VA Launches Pilot To Restructure Claims Processing

WASHINGTON – The Department of Veterans Affairs (VA) is reforming its claims processing system to create specialized teams to decide benefits claims for veterans and their survivors.

A pilot program to institute some of the broad recommendations of a 12-member Claims Processing Task Force will refine new day-to-day duties and procedures for the specialized teams.

“I have approved actions on multiple fronts to ensure speedy processing and high quality in decisions on veterans’ claims,” VA Secretary Anthony J. Principi said.  “Our programs to serve disabled veterans or their survivors must be based on prompt decisions, and we need to get them right the first time.”

The Claims Processing Task Force chaired by retired Navy Vice Admiral Daniel L. Cooper, who since has become VA’s under secretary for benefits, announced a report in October that found the past work management system was inefficient and caused errors.  It noted that VA’s “veteran services representatives” working on claims currently must understand and perform more than 10,000 separate tasks.

Under the revised concept now being pilot-tested, one specialized team will perform triage on incoming mail to look for claims that can be decided without the need for additional evidence and that can be processed that day or the next day.

In the past, all incoming claims were placed in the queue and worked when their turn came.

The triage team will distribute more complex claims to the office’s other specialized teams.  These teams will focus on particular types of claims, such as appeals, or claims at varying levels of preparation for decision-making or award action.

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For example, service-connected disability compensation requires evidence showing that the injury or illness claimed by the veteran can be associated with the time the veteran was in service.  If the evidence shows this association, then the degree of disability must be determined in order for an award of benefits to be made to the veteran.

Another specialized team, a public contact team, will be devoted to providing customer service to veterans who walk in, write or e-mail the office about their claim.  In addition, since more than half of all calls received at regional offices are for general information, regional call centers are being developed to provide more efficient service to veterans who have general questions or who have questions about the status of their claim that can be answered from computerized tracking systems.

The pilot test is being conducted at four of the 57 regional offices.  This test will help identify any potential problems in the specialized teams approach, and will help assure an efficient transition for the rest of the country. 

Specific claims processing procedures and training needs will be developed based on the pilot so that other regional offices can adopt the procedures uniformly and with a minimum of disruption.  The offices participating in this pilot test are in Milwaukee, Reno, San Diego and Roanoke, Va.

In addition to reorganizing work flow and organizational structure, VA is placing increased attention on employee performance standards.  It also is promoting uniformity in basic tools, processes and measurement systems to ensure accountability for all employees, from the top leadership in Washington to the mail clerks in the regional benefits offices.

Other reforms recommended by the task force are already in progress, including devoting extra resources to tackle the claims of older veterans as well as improved records retrieval from archives.

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