GAO Report: VA Benefits Appeals Process in Need of Reform
A new GAO report recommends that the Department of Veterans Affairs revamp its benefits appeals process to speed up services.
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By - The Government Accountability Office (GAO) has identified notable inefficiencies in the VA benefits appeals process which have resulted in an average processing wait time of three years.
In its report on the issue, GAO also makes several suggestions for improving the process, including developing pilot programs and using more flexible modeling strategies.
In 2015, more than 427,000 veterans waited three years or longer to complete their benefits appeals process. Of that number, 81,000 waited 5 or more years to complete that same process.
Wait times are a significant administrative problem within the VA. When veterans seek care at a VA health facility, appointment times are often inconveniently high. GAO has repeatedly conducted research on ways the VA can improve administrative tasks for veteran services, including the process of disputing benefits decisions.
Even though the Board of the VA had received approval to increase staffing throughout 2017, GAO reported that there would need to be a hiring surge in the year 2018 as well.
Without a proper increase in staffing rates, veterans will experience an average wait time of eight years to complete the benefit appeals process.
The VA modeled different options to increase staff levels that would help the health system meet demand, but GAO noted that the VA models relied on fixed estimates rather than possible variations, and did not include mitigation strategies for challenges involving recruiting, hiring, and training new employees.
“For example, while VA 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 that it encountered for hiring staff in fiscal year 2017,” GAO said.
“Without a timely, detailed workforce plan, VA risks delays in hiring and preparing staff to help manage workloads as soon as possible.”
The VA identified a veteran’s ability to submit new appeals evidence any time during an appeals process often created delays. The VA has developed new proposals to streamline this process with the help of veterans service organizations (VSOs).
GAO found several gaps within the VA's attempt at reform. One point of concern stemmed from the VA plans to do this during a hiring surge and large-scale infrastructural redesign. GAO believes that the risk of the VA for getting overwhelmed would be extremely high.
GAO also suggested that the VA should conduct pilot programs or similar testing efforts to ensure that new processes can actually improve efficiencies. Increased monitoring and transparent reporting on the reform process are advised as well, in order to inform Congress and the public on the health system’s progress.
“Without a strategy for assessing the proposed new process that includes comprehensive measures, VA, the public, and Congress cannot know the extent to which the proposed process represents an improvement over the old process,” GAO said.
The VA noted that its technology infrastructure is outdated and needs improvement. While the VA proposed new IT systems, GAO reported that the VA lacked a plan for how and when the new system will be implemented.
“Without a detailed schedule, VA risks not having new systems aligned with potential changes in the appeals process when they are implemented,” GAO stated.
GAO’s report concluded with five general recommendations that will make the VA’s attempts at reforming the benefits appeal process more feasible.
The suggestions include applying sensitivity analyses when projecting staff needs, developing a more timely and detailed workforce plan, and developing a robust plan for monitoring process reform.
Other suggestions involve developing a strategy for assessing process reform, and creating a schedule for IT improvements that takes into account plans for potential process reform.
The VA agreed with GAO’s findings, officials stated in a press release.
“Veterans are waiting far too long for decisions in our current appeals process,” said Secretary of Veterans Affairs Dr. David J. Shulkin. “We have made bold changes to remove the bureaucratic red tape that has caused Veterans to wait an average of three years before they get a decision.”
