VA disability claims backlog grows despite paperless fix (Military.com)
Officials from the Veterans Affairs Department were pressed Tuesday to explain how the paperless fix to the disability claims process has initially resulted in growing backlogs. The claims backlog stood at about 76,000 last May before the VA solution called the National Work Queue was fully implemented, but the backlog last week was at 101,000 cases, said Rep. Mike Bost, an Illinois Republican and chairman of the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs. At a hearing of the panel, Ronald S. Burke Jr., the VA assistant deputy secretary for Field Operations National Work Queue, didn’t dispute Bost’s numbers but said one of the problems is that “this is a relatively new initiative.” Willie C. Clark Sr., deputy under secretary for Field Operations, said the new system has improved efficiency for veterans and the result is that “they submit more claims.” The queue was described by Thomas J. Murphy, acting under secretary for benefits at the Veterans Benefits Administration, as an electronic records system “to ensure veterans receive a more timely decision on their disability compensation claims.” With the technology, the VA now has the ability to shift overloads in the system from one regional VA office to another. “This new environment allows VA the flexibility to move claims around the country that have the capacity to take the next action on a veteran’s claim,” Murphy said. “On its face, this is common sense,” Bost said. “NWQ allows VA to distribute its workload evenly across the nation to reduce waiting times for veterans who file claims for benefits. However, there are some concerns about whether NWQ is actually performing as it should.” The claims backlog was at about 99,000 cases as of Tuesday, Murphy said, and he acknowledged that “we’re never going to get to zero. That’s not going to happen.” Some claims, particularly those involving radiation disability, simply take more time, and it would “not be the right thing to do” for the veteran to speed up the process, he said. Rep. Elizabeth Esty, a Connecticut Democrat and the acting ranking member on the subcommittee, said she is concerned that the electronic system allows too many VA claims processors to become involved, or have “touches,” on a particular case. Burke said that a claim in the new system normally involves five or six involvements by processors. “We need to reduce the number,” Esty said. In a separate panel at the subcommittee hearing, several veterans service organizations said they are generally in favor of the paperless claims system that allows VA to shift cases among regional offices. The implementation of the electronic system “has been credited with assisting in the reduction of the backlog that peaked at 611,073 claims in 2013,” said Zachary Hearn, deputy director of claims in the National Veterans Affairs and Rehabilitation Division of the American Legion. However, in his prepared remarks for the subcommittee, Hearn said the Legion is concerned that its accredited representatives assisting veterans with claims at local regional offices are not being kept fully informed when cases are processed at another regional office. Hearn said there is a need for a notification system to be installed in the queue “for accredited representatives so that they would know when a claim adjudicated in another location requires a review.” A similar complaint came from Ryan Gallucci, deputy director for National Veterans Service at the Veterans of Foreign Wars, who also said that the VFW’s accredited representatives are sometimes out of the loop when ratings decisions are made at another VA regional office. “At first, it may look good that VA was able to send the rating to the veteran more quickly,” Gallucci said, “but this is no good if the decision is inaccurate and if our advocates have no way to explain the rating decisions to our veterans.”
Senate confirms David Shulkin as new VA Secretary (MilitaryTimes)
The Senate easily confirmed Dr. David Shulkin as the new Veterans Affairs Secretary on Monday night, making him the first non-veteran ever to serve in the post. Shulkin, who currently serves as the head of VA health programs, was approved by a vote of 100-0. He is expected to be sworn into the Cabinet post on Tuesday. The 57-year-old physician was praised by lawmakers from both parties and veterans advocates as a leader with inside knowledge of the veterans bureaucracy and critical perspective of ways to reform those offerings from his time as a healthcare executive. “The solutions to VA’s problems should be based on common sense rather than partisanship or an extreme agenda, and I think Dr. Shulkin recognizes that,” said Sen. Jon Tester, D-Mont., and ranking member of the Senate Veterans’ Affairs Committee. “He is committed to our nation’s veterans above all. Through the conversations I’ve had with him over the last year and a half, I think he understands the challenges that are ahead of us in the VA … Dr. Shulkin is on top of it.” Committee chairman Sen. Johnny Isakson, R-Ga., called Shulkin “the right man for the veterans administration” and hailed the vote as a rare moment of bipartisanship in the increasingly divided chamber. Shulkin is the only member of President Donald Trump’s Cabinet to be held over from former President Barack Obama’s administration. He’s also the first non-veteran to oversee the department or any of its predecessor agencies. Over the last 94 years, each of the 26 other men to serve in the job boasted military experience. Shulkin’s parents both served in the Army, and he was born on a military base in Illinois. In his confirmation hearing earlier this month, Shulkin said the military and veterans care has played a persistent role in his life. “As a young doctor, I trained in several VA hospitals,” he said. “I view my service at VA as a duty to give back to the men and women who secured the uniquely American freedoms and opportunities we all enjoy, because of sacrifices they made.” He also repeatedly promised not to “privatize” VA services, and told lawmakers he would not have accepted Trump’s nomination if it came with such a requirement. “What I told him is that I am a strong advocate for the VA, that the services that are available in VA are not available in the private sector,” Shulkin told senators. “My view of where VA needs to go is an integrated system of care, taking the best of VA and the best in the community, and that’s what I would work towards.” In a statement, Veterans of Foreign Wars National Commander Brian Duffy praised the Senate vote as an important step ahead for the community. “Veterans are very fortunate to have Dr. Shulkin voluntarily stay in what has evolved into the most scrutinized and criticized position in the country. And it should be,” he said. “What he brings to the job is a love for veterans, for doing what’s right, and for knowing what needs to be done to fix what’s broken, to hold employees accountable, and to restore the faith of veterans in their VA. The VFW looks forward to working with him and his staff.” Paul Rieckhoff, CEO of Iraq and Afghanistan Veterans of America, in a statement said his membership supported Shulkin’s confirmation “but now the hard work for Shulkin and the President begins.” “Big promises from the campaign must be followed by big outcomes,” he said. “Dr. Shulkin knows the VA and should not require time to learn. We expect and deserve to see results right away.” Trump made VA reform a pillar of his presidential campaign, including releasing a 10-point plan which called for more mental health care professionals in the department, a private White House hotline devoted to fielding complaints from veterans, and a commission to “investigate all the fraud, cover-ups, and wrongdoing that has taken place in the VA” in recent years. Much of that work has been stalled waiting for a new permanent head for the department. Decisions on who will serve as Shulkin’s chief of staff, top health official and other key deputies are expected to be announced in coming days. Shulkin is the ninth permanent secretary confirmed by the Senate since the Department of Veterans Affairs was reorganized in 1989. Each of other eight were also approved without opposition, either through unanimous or voice votes.
New VA Secretary urged to push hiring freeze exemptions (Military.com)
Dr. David Shulkin was sworn in Tuesday as secretary of the Veterans Affairs Department and immediately was urged to begin approving thousands of exemptions to President Donald Trump’s federal hiring freeze. At Shulkin’s swearing-in, Vice President Mike Pence said, “Few duties of government are as important as fulfilling what President [Abraham] Lincoln promised, which is that we as a nation shall care for him who has borne the battle.” Trump “has now called on you to lead the department charged with that solemn and historic promise,” Pence said. Shulkin, who was approved by the Senate in a 100-0 vote Monday night, said, “I think we have a system that’s doing terrific things with very dedicated people, but we all know we have a lot of work to do. We all agree that our veterans deserve the very, very best that we can do.” He said the bipartisan nature of the unanimous vote that approved him was reflected in the presence at the oath ceremony of the chairmen and ranking members of the Senate and House Veterans Affairs Committees — Sens. Johnny Isakson of Georgia and Jon Tester of Montana, and Reps. Phil Roe of Tennessee and Tim Walz of Minnesota. Earlier, Walz told Military.com that Shulkin should get busy signing off on public safety exemptions to Trump’s across-the-board 90-day hiring freeze. “Let Dr. Shulkin make those decisions. I trust his take on this,” said Walz, a retired command sergeant major in the Army National Guard and the highest-ranking enlisted service member ever to be elected to Congress. In his Senate confirmation hearing last month, Shulkin said there are about 45,000 vacancies at the VA and he is in favor of filling 37,000 of them, particularly for critical shortages for doctors and nurses. New Defense Secretary Jim Mattis is in a similar situation at the Pentagon. He also has the authority to make public safety exemptions to the hiring freeze for the civilian workforce. A Pentagon spokesman said Monday that there are about 67,000 vacancies at the Defense Department, but no exemptions have been approved yet. The initial guidance put out by the Office of Personnel Management, which oversees the civil service, said exemptions to the hiring freeze would be “limited” but also said that the secretary of Veterans Affairs and the defense secretary would have wide discretion to approve exemptions for public safety and health reasons. Shortly after Trump issued the memo on the hiring freeze last month, then-acting VA Secretary Robert Snyder stated, “The Department of Veterans Affairs intends to exempt anyone it deems necessary for public health and safety, including frontline caregivers. The president and VA remain committed to seeing that our veterans receive the quality care and benefits they’ve earned. This is the right thing to do for our veterans.” Snyder then issued his own memo listing the positions that could be exempted, ranging from medical officer and nurse to security guard and laundry worker.
Study tracks veterans with traumatic brain injury (WTOP)
A far-reaching federal study hopes to provide new detail for veterans suffering from a traumatic brain injury, or TBI. Early research from the Department of Veterans Affairs shows at least 20 percent of all veterans who fought in Iraq or Afghanistan have suffered a TBI. Many heal within weeks or months, but others suffer long-lasting implications. The study hopes to track 1,100 veterans over a 20-year period to learn more about the issue and how such an injury can best be evaluated or treated. Only 700 have signed up so far. Dr. William Walker, a TBI expert at the Hunter Holmes McGuire Veterans Administration Medical Center and Virginia Commonwealth University, is leading the new study. He says the long-term observational study is one of the most comprehensive TBI projects to date in terms of size, scope and rigor. Veterans Affairs sites in Houston, Tampa, San Antonio and Richmond are enrolling in the study, including a defense site, the National Center for the Intrepid at Fort Belvoir in Virginia. An additional three VA sites will start enrolling in the spring in Boston, Minneapolis and Portland. Walker says one reason for the long time period of the study is the need to look at neurodegenerative conditions that develop only later in life, such as Alzheimer’s or chronic traumatic encephalopathy (CTE). CTE has been in the news in recent years largely because of its link to concussions among athletes in sports including football, boxing and hockey.
VA decides to move forward with scheduling enhancements developed in-house (MeriTalk)
The Department of Veterans Affairs plans to move forward with a nationwide rollout and test of homegrown improvements to the scheduling component of its electronic health record, MeriTalk learned late Monday. Although a decision had been planned for Feb. 10, VA officials notified Congress of a minor delay until today. A VA official, who spoke to MeriTalk on condition of anonymity, said agency IT leaders have decided to continue and expand the in-house developed VistA Scheduling Enhancement. The decision has raised concerns on Capitol Hill about the department’s commitment to adopting modern commercial IT systems. The scheduling component of the Veterans Health Information Systems and Technology Architecture (VistA) was at the center of the scandal involving secret waiting lists and veterans dying while waiting to receive care. The overall VistA EHR system is a massive collection of functional modules that have evolved independently over more than 30 years. There are now more than 130 distinct instances of VistA in use across the country. The decision comes just days after congressional leaders sent a letter to VA Acting Chief Information Officer Rob C. Thomas requesting the agency begin submitting quarterly status reports on all major IT projects and programs, including four major scheduling component efforts. The $642 million Medical Appointment Scheduling System (MASS) contract awarded in 2015 was suspended last year to study the homegrown enhancement effort–a move that immediately attracted the ire of Congress. MASS includes commercial scheduling software for VA schedulers, as well as a self-scheduling capability for veterans. VA is also trying to expand the VistA Veterans Appointment Request (VAR) self-scheduling application from 45 Veterans Health Administration facilities to all VHA facilities. In addition, VA remains committed to evaluating a request for proposal for a commercial EHR pilot program required by the Faster Care for Veterans Act of 2016. The House Committee on Veterans Affairs expressed concern about the number of programs underway to improve scheduling systems. “Suddenly, VA has four similar scheduling programs going at once,” wrote Committee Chairman Rep. David Roe, R-Tenn., and Ranking Member Rep. Tim Walz, D-Minn. “Please explain how these four programs will be managed so that modern scheduling technology can be quickly delivered without creating unnecessary duplication, and without undermining [VA’s] preference for existing commercial off-the-shelf solutions.”
Cherokee Nation eligible for accreditation by Veterans Affairs (Tahlequah Daily Press)
Native Americans serve in the U.S. armed forces in greater numbers per capita than any other ethnic group, and they’ve been a part of every major conflict over the last 200 years. Also, Native Americans have a higher concentration of female service members than all other ethnicities, resulting in a lot of veterans. More active duty members become veterans every day, and many require the help of benefit services such as disability compensation, pension, home loans, life insurance and health care. For veterans living in tribal communities, finding representation for benefit claims can be a difficult task. That’s why the Department of Veterans Affairs has recently changed a rule in the Code of Federal Regulations, allowing eligible tribal organizations to become accredited by the VA. In a VA release, Reyn Leno, Vietnam veteran and chairman of the Confederated Tribes of Grand Ronde, said that the rule change is a positive step forward for Indian Country and the VA. The VA’s Office of Tribal Government Relations and Office of General Counsel have worked in conjunction to implement the rule change. “For decades, tribes with accredited facilities have been able to provide quality services to our Native American Veterans and Veterans alike,” Leno said. “The piece that was missing was the ability to provide assistance on VA benefit claims. This rule recognizes the unique relationship our tribes have with our federal government and Veterans in some of our most rural communities.” The rule allows a tribal organization that is established and funded by one or more tribal governments to be recognized for the purpose of providing assistance on VA benefit claims. So the Cherokee Nation Office of Veterans Affairs may apply for recognition under the rule. If the Cherokee Nation decides to apply for recognition, the VA must ensure that any program under the tribe has the ability to provide long-term quality representation. The CN government would also have to send a certificate of approval for the organization it wishes to become recognized. OTGR can assist with tribal applications before they are sent to OGC, which makes the final approval. In addition, the rule allows for an employee of a tribal government to become accredited through a recognized state organization. This is to address the needs of Native American populations who are geographically isolated from existing recognized veterans service organizations. “No Veteran should have to drive hundreds of miles to receive care they could be eligible to receive next door at a tribal facility,” Leno said. “The ability to credential tribal employees as [veterans service organizations] will also help to further extend services to Native veterans in a culturally appropriate manner. I applaud the rule and the VA for their due diligence on this matter.” Cherokee Nation officials were unavailable for comment regarding the new rule change, which becomes effective Feb. 21.
Military veteran details struggle with VA benefits system (KRTV)
For some military veterans, the Department of Veterans Affairs is a revolving door of disappointment. Now some of them are finding themselves having to pay back benefits they had no idea they owed in the first place. Mark Hall is a Great Falls veteran who had no idea he had an outstanding debt with the Department of Veterans Affairs debt management department. Halls says he is not the only one affected, as thousands of other veterans find themselves owing money dating all the way back to 2011. “I have a life I can live now. I have hope again,” Hall said. One year ago, Mark Hall left his family to receive treatment for PTSD and a traumatic brain injury that he developed after a deployment in Iraq. “All of this small success is like winning small battles at a time. I can’t tell you how excited I am to be moving forward and to still be here to be able to move forward,” Hall said. Halls says after he came home from treatment is when everything changed for the worse. When Hall left for treatment he applied for 100% disability pay so his family would not struggle while he was away. That is when he started to receive letters stating he owed money to the VA. “I received a letter stating that I owed I think it was 4,900 dollars. I It states right on the letter, ‘In the previous letter we have sent you tells why you have this debt.’ Well, the previous letter never came.,” Hall said. Hall tried calling the debt management branch of the VA but he gave up after being on hold for more than three hours. “The next time I called, I never got that far. It said they were experiencing a high level of calls and disconnected the call,” Hall said. Some of the people Hall has talked to about his debt accused him of double-dipping. The Department of Veterans Affairs says anyone who gets paid for active-duty training but is also receiving disability must choose which benefit they prefer, so they’re not paid for both. But Hall disputes that. “I can not tell you how much that infuriates me. Half the folks, specifically me, did not know what payments are what,” Hall said. Hall says the process is confusing, and he never received an accurate breakdown of his paycheck, including deductions, from month to month. “You figure out what you can do and you set up payment arrangements to pay back that drill pay. My payments over 2016 have varied every single month, how would I know if they were taken out or not taken out? Especially if I can’t contact anybody,” But as fall rolled in, Hall says the VA withheld his entire disability check for the month of November, leaving Hall and his family without money to pay their mortgage and other bills. “Then I went to my last ditch effort, after I have exhausted all of my resources, was to go to Senator Tester for help,” Hall said. Hall says since that initial shock, the VA has explained the situation and they were also paid back some of the funds withheld from his November check. “I had called my power of attorney that I have, that works on my behalf for the VA. They expressed to me 80,000 veterans, that specifically serve in the Guard and are receiving a disability from the VA, are currently faced with this problem,” Hall said. Hall and his brother decided to go all the way back to 2005 and they found more and more problems that Hall was not aware of. “When we are looking at it, we are looking at all of these problems from day one. How it is possible for us to have ever known what was right and what was not right with our payments from the VA,” Hall said. Hall and his brother are currently working on a proposal to continue to repay the debt, while having enough money to pay for his family’s living expenses. Hall hopes that the VA will provide better information to veterans so they can understand what is being taken out of their paychecks and why, and so they aren’t facing emergency situations such as he and many other veterans have experienced. We have made multiple calls to the Department of Veterans Affairs over the past several week, but our calls have not been returned.