Veterans' Disability Benefits:

Further Evaluation of Ongoing Initiatives Could Help Identify Effective Approaches for Improving Claims Processing

GAO-10-213: Published: Jan 29, 2010. Publicly Released: Jan 29, 2010.

Additional Materials:

Contact:

Daniel Bertoni
(202) 512-5988
contact@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

For years, the disability compensation claims process has been the subject of concern and attention by the Department of Veterans Affairs (VA), Congress, and veteran service organizations (VSO), due in part to long waits for decisions and the large number of claims pending a decision. As GAO and other organizations have reported over the last decade, VA has also faced challenges in improving the accuracy and consistency of disability decisions. GAO was asked to examine (1) trends in VA's disability compensation claims processing at the initial claims and appeals levels and (2) actions that VA has taken to improve its disability claims process. To do this, GAO reviewed and analyzed VA performance data, budget submissions, program documents, and external studies and interviewed VA officials and VSO representatives.

VA's disability claims and appeals processing has improved in some aspects and worsened in others. In recent years, the number of claims completed annually by VA has increased but not by enough to keep pace with the increasing number of compensation claims received, resulting in more claims awaiting a decision. In addition, the average days that VA took to complete a claim--196 days in fiscal year 2008--has varied over time, but was about the same in fiscal years 2000 and 2008. Several factors have challenged claims processing improvements, such as the increase in the number and complexity of claims submitted to VA, laws, and regulatory changes. VA has reduced the number of pending appeals and improved the accuracy of some appellate work, but the time that it takes to resolve appeals has worsened in recent years. For example, in fiscal year 2008, VA took on average 776 days to process appeals; 78 days longer than in fiscal year 2004. One factor that has contributed to worsening appeals timeliness is the increase in the number of appeals received by VA. VA has taken several steps to improve claims and appeals processing, but their impact is not yet known. VA has hired a significant number of disability claims staff to process disability workloads. VA's Veterans Benefits Administration (VBA) has also expanded its practice of workload redistribution, which could improve the timeliness and quality of its decisions. VA is also testing new claims processing approaches--such as shortening response periods for certain claims and appeals through Expedited Claims Adjudication (ECA) and reorganizing its claims processing units. However, VBA has not established plans to evaluate the effect of some initiatives. In addition, VA has taken other steps to improve claims and appeals processing, such as expanding its quality assurance program; upgrading claims processing software; and moving toward paperless processing, which remains elusive in part due to technical challenges.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: The Secretary of Veterans Affairs should direct the VBA to collect data on redistributed claims for development, rating, and appellate work to help assess the timeliness and accuracy of resource centers' output and the effectiveness of workload redistribution.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: VA agreed with the recommendation that VBA collect data on redistributed claims and appellate work to help assess the timeliness and accuracy of resource centers' output and the effectiveness of workload redistribution. In August 2010, VBA deployed a workload management tool to help collect timeliness data on redistributed claims and appellate work. This functionality and other inputs help VBA assess the effectiveness of workload redistribution.

    Recommendation: The Secretary of Veterans Affairs should direct the VBA and the Board to establish an evaluation plan for assessing the ECA pilot process and guiding any expansion decisions. Such a plan should include criteria for determining how much improvement should be achieved under the pilot on specific performance measures--such as average VBA and Board processing times--and include methods for how VBA and the Board will consider ECA's impact on non-ECA claims and appeals processing before implementing the process widely.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: The Board worked with VBA to establish evaluation criteria and a plan for evaluating the Expedited Claims Adjudication (ECA) pilot.

    Recommendation: The Secretary of Veterans Affairs should direct VBA to establish a plan to evaluate its claims processing reorganization pilot and guide any expansion decisions. Such a plan should include criteria for determining how much improvement should be achieved in the pilot on specific performance measures--such as decision timeliness and accuracy--before the process is implemented throughout VBA.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: VBA established a plan with criteria to evaluate its claims processing reorganization pilot.

    Apr 9, 2014

    Mar 25, 2014

    Mar 5, 2014

    Feb 27, 2014

    Jan 15, 2014

    Jan 14, 2014

    Jan 13, 2014

    Dec 3, 2013

    Nov 13, 2013

    Oct 31, 2013

    Looking for more? Browse all our products here