Veterans Disability Benefits: Clearer Information for Veterans and Additional Performance Measures Could Improve Appeal Process
Highlights
The Department of Veterans Affairs (VA) has struggled to provide timely reviews for veterans who appeal decisions on their disability compensation claims. A veteran appeals to the VA regional office that made the initial decision, and if still dissatisfied, to the Board of Veterans Appeals (Board). An appeal to the Board adds more than 2 years, on average, to the wait for a decision on the appeal. To resolve more appeals at the regional level and avoid waits at the Board, VA, in 2001, established the Decision Review Officer (DRO) review as an alternative to the traditional regional office appeal review. A DRO is given authority to grant additional benefits after reviewing an appeal based on a difference of opinion with the original decision. In contrast, under the traditional review, new evidence is generally required for a grant of additional benefits. GAO examined (1) the extent to which veterans choose a DRO review, (2) outcomes for DRO reviews, and (3) VA's challenges in managing DROs. GAO analyzed Board data, surveyed managers in all 57 regional offices, visited 4 offices, and interviewed veterans.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Veterans Affairs | To clarify information for veterans and ensure the most effective use of DROs, the Secretary of Veterans Affairs should direct the Veterans Benefits Administration to revise the sample appeals election letter in its policy manual to define unfamiliar terms and emphasize key deadlines, and test any revised letter's clarity with veterans before implementing it. |
The Department of Veterans Affairs (VA) has completed a pilot of changes to the appeals process--including modifications to the appeal process election letter--at its Houston regional office. After analyzing the results of this pilot, the VA decided to make permanent changes to the appeal process election letter that is used by regional offices nationwide. These changes are intended to enhance clarity, and include defining key terms such as Decision Review Officer and highlighting important deadlines at the beginning of the letter. These changes were announced to regional office managers in January 2014.
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| Department of Veterans Affairs | To clarify information for veterans and ensure the most effective use of DROs, the Secretary of Veterans Affairs should direct the Veterans Benefits Administration to establish national and regional office performance measures related to appeal resolution at the regional level and ensure that sufficient quality review procedures are in place to prevent DROs from granting unjustified benefits. |
The Department of Veterans Affairs (VA) has completed a pilot of changes to the appeals process--including to the Decision Review Officer (DRO) performance measures--at its Houston regional office. Based on the results of the pilot, VA drafted revised DRO performance measures that included a focus on appeals resolution at the regional office level. However, VA reports that despite extensive negotiations, it has not reached agreement with the American Federation of Government Employees on a revised set of measures, and has therefore decided to retain the existing measures.
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| Department of Veterans Affairs | To clarify information for veterans and ensure the most effective use of DROs, the Secretary of Veterans Affairs should direct the Veterans Benefits Administration to assess the knowledge and skills that DROs need to perform their varied responsibilities, determine if any gaps exist in the training currently available, and, if necessary, develop a training curriculum or program tailored to DROs. |
The Department of Veterans Affairs (VA) has assessed Decision Review Officers' (DRO) training needs and provided training accordingly. VA developed a curriculum specifically for DROs and Appeals Team supervisors, based on factors including quality assurance trends, a job task analysis, and the results of DRO skills certification tests. Six hundred and nine DROs and Appeals Team supervisors attended courses based on this curriculum between November 2011 and December 2012. VA is developing additional DRO training based on feedback regarding these courses.
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