By Sandra Basu

The Decision Ready Claims (DRC) initiative is a disability claims submission option being offered in partnership with accredited Veterans Service Organizations (VSO). It is hoped it will ease the burden on claims officers, shown here in a Veterans Benefits Administration claims center.

WASHINGTON An initiative that promises faster processing of certain claims has now been made available at all VA regional offices, the agency announced last month.

The Decision Ready Claims (DRC) initiative is a disability claims submission option being offered in partnership with accredited Veterans Service Organizations (VSO). Through it, a veteran can get a decision within 30 days from the time VA receives the claim seeking increased compensation.

 “VA works closely with participating VSOs to make sure they are properly trained in this new process and given the tools they need to participate successfully in the program on behalf of the veterans they serve,” explained VA Secretary David J. Shulkin, MD.

The DRC was first implemented May 1 at the St. Paul, MN, regional office and is only available for claims seeking increased compensation—commonly known as claims for increase. VSOs take on the responsibility of ensuring that all supporting evidence, such as medical exams and military service records, is included with the claim submission.

The Disabled American Veterans (DAV) organization wrote on its website that it “strongly encourages folks who think they qualify for an increase in compensation to reach out to a DAV service officer.”

The VA, meanwhile, said its goal is to expand the types of claims accepted under the initiative and to allow veterans other ways to submit their claim under DRC.

The initiative is one of the ways VA is trying to break the bottlenecks in its claims process. The system was weighted down with nearly 900,000 claims in its inventory in 2012 but now has nearly 331,410 claims in inventory as of the beginning of September.  

As for claims taking more than 125 days, the VA has reported a drop from 611,073 in 2013 to 81,646 backlogged claims at the beginning of September.

 

Area of Risk

Disability claims and appeals are among the 13 areas of risk for VA, compiled by Shulkin at the end of May. The VA secretary said his agency is trying “to cut in half over the next two years” disability claims taking more than 125 days to process. At the time, he also said that, in addition to rolling out DRC nationwide, the Veterans Benefits Administration (VBA) plans to go paperless throughout all of its veterans’ benefits offices by mid-2018.

“So we are focused on not doing claims fast enough now, but we have plans to get much better,” Shulkin noted at the time. “In addition, it’s very hard for a veteran to get information on where their claim status is, and we need to make that process more transparent.”

Shulkin has said that it takes nearly three years to get an appeals decision. A bill reforming the appeals process was signed into law this summer, and VA administration and lawmakers said they hope it will help fix the process.

The new law implements a “Local Higher Level Review Lane” in which an adjudicator reviews the same evidence considered by the original claims processor; a “New Evidence Lane,” in which the veteran could submit new evidence for review and have a hearing; and a “Board Lane,” in which jurisdiction for the appeal would go immediately to the Board of Veterans’ Appeals (BVA).

Under the statute, the VA secretary has the authority to test the new system prior to full implementation and would allow some veterans already going through the appeals process to opt into the new system.

A Government Accountability Office (GAO) report earlier this year pointed to some of the challenges that the agency was facing in dealing with improving the appeals process.

The report noted thatVA determined that staff resources have not sufficiently kept pace with increased pending appeals, and concluded that additional staff are needed, particularly at the board, to improve timeliness and reduce its appeals inventory.”

 “As of October 2016, officials estimated that if the agency does not take any action, such as increasing staff In 2018, veterans may have to wait an average of 8.5 years by fiscal year 2026 to have their appeals resolved,” the report added.