Policy: Health Care

VA progress on claims backlog is a statistical illusion, vets groups say

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Building backlog of VA Disability Claims

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President Obama's claim that the Department of Veterans Affairs is "turning the tide" on backlogged disability claims is premature because the costly push to bring the numbers down is unsustainable and could doom those seeking benefits to years-long waits in appeals, according to veterans' advocates.

Drops in both the number and percentage of disability claims considered backlogged because they are more than 125 days old are real. But they have come at a high price in mandatory overtime and accuracy, representatives of veterans groups say.

There also are worries that the VA is using statistical or administrative tricks to bring down the numbers by changing what is counted and shifting staff from other critical areas such as appeals.

"They really are struggling to try and make it seem like they're making progress, and I think they are making some progress," said Jerry Manar, deputy director for national veterans' services at the VFW.

"They're going to claim victory at some point, but there's still going to be a whole lot of veterans out there waiting for some or all of their benefits," Manar said.

The backlog was defined by VA Secretary Eric Shinseki shortly after he took office in 2009. He vowed that all claims tied to military service would be processed within 125 days with 98 percent accuracy by 2015.

In August 2010, Obama called it a "moral obligation" to ensure disabled veterans got a quick resolution to their claims in a speech to the Disabled American Veterans.

Since then the backlog has ballooned. It peaked in March 2013, when there were more than 600,000 backlogged claims, about 70 percent of the total inventory.

By then, VA was under intense pressure from Congress, veterans groups, the media and the public to bring those numbers down. It launched a series of initiatives, including prioritizing older cases and mandating overtime for claims processors.

Now the numbers are dropping. The most recent report shows there are 479,926 backlogged claims, about 62.6 percent of the total.

The downturn was well timed for the president, who spoke again at the DAV convention earlier this month and repeated his promise to fix the problem. The backlog dipped below 500,000 cases on the same day the president spoke for the first time since October 2011.

"After years when the backlog kept growing, finally the backlog is shrinking," Obama said. "And we are not going to let up until we eliminate the backlog once and for all."

One quick fix announced in May was to require about 10,000 claims processors to work at least 20 hours of overtime per month. That is expected to cost about $44 million through Sept. 30, when the requirement ends, according to VA.

That raises questions about whether the overtime was a temporary fix to respond to political pressure, said Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs.

"I am skeptical as to whether the VA's current strategy is a sustainable one," Miller said. "My main concern right now is that VA's primary focus is quelling the backlash about the backlog, rather than providing long-term, sustainable solutions to the systemic issues that created the backlog in the first place."

VA also prioritized its oldest claims, clearing 65,000 that were more than two years old with an initiative that began in April. Agency officials, who would not agree to an on-the-record interview, say about 70 percent of the claims were approved, which is comparable to approval rates on standard claims.

But that number is misleading, according to veterans' representatives. If a veteran has multiple medical conditions, and the VA grants benefits for only one, the agency considers the claim to be approved and closed.

That applies even if the major disabling condition is rejected or unresolved, and a minor ailment is approved. It looks good in agency statistics, but leaves the veteran no better off, said Joe Violante, legislative director for DAV.

"It doesn't solve anything," he said.

It might make matters worse because hasty rejections force veterans into an appeals process that typically takes three or four years, said Glenn Bergmann of the law firm Bergmann & Moore, which represents veterans with disability appeals.

"They are playing a numbers game," Bergmann said of VA. "They get credit for making a decision."

The number of appeals is creeping up. In March, about 250,000 cases were on appeal. The number is now more than 254,000. Veterans with the oldest claims rated under the fast-track initiative have a year to appeal, so a future spike is likely, advocates say.

Appeals are not counted as part of the backlog.

Also, in its push to lower the backlog of disability claims, VA has transferred experienced staff who would normally handle appeals to processing initial ratings, meaning delays will get worse, said Ron Robinson, president of the AFGE union that represents VA workers in Columbia, S.C.

"The appeals, nobody is working those," Robinson said. "Those are just sitting there."

Even the numbers themselves are evolving. For years the top line in VA's weekly disclosure reports was a total figure for all types of claims awaiting a decision, as well as the smaller subset of compensation and pension claims ready to be rated.

Then in April, VA began highlighting the smaller number in orange, for the first time defining that as the relevant number in terms of Shinseki's pledge to eliminate the backlog.

Now the weekly reports no longer list the larger figure, which included things like claims for survivors' benefits after a veteran's death. That number is listed deeper in the report: almost 41,000 claims pending and 26,000 backlogged.

It is not highlighted in orange or counted in the backlog.

"The numbers are highly suspect," said Darin Selnick of the group Concerned Veterans For America. "Anytime VA releases numbers it's suspect because VA has a history of fudging the numbers."

Even if VA is being honest, and the quick fixes are sustainable, having a half-million veterans with backlogged claims, and another quarter-million with appeals, is still "atrocious," said Tom Tarantino, chief policy officer at Iraq and Afghanistan Veterans of America.

"This is not a time to start spiking the ball or saying we're turning the corner," Tarantino said. "Doing slightly better is not the same as doing good."

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