The VA in a letter recently- promised me 3 VCAA letters on claims I filed in 2004.
The 2003 clams- one never got a VCAA letter and the other one- it does not refer to the VCAA at all- so maybe that isnt one either-
Does anyone have a link to an actual VCAA letter?
These letters are supposed to specifically advise the veteran but-if they dont send them- and begin working on the claim- what good are they?
This bothers me:
see under Other Areas of concern-re the VCAA
STATEMENT OF DONALD L. MOONEY, ASSISTANT DIRECTOR
VETERANS AFFAIRS AND REHABILITATION DIVISION
THE AMERICAN LEGION
BEFORE THE
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES HOUSE OF REPRESENTATIVES
ON
CHALLENGES AND OPPORTUNITIES FACING DISABILITY CLAIMS PROCESSING IN 2006
DECEMBER 7, 2005
Mr. Chairman and Members of the Committee:
(I am skipping alot here-)
Thank you for this opportunity to present The American Legion’s views on the challenges and opportunities facing Department of Veterans Affairs (VA) disability claims processing in 2006. We commend the Committee for holding this hearing to discuss these important issues.
Workload and Claims Backlog
The VA has a statutory responsibility to ensure the welfare of the nation’s veterans, their families, and survivors. Providing quality decisions in a timely manner has been, and will continue to be, one of the VA’s most difficult challenges.
There are currently almost 2.6 million veterans receiving disability compensation and VA reports that this number is increasing at a rate of 5,000 to 7,000 per month. VA reported that its 57 Veterans Benefits Administration (VBA) regional offices issued more than 763,000 disability determinations in fiscal year 2005. Three and four percent increases are expected in fiscal years 2006 and 2007, amounting to approximately 826,000 claims in fiscal year 2006 and 842,000 in fiscal year 2007. A majority of these claims involve multiple issues that are legally and medically complex and time consuming to adjudicate.
The increasing complexity of VA claims adjudication continues to be a major challenge for VA rating specialists. Since judicial review of veterans’ claims was enacted in 1988, the remand rate of those cases appealed to the United States Court of Appeals for Veterans Claims (CAVC) has, historically, been about 50 percent. In a series of precedent setting decisions by the CAVC and the United States Court of Appeals for the Federal Circuit, a number of longstanding VA policies and regulations have been invalidated because they were not consistent with statute. These court decisions immediately added thousands of cases to regional office workloads, since they require the review and reworking of tens of thousands of completed and pending claims.
As of November 26, 2005, there were almost 368,000 rating cases pending in the VBA system. Of these, more than 84,000 (22.9 percent) have been pending for more than 180 days. According to the VA, the appeals rate has also increased from a historical rate of about 7 percent of all rating decisions being appealed to a current rate that fluctuates from 11 to 14 percent. This equates to more than 152,000 appeals currently pending at VA regional offices, with more than 130,000 requiring some type of further adjudicative action.
Staffing
Whether complex or simple, VA regional offices are expected to consistently develop and adjudicate veterans’ and survivors’ claims in a fair, legally proper, and timely manner. The adequacy of regional office staffing has as much to do with the actual number of personnel as it does with the level of training and competency of the adjudication staff. VBA has lost much of its institutional knowledge base over the past four years, due to the retirement of many of its 30-plus year employees. As a result, staffing at most regional offices is now made up largely of trainees with less than five years of experience. Over this same period, as regional office workload demands escalated, these trainees have been put into production units as soon as they completed their initial training.
Concern over adequate staffing in VBA to handle its demanding workload was addressed by VA’s Office of the Inspector General (IG) in a report released in May of this year (Report No. 05-00765-137, dated May 19, 2005). The IG specifically recommended, “in view of growing demand, the need for quality and timely decisions, and the ongoing training requirements, reevaluate human resources and ensure that the VBA field organization is adequately staffed and equipped to meet mission requirements.” Additionally, the chairman of the newly established Veterans’ Disability Benefits Commission questioned the Under Secretary for Benefits about the adequacy of current staffing levels during a Commission meeting this past July. The Under Secretary conceded that the number of personnel has decreased over the last three years. It is an extreme disservice to veterans, not to mention unrealistic, to expect VA to continue to process an ever increasing workload, while maintaining quality and timeliness, with less staff. Our current wartime situation provides an excellent opportunity for VA to actively seek out returning veterans from Operations Enduring Freedom and Iraqi Freedom, especially those with service-connected disabilities, for employment opportunities within VBA.
Training
Over the past few years, The American Legion’s Quality Review Team has visited almost 40 VA regional offices for the purpose of assessing overall operation. This includes a review of recently adjudicated claims. Our site visits have found that, frequently, there have been too few supervisors or inexperienced supervisors to provide trainees necessary mentoring, training, and quality assurance. In addition, at many stations, ongoing training for the new hires as well as the more experienced staff would be postponed or suspended, so as to focus maximum effort on production. However, we are encouraged by the Under Secretary for Benefits’ public commitment to improving the training of VBA personnel and we look forward to improvements in this area in 2006.
Production Versus Quality
Any rational, informed observer of the VA adjudication system would find that the VA suffers from a quality problem. Despite the fact that VBA’s policy of “production first” has resulted in many more veterans getting faster action on their claims, the downside has been that tens of thousands of cases have been prematurely and arbitrarily denied. Approximately 65 percent of VA raters and Decision Review Officers (DRO) surveyed by the IG, in conjunction with its May 2005 report, admitted that they did not have enough time to provide timely and quality decisions. In fact, 57 percent indicated that they had difficulty meeting production standards if they took time to adequately develop claims and thoroughly review the evidence before making a decision. Inadequate staffing levels and pressure to make quick decisions, resulting in an overall decrease in quality of work, has also been a consistent complaint among Service Center employees interviewed by The American Legion staff during our regional office quality checks. As a consequence, the appeals burden at the regional offices, the Board of Veterans’ Appeals (Board or BVA) and the Appeals Management Center (AMC) continues to grow. In fiscal year 2005, the BVA issued more than 34,000 decisions and, of these, the BVA either overturned the regional offices’ decisions or remanded for additional development in almost 60 percent of the appeals.
For years The American Legion and other veterans service organizations (VSOs) have stated that the driving force behind most VA adjudications is the need for the VA to process as many claims as possible in the fastest possible time. Awards and bonuses are often centered around production and even the IG acknowledged that because the VA often does not take the time to obtain all relevant evidence and information, there is a good chance that these claims are not properly adjudicated. The emphasis on quantity and speed of adjudication results in premature adjudications, improper denials of benefits, and of course, inconsistent decisions. The growing claims backlog and the immense pressure on VA leadership to reduce it and provide timely decisions is often at odds with efforts to maintain or improve the quality of the decisions. Instituting realistic production goals and timelines that take into consideration the number of pending cases and the complexity of the work must be accomplished if VA is to ever reach a much needed balance between production and quality in its adjudication process. In addition to providing rating personnel with enough time to properly develop and rate claims, it is essential for VA management to actively encourage and reward quality work.
Additional Areas of Concern
VBA Communication with Veterans
The Veterans’ Claims Assistance Act of 2000 (VCAA), P.L. 106-475, was designed in part to improve the way VBA communicated with claimants and the way in which VA regional offices developed claims. Great pains were taken in the wording of the statute to make clear the exact nature and extent of VA’s obligations and responsibilities in notifying and assisting claimants. Essentially, the VCAA required the VA to inform veterans of the evidence and information that was needed in order for the VA to award benefits. This process was a major departure from longstanding adjudication policies and procedures, which did not adequately inform and assist individuals with their claims. This legislation was expected to result in claims that were more fully developed and which could be adjudicated in a more expeditious and accurate manner, thereby, improving service to claimants. There was also an expectation that these improvements would increase claimant’s satisfaction with the decision received and, over time, reduce the appellate workload for the Decision Review Officers and for the Board of Veterans’ Appeals.
Unfortunately, many VCAA development letters have not fulfilled the intent of the legislation. It is the experience of The American Legion, based on over 36 quality reviews of VA regional offices, that many VCAA letters are poorly written and difficult to understand. We have identified instances where the letter sent to the claimant did not even begin to address relevant issues. Additionally, during our site visits, some VA regional office adjudicators and managers expressed dissatisfaction with the content of the VCAA letters issued by VA Central Office. These regional office employees were upset that they were not permitted to alter or amend the language provided by VA Central Office. In addition, it has been the experience of The American Legion that in some VA regional offices, relatively inexperienced regional office employees are tasked with the job of developing claims. Inadequate early development and notification can lead to a plethora of later adjudication problems.
Veterans seeking VA benefits should not have to wait until they receive a statement of case in order to understand what evidence the VA needs in order to properly adjudicate their claims. Properly and promptly informing the claimant of the evidence and information required to win the claim is an essential part of the VA’s duty to assist the claimant in the development of his or her claim and it is an integral part of the non adversarial VA claims adjudication process. It is evident from the high appeals rate and remand rate for VCAA deficiencies that in many instances this is not being done.
The American Legion wants to stress that besides inadequate VCAA notifications being a legal issue, the failure to properly communicate with veterans seeking VA benefits is a fairness issue. It makes no sense for the VA to hide from what evidence would support the grant of VA benefits.
Additional Outreach Requirement
A provision in the Military Quality of Life Functions, Military Construction, Veterans Affairs, and Related Agencies Appropriations Act of 2006, passed by Congress on November 18 and signed by the President on December 1, requires the VA to conduct outreach to veterans in states with an average annual disability compensation payment of less than $7,300 (based on the findings of the May 2005 IG report). Specifically, VA would be required to notify, by mail, all veterans in these states, who are receiving
" The American Legion wants to stress that besides inadequate VCAA notifications being a legal issue, the failure to properly communicate with veterans seeking VA benefits is a fairness issue. It makes no sense for the VA to hide from what evidence would support the grant of VA benefits"
I do not know if a denied claimant with a final decision has challenged the lack of proper VCAA notification as a CUE yet-it hasn't been around too long-only since 2000-and the AL sees this as a Legal issue which seems to be beyond the Duty to assist-which is not CUE criteria-
however I sure put this right onto my I-9 appeal form, that I have not received any VCAA letters yet-
they have to be specific to each claim and this is why the VARO promised me three of them 3 weeks ago.
Question
Guest Berta
The VA in a letter recently- promised me 3 VCAA letters on claims I filed in 2004.
The 2003 clams- one never got a VCAA letter and the other one- it does not refer to the VCAA at all- so maybe that isnt one either-
Does anyone have a link to an actual VCAA letter?
These letters are supposed to specifically advise the veteran but-if they dont send them- and begin working on the claim- what good are they?
This bothers me:
see under Other Areas of concern-re the VCAA
STATEMENT OF DONALD L. MOONEY, ASSISTANT DIRECTOR
VETERANS AFFAIRS AND REHABILITATION DIVISION
THE AMERICAN LEGION
BEFORE THE
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES HOUSE OF REPRESENTATIVES
ON
CHALLENGES AND OPPORTUNITIES FACING DISABILITY CLAIMS PROCESSING IN 2006
DECEMBER 7, 2005
Mr. Chairman and Members of the Committee:
(I am skipping alot here-)
Thank you for this opportunity to present The American Legion’s views on the challenges and opportunities facing Department of Veterans Affairs (VA) disability claims processing in 2006. We commend the Committee for holding this hearing to discuss these important issues.
Workload and Claims Backlog
The VA has a statutory responsibility to ensure the welfare of the nation’s veterans, their families, and survivors. Providing quality decisions in a timely manner has been, and will continue to be, one of the VA’s most difficult challenges.
There are currently almost 2.6 million veterans receiving disability compensation and VA reports that this number is increasing at a rate of 5,000 to 7,000 per month. VA reported that its 57 Veterans Benefits Administration (VBA) regional offices issued more than 763,000 disability determinations in fiscal year 2005. Three and four percent increases are expected in fiscal years 2006 and 2007, amounting to approximately 826,000 claims in fiscal year 2006 and 842,000 in fiscal year 2007. A majority of these claims involve multiple issues that are legally and medically complex and time consuming to adjudicate.
The increasing complexity of VA claims adjudication continues to be a major challenge for VA rating specialists. Since judicial review of veterans’ claims was enacted in 1988, the remand rate of those cases appealed to the United States Court of Appeals for Veterans Claims (CAVC) has, historically, been about 50 percent. In a series of precedent setting decisions by the CAVC and the United States Court of Appeals for the Federal Circuit, a number of longstanding VA policies and regulations have been invalidated because they were not consistent with statute. These court decisions immediately added thousands of cases to regional office workloads, since they require the review and reworking of tens of thousands of completed and pending claims.
As of November 26, 2005, there were almost 368,000 rating cases pending in the VBA system. Of these, more than 84,000 (22.9 percent) have been pending for more than 180 days. According to the VA, the appeals rate has also increased from a historical rate of about 7 percent of all rating decisions being appealed to a current rate that fluctuates from 11 to 14 percent. This equates to more than 152,000 appeals currently pending at VA regional offices, with more than 130,000 requiring some type of further adjudicative action.
Staffing
Whether complex or simple, VA regional offices are expected to consistently develop and adjudicate veterans’ and survivors’ claims in a fair, legally proper, and timely manner. The adequacy of regional office staffing has as much to do with the actual number of personnel as it does with the level of training and competency of the adjudication staff. VBA has lost much of its institutional knowledge base over the past four years, due to the retirement of many of its 30-plus year employees. As a result, staffing at most regional offices is now made up largely of trainees with less than five years of experience. Over this same period, as regional office workload demands escalated, these trainees have been put into production units as soon as they completed their initial training.
Concern over adequate staffing in VBA to handle its demanding workload was addressed by VA’s Office of the Inspector General (IG) in a report released in May of this year (Report No. 05-00765-137, dated May 19, 2005). The IG specifically recommended, “in view of growing demand, the need for quality and timely decisions, and the ongoing training requirements, reevaluate human resources and ensure that the VBA field organization is adequately staffed and equipped to meet mission requirements.” Additionally, the chairman of the newly established Veterans’ Disability Benefits Commission questioned the Under Secretary for Benefits about the adequacy of current staffing levels during a Commission meeting this past July. The Under Secretary conceded that the number of personnel has decreased over the last three years. It is an extreme disservice to veterans, not to mention unrealistic, to expect VA to continue to process an ever increasing workload, while maintaining quality and timeliness, with less staff. Our current wartime situation provides an excellent opportunity for VA to actively seek out returning veterans from Operations Enduring Freedom and Iraqi Freedom, especially those with service-connected disabilities, for employment opportunities within VBA.
Training
Over the past few years, The American Legion’s Quality Review Team has visited almost 40 VA regional offices for the purpose of assessing overall operation. This includes a review of recently adjudicated claims. Our site visits have found that, frequently, there have been too few supervisors or inexperienced supervisors to provide trainees necessary mentoring, training, and quality assurance. In addition, at many stations, ongoing training for the new hires as well as the more experienced staff would be postponed or suspended, so as to focus maximum effort on production. However, we are encouraged by the Under Secretary for Benefits’ public commitment to improving the training of VBA personnel and we look forward to improvements in this area in 2006.
Production Versus Quality
Any rational, informed observer of the VA adjudication system would find that the VA suffers from a quality problem. Despite the fact that VBA’s policy of “production first” has resulted in many more veterans getting faster action on their claims, the downside has been that tens of thousands of cases have been prematurely and arbitrarily denied. Approximately 65 percent of VA raters and Decision Review Officers (DRO) surveyed by the IG, in conjunction with its May 2005 report, admitted that they did not have enough time to provide timely and quality decisions. In fact, 57 percent indicated that they had difficulty meeting production standards if they took time to adequately develop claims and thoroughly review the evidence before making a decision. Inadequate staffing levels and pressure to make quick decisions, resulting in an overall decrease in quality of work, has also been a consistent complaint among Service Center employees interviewed by The American Legion staff during our regional office quality checks. As a consequence, the appeals burden at the regional offices, the Board of Veterans’ Appeals (Board or BVA) and the Appeals Management Center (AMC) continues to grow. In fiscal year 2005, the BVA issued more than 34,000 decisions and, of these, the BVA either overturned the regional offices’ decisions or remanded for additional development in almost 60 percent of the appeals.
For years The American Legion and other veterans service organizations (VSOs) have stated that the driving force behind most VA adjudications is the need for the VA to process as many claims as possible in the fastest possible time. Awards and bonuses are often centered around production and even the IG acknowledged that because the VA often does not take the time to obtain all relevant evidence and information, there is a good chance that these claims are not properly adjudicated. The emphasis on quantity and speed of adjudication results in premature adjudications, improper denials of benefits, and of course, inconsistent decisions. The growing claims backlog and the immense pressure on VA leadership to reduce it and provide timely decisions is often at odds with efforts to maintain or improve the quality of the decisions. Instituting realistic production goals and timelines that take into consideration the number of pending cases and the complexity of the work must be accomplished if VA is to ever reach a much needed balance between production and quality in its adjudication process. In addition to providing rating personnel with enough time to properly develop and rate claims, it is essential for VA management to actively encourage and reward quality work.
Additional Areas of Concern
VBA Communication with Veterans
The Veterans’ Claims Assistance Act of 2000 (VCAA), P.L. 106-475, was designed in part to improve the way VBA communicated with claimants and the way in which VA regional offices developed claims. Great pains were taken in the wording of the statute to make clear the exact nature and extent of VA’s obligations and responsibilities in notifying and assisting claimants. Essentially, the VCAA required the VA to inform veterans of the evidence and information that was needed in order for the VA to award benefits. This process was a major departure from longstanding adjudication policies and procedures, which did not adequately inform and assist individuals with their claims. This legislation was expected to result in claims that were more fully developed and which could be adjudicated in a more expeditious and accurate manner, thereby, improving service to claimants. There was also an expectation that these improvements would increase claimant’s satisfaction with the decision received and, over time, reduce the appellate workload for the Decision Review Officers and for the Board of Veterans’ Appeals.
Unfortunately, many VCAA development letters have not fulfilled the intent of the legislation. It is the experience of The American Legion, based on over 36 quality reviews of VA regional offices, that many VCAA letters are poorly written and difficult to understand. We have identified instances where the letter sent to the claimant did not even begin to address relevant issues. Additionally, during our site visits, some VA regional office adjudicators and managers expressed dissatisfaction with the content of the VCAA letters issued by VA Central Office. These regional office employees were upset that they were not permitted to alter or amend the language provided by VA Central Office. In addition, it has been the experience of The American Legion that in some VA regional offices, relatively inexperienced regional office employees are tasked with the job of developing claims. Inadequate early development and notification can lead to a plethora of later adjudication problems.
Veterans seeking VA benefits should not have to wait until they receive a statement of case in order to understand what evidence the VA needs in order to properly adjudicate their claims. Properly and promptly informing the claimant of the evidence and information required to win the claim is an essential part of the VA’s duty to assist the claimant in the development of his or her claim and it is an integral part of the non adversarial VA claims adjudication process. It is evident from the high appeals rate and remand rate for VCAA deficiencies that in many instances this is not being done.
The American Legion wants to stress that besides inadequate VCAA notifications being a legal issue, the failure to properly communicate with veterans seeking VA benefits is a fairness issue. It makes no sense for the VA to hide from what evidence would support the grant of VA benefits.
Additional Outreach Requirement
A provision in the Military Quality of Life Functions, Military Construction, Veterans Affairs, and Related Agencies Appropriations Act of 2006, passed by Congress on November 18 and signed by the President on December 1, requires the VA to conduct outreach to veterans in states with an average annual disability compensation payment of less than $7,300 (based on the findings of the May 2005 IG report). Specifically, VA would be required to notify, by mail, all veterans in these states, who are receiving
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This part:
" The American Legion wants to stress that besides inadequate VCAA notifications being a legal issue, the failure to properly communicate with veterans seeking VA benefits is a fairness issue. It makes no sense for the VA to hide from what evidence would support the grant of VA benefits"
I do not know if a denied claimant with a final decision has challenged the lack of proper VCAA notification as a CUE yet-it hasn't been around too long-only since 2000-and the AL sees this as a Legal issue which seems to be beyond the Duty to assist-which is not CUE criteria-
however I sure put this right onto my I-9 appeal form, that I have not received any VCAA letters yet-
they have to be specific to each claim and this is why the VARO promised me three of them 3 weeks ago.
Hope they come.
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