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Reclaiming the Process: Examining the VBA Claims Transformation Plan as a Means to Effectively Serve Our Veterans

 

STATEMENT OF  

   

                                   GERALD T. MANAR, DEPUTY DIRECTOR  

NATIONAL VETERANS SERVICE  

VETERANS OF FOREIGN WARS OF THE UNITED STATES  

   

BEFORE THE  

   

COMMITTEE ON VETERANS’ AFFAIRS  

UNITED STATES HOUSE OF REPRESENTATIVES  

   

WITH RESPECT TO  

   

Reclaiming the Process:  Examining the VBA Claims Transformation Plan as a Means to Effectively Serve Our Veterans  

   

WASHINGTON, DC                                                                                               June 19, 2012  

   

MR. CHAIRMAN AND MEMBERS OF THIS COMMITTEE:  

   

On behalf of the more than 2 million members of the Veterans of Foreign Wars of the United States (VFW) and our Auxiliaries, I would like to thank you for the opportunity to testify today on the VBA claims transformation plan within the Veterans Benefits Administration (VBA).   

   

Over the last 20 years we have watched VBA struggle to determine how it would modernize its claims processing systems.  “Struggle to determine” because VBA has lacked a coherent vision of what a 21st Century claims processing system should be.  Lewis Carol, author of Alice in Wonderland, is often quoted as saying: “If you don’t know where you’re going, any road will get you there.”  To the despair of many of us, VBA started down many roads, only to find that nearly all got them precisely nowhere.  

   

In our view, VBA is still struggling to find its vision.  Without a clear vision, an ultimate goal, it advances in fits and starts, making some progress, but often at the cost of wasted time, money and the energy of its people.  

   

In the last year Allison Hickey, Under Secretary for Benefits, has worked hard to bring that vision into focus.  Just a year ago this month she called 50 people to a Strategic Planning and Implementation Workshop.  Through two grueling, 12- hour days she worked with them to define where VBA should be by 2015.  By the end of the workshop they had taken the vision from its murky, ethereal shape and had developed the outline of goals and the start of a plan.   

   

They started the process of paring away the programs and pilots that weren’t working.  They sought to identify those things that were working but not delivering sufficient value to continue.  Then they began to examine which of the remaining initiatives would help them get to their goals, and figure out what was required to further the process.  

   

In all of this there was a recognition that VBA could not overhaul its claims processing systems without first overhauling its computer and software infrastructure.  

   

How best to describe the computer systems used by VBA to process claims?  Imagine a house first built in the late 1970’s.  The house was an old design but because the plans and materials were already out of date, the price to build it was considered reasonable.  The house was modest at first, and because it was new, its owners thought that it would serve them for many years to come.  

   

Over the next 40 years many rooms were added to the house.  The rooms had funny names, such as BIRLS, COVERS, RBA 2000, BDN and MAPD, to name a few.  Each room was added at different times.   Some doors failed to open onto hallways.  Some had central air conditioning while others had none.  In some rooms the plumbing worked fine while there were chronic problems in others.  Visitors to this house often had to go back outside and enter through a different door just to get to another room.  As a consequence of poor planning and design, the house was not very efficient and it was difficult to live in.  

   

This analogy describes the computer systems VA uses today.  While it is true that many changes and improvements have been made, the basic foundation on which all these systems are built is inadequate to support a functional claims system.  It is slow, inefficient, requires repetitive input and it is difficult to update and repair.  

   

VBMS is VBA’s attempt to build a foundation for a new house.  It’s not just designed to sustain the software programs VBA envisions for the immediate future, it is intended to be sufficiently flexible to allow the addition of programs not yet contemplated.   

   

It is important to understand that VBMS is the foundation.  VBMS is designed to facilitate the creation of efficiencies. As such, we do not anticipate that the rollout of VBMS over the next year will initially result in significant improvements in claims processing timeliness or quality.  In fact, if history is any guide, the deployment of VBMS will actually slow claims processing during the first 6 months as software problems are identified and fixes installed.  

   

We do anticipate some efficiencies from the start.  For instance, information concerning individual veterans, now scattered in multiple locations requiring separate input, will be stored in one location.  Whenever that information is required, VBMS is designed to retrieve that centrally stored data.   

   

For instance, right now a Veterans Service Representative (VSR) must enter a veteran’s address in several different programs to ensure that the address is current.  Systems do not automatically update. Similarly, a veteran’s Power of Attorney (POA) must be entered in different programs to allow access by veterans representatives.  With VBMS, a VSR need update the system in one place only and other programs will draw from that central data point to find the most current address or POA.  

There has been some discussion of late that the deployment of VBMS may be delayed.  There is a fine line between rolling out a new program too soon and delaying rollout too long while seeking to fix all the problems.  VBA’s initial plans for rapid development and deployment of VBMS were, in our view, unrealistic from the start.  It is our understanding that development and testing of VBMS was to be conducted in rapid succession: collect the business requirements in Baltimore for a few months, deploy the first version to Providence for 6 months, update and deploy the second version to Salt Lake City for 6 months then roll it out to the other regional offices.  To date VBMS is in four regional offices and, we are told, fewer than 800 cases have been processed to completion.  

   

We believe that rolling out VBMS prematurely, before it is fully stressed to identify the majority of issues and problems it contains, is a bad business practice, bad for veterans and bad for morale of an already demoralized VA workforce.  Examples are replete in the history of VBA claims processing of what happens when a new software program is deployed before it is ready for prime time.   

   

BIRLS has been a useful tool to aid claims processors for many decades.  It contains, among other things, data on veterans’ military service.  In an effort to clean up and verify the data contained in this program, VBA undertook a project in the1980’s called BIRLS Redesign.  This program was rolled out to the field without adequate testing.  As a result, tens of thousands of records had to be corrected or updated by hand, costing VBA thousands of man-hours of lost productivity.  

   

In the 1990’s VBA developed a program called RBA to assist rating specialists in the completion of rating decisions.  In 2000, VBA updated the program and deployed it to the field without sufficient beta testing.  As a consequence, creation of rating decisions slowed to a crawl while thousands of VA’s most critical decision makers spent months identifying software bugs and struggled with “workarounds” while computer programmers fixed problems.  

   

While it is counterproductive to delay release of a computer program until all the bugs are identified, these two examples are ample evidence of what happens when a new program is inadequately tested and released too soon.  

   

We encourage this Committee to continue its oversight of VBA and VBMS while recognizing that it may be necessary to accept modest delays in deployment of this major initiative in order to avert the negative effects of rolling out a program with defects simply to meet a deadline.  

   

VBMS is just one of many initiatives underway in VBA.  A list of Transformation Initiatives on VA’s website offers a fascinating, though dated, summary of the dozens of ideas tried, adopted or discarded in a quest to find the most efficient way to develop and decide claims in a timely manner.  

   

Simplified Notification Letters (SNL) is an initiative thoroughly embraced by VBA leadership.  An examination of what this initiative does to veterans is illustrative of the mindset of VBA in the last year.  

   

The veteran service organizations first became aware of this project in June 2011 when our service officers in Atlanta notified us of its existence.  Initially called Disability Evaluation Narrative Text Tool (DENTT) and later Rating Redesign, a team working in the Atlanta and St. Paul regional offices designed a process which could best be described as “Back to the Future”.  Instead of creating a time machine in a DeLorean, this team reached back to a simpler pre-VCAA, pre-veterans court era when ratings were simply conclusions with no discussion of the evidence considered nor the reasons and bases as to why the decisions were made.   

   

Instead, this initiative, now called SNL, required the rating specialist to include a set of codes at the end of the rating.  The codes, in turn, were used by VSR’s to select standard paragraphs for inclusion in the decision notice letters to veterans.  While these standard paragraphs were better written and more understandable than those previously used by VA, they were generic and did not include the minimum information needed by a veteran to decide whether the decision was likely to be correct.  With only general information provided by VA, veterans are faced with the choice of blindly accepting the decision or filing a Notice of Disagreement in order to obtain the reasons for the decision.  

   

In September 2011, the VFW conducted an on-site review in Atlanta of rating decisions made under this initiative.  After reviewing 60 ratings and accompanying notice letters we concluded that the quality of the rating decisions was worse than that reported by VA through its STAR quality review program, and that veterans were not receiving adequate notice to satisfy legal and judicial requirements.  Local management bragged that production was increased by 40 percent when cases were rated under this initiative.  

   

Over the ensuing months we continued to complain about the inadequate notice being provided to veterans.  To be fair, Under Secretary of Benefits Hickey listened to our concerns and changes have been made in the SNL program in an attempt to address the problems we noted.   

   

Under the most recent changes, rating specialists were given additional instructions on providing sufficient details and discussion to explain their decisions.  Restrictions on how much “free text” narrative they could insert in a rating were removed.  At the time these changes were implemented in late February, 2012, we concluded that if field personnel followed the instructions it would be possible to create barely adequate decisions and notice letters.  

   

Since May 2012, the VFW has conducted a review of SNL ratings and letters from several regional offices.  Fifty three (53) percent of the cases reviewed contained errors in either the rating, decision letter or both.  There were only a few examples of where claimants were provided what we view as legally adequate notice.  

   

VBA’s apparent inability to compel compliance by rating and authorization personnel with the most recent written directives concerning the SNL program force us to renew our opposition to this initiative.  While we understand VBA’s desire to increase production, we believe that this increased output is being done at the expense of veteran’s legal right to know why decisions have been made in their cases.  No two veterans, nor their disabilities, are alike.  Canned generic paragraphs are not sufficient to tell them why their claims were decided in a particular way.  VBA should suspend the SNL program until they can ensure that veterans receive adequate notice as required by law.  

   

Mr. Chairman, this concludes my testimony, and I look forward to any questions you and the Committee may have concerning these issues or other programs or pilots the VA is conducting to improve the claims process.  

Information Required by Rule XI2(g)(4) of the House of Representatives  

   

Pursuant to Rule XI2(g)(4) of the House of Representatives, VFW has not received any federal grants in Fiscal Year 2012, nor has it received any federal grants in the two previous Fiscal Years.  

 

Benefits Identification and Records Locator System

Control of Veterans Records System

Rating Board Automation 2000 was an updated version of the original Rating Board Automation program

Benefits Delivery Network

Modern Awards Processing - Development

Transformation Initiatives; http://benefits.va.gov/TRANSFORMATION/docs/initiatives.asp#i-lab, November 18, 2011.

A Notice of Disagreement is the first step in the appeal process.  Upon receipt, VA is required to review the decision, determine if additional development is required, and a new decision is warranted, If no change is warranted,  a Statement of the Case, which provides the reasons and bases, as well as applicable citations of law and regulations supporting the decision,  is issued to the appellant.  38 CFR 19.26; 20.201.

A regulations and Federal court decisions make it clear that VA must provide claimants the reasons and bases for the decisions it makes.  “Every claimant has the right to written notice of the decision made on his or her claim…”  38 CFR 3.103(a).  “Claimants and their representatives are entitled to notice of any decision made by VA affecting the payment of benefits…  Such notice shall clearly set forth the decision made, any applicable effective date, the reasons for the decision…”  38 CFR 3.103(b).   See also Gilbert v. Derwinski, 1 Vet.App. 49, 56-57 (1990) and Bolton v. Brown, 8 Vet.App. 185, 191 (1995).  

 

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