Are VA Benefits Processed More Efficiently? Congress Gets Conflicting Answers

by U.S. Medicine

August 5, 2014

By Sandra Basu

WASHINGTON – The work of the Veterans Benefits Administration (VBA) was vehemently defended before lawmakers last month, with VA Under Secretary for Benefits Allison Hickey testifying that the agency had reduced the claims backlog from a high of more than 600,000 last year to 271,000 as of last month.

 VA Undersecretary for Benefits Allison Hickey testified that the agency had reduced the claims backlog from a high of more than 600,000 last year to 271,000 as of last month. VBA photo

VA Undersecretary for Benefits Allison Hickey testified that the agency had reduced the claims backlog from a high of more than 600,000 last year to 271,000 as of last month. VBA photo

At the same time, the accuracy of rating decisions continued to improve with VA’s national “claim-level” accuracy rate increasing from 83% in 2011 to currently 91%, Hickey emphasized.

“VBA takes seriously our commitment to provide timely, accurate benefits and maintain the integrity of our systems and processes,” she said.

Hickey testified at a hearing before the House Veterans’ Affairs committee, but her comments were met by skepticism by some lawmakers who questioned the integrity of VBA data. That skepticism was shared by VA’s Assistant Inspector General for Audits and Evaluations Linda Halliday, who also testified.

Halliday told lawmakers that her office has received several serious allegations regarding “mail mismanagement, manipulation of date of claims and other data integrity issues,” in the VA regional offices in Baltimore, Philadelphia, Los Angeles, Oakland, Houston and more recently the Little Rock Veterans Affairs Regional Office (VARO). She said the IG’s office is concerned by how quickly the number of VAROs with allegations is growing.

When asked whether she trusted VBA’s data, she responded that she would say “no” at this point.

“I can’t trust those numbers. I think we have a lot of work ahead of us to address the allegations we have just received. They all seem to focus on data integrity,” Halliday said.

Numerous Allegations

Halliday said her team is looking into integrity issues including a discovery that VBA’s Pension Management Center staff in Philadelphia had inappropriately interpreted a VA letter to justify not recording the original date claim on some claims as they should have. Other discoveries at the Philadelphia VARO included instances where veterans or their dependents received duplicate payments resulting from duplicate records in VBA’s electronic system.

Halliday said the IG also has been looking into mail mismanagement. In June 2014, VBA reported to the OIG that a VARO employee in the Baltimore office had inappropriately stored approximately 8,000 documents and 80 claims folders in his office for an extensive period of time, she reported in written testimony.

Halliday also told lawmakers that inspectors “continue to find significant claims processing error rates resulting in improper payments.”

As an example, Halliday said her office has found that VBA continues to incorrectly process temporary 100% evaluations, which has led to overpayments of nearly $85 million since January 2012 because the claims lacked adequate medical evidence.

“We remain concerned about VBA’s financial stewardship of these claims and project that, without action, VBA could continue making unsupported payments to veterans totaling about $371 million over the next five years. In fact, we identified a $456 million ($85 million plus $371 million) total impact to the government,” she wrote.

Also testifying were three VBA whistleblowers who said that their complaints of unresponsive leadership and the handling of claims were not taken seriously.

“The unreasonable and unattainable production requirements that start in Washington DC that are placed on employees have required employees to decide between what is right in helping the veteran and what is wrong in order to keep their jobs,” testified Kristen Ruell, an employee at the VBA Philadelphia Regional Office.

VBA Responds

Hickey forcefully defended VBA, however, pointing to achievements such as a speedy transformation from a paper to a paperless system. VBA now does 91% of its work in a paperless environment, she said.

Noting that 1.4 million claims have been done on the system, she asked, “Do you know what that does for veterans? It means they get answers faster and better. The system isn’t just a system; there are tools in that system to help make that employee better at making that decision.”

Hickey also said that retaliation against whistleblowers will not be tolerated and that employees can reach out to her directly by email. She told lawmakers that she talks directly to bargaining union employees to get information and input about what’s going on at the VBA.

She also told the committee at the contentious five-hour hearing that she knows that the primary question is whether VBA data could be trusted. She responded that there are many checks and balances in the system and that VBA is seeking additional outside verification of the quality of its work including pursuing ISO 9001 certification, which she said is considered the global benchmark for quality management. Hickey also said that she has also ordered a facility and desk audit of mail and documentation at all VA’s regional offices to make sure paperwork is being treated appropriately.

“I want every veteran in this country and all of you to believe us when we say we are making good decisions,” Hickey said.

Rep. Julia Brownley (D-CA) said she was having trouble reconciling the different pictures of VBA’s situation provided by Halliday and Hickey.

“I understand that we are putting you in a bind. That is why I am going to get an independent review,” Hickey answered.

Halliday said she was providing “a very close inspection of certain initiatives that I do not feel have achieved what they were expected to achieve.”

 


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