<--GAT-->

DoD’s Slow Transfer of Service Records Contributes to VA Claims Backlog

by U.S. Medicine

September 2, 2014

By Sandra Basu

WASHINGTON – While VA is under heavy pressure from lawmakers to reduce the claims backlog and process claims faster, the agency is not the only one to blame for these delays, according to the DoD Office of Inspector General (IG).

A recent DoD IG audit found that DoD has not consistently transferred timely and complete service treatment records (STR) to the VA. Those records are necessary to support veteran benefit claims.

 Army Timeliness Results – January to December 2013

Army Timeliness Results – January to December 2013

Specifically, the IG reported that the 77% of the service treatment records transferred by the DoD from January to December 2013 were not handed over in a timely fashion—meaning they were not sent within 45 days—and 28% were incomplete.

For the Air Force, specifically, of the 45,912 STRs transferred to the VA from January to December 2013, 35% were not conveyed within 45 days and 11% were not complete.

While the Navy and Marine Corps did not maintain “sufficient data” to determine results from that time period, according to the report, data provided for July and August 2013 indicated that of the 3,217 STRs transferred to the VA, 1,479 were not transferred within 45 days. In addition, the Navy was not maintaining the data necessary to determine whether the STRs were complete.

“DoD’s failure to consistently make timely and complete service treatment records available to the VA likely contributed to delays in processing veterans’ benefit claims,” stated a memo from the DoD assistant inspector general which accompanied the report.

Claims Processing

The audit was ordered to determine whether DoD was effectively transferring service treatment and personnel records to VA.

The report comes amidst efforts to reduce the disability claims backlog by the VA. The department announced this summer that it had completed its one millionth disability claim in fiscal year 2014 and was on track to complete more than 1.3 million claims this year. The VA also announced in July that it had reduced the claims backlog by more than 55% from its peak of 611,000 in March 2013.

“At the same time, the accuracy of rating decisions continues to improve. VA’s national “claim-level” accuracy rate is currently 91%—an eight-percentage-point improvement since 2011,” VA said in a written statement.

The DoD IG pointed out that the VA claims process “is contingent upon DoD providing sufficient evidence to support the veteran’s claim.”

“If the VA does not receive sufficient evidence to process a claim, the agency will request additional information from the veterans’ service point of contact. In 2013, the VA reported that 58% of benefit claims took 125 days or more to process. Returning the claim to DoD for additional evidence adds to the processing time. The VA’s goal for 2015 is to process benefit claims within 125 days or less,” the report stated.

The DoD IG report suggested that the DoD delays have occurred because “DoD did not provide the military departments with clear or comprehensive guidance concerning the STR transfer process, to include the DoD-VA agreed upon procedure for certifying STR completeness.”

“In addition,” according to the document, “the Army Reserve, National Guard, and the Navy had inefficient procedures in place for transferring STRs.”

For the Army, MTFs as well as the central cells, out-processing centers responsible for transferring the records to VA, contribute to the untimely transfers, the IG’s office pointed out.

“During a site visit to an Army MTF in December 2013, we found several boxes of STRs for servicemembers who separated from the military as far back as July 2011. According to the MTF staff, the central cell asked them to keep the STRs because there was no room at the central cell and that the MTF could just wait and process the STRs using the new paperless system that was to be in place after January 1, 2014. At the central cell, the program manager stated that ensuring an STR was complete took precedence over timeliness and that they would sacrifice timeliness in an attempt to ensure completeness,” the report stated.

The DoD IG also described inefficient procedures used in the Army Reserve, National Guard, and the Navy for transferring the STRs.

“The Army Reserve and National Guard were scanning STRs that were already available in an electronic system and the Navy was mailing hard copy STRs to two different facilities before they were mailed to a third facility for scanning,” the report documented.

In response, DoD officials agreed with IG recommendation to revise its instructions on certifying STRs as complete and said that a draft DoD Instruction has been updated and was to have begun coordination last month. In addition, DoD agreed with the recommendation to require the military departments to perform annual reviews of STRs with military personnel to ensure the records are complete.


2 Comments

  • Paul says:

    A single integrated electronics health record (iEHR) between DOD (to include records from Guard and Reserve Components) and VA was planned. In the fall of 2012 after the investment of approximately one billion dollars the work on creating an iEHR was abandoned and substitute systems (Virtual VA and VBMS) were implemented.
    Speaking as an end user of Virtual VA and VBMS I can say that neither Virtual VA nor VBMS meet the definition of an integrated electronics health record. They are a compilation of historical medical records scanned into a data base without regard for clarity or chronology of events:
    1. No provisions were made to have “test patient” data so that users could familiarize themselves with VBMS prior to actually negotiating a real veterans records.
    2. Term “Best Copy Available” is a euphemism that the documents that follow are illegible.
    3. Documents scanned in upside down.
    4. Same documents scanned in more than once.
    5. VBMS/STR contains records of more than a single veteran.
    6. No distinction made in Service Treatment records if individual was active duty or military dependent at time treatment provided. Example 1: “STR” contains record when 14 year old military dependent was treated for sprained shoulder. Individual fully recovered and would later enter military service for a term of contract with no subsequent shoulder injuries. Example 2: Female veteran marries male veteran. Female separates from military service 2 years later seen at Base hospital for new medical condition. All records listed under STR. Example 3: Twenty year career veteran retires later goes to work for AFEES five years after retirement diagnosed with new medical condition at base hospital all listed under STR.
    These are some of the most obvious challenges there are more but they would be difficult to communicate to others not familiar with these systems.
    There needs to be an audit of the process as it currently exists to determine baseline reliability of VBMS and Virtual VA and how to improve on what is. There needs to be a system in place where when errors are found they can to brought to the attention of the appropriate personnel for timely correction. There needs to be periodic auditing of the virtual process to insure continued quality and compliance.

  • Paul says:

    A single integrated electronics health record (iEHR) between DOD (to include records from Guard and Reserve Components) and VA was planned. In the fall of 2012 after the investment of approximately one billion dollars the work on creating an iEHR was abandoned and substitute systems (Virtual VA and VBMS) were implemented.
    Speaking as an end user of Virtual VA and VBMS I can say that neither Virtual VA nor VBMS meet the definition of an integrated electronics health record. They are a compilation of historical medical records scanned into a data base without regard for clarity or chronology of events:
    1. No provisions were made to have “test patient” data so that users could familiarize themselves with VBMS prior to actually negotiating a real veterans records.
    2. Term “Best Copy Available” is a euphemism that the documents that follow are illegible.
    3. Documents scanned in upside down.
    4. Same documents scanned in more than once.
    5. VBMS/STR contains records of more than a single veteran.
    6. No distinction made in Service Treatment records if individual was active duty or military dependent at time treatment provided. Example 1: “STR” contains record when 14 year old military dependent was treated for sprained shoulder. Individual fully recovered and would later enter military service for a term of contract with no subsequent shoulder injuries. Example 2: Female veteran marries male veteran. Female separates from military service 2 years later seen at Base hospital for new medical condition. All records listed under STR. Example 3: Twenty year career veteran retires later goes to work for AFEES five years after retirement diagnosed with new medical condition at base hospital all listed under STR.
    These are some of the most obvious challenges there are more but they would be difficult to communicate to others not familiar with these systems.
    There needs to be an audit of the process as it currently exists to determine baseline reliability of VBMS and Virtual VA and how to improve on what is. There needs to be a system in place where when errors are found they can to brought to the attention of the appropriate personnel for timely correction. There needs to be periodic auditing of the virtual process to insure continued quality and compliance.


Related Articles

Democrats Look at VA Role of Trump’s Mar-a-Lago Associates

WASHINGTON—Congress announced last month that it will be opening an investigation into alleged improper influence by three civilian consultants to President Donald Trump on administration of the VA. The three men—Ike Perlmutter, CEO of Marvel... View Article

VA Announces Proposed Standards for Access to Mission Act Outside Care

WASHINGTON—VA has released its proposed new access standards, defining new eligibility criteria for veterans seeking care by non-VA providers. The standards are part of the VA MISSION Act signed into law in June 2018, and... View Article


U.S. Medicine Recommends


More From department of defense dod

Department of Defense (DoD)

DoD acknowledges its medical adverse event reporting is ‘unreliable’

The process for tracking the DoD’s most serious adverse medical events is “fragmented, impeding the Defense Health Agency’s (DHA) ability to ensure that it has received complete information,” according to a new review.

Department of Defense (DoD)

Automation Speeds Results and Increases Accuracy for Point-of-Care Testing at Walter Reed NMMC

With a long history of point of care testing at both of its predecessor organizations, the Walter Reed National Military Medical Center (WRNMMC) laboratory services staff were keenly aware of the advantages of using portable testing devices to obtain rapid patient assessments.

Department of Defense (DoD)

High Rate of Pectoralis Tears Among Deployed Servicemembers Lifting Weights

Lifting weights is one way servicemembers keep in peak physical condition during deployment.

Department of Defense (DoD)

DoD Study Finds That Type 2 Diabetes Increases Breast Cancer Mortality

Having Type 2 diabetes mellitus (DM-2) increases mortality risk in breast cancer patients, regardless of whether diabetes was diagnosed before or after breast cancer, according to a recent study.

Department of Defense (DoD)

Now Hear This: Otolaryngologist Leads Effort to Prevent Auditory Issues

Among those who are exposed to combat, it’s the weapons fire that does it. In the Navy, it’s the noise levels in engine rooms and on the decks of carriers.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up