VA Appeals Backlog: Will Reform Plans Work?

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By on April 9, 2017 in Agency News with 0 Comments

Cartoon depiction of a person sitting at a desk hidden behind stacks of paperwork holding up a 'help' sign

There is a problem at the Department of Veterans Affairs (VA) regarding the timeliness of benefit compensation appeals from veterans. The issue was recently reviewed by the General Accountability Office (GAO)

The GAO outlines problems with plans for resolving the large backlog of appeals at the agency. The agency disagrees with the GAO that pilot testing and more detailed strategy for assessing proposed reforms are necessary.

The summary below summarizes the conclusions of the GAO.

The Problem: Veterans Wait Years for Decisions

The VA compensates veterans for disabling conditions as a result of military service. Veterans can appeal decisions from the Board of Veterans’s Appeals (VBA) on their compensation claims. The appeals initially go to VBA. An appeal can then go to the Board, a separate agency within VA.

In fiscal year 2015, more than 427,000 appeals were pending and veterans waited over 3 years on average for decisions. About 81,000 were pending at the Board. The average cumulative time veterans waited for a decision by the Board in 2015 was almost 5 years.

Hiring More People to Reduce Wait Times

The VA has decided it needs more people to improve time for handling appeals and reducing the appeals backlog. The Board received approval to hire more people in fiscal year 2017. It anticipates a need for another hiring surge in fiscal year 2018.

As of October 2016, VA officials estimate 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.

The GAO found that the agency modeled different options for increasing staff levels in concluding that hiring more people and making process changes would reduce the appeals inventory. The GAO concluded this action was consistent with sound workforce planning practices.

GAO also found that the VA’s written workforce plans—which cover recruiting, hiring and training—did not include detailed steps, time frames, and mitigation strategies.

For example, while the agency has established a center for excellence in hiring to focus on recruitment and hiring, the agency has not finalized training or telework plans or otherwise mitigated space constraints it encountered for hiring more people in fiscal year 2017. Without a timely, detailed workforce plan, VA risks delays in hiring and preparing staff to help manage workloads as soon as possible.

Changing How Appeals are Handled Without Pilot Testing

The VA has also concluded that new evidence—which a veteran can submit at any point during his or her appeal—causes more reviews, and delays. The agency has proposed legislation for streamlining the process.

While the GAO concluded the VA’s proposed reform is promising, there are gaps. In particular, the agency plans to fully implement appeals process reform at the Board as well as at VBA regional offices across the country.  At the same time, it plans to manage the existing appeals inventory, a hiring surge, and planned system changes.

The agency does not plan to do pilot testing of the process before fully implementing the changes. VA officials told GAO pilot testing requires legislation and will prolong using a broken system. The GAO’s concern is that without pilot testing, the agency may experience  setbacks on a broader scale and perhaps make the existing problems more severe.

In addition, GAO notes that the VA has not sufficiently identified how it will monitor progress, evaluate efficiency and effectiveness, identify trouble spots, and otherwise determine whether the proposed process changes are working.

The absence of a monitoring plan with success criteria is inconsistent with sound planning practices for redesign and places the agency at risk of not being able to quickly identify and address setbacks. In addition, the timeliness measures that VA currently plans to report to Congress and the public lack transparency. They focus on individual parts of the agency and pieces of the new process rather than overall appeals resolution time from the veterans’ perspective.

Without a strategy for assessing changes, GAO does not believe it will not be possible to know if the changes are really an improvement.

Updating Computer Systems

VA determined that the computer system supporting its appeals process is insufficient. VA proposed a new IT system to reduce delays in appeals to the Board, and better integrate data from other systems.

Consistent with sound practices, according to the GAO,  the VA laid out the scope and purpose of IT upgrades. It also identified risks and strategies to mitigate problems. However, the agency’s plan lacks details for how and when its new system will be implemented. Without a detailed plan, VA risks not having new systems aligned with potential changes in the appeals process when they are implemented.

This report examines VA’s approaches to address challenges it identified as contributing to lengthy appeals processing times, and the extent to which those approaches are consistent with sound planning practices.

GAO focused mainly on the Board, which experienced an increase in workload of about 20 percent from fiscal year 2014 to 2015. GAO reviewed VA’s proposed plans and actions and compared them to sound practices relevant to workforce planning and implementing process redesign and new information technology identified in federal guidance, such as internal control standards, and prior GAO work. GAO also analyzed VA’s data for fiscal years 2011-2015 (the most recent available) on appeals decision timeliness and workloads; reviewed relevant federal laws, regulations, and planning documents; and interviewed VA officials and veterans service organizations.

GAO Recommendations

GAO is making five recommendations to VA and one matter for congressional consideration. The agency should:

  • apply sensitivity analyses when projecting staff needs,
  • develop a more detailed workforce plan,
  • develop a plan for monitoring process reform,
  • develop a strategy for assessing these reforms, and
  • create a schedule for IT improvements taking into account plans for potential process reform.

The VA concurred in principle with the five recommendations, but believes it has met the intent of those recommendations and does not need to take additional action.

The GAO disagrees. It believes more work is needed to improve  the VA’s ability to successfully implement reforms.

The VA also disagreed with a recommendation of incorporating pilot testing of its proposed appeals process and pursue necessary legislative authority. VA cited its perspective that the appeals process is broken and that piloting a new process would result in further delays to veterans appealing their disability decisions. GAO maintains that the benefits of pilot testing—which provides an opportunity to resolve implementation challenges and make refinements to the process on a smaller scale—outweigh the potentially negative consequences of delaying full implementation.

Therefore, GAO removed the recommendation and added a matter for congressional consideration stating that Congress should consider requiring that appeals process reform be subject to a pilot test.

© 2019 Ralph R. Smith. All rights reserved. This article may not be reproduced without express written consent from Ralph R. Smith.

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About the Author

Ralph Smith has several decades of experience working with federal human resources issues. He has written extensively on a full range of human resources topics in books and newsletters and is a co-founder of two companies and several newsletters on federal human resources. Follow Ralph on Twitter: @RalphSmith47

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