AFGE Local 520 US House and Senate VA Committees 09-15-13

7/29/2019 AFGE Local 520 US House and Senate VA Committees 09-15-13

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VA Regional OfficeAFGE LOCAL 520PO BOX 1778COLUMBIA, SC 29202September 15, 2013

Chairmen, Ranking Members, Mem bers of the US House and Senate Committees of V eteransAffairsDear Committee Members:Local 520, the exclusive representative of the bargaining unit of VA RO Columbia, SC , wants toaddress the topics in the media this week - appeals (quarter- million), accuracy, acc ountability,and thepaperless system - VB MS that isproduc ing results.First, we will begin with the excerpts from the article Veterans face another backlog as aquarter-million appeal disability claims, Washington Post, September 10, 2013.

> As the O bama administration touts its recent progress hi reducing the enormous backlogof veterans' disability claims, a second backlog is rarely mentioned.> The 256,061 veterans appealing decisions represent an approximately 50 percent increasesince P resident O bama took office. A nd more are coming. Th e Board of Veterans'Appeals, which m akes the final administrative decisions on appeals, expects its numberof pending c ases to double over the next four years.> The appeals backlog has grown partly because V A has directed resources away fromappeals and toward the high-profile disability backlog, according to interviews with VAworkers and veterans' advocates.> Gerald Manar, deputy national veterans service director for the Veterans of ForeignWars, said VA officials at regional offices often make a "calculated decision" to pullworkers off appeals and redirect them to new c laims. "Over the last three years or so,every time V A has made a push, they pull almost all of the employees out of appeals andinto front-end work," said Manar, a former V A benefits manager.> VA Secretary Eric K. Shinseki acknow ledged in an interview last week that appeals donot get the same emphasis as new c laims but said that will change as the backlog shrinks."Yes, there is a need to focus on appeals," Shinseki said. "This is an elephant. You have

to take bites one at a time."> A veteran who takes an appeal throu gh all available administrative steps faces an averagewait of 1,598 days, according to VA figures for 2012. If the veteran pursues the caseoutside VA to the U .S. Court of Appeals for V eterans Claims, it takes an additional 321days on average, according to court documents.

The bottom line is appeals are being shoved to the back of the line and no one cares.As the focus is on National numbers, the real problems are at the individual regional office level.For example, the Colum bia regional office according to the M onday Morning W orkload Report


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(MMWR) as of September 7, 2013 shows that there are 6995 appeals pending. O n September 5,2009, there were 31,80.However, there are only 4 Decision Review O fficers (DRO) assigned to conduct formalhearings, informal conferenc es, DeNovo reviews, process dec isions based on their reviews, andcertify claims to the BVA.The num ber of appeals has doubled in the past four years. However, the number of DRO s hasremained static. The number of DRO s assigned in 2001 was three.They are further tasked with holding hearings for paperless claims located at the BenefitDelivery at Discharge (BDD) sites and employee-veterans that have appeals pending, as well asholding hearings and conducting DeNovo reviews for the appeals located at the PensionMaintenance Centers (m any new DRO s in other regional offices have never even workedpension and DIG claims, but they are charged with being subject-matter experts in these c ases(including rating and non-rating issues).It should also be pointed out that the Statement of Case (SOC) program used by the appeals teamhas not been updated fo r many years to include the current laws in existence and it has manyflaws and errors causing a loss of work only to have to be redone wasting tim e and resources.Furthermore, the new Notice of Disagreement (NO D) form recently c reated by V BA tostreamline the process has only made it more labor intensive by requiring DRO s to call theVeteran if it is requested. How can this happen with the number of NODs submitted, the numberof DRO s assigned, and at times they get pulled to work regular rating inventory?Further, it is also a waste of human resources calling a V eteran today for c larification when theDRO can't w ork these newest appeals for one to two years or longer due to the backlog. We dorealize all roads arepaved w ith good intentions, but sometimes things just don't work out likethey were intended!Moreover, the decisions (grants and remands) made by the Board of V eterans Affairs (BVA) laydormant in regional offices. These decisions according to VA regulations are required to behandled expeditiously, but most are not.Th e Subcommittee on Disability Assistance and Memorial Affairs (DAMA) conducted ahearing on the issue on June 18, 2013 - Why A re V eterans W aiting Years on Appeal?: AReview of the Post-Decision Process for Appealed Veterans' Disability Benefits Claims.What were the results?


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Considering the BVA's reversal rate of regional office's decisions, the appeal process is criticalfor Veterans and their survivors to receive the com pensation they have earned by serving theirCountry in the Armed Forces. Moreover, how many of them die waiting on their decisions?What will it take to hold VA responsible fo r "all claims" submitted by Veterans and theirsurvivors? Congress is giving the V A a license to disregard certain c laims submitted by ourNation V eterans and their survivors. How can this be called an efficient and effective claimsprocess?These excerpts from the article Legion challenges VA on claims accuracy Marine Times,September 12, 2013 only confirms why appeals are important and why accurac y numbersreported by V A is not reliable.

> The nation's largest veterans' group is challenging the Veterans Affairs Department'srecord of accuracy in deciding benefits claims.> The 2.4 million member American Legion, the nation's largest veterans' group and apartner with VA in processing c laims, says these acc uracy c laims are "inconsistent w ithour Regional Office A ction Review visits nationwide, where errors are found routinely inover half of the cases reviewed," according a statement prepared by Vera Jones, directorthe Legion's veterans affairs and rehabilitation division.> The higher error rate was discovered in a review of cases chosen by VA employees, notby the Legion, Jones said. In cases where the Legion represents a veteran before theBoard of V eterans' A ppeals, the Legion "successfully argues that VA has either erred orfailed to properly develop claims in over 70 percent of claims," she said.> Responding to the Legion's testimony, VA spokeswoman Victoria Dillon said "accuracyon claims dec isions is now over 90 percent with 96.7 percent acc uracy for medical issues

within the claim."> "By stressing accuracy as a measure of equal quality with speed of adjudication, VA canpromote a c ulture among employees to get the job done right the first time, thus reducingthe backlog," Dellinger said.The number of appeals and BV A decisions - grants and remands only confirms that the VAaccuracy numbers are not acc urate.When the largest service organization's reviews accuracy numbers are sufficiently different fromV A, it shows that accuracy rates reported by VA need an independent examination. The VA foxis watch ing the chicken coup. This has and continues to spell trouble for Veterans and theirsurvivors. However, the greatest tragedy is that it is allowed to continue.Th e excerpts for the article Getting to backlog zero: Ensuring accountability across VA, The H illCongress Blog, September 12, 2013 outline what must happen at the VA.

> More than 475,000 veterans are still waiting more than 125 days for the benefits they'veearned. To support these veterans and to reach backlog zero requires comprehensive


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solutions to some of the systemic problems that have both created and prolonged the VAbacklog. No plan to end the backlog w ill succeed without addressing critical issues thatwe will highlight this week, continuing w ith Ensuring A cc ountability Ac ross V A .> Since September 11th, 2001, five secretaries of the Department of Veteran Affairs (VA)have pledged to end the VA disability claims backlog. Years later, the bac klog remains acritical issue for veterans who face enormous wait tunes for decisions on their disabilityclaims. A s of September 3, 769,974 c laims are pending at the V A and 476,988 of theseare stuck in the V A backlog.> A chief role of leaders in the veterans community is holding our government responsiblefor serving the needs of veterans and their families. This accountability must start at thetop, with the Comm ander-in-Chief and the Secretary of the VA. They are ultimatelyresponsible f or delivering results to the many veterans stuck in the V A disability benefitsbacklog. But acc ountability also must extend to each regional office and every claimsrater if we are to bring about the lasting change our vets need.> Right now, the existing metrics show that the VA is not moving fast enough. At theVFW 's 2012 national convention, Secretary Shinseki reported that he intended to returnto the 2013 summer conferenc e to report, "just 40 percent of c laims will be older than125 days." Days after the 2013 conference, almost 65 percent of pending disability claimswere backlogged. In early September, 62 percent of c laims are backlogged. If these aren'tthe benchmarks the VA is using to measure its success, veterans need to know wh at theyshould look for.

VA history shows that there is a lack of accountability at the organization. The lack ofacc ountability continues to plague claims processing. The HVAC continues to show that there isa lack of accountability of senior executives at the VA,Again, employees are being held accountable as we outlined in our letter last week, but seniorexecutive and managers are not.Therefore, if they are allowed to continue to renege on their promises, use A DHO C procedures,use public relations to cover up their failures, use numbers that are not validated, and seniorexecutives and managers are not held ac countable, V eterans and their survivors will continue tosuffer.Excerpts from V A finally making progress on benefits claims backlog, Lo s Angeles Times,September 12, 2013 reports the following:

> With the help of a new computer system that will be fully functional next year, theDepartment of Veterans Affairs is making gains in clearing its notorious logjam ofbenefits claims.> The O akland and Los Angeles offices together ship about 85 boxes of files a week to avendor in W isconsin, which does the scanning. But, said W illie Clark, the western areadirector for the Veterans Benefits Administration, "the lion's share of our work is still onpaper."


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The implementation of the Veterans Benefit Management System (VBMS) has created moredelays than progress. The system cannot process a claim from start to finish. Furthermore, VAhas to use to different systems to process paperless claims - VBMS andVirtual VA.VA examinations and V A outpatient progress notes are stored in Virtual VA . The indexing ofpaperless documents in VBMS and Virtual VA is problematic.No, the progress that has been made is the results of mandatory and voluntary overtime"taxpayer's dollars" which w ill now be continued until at least November, AD HO C proceduresthat will eventually create m ore workload m anagement problems, changing the way num bers arereported on the MMWR, shifting resources from appeals and other claims, and using publicrelations as a tool fo r deception. /Local 520 will continue to take its responsibility given by law to safeguard the public and tocontribute to the effective conduct of public business, seriously.Therefore, we w ill continue to c hime in weekly on this most critical subject with "objectiveevidence" because V eterans have earned the right to have a claims processing system that worksfo r attof them and employees can only effectively serve them if they are provided with theleadership, processes, people systems a nd work place culture that are conducive to providingtimely and accurate decisions.

Ronald RobinsonPresident(803) 647-2385 (O fc )(803) 239-7682 (Cell)[email protected]:Weekly A nalysis of VBA Progress - MMWRCF:President ObamaVA Secretary ShinsekiPresident A FGEPresident NVAC60 MinutesNY TimesWashington PostCenter for Investigative ReportingThe Washington ExaminerVA Watchdog


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P R A T I N G B U N D L E Q/7/?nn*4/27/2013 8/24/2013010110140020320681687405409310120180

70,277231,946

9,796478,0921,616

4710

2,16526917,167

19,70414,720

56,627189,063

8,739446,6642,1432,589

116113622,802

18,03913,856

55,981183,237

8,674442,4022,3042,730

310911024,149

18,01513,650

C&P RB 846,223 760,820 751,364*190 ^ 50,868 40,394 38,548O T C & P E N T 897,091 801,214 789,912**930 28,923248,012

28,446254,957 27,406256,081T O T A L 1,174,026 1,084,617 1,073,399

DIFF Initiatives DIFF-646 -14,296-5,826 -48,709

-65 -1,122-4,262 -35,690161 688141 2,259

2 3-52 -2,056-26 -1591,347 6,982-24 -1,689-206 -1,070

> -5,968 -94,859-537 -12,320-6,505 -107,179

-436 -1,517338 8,069

-6,603 -100,6274/27/2013 9/7/2013 DIFF >125 %

Appeals 248,012 256,061 8,049Other Claims

130 192,111 207,756 15,645 72.6%290 83,645 87,233 3,588 78.7%600 45,034 52,531 7,497 52.0%

*400 24,461 61,406 36,945 29.0%**137 10,214 8,705 -1,509 49.2%**150 53,948 39,144 -14,804 71.2 %**297 17,796 12,375 -5,421 34.7%**607 18,546 19,326 780 24.7%**160 60,850 47,697 -13,153**165 15,002 15,050 48521,607 551,223 29,616

Totals 769,619 807,284 37,665*Associated with Provisional Ratings**Pension Maintenance Center (PMC ) claims


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RB>125 4/27/2013 8/27/2013 09/07/13010110140020320

51,015169,997

3,511334,813

647681 115687 0405 2,161409 224310120180

TOTRB>125*190TOT

ENTITLEMENT930

8,0588,3195,056

583,91632,609

616,52525,754

35,962126,052

1,888284,152

986379

0153112

9,3747,0025,590

471,65025,257

496,90724,064

34162119654

2063278093

1067537

010092

928967845537

45737824798

48217622917

*DIFF-1,800-6,398

175-6,059

81158

0-53-20-85

-218-53

-14,272-459

-8,683-1,147

**DIFF-16,853-50,343-1,448

-56,720420422

0-2,061

-1321,231

-1,535481

-126,538-7,811

-134,349-2,837

4/27/201372.6%73.3%35.8%70.0%40.0%24.4%0.0%

99.8%83.3%46.9%42.2%34.3%69.0%64.1%69.9%86.3%

09/07/1361.0%65.3%23.8%62.9%46.3%19.7%0.0%

91.7%83.6%38.5%37.7%40.6%60.9%64.3%78.2%83.6%

DIF-11.6'-8.0'

-12.0'-l.V6.3'-4.7*0.0'

-8.1'0.3'

-8.4'-4,5'6.3'

-8.1'0.2'8.3'

-2.7'

G R A N D T O T AL 642,279 520,971 505093 -15,878 -137,186

AFGE Local 520 US House and Senate VA Committees 09-15-13

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Transcript of AFGE Local 520 US House and Senate VA Committees 09-15-13