By Sandra Basu

WASHINGTON President Donald Trump signed a bill last month aimed at reforming a backlogged claims appeal process by creating three “lanes” for veterans’ appeals.

The Veterans Appeals Improvement and Modernization Act of 2017 changes the process by implementing the:

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

In addition, the bill gives the VA secretary 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. The bill requires VA to provide a plan for how the new system will be implemented.

“For too long our veterans and their families have faced unacceptable delays during the VA’s benefits claims appeal process. There are currently hundreds of thousands of veterans still waiting on a decision from VA,” said Rep. Mike Bost (R-IL), who introduced the House version of the bill.

Ranking Member of the Senate Committee on Veterans’ Affairs, Sen. Jon Tester (D-MT), said “this bipartisan bill will cut government red tape and give the VA the flexibility and resources to process claims in a faster and more accurate way.”

Veteran service organizations (VSO) helped craft the bill.

“The American Legion worked very hard on this important legislation from the very start, and we take a lot of pride in this bill to help veterans expedite appeals to their VA disability claims with the goal of significantly reducing wait-times,” said American Legion National Commander Charles E. Schmidt.

Six-Year Wait

The VA sought comprehensive appeals reform last year, but legislation addressing it did not make it out of Congress. VA Secretary David Shulkin, MD, continued to press lawmakers for reform this year.

At a hearing earlier this year, Shulkin explained in budget material that the average processing time for all appeals resolved by VA in FY 2016 was approximately three years. For those appeals that were decided by the Board of Veterans’ Appeals in FY 2016, on average, veterans waited at least six years from filing their Notice of Disagreement until the board’s decision was issued.

“Comprehensive legislative reform is necessary to replace the current lengthy, complex, confusing VA appeals process with a new process that makes sense for veterans, their advocates, VA, and other stakeholders,” Shulkin said at the time.

A Government Accountability Office (GAO) report earlier this year pointed to some of the challenges that the agency was facing in trying to improve the appeals process. The report explained that “VA determined that new evidence—which a veteran can submit at any point during his or her appeal—inefficiently causes an additional round of reviews, and thus delays appeals decisions.”

When it comes to the Board of Appeals, 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,” according to the document.

That report suggested that VA needed to pilot its proposed appeals reform, but the agency disagreed, stating that would “only unnecessarily delay the implementation of the bold changes veterans expect us to make.”

The appeals reform legislation passed the House on May 23. On Aug 1, the Senate passed an amended version of the bill, which was later approved by the House.

To address concerns raised by the GAO, the bill directs VA to provide a plan for processing legacy appeals’ and for implementing the reform proposal to Congress and GAO within 90 days after the date of enactment. GAO would then assess the plan and submit written findings and recommendations to Congress 90 days after receipt of the plan.