<--GAT-->
Agencies

VA Vows to Meet Deadline for Revamp of Veteran Claims Appeal Process

by Sandra Basu

March 20, 2018

By Sandra Basu

WASHINGTON—VA has told legislators that the agency is on track with a new law that will give veterans more options to have their claims appeals reviewed.

“We are working against the clock. Time is of the essence,” VA Deputy Secretary Thomas Bowman told lawmakers last month. Implementation has a February 2019 deadline.

Bowman made his comments at a House Committee on Veterans’ Affairs hearing where lawmakers had a lot of questions about how VA is preparing for the implementation of the appeal reforms plan. The bill mandating the plan was signed into law last year after VA and advocacy groups sought modernization of the current appeals system.

House Committee on Veterans’ Affairs Chairman Rep. Phil Roe, MD, (R-TN) pointed out during the hearing that VA has a backlog of more than 470,000 appeals and that passing the bill “was only the first step.”

ADVANTAGES TO RAMP

  • Early participation in the new, more efficient review process for VA benefit decisions
  • Potentially faster decisions and early resolution of disagreements
  • Multiple review options (supplemental claim, higher level review, or appeal to the Board after February 2019)
  • The same potential effective date for benefits regardless of the review option chosen
  • The option to ask for a quick, fresh look at a VA decision by an experienced claims reviewer
  • A new requirement that we must have clear and convincing evidence to change any findings favorable to you in a VA decision

“We intend to continue to work closely with VA and the stakeholders to ensure that veterans who file an appeal receive an accurate decision in a more timely manner,” Roe said.

The new law creates new “lanes,” among other changes, for appeals processing as a way to speed up the handling of claims.

“The new system is easier to understand. Veterans will be able to tailor reviews to their needs, and it will provide both faster decisions and greater transparency,” Bowman told lawmakers.

Testifying at the hearing on the Government Accountability Office’s review of the implementation was U.S. Comptroller General Gene Dodaro. He told lawmakers that the GAO had found that VA’s implementation plan for the new system was lacking.

Specifically, the oversight group found in a recent report that, while VA’s implementation plan addresses 17 of 22 required elements, it partially addressed four and did not address one of the required parts of the plan, at all.

Without complete information on all 22 of the required elements, Congress does not have the information it needs to fully conduct oversight of VA’s appeals plan and the agency’s efforts to implement and administer the new process while addressing legacy appeals,” the report stated.

Dodaro told lawmakers that, despite evidence that “VA was using certain sound planning practices,” GAO “found also there were a number of other areas that could benefit from better planning practices.”

Bowman told lawmakers that the VA agrees with that assessment and that the agency will be “working closely with GAO every step of the way.”

Low Pilot Participation

Roe voiced concerns, meanwhile, that, so far, only 3% of invited eligible veterans with pending appeals with VBA have chosen to participate in the pilot program of the system known as Rapid Appeals Modernization Program (RAMP). The pilot began in November of 2017 and tests two of the five new processing options.

Participating in the pilot program is voluntary and designed to provide VA with data before the agency fully rolls out the program. In order to participate, veterans have to withdraw their pending legacy appeal but those opting to use the pilot system are getting decisions within 30 days.

David R. McClenachen, director of the VBA Appeals Management Office, told lawmakers that 15,500 invitations for the program had gone out at the time of the hearing.

“The obligation is for us to message to veterans that this new approach is worth their consideration,” Bowman said.

Dodaro suggested that veterans might be deterred from using RAMP because, under the pilot program, they have to wait until February 2019, when the new system is fully implemented, to be able to appeal a RAMP decision with which they disagree.

“I think VA needs to try to find out whether or not that’s deterring anybody from picking the RAMP option,” he said.

Veterans’ service organizations also weighed in on progress made with implementation of the system. Disabled American Veterans National Service Director Jim Marszalek said his organization believes that VBA and the board are “off to a good start” in implementing the new appeals system.

On the other hand, Paralyzed Veterans of America Associate Legislative Director Steven Henry told lawmakers that the “speed at which VA is implementing RAMP is troubling.”

“Our greatest concern is that VA may be rushing its implementation as seen by the rapidly increasing number of veterans contacted for the pilot without VA considering the metrics of the pilot,” he said.


Comments are closed here.


Related Articles

VA Continues Efforts to Reduce Drug Diversion; Focuses on Opiates

WASHINGTON—In the past two years, the VA has implemented a nine-step process to minimize drug diversion, but cases continue to slip through. In December 2018, the VA’s Office of the Inspector General reported two instances... View Article

VA Struggles to Overcome Women’s Healthcare Disparities

WASHINGTON—VA is straining its capacity and struggling against a culture that can sometimes be hostile to women as it responds to what VA officials consider a “tsunami wave of women veterans” over the last decade.... View Article


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

VA Continues Efforts to Reduce Drug Diversion; Focuses on Opiates

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

Department of Veterans Affairs (VA)

VA Struggles to Overcome Women’s Healthcare Disparities

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

Department of Veterans Affairs (VA)

VA Researcher Seeks to Include Veterans’ Voices in Healthcare Decisions

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

Department of Veterans Affairs (VA)

House Committee Looks at Influence Trump Friends Have Had on VA

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

Department of Veterans Affairs (VA)

VA Announces Proposed Standards for Access to Mission Act Outside Care

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

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