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REPUBLICAN PRESS RELEASE

May 24, 2007

VA committee claims backlog roundtable hears about automation’s potential

Washington, D.C. — The House Committee on Veterans’ Affairs held a roundtable Wednesday with representatives of government agencies, veteran’s service organizations and academia to discuss the disability claims backlog and system challenges at the Department of Veterans Affairs (VA).

The committee’s deputy ranking member, Cliff Stearns (R-Fla.), addressed the committee’s bipartisan addition of 1,000 full-time employees above the president’s fiscal year 2008 budget recommendation.

Stearns told roundtable participants that the addition of more staff will create significant production problems for the Veterans Benefits Administration (VBA) because experienced staff will be diverted to training and mentoring.

“New employees . . . offer the potential for increased production in time, but present opportunities for subjective mistakes, exacerbating an already too-subjective system,” Stearns said.

Stearns then provided a description of how automation could help improve the speed, consistency and accuracy of claims decisions. The idea of automation has been introduced by Doug Lamborn (R-Colo.), Subcommittee on Disability Assistance and Memorial Affairs ranking member, in his bill, H.R. 1864.

“Our collective goal should be to bring consistency, accuracy, and timeliness to the adjudication system. Significantly increasing the role of automation in arriving at a disability rating has the potential to do just that.

Let me describe the system I envision.

A veteran files a disability claim for three issues: a knee, loss of hearing, and PTSD [post-traumatic stress disorder]. The vet either files online or submits a paper claim which is processed by data entry staff. The system requests a C&P [compensation and pension] examination and orders service records if they are not already in the system.

Ideally, at some point, DoD records would have been electronically transferred directly to VA for reference by adjudication staff.

The examining physician completes the exam template and enters data on each of the issues. The system uses artificial intelligence to “know” when secondary issues would likely be present based on the physician’s findings and requests information on those issues if needed.

The physician’s entries are alphanumeric and relate to the rating schedule. For example, the physician may find the knee has a range of motion of 30 degrees. The physician enters 30 in the appropriate data field.

The system ‘knows’ that 30 degrees corresponds to a rating percent. The physician also enters the numeric data from the hearing exam. Again, the system “knows” from the measured hearing loss data that a certain percent disability is warranted.

Finally, the mental health staff examines the vet and determines the vet suffers from one or more symptoms and provides a verbal description of each symptom in a manner that again relates to a level of disability rating.

The system compiles the data and informs VBA the medical exam is complete. VBA staff then verifies the presence of service connection from the vet’s service record, either by manually examining the paper record, or accessing the online record.

Eventually, an electronic service record listing service medical data could allow the system to determine service connection without staff interaction. With the medical data and service data reconciled, either manually or electronically, the system recommends a rating.

Thus the system has largely eliminated the current application of a subjective judgment by VBA on what is often a subjective judgment by VHA [the Veterans Health Administration]. The system issues consistent evaluations and recommendations: no more Illinois versus New Mexico.

Discussions with staff from the American Association for the Advancement of Artificial Intelligence lead me to believe that such a system is absolutely achievable in a relatively short time.

Industries such as insurance sector use this technology on a daily basis to provide accurate, consistent and objective customer service because it is good for the customer and good for the bottom line. VA must move in this direction or forever be trapped in the old paradigm that demands yet more money and yet more people.

I look forward to the discussion today and am confident there are other ideas that merit exploration. We should go at this without blinders, we should question the status quo and the conventional, and we should always keep the veteran in the center of our focus.

We will then not likely go wrong.”

On Wednesday, the House passed H.R. 2199, which establishes a pilot program of mobile Vet centers that would provide readjustment counseling and mental health services to veterans. An amendment offered by Lamborn would include in these mobile centers counselors trained to help veterans file disability claims.

Other topics included changing the culture of VBA to one that focuses on helping veterans, improving operations of the Board of Veterans’ Appeals and the Court of Appeals for Veterans Claims, presumptively awarding disability benefits to claimants before their case is adjudicated, and accountability among VBA employees at all levels.

As of May 21, 2007, there were 686,660 in the backlog of compensation and pension claims awaiting action. This number has increased by 60,608 from this time last year.



* 29 percent (114,717 claims) have been waiting for more than 180 days.
*
Eleven VA regional offices, have over 30 percent of their claims waiting longer than 180 days to be adjudicated.
* Three VA regional offices have over 40 percent of claims waiting longer than 180 days to be adjudicated.

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Larry Scott

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