By TOM PHILPOTT
The Department of Veterans Affairs is processing more than a million disability compensation claims a year, for veterans of every age and era, whether they served in wartime or during periods of relative calm.
But that has not been enough to keep the claims backlog from rising through current wars and the expansion of compensation eligibility to more medical conditions, particularly for veterans who served in Vietnam.
Claims today are more complex, involving nine to 11 medical issues apiece, on average, versus an average of two raised by claimants after World War II. With claims increasingly complex, with more conditions eligible for payment and with VA still operating an archaic paper-driven process, 65 percent of pending claims remain in “backlog” status.
That means they’ve been on file more than 125 days without a decision.
The size of the current backlog is 558,000 claims out of an inventory of pending cases just below 900,000. VA Secretary Eric Shinseki promised two years ago to eliminate the backlog by 2015, and to raise the accuracy rate of claim decisions to 98 percent, up from 84 percent.
A plan to get there is being executed, says VA under secretary for benefits, retired Air Force Brig. Gen. Allison Hickey. She and other senior officials explained key elements of it to reporters Wednesday.
They include adopting a new electronic claims processing system VA wide, which still sounds like a Herculean task. But the effort also involves better training for claims-handlers and a new operating model for how claims are categorized to move faster through the system on one of three tracks.
There will be an “express” lane for uncomplicated claims of one or two health conditions, and also for “fully developed” claims that include all the evidence and supporting documents needed to process, typically compiled for vets with help from service officers of major veteran organizations.
Another “special operations” lane will handle claims requiring special attention because wounds or illnesses are particularly serious, or the veteran is homeless or suffering a financial hardship.
Finally a “core” lane will handle the roughly 60 percent of claims, those seeking compensation for more than two medical conditions and clearly needing more evidence gathering to process.
Claims will be routed into one of these three segmented lanes through a new “intake processing center,” Hickey explained. She estimated that 20 percent of claims could be resolved using the express lane, with the other 20 percent triaged into the special operations lane where claim reviewers and raters with greater skills and experience will work on them as teams.
The new operating model will be in 16 VA regional offices by Sept. 30 and in all remaining regions by December 2013, Hickey said.
Having served in her post 13 months, Hickey knows how frustrated members of Congress are with promises over many years that the claims backlog was being addressed. But no VA official called to testify in recent memory has been so verbally abused as Hickey was last month by Rep. Bob Filner of California, ranking Democrat on the Veterans Affairs committee.
At one point, in mocking Hickey, Filner shifted to falsetto voice to mimic the female retired general. It wasn’t the committee’s proudest moment in a Congress with public approval ratings near single digits.