System to Smooth Out VBA Claims Backlog Creates Other Issues

by U.S. Medicine

April 10, 2017

By Sandra Basu

A VBA employee helps veterans file claims. VA photo

WASHINGTON — Implementation of a new process to distribute disability claims to offices with capacity to process them will benefit veterans, Veterans Benefits Administration (VBA) told lawmakers in an effort to reassure them.

Previously, a veteran’s claim was processed at the regional office (RO) in the state where the veteran lived, but that meant some veterans faced large backlogs even while other offices had shorter wait times.

To remedy that, the VBA implemented the National Work Queue (NWQ) system so that claims are sent to the location able to process them most efficiently, despite geographic location.

“One of the principles of NWQ is to ensure that veterans are served equally regardless of where they live,” explained VBA Acting Under Secretary for Benefits Thomas J. Murphy.

“This new environment allows VA the flexibility to move claims to locations around the country that have the capacity to take the next action on the claim, while maintaining the flexibility at each facility to assign work to the right person,” Murphy told the House Committee on Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs.

Backlog Increase

Murphy told lawmakers that a review of 2015 claims found that the timeliness of a decision “was significantly impacted based solely on the state in which the veteran lived.”

“Some were receiving decisions in 106 days, while others took more than 213 days, nearly double the time,” Murphy pointed out.

Since VBA rolled out NWQ, he noted, the average days pending for a disability claim has fallen from 94 days to 85 days. In addition, the backlog of claims waiting for initial review dropped from 56,000 pending cases in May 2016 to 18,000 by the end of January 2017.

Still, some lawmakers voiced concerns about how the system was working out. Rep. Mike Bost (R-IL), who chairs the subcommittee, said the number of disability claims backlogged rose from about 76,000 in May 2016 before VA fully implemented the NWQ to nearly 101,000 as of the beginning of 2017.

One explanation, according to VBA Deputy Under Secretary for Field Operations Willie Clark, is that more veterans are submitting claims now.

“As we get more efficient, more veterans are aware of benefits that are available to them. “They come in and submit more claims,” Clark said.

He also told lawmakers that VBA is now “taking a more balanced approach to the work that we’re doing.” In the past, he said that they “probably focused too much on the backlog.”

Murphy noted that with any system you can “get better,” but reducing the backlog to “zero” is not necessarily desirable, since some cases need more time.

“There are some cases that will never be in 125 days because you are just shortchanging the veteran to do that,” he said.

Claims Distribution

Lawmakers said they also were concerned that multiple VBA processors from around the country might work on a single claim, creating confusion about the case.

“Do you see a problem with that?” Bost asked.

In responding, VBA Assistant Deputy Under Secretary for Field Operations Ronald Burke Jr., said that, to address that issue VBA is implementing an improvement to the system that should route more of the claims back to the station where they originated, when possible.

“That will most likely assign a claim to an employee who has seen it before,” Burke said.

Veteran Service Organizations (VSO) shared their frustrations with the process, however.

VA rules require VSO representatives to have 48 hours to fully review decisions for errors before they are given to veterans. Before the use of NWQ, all claims were adjudicated in the same state where the veteran resided, which allowed service representatives to develop working relationships with VA claims raters at their respective ROs.

Tracking the claims is now much more difficult, the groups said.

“Currently it is easier to track a FedEx package than a VA claim,” said Vietnam Veterans of America Benefits Director Kelsey Yoon.

Lawmakers also wondered whether the NWQ would be compatible with a new or updated benefits management system if VBMS, the current system VA uses, is replaced.

Burke said that “right now” the NWQ is connected “solely to VBMS” to operate and that, if VBMS is replaced, the new system would have to be integrated with its replacement.

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