Senator Heller Blasts Local VA for Benefits Delays - KTVN Channel 2 - Reno Tahoe News Weather, Video -

Senator Heller Blasts Local VA for Benefits Delays

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Senator Dean Heller is leveling some powerful accusations of delays in benefits and healthcare for veterans here in the state of Nevada. And the VA is revealing a plan to eliminate any backlog by 2015.

Just last week Heller was at the committee hearing that put the Secretary of the Veterans Administration on the hot-seat for life-threatening delays in service nationwide.

"Can you give me even one reason why you shouldn't resign?" the Senator asked.

"I have done some good things in the past five years," Eric Shinseki answered. "And we still have more to do and we are not done yet."

Just yesterday darin Farr with the Reno VA hospital told us that vets are being seen in a timely fashion once their benefits are cleared.

"The problems is not with the hospital or with the care here," Farr said. "The glitch is with getting the veterans benefits cleared at the Veterans Benefits Office."

This Regional VBA office in Reno does see veterans from Ely to Tonopah and from nine California counties that border Nevada. And they are seeing an avalanche of claims. But Heller says that is no excuse.

"I'm not happy with the regional office here in Reno that serves the whole state. It takes three times longer to get paperwork done here through that office that it should and it's the worst in the nation!"

While we couldn't confirm Reno's delays are the worst in the nation....we did question officials there. They sent us this statement.

Nevada’s Congressional delegation has been very supportive of Nevada’s Veteran population. The noted improvements below at the Veterans Benefits Administration (VBA) could not have been possible without Congressional support. The Reno VA Regional Office is committed to the Secretary’s goal of eliminating the claims backlog with 98% accuracy by 2015.

This Administration has shown unwavering commitment to serve Veterans, their families and survivors.  VA completed a record-breaking 1 million claims per year the last four fiscal years. We agree that no Veteran should have to wait to receive benefits that have been earned and deserve.  That’s unacceptable,  which is why we have implemented a robust plan to automate the process and end the disability claims backlog by the end of 2015. We still have more work to do but we’ve made strong progress.  Since April of this year, we have reduced the backlog in compensation claims 47 percent, a decrease of over 285,000 claims in about 240 days – while increasing the accuracy of claims we process.

The claims backlog at the Reno Regional Office peaked in March 2013 at 10,592 claims. As of May 28, 2014, the claims backlog at the Reno Regional Office is 2,693, a 75% decrease since March 2013. Veterans served at the Reno Regional Office are waiting less time for decisions and benefits. The age of the claims inventory at the Reno Regional Office peaked at 357.4 days for a decision in February 2013. Today, Veterans are waiting on average 168 days for a decision on their claim. The Reno Regional Office exceeded production targets for the last four months and is confident this trend will continue throughout 2014. The Reno Regional Office is committed to serving  Nevada’s Veteran population in a fair and timely manner.

Background:

Please consider the breakthroughs we’ve made in reducing the claims backlog, and understand that some regional office’s numbers may fluctuate as we move claims around to assist veterans who’ve waited the longest. If you don’t know much about these initiatives (our 2yr.old claims initiative, and later our 1yr.old claims initiative), you can read about them here:

http://www.benefits.va.gov/TRANSFORMATION/

Some national statistics of note:

·         The national backlog is at 308,000; reduced by 50% or 302,000 claims (as of 5/5/14) from its highest point in March of ‘13

·         Inventory is at 596,000; reduced by 33% or 288,000 claims (as of 4/26/14) from its highest point in July of ‘12

·         We completed more than 500,000 of our oldest claims in 2013, providing quality decisions to Veterans who had been waiting the longest for the benefits they earned and deserved

·         Today more than 87% of VBA’s inventory is electronic

·         More than 460,000 claims have been completed using this digital system since inception

VA IS AT THE HALFWAY POINT IN IMPLEMENTING ITS TRANSFORMATION PLAN

In the first half, or phase one, VA achieved many important milestones, which provide both the platform and the momentum to launch into phase two:

? Transitioned all 56 regional offices into a new Organizational Model with new Segmented Lanes for claims processing, nine months ahead of schedule

? Developed and deployed the Veterans Benefits Management System – VBA’s web-based, electronic claims processing solution – six months ahead of schedule

? Updated our nationwide Challenge Training program to improve the core skills of our employees

? Launched Quality Review Teams at every regional office to catch errors early and conduct real-time, in-process re-training (more than 230,000 in-process reviews to date)

? Collaborated closely with our Congressional and VSO partners to launch the Fully Developed Claims initiative, which puts faster decisions into the hands of Veterans by helping them submit claims with the needed evidence – in Q3 of FY12 VA received 3.6% claims as FDCs; today we receive 35% claims as FDCs

? Launched the Stakeholder Enterprise Portal to give our VSO partners power-of-attorney access to Veterans’ claims using a secure, web-based portal

? Began our “Digits to Digits” pilot which enables our VSO partners to submit claims directly to VA using their own claims management systems

? Increased awareness of and access to our joint VA/DoD eBenefits Web portal; VA currently has more than 3.6 million eBenefits users

? Scanned 645 million images to date through Veterans Claims Intake Program (VCIP), which continues to ensure new paper claims are scanned, uploaded and turned into electronic records in VBMS

THANKS TO TRANSFORMATION, VA HAS MADE STRONG PROGRESS ON ELIMINATING THE DISABILITY CLAIMS BACKLOG

? Inventory was last under 600,000 on 10/29/2010.  The next day, inventory jumped from 556,320 to 709,772 due to an influx of Nehmer claims.

? Backlog is at 319,000; reduced by 48% or 291,000 claims (as of 4/26/14) from its highest point in March of ‘13

? Inventory is at 596,000; reduced by 33% or 288,000 claims (as of 4/26/14) from its highest point in July of ‘12

? Completed more than 500,000 of our oldest claims in 2013, providing quality decisions to Veterans who had been waiting the longest for the benefits they earned and deserved

? Increased our claims-based quality from 83% in June 2011 to 90.7% today

? When quality is measured at the issue-based level – which calculates how accurately each issue in a claim is rated, and serves as a truer measure of our workload – accuracy is actually 96%

? Made an important shift away from a paper environment and into a digital environment

? Today more than 87% of VBA’s inventory is electronic

? More than 444,000 claims have been completed using this digital system since inception

? VBA receives approximately 1,500 claims a week electronically through eBenefits; more Veterans are interacting with VA via the internet than ever before

? Today 1,300+ VSO representatives can digitally access VBA through the Stakeholder Enterprise Portal

? In 2009: 9.1M contacts w/Veterans, 80% by phone; In 2013: 56.3M contacts w/Veterans, 88% online

BUT THERE IS MORE WORK TO BE DONE – PHASE TWO OF VBA’S TRANSFORMATION

? The groundwork laid during phase one is helping VA launch initiatives in 2014 and 2015 that are changing the way benefits are delivered to Veterans, their family members and survivors for generations to come

People: Initiatives to re-train and reorganize our people

? Customized, Modular Training is in development at the RO level, and VBA is working toward training at the individual level

? Consistency Studies are conducted monthly to assess accuracy/consistency of complex medical issues

? Electronic Claims Submission (ECS) is the fastest way to file claims, and VA is driving and incentivizing Veterans and VSOs to increase their use of ECS through videos, training modules, PSAs, radio spots and outreach toolkits – every separating Servicemember will have the opportunity to learn ECS in the new TAP

? VHA Clinicians are Co-located in ROs to provide onsite medical opinions; clinicians are doing a record number of exams and providing on-the-spot answers on claims

? Mandatory Overtime focuses employees for 20 extra hours per month on the backlog and priority claims

Process: Initiatives to streamline our business processes

? New “Ready-to-Rate” FDCs will provide quicker decisions than even today’s FDCs by requiring submission with all evidence needed to decide the claim (complete medical exams, DBQs, etc.)

? Centralized Mail & Privacy Act/FOIA will route mail and Privacy Act/FOIA requests to centralized sites and refocus RO employees on claims production

? Increasing Automation: “Portal to payment” currently in pilot; working on automating exam-ordering

? Automated Disability Benefits Questionnaires (DBQ) capture all evidence needed for a condition and allow private doctors to submit ready-to-rate evidence; 26 DBQs will be automated by Spring 2014, where computable data is auto-populated in VBMS

? Non-Rating Claims Automation is being leveraged across the enterprise; more than half of the dependency claims filed online are processed in 1 day; also working to auto-pay certain burial benefits

Technology: Initiatives to build and implement new solutions that enable us to do our jobs better

? Advanced Generations of VBMS will improve access; drive automation; and enable greater exchange of information and increased transparency to Veterans, our workforce, and other stakeholders

? Embedded Rules Engine digests data from files in VBMS, computes proper disability percent levels, and generates text for rating decision notification letters; currently covers 74% of diagnostic codes and applies laws, regulations, and policies when computing a level of disability

? Tele-health Exams are being increasingly used to offer disability exams for rating purposes without needing in-person exams; provides greater access for rural Veterans, flexible scheduling and fewer missed exams

? Gold Standard Service Treatment Records are now being securely transmitted between DoD and VBMS

? VSO-focused Technologies offer comprehensive, 24/7/365 engagement during the claims process; includes a dedicated phone line, self-service access through VBMS, about a dozen service features in SEP, direct claim submission using Digits to Digits (D2D), co-location at all 56 ROs & soon online chat for all users!

? Integrated Initiatives: Initiatives that cross all three dimensions of our organization

? Electronic Regional Office (eRO) launched in Newark on 1 Nov. 2013; every claim is processed electronically in VBMS, no more printing, boxing and storing paper… all ROs now have eRO foundation – majority of the compensation rating inventory will be electronic this Spring

? National Work Queue (NWQ) sends claims to next available claims processor, regardless of RO (local RO remains as first filter if it has capacity); first used during “Oldest Claims Initiative” with great success

? Building on the successes of phase one, VA will continue implementing phase two of transformation until we reach 98% quality and the backlog is eliminated in 2015 – not reduced or better managed, but eliminated

BACKGROUND: WHAT IS THE BACKLOG & WHERE DID IT COME FROM?

? WHAT IS IT? The backlog is any claim more than 125 days old, and is made up of both original and supplemental claims

o Original claims – Veterans claiming for the first time (32% of current backlog)

o Supplemental claims – Veterans seeking to increase existing benefits/filing for new disabilities (68% of current backlog)

? FACT: About half of all claims in the inventory come from Veterans who are already receiving compensation payments from VA

? WHO IS IN IT? The backlog includes claims from all Veterans, both young and old and from all eras:

o The largest percentage of claims come from Vietnam-era Veterans, many of whom are claiming presumptive conditions, the progression of which is often age-related (35% of backlog, 35% of inventory); OIF/OEF Veterans’ claims make up 24% of the backlog and 23% of the inventory

? WHERE DID IT COME FROM? Increased access, increased demand, more complex claims and a manual paper-bound system led to the creation of today’s backlog

o Access: 3 new presumptive diseases for in-country Vietnam Veterans increased the total number of presumptives to 15; VA also expanded outreach through technology, social media and joint DoD-VA pre-discharge programs

o Demand: Post-conflict downsizing of military, 10 years of war and high survival rates, impacts of a difficult economy; VA added 1.2M Veterans to the rolls from 2009 to 2013 – more than the active duty Army/Navy combined

o Complexity: 250% increase over last 11 years in original claims with 8 or more medical issues; the number of medical issues completed each year has risen 124%, from 2.5 million in 2009, to 5.6 million in 2013

o Paper-bound: For decades, claims were stuck in paper and manual processes

? BOTTOM LINE: There is no more business as usual – Transformation is changing benefits delivery for generations to come


Written by Erin Breen
 
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