panel will come to the witness table. I want to say welcome to everyone and thank you for coming. Department director of claims of the Veterans Affairs and rehabilitation edition of the american lesion. The director ofm Veterans Benefits of america. The duty director of the national Veterans Services for the veterans of foreign wars. First we will hear from the representative. Thank you. The American Legion past initiated an conley series of visits. Afterwards, the mva was declared a system worth saving. This truth remains. The American Legion knows the v. A. Is a system worth saving. On behalf of the National Commander charles the schmidt and the members of the American Legion we welcome this opportunity to speak regarding the impact. The value and place the v. A. Has , we fervently believe the v. A. As a system worth saving. To work with. A. Us. There are over 200 accredited representatives with representatives that each of the v. A. Offices. Expertise by these individuals led them to represent it hundred 48,000 over the last fiscal year. The fact is, we could be a fleet butdvocates for the v. A. They not only need to listen but implement what we ask for. They are inextricably intertwined. It needs a fully functioning vbms. The it was designed to maximize its workforce and adjudicate claims. American legion of recognize the potential, however concerns existed then continue to exist regarding its implementation and execution. The adjudication of claims has historically been a local venture. A veteran could reasonably expect a claim to be developed and at adjudicate it at the Regional Office. Will be severed by ann w queue. V. A. Provides a Regional Office is a first filter where the claims could be adjudicated, however in the case of some offices this is untrue. The st. Paul office reduce the adjudication form veterans from oversota from 99 to 33 the course of two years. A major complaint is that the bs does not have the ability to war them of development. There is a 48 window. V. A. Has occasionally removed a case prior to its closure during the allotted time. In 2016, Service Workers working in Regional Offices were asked to raise their hands, they were asked to lower the hands of they came across a case that had been the 48 window. O not one hand was raised. These concerns have been raised but the problem lingers. Even if the local representative was notified it would be of little assistant. Officers are with service agencies. They are working to assist veterans and their given state. Legion regularly conducts regular quality review visits. Last year we met and discussed the impact of nwq. Some welcomed it, others had concerns. These concerns exist from line to leadership. A disconnect exists. A developer at one location may not develop a claim related to another. Another complaint of nwq was pulling claims in and redistributing. Despite completing the bulk of the work on the original Regional Office does not receive the credit. One said it was disheartening to have an employee complete the bulk of the work while another area against the credit. Implementation they simply need to listen. On behalf of the nations largest veteran Service Organization, we thank you for the opportunity to speak. I will be happy to it answer to questions you have. Thank you. Chairman, Ranking Member, members of the subcommittee, on behalf of the 1. 3 million vfw andof the accelerate, i thank you for the opportunity to testify. I want to clarify the vfw supports nwq and this is how we believe we can maximize efficiency using every resources. Promise. Our concern rests with the final step. Unfortunately, this issue is so complex we saw it prudent to articulate every way we believe this affects the v. A. Ability to deliver a quality not to veterans and our ability to deliver quality service. [indiscernible] vsos see this as a way to make sure they get it right. We find errors in about one of 10 claims we process and we can work with v. A. To fix them nose. The veteran this is not only positive for eterans, but for the v. A. On a grand scale, the vso can perform quality ratings. We cut down on appeals and build confidence in the ba system. Locally, vsos learn to be better advocates. Veterans receive consistent, accurate, timely benefit decisions. While this policy has been supported, the vfw had seen examples where is the now and Regional Offices, reacting to pressures on productivity will finalize decisions before the 48 hours expire. We have also seen nwq pull out before 48 hours which means we lose our optics. We have also seen brokered workstations update if no representative is present in accordance with the manual m 21one. This makes it impossible to track and award regardless of the filtering work through vbms. We appreciate the workarounds but asf code filtering we articulated in our rate remarks, the workarounds do not resolve the overall problem. Facing systemic to help veterans navigate. As such, we try to help the needs of the Committee Like and with a kodiak oil like in winstonsalem, salt lake city. Veteran attorney for claim, the veteran is placing his or her trust in the vfw to serve as a quality advocate and not just filing or veteran benefits but awarding assuring any benefit awarded is accurate. Trust and credibility, local v. A. Colleagues to advocate properly for veterans. When advocates do not have the opportunity to review everybody suffers. At first, it looked good when they were able to send it more quickly but it is no good if it is inadequate. As someone said, we have lost global advocacy. We have three asks. Return to the station of origination said the vso representative who is most familiar can conduct a proper review. Second, luck to 40 00 so via cannot pull back the rating decision before it is reviewed nor the 48 hours lapses. Third, allowing to be marked as queried so they can track potential errors and told staff accountable to address any errors. Tobelieve it already exists add these three steps. The vfw and our partner vsos have asked for these solutions. Unfortunately, we were these requests of been pushed aside in favor of v. A. s internal priorities. We understand their objectives to improve the work product and our purpose today is to demonstrate the vso priority is also v. A. Priority. Workso leaves and once to with 3 00 a. M. Subcommittee to make this successful. The v. A. Can execute these deliverables we believe we will have timely, quality, and consistent benefits. Testimony. Des my i am happy to answer any questions you may have. Thank you. We want to recognize you for bus. Ses of boston that is how the name is pronounced. That is ok, that is however one doesnt. Thank you. Good morning. Representatives. Thank you for inviting to testify about the National Work queue impact on work assessing. Vba is supportive of using technology to create a better claim system. However, not at the expense of accuracy, transparency, or a proveteran claim prizes. Currently it is easier to track a fedex package than a the a claim. In thes sidelined vsos implementation of the National Work you by not prioritizing the the vfw. Ole of they are using it as a told to eliminate backlog. Strongly oppose the National Work you to appeal a National Work claim until at a minimum the three recommendations are fully implemented. I would like to take this time to briefly discuss three barriers to the claims process the vba currently experiences. First, vsos are unable to track accurately its claims that need review before a claim is an bbs us. If a claim is filed in seattle, that can be kicked to savannah. That Service Officer is unable to track that claim to its decision. Vba believes onehour Service Officers are unable to review the claims they filed, the a is of their veterans right to competent representation. The importanced of a station of origin search filter in vbms but v. A. Continues to give this request zero priority. Adding a station of origin search feature will permit search officers who filed the claim to be able to competently assist their veteran to the entire claims passes regardless of the claim is educated in another station. The second bear, assuming the vso is able to identify which aro the claim is sent to, v. A. Has yet to provide accurate Contact Information for each station. Dresseshat emailer provided are outdated or incorrect, leaving the vso interest to who to contact at the station. This is extremely important when we are trying to contact during the 48 hour review time. The third barrier, even if we have the correct Contact Information for the station it is difficult to receive a timely response if we get one at all since implementation at the they arework you, further distance from the work process and in some instances locked out entirely. Forced to review where claims than previously which adds to the backlog. All of these problems did not happen preNational Work queue because relationships were created and all claims were a jew to get it in the same state where the veteran resides. The Veterans Benefits claims process is a unique system. It seeks to be nonadversarial and proveteran. To prioritize recommendations in our statements have veterans and their representatives are again included in the claims process. Thank you for the opportunity for vba to share its thoughts. Thank you. I will go with the first five minutes of questioning. Our number of backlog claims was 76,000, now it is about 101,000 or thereabouts. Hasou think that the nwq actually improved the situation or not . Legion has noted there has been an increase in the backlog of claims during this time as far as a contributes to the backlog i cannot say. Notit certainly has decreased it as the numbers would bear out. What suggestions would the you have to improve this . I think, again, a lot of it when we go through a end we look at how these claims are being adjudicated or processed in the system, there is a lot of backandforth between the bsr into the raters. Lets just take a poorperforming Regional Office and that developer cuts the mustard as far as they are concerned, then it goes to a higher performing area, they were not except that is being one. Ecessarily had this been in the same office, they office, they couldve walked across the Service Center and said, we need to schedule an exam, we need to do this development. I think some of these issues are contributing to a certain xtent. Ok, that leads to this question. Right now, i just asked you specifically what input you would have to your organization so i am going to ask this of all three members. Has the va asked each one of you what they could do to improve this and what has been the response . They have asked. We have offered solutions. We continue to ask for those same solutions. Those same asks keep getting asked over and over. Legions in improving the business flow in those Regional Offices. Its good that v. A. Wants about 50 of the work to stay at the original office of jurisdiction, but, again, i dont know if thats going to solve their problem. Automation has the potential to improve this process. Mr. Bost ms. Yoon. Ms. Yoon yeah. I would also concur with mr. Hearn and mr. Galluci. V. V. A. Has continually, as i stated earlier, for years been working with the v. A. To try to explain what we need in order to assist the claims process. And like i mentioned, because of our inability to properly track and assist claims with the original Service Officer who worked on it, it forces us to appeal claims we wouldnt have had to appeal preNational Work queue thereby adding to the backlog. I would emphasize that, again, as mr. Galluci said, we are all on the same team. Were trying to do the same thing and achieve final and just decision at the lowest level possible. And the recommendations that we put forth seek to achieve that. Mr. Bost let me tell you, i think this committee is on the same team with you as well. In your original testimony, you actually brought up the fact quite often the Communications Come with the wrong email address . Ms. Yoon yes. So as was earlier stated, the v. A. Has provided a Contact Person or generic mailbox at each r. O. So if we dont know who to contact at that r. O. , if we dont know the rater, were instructed to email this email address. Its either a personal email address, name someones name va. Gov or a corporate email. Those are often wrong and the response if we get a response which is common not to get a response youre contacting the wrong person. I dont do this. So the request that we made in our written statement is that v. A. Publish on its website an updated list. You certainly understand theres turnover and that person of contact switched but they need to be able to provide that real time updated to Service Organizations so we know who to contact at that point. Mr. Bost thank you. I will turn it over to the Ranking Member. Ms. Esty thank you, mr. Chairman. And i take it i think we are all on the same page and i think its going to be up to us in congress to prioritize these issues to better serve veterans. Part of what weve done now, theres been a lot of folks on backlog so the v. A. Is focusing on backlog. If we want these quality measures and transparency and accountability in place, we need to prioritize that and we need to be pushing v. A. And thats why we are thanking you for your partnership with us in ensuring that happens. Again, i have no doubt v. A. Wants this, too, but if its not prioritized from somebody who can assist or not and shine some light on it may not happen. Is it a 50 goal enough . We heard from mr. Murphy that their goal is now to return 50 or leave 50 in the r. O. Any thoughts from the three of you on whether we think thats an appropriate goal . Mr. Hearn first of all, thank you, representative esty. You may have seen in my written testimony in talking about some of these solutions, to the v. F. W. They seem like work arounds. An objective to have 50 of the work in the station of origination sounds good. Its better than 30 , dont get me wrong. Having a station of origination work filter in vbms is also better. But i dont think its 100 solution for some of the reasons that i pointed out before. The manual allows v. A. To immediately promulgate decisions if we have no v. S. O. Representative in that office. Just for little bit of background, the way our resources are allowed at the v. F. W. , sometimes we do have turnover in those offices. The example i had in my written testimony was a Regional Office that had a vacancy at the moment. We at our headquarters were tracking a claimant that we were hoping to review that rating when it was posted for the 48hour review period. That 48hour review period never happened because they were promulgating that decision. It wouldnt have helped us in the situation with that veteran. Whats interesting about the specific case is that v. A. Failed to evaluate one of the claims and it resulted in an eightmonth ordeal with the veteran and for the v. F. W. The filter to us, the 50 station of origination work doesnt really solve the problem. Thats why i mean really our testimony was more of a wish list. If we had an optimal situation, what wed want is return it to the s. O. O. , return it to the s. O. , freeze the clock so they cant pull it back into the National Work queue and then allow us to mark ratings as queried in vbms as opposed to just reviewed or lapsed. Ms. Esty thank you. Thats helpful. We had some of those cases in my office. We were thinking we managed to crack the code in immigration cases, a coding system that they used that allowed us to actually track, ms. Yoon, as you mentioned, who is handling the case, how its been coded and i think thats something we want to explore in more detail. Could we do better coding so you would know who was in charge so if that person is no longer there you would be able to go and look at that r. O. Site and say, 132 is not there so we need to figure out who is taking over those cases. It seems like the technology ought to be able to offer us that transparency and accountability, but we may need to push v. A. To say you need to prioritize in coding that allows us to let us know who to contact and get realtime information. I dont know if youve done any work on that. Maybe, mr. Chairman, we can look at utilizing exactly this technology to say, ok, if were going to use it, lets use it for the benefits of veterans, not just reduce the backlog but to have that accountability and that touch. As we move forward id welcome your thoughts on whether we can use the technology to help solve this problem. Mr. Bost Ranking Member esty, if you mind, id like to followup on that. Mr. Galluci there was another point about the list of points of contact that kelsey made in the Regional Offices. This becomes problematic because it takes reporting of errors outside of that digital environment. So vbms is a Digital Claims management, how v. A. Is tracking all their work. Mr. Murphy articulated they have been able to glean so much data on there that theyve been able to hold individual employees accountable. For rating review, if we find errors theres no such opportunity. By having to send a separate email to a random v. A. Staffer or corporate inbox theres no accountability for reporting those errors. And i know when we click reviewed or let the 48 hours lapse so it will say expired, theres then no accountability on the back end for v. S. O. s to say, look, we found an error. It wasnt addressed in a timely manner. Thats one of the reasons were asking them to mark them as queried in vbms. Ms. Esty thats great to figure out how to embed that. Thats a great point. If we are getting incomplete i wouldnt say inaccurate incomplete data about the error rate, thats important how to code that and i think we should continue on. Thank you very much. Mr. Bost thank you. Mr. Bergman first of all, thanks to all you do for the veterans. The Veterans Service organizations vary in their scope. Vary in some of the populations that they serve. Im hoping for all of you that you are working very hard to encourage those veterans to whether they join the American Legion, the v. F. W. , the Vietnam Veterans of america, we need to know whats going on amongst the youngsters that have served so honorably. To all of you, the v. A. Has claimed that the n. W. Q. Could improve on rating consistency and accuracy from the perspective of you, the v. S. O. s, have you noticed improvement in these areas . Mr. Hearn the American Legion conducts quality review visits every year. We just did return from san juan last week, and to their credit, to san juans credit, they are vastly improved from where they were 18 to 24 months ago. However, i would still contend and the American Legion has historically differed in what the definition of error is with v. A. And a static appellate or a declining appellate rate is not better. It means less people has appealed. Typically 20 to 30 of error rate is what we see. What we determine as error rate, there was something done wrong in the development process. Not just strictly a yes or no or grant or denial of the benefits. So i wouldnt say it certainly isnt the panacea to v. A. s problems as far as the error rate is concerned. Mr. Galluci general bergman, thank you for that question. Its tough to draw a conclusion at this point. National work queue is a very new business process which is one of the reasons why we wanted to get out in front of this and really appreciate the opportunity to address the subcommittee on this issue today is because from the v. F. W. s perspective, we think moving work efficiently in a Digital Space around v. A. Has potential to improve accuracy. I dont think were there yet. Based on our own review of rating decisions we find one in 10 has an error. Thats been fairly consistent. Two months ago we were getting close to two in 10 where we were identifying errors. Whether thats because of National Work queue its tough to say because looking at v. A. s selfreported data on claimsbased accuracy, thats a number thats also been decreasing over the past few years. When they break down claimsbased accuracy, it also is directly correlated to the number of issues that a veteran claim. So one to two issue per claim are more likely to be accurate than if you have seven to 12 issues in that claim. And that become a problem because veterans are claiming more issues as they become more aware to the benefit to which they are entitled. I think, at least from the v. F. W. s perspective, its too soon to tell. One of our objectives is to get in front of us and provide us the tools they need to hold them accountable for any errors and to fix them before they go out the door. Ms. Yoon i dont have too much to add. I concur with both statements already made. I would just emphasize that i do agree that it is too early to determine whether its helping. I do agree there is potential with the Additional Data we can get from the National Work queue. However, i would also emphasize that if we continue long the pathway that we are without including the v. S. O. s into the process of the claims process, then it could potentially have very negative impact on the accuracy of decisions. Mr. Bergman thank you. Mr. Hearn, how do you feel v. A. Handled the rollout of n. W. Q. . Mr. Hearn its kind of interesting because when v. A. Was testifying, the statement had been made they are just now hearing that cases arent being adjudicated at the local level as much as the v. S. O. s would like. When it was rolled out, we were initially told that the essentially the right of first refusal was local Regional Office. When you drop from 90plus percent down to 30 in minnesota, thats not even the majority. And so that has been a big problem with us. Its not only that but its also dealing with the issues of claims development, not getting our mail. Thats the mantra were hearing from our Service Officers is we want our mail back. In other words, if something happens along the claims process as far as development is concerned, unless the v. S. O. Or Service Organization is specifically putting that veterans claim number in, theres no way for the representative to know so we need this type of information as well. Mr. Bergman thank you. Mr. Bost ms. Brownley. Ms. Brownley thank you, mr. Chairman. Thank you for your testimony. It seems to me this is, you know, a Pretty Simple problem to resolve. And there should be ways in which it can be resolved. You know, i would just ask the chairman and the Ranking Member if, you know, we dont have the v. A. Here now and so we cant ask them that question but we need to ask the question, you know, when are you going to take these recommendations and when are you going to have a response to them . We believe its a priority, and we want to make it a priority for you. When will that happen and when can they report back to us on it to make sure that it does indeed happen . I mean, it is you know, within the v. A. Sent out a fact sheet when this process was going to be incorporated and they made a strong commitment that the relationship between v. S. O. s and the r. O. Managers will not change as a result of this new process, n. W. Q. Clearly youre making it very clear to all of us that is not the case. So timeliness of these benefit claims are clearly important, but the quality of those claims and the role that you play and the relationship to the veteran at home is equally is equally as important. I hope that we can clear this up sooner rather than later. I just wanted to ask, can the veterans check the status of their claims through their e benefit accounts . Mr. Hearn yes, they can. But its not like dominos like you know they are putting the cheese on the pizza. Sometimes theyre putting the sauce. Its not a good reporting structure. And ms. Brownley its not a good reporting structure because mr. Hearn in other words, from the input ill get calls from veterans in my office. They are saying this. Its not matching up exactly. So i have raised this issue before with v. B. A. Going back years and i said, again, using dominos as an example. If they can figure this out as far as where theyre what toppings theyre putting on the pizza, why cant v. A. Use Similar Technology . I have never gotten a good response on that. To me that would be an easy solution like you were talking about. Ms. Brownley ok. Well, i guess i really dont have any more questions. It seals the problems have been laid out pretty clearly. And i think the to resolve it seems to be Pretty Simple. I will yield back. Mr. Bost mr. Coffman. Mr. Coffman thank you, mr. Chairman. Let me ask each of you first. Do you think that the claims when its switched to the new system, were the claims processors up to speed and ready to go . Were they trained up for this . Mr. Hearn, lets start with you. Mr. Hearn by claims process do you mean on v. A. Side or our representatives . Mr. Coffman v. A. s side . Mr. Hearn anytime you implement a new system there are going to be problems, i think. At large i would say they were trained on how to do it. I think one of the things we need to caution with, everything is getting more electronic. Theyre leaning all this gleaning all this out of the system. No baseball umpire is a computer. We need the Human Element to this. Theres too much reliance on the network when they say if the computer shows this could be potentially an error, to avoid a quality review hit, they wont they wont override that. And that sometimes has been some of the problem we noted. As far as their understanding of the system, its been my experience when working with the employees that theyve been properly trained. Mr. Coffman mr. Galluci. Mr. Galluci i would tend to agree that there was proper training prior to implementation. However, because this was such a complex overhaul, i think the unforeseen consequences made it much more problematic. At least on our end as v. S. O. s. Whether just how much work was moving around. I think even and i pointed out in my testimony they had moved work for the predischarge program, delivery claims. There were hiccups all up and down the v. A. System. Our review specialist in winstonsalem identified a number of claims that disappeared before the 48hour queue. When we reported it to v. A. They didnt think it was happening at first. It took about two days of back and forth and then providing claim numbers and a hard count of the claims that were pulled back from winstonsalem pending rating review, they were in the cloud, 499 for the National Work queue, they didnt believe us at first. They almost didnt recognize this was happening within their own business process. So i think there were a lot of unforeseen complications with the rollout of National Work queue. Again, one of the reasons we wanted to come here today and articulate this not to take too many shots at v. A. , but we want to be a constructive partner on this. We hope they will be responsive to the needs of our clients, the veterans we serve. Mr. Coffman ms. Yoon. Ms. Yoon thank you for the question. We are leaving the hearing to charo, they often have. Heir own systems when a claim is sent to another ro the other r. O. Might do something else. A lack of consistency across each office has been more apparent. The hope is in the near future that that is something that could hopefully be standardized more. All weickly if you are over 90,000 in terms of claims backlog right now. Weve made some progress that we have a lot of progress to go. If youre going to identify one that as the leading issue the Veterans Administration to change in order to reduce the backlog what with that issue be mr. Hearn . Mr. Hearn thats a big question, congressman. Honestly this is not going to impact the backlog as much as it it will impact the appeals and quality of the decisions. To stop and look at what youre doing as a writer and as a bsr and make sure you are considering the entirety of the evidence. That has been one of the biggest problems we have seen. The reason why you have 50 reman rate at the board. 25 grant rate at the board. Nobody is sitting back and thinking about what they are doing when it comes to these decisions. Mr. Gallucci . Mr. Galucci congress and coffman i think you saw my head nodding at a number of times. It has to do with conflating timeliness and accuracy. Theres so much focus on the time it takes to get a claim, weve got to move through this process fast fast fast and were finding haste makes waste. A common euphemism. Part of my dad joke pardon my dad joke. Clients come to us for personal interactions another what we are claiming is accurate. That v a took into consideration the entirety of evidence. I believe the board of veterans datapeals docket backlog several years. That is harder on those veterans. Inaccuratebly an rating decision. We want to get this right the first time. This becomes a problem with the 48hour review because sometimes we been told we just need to get the rating out there. The veteran needs the rating quickly. Process. In a 125 day in the clients we work with, they understand if they get two days for a quality check its not going to affect it will only affect their benefits for the positive on the backend. That two days is ample time for them to make sure that the rating decision is accurate. Im over time here. Ms. Yoon i would emphasize possibly to reevaluate the work Credit System that the a employees have. Theres this emphasis on speed and not as much of an emphasis on accuracy. Our accuracy measurements may be different. And there needs to be an emphasis on reviewing the entire claims file, development, looking to see if theres any more development that is needed. If an exam has been issued was that exam adequate . I think one of the most common reasons we see cases kick back from the board is because the exam is inadequate. I think thats an example of something that could be worked on an improved. But he say thank you for being here but also let me tell you the sheridan in the new position the chairman in the new position hes got made an error. I think that they should be here. I think you should get answers to those questions and if it needs to be done in front this committee that is exactly where i think it needs to be done so that we can actually hold them accountable. I think the intent of this program is good. We want the process to be as smooth as possible. When it takes away your ability to be the advocates that you not to say the v. A. Does not have their best , but youof the veteran being the overseers who are we want you to have the opportunity to do that. We will redo this at some time and make sure we can tell the v. A. We want to see a progress date of where we are at and where the communications are you. I say that with this committee that we will move forward with that and we will do this again. Thank you for being here today. Thank you very much. The committee is adjourned. Announcer coming up this morning, actor Ashton Kutcher will be on capital hill to talk about efforts to end modern slavery and human trafficking. That is at the Senate Foreign Relations Committee on cspan3, cspan. Org, and the free cspan radio app. In the afternoon, the government foreign Affairs Committee meets to review the report on government waste and inefficiency. That is live at 2 45 p. M. Eastern also on cspan3. Supreme Court Nominee neil worst gorsuch continued meeting. Monday on the senate floor, Majority Leader Mitch Mcconnell talked about what he sees as a double standard in the confirmation process. After much unnecessary delay from senate democrats, we will finally confirm two more key cabinet nominees this evening. Secretary of and treasury and David Chilton as secretary of Veterans Affairs. Candidatesalified who will lead the charge on strengthening our economy and providing veterans with more of the care they deserve. I will have more to say tomorrow but for now i look forward to their confirmation later this evening. After