The Department of Veterans Affairs made significant strides in reducing the backlog of veteran disability claims last year, but aggressive steps are needed if the remaining 400,000 cases are to be handled and considerations are made for future claims, a new report suggests.
"The Battle to End the VA Backlog" -- released Monday by the non-profit advocacy group Iraq and Afghanistan Veterans of America -- suggests creation of long-promised electronic medical records shared by the VA and the Defense Department; standardization of VA claims forms; and incentives for VA raters who cut the number of appeals by getting it right the first time.
"The VA … has implemented a number of initiatives focusing on automation, personnel and processes to try and update this outdated, paper-based system and address this enormous backlog of claims," according to the report's executive summary. "While there has been some progress to decrease the backlog, there is nothing to support which of these initiatives are working and which are not, nor is there evidence of planning beyond FY 2015.
"Overall it must create an infrastructure that allows the disability compensation system to project future needs and adapt to a growing population of new veterans and even more complex injuries."
The report comes on the heels of President Barack Obama's State of the Union address, in which he vowed continued progress in addressing the backlog -- a major part of his agenda for the past four years -- but offered no concrete solutions.
In a statement addressing the report, the VA cites its aggressive plan to end the problem in 2015. "No Veteran should have to wait for benefits they've earned and deserve. ... We have made strong progress, and we know there is more work to do. ... Many of the recommendations in this report are consistent with our goals, addressed in our Transformation Plan, and reflect action already taken or underway."
VA disability claims ballooned when America's veterans began returning home -- many severely injured -- from wars in Iraq and Afghanistan. As the wars dragged on, the VA struggled to keep up as more and more entered the system.
Between 2009 and 2012, the number of backlogged claims -- those pending for more than 125 days -- tripled, and more than two-thirds of the pending claims were backlogged, according to the report.
In March 2013, the number of backlogged claims topped 600,000, with an additional 300,000 in the system.
Initiatives by the department reduced the backlog by more than 35 percent through December, the report said. VA officials have said they are on pace to end the backlog in 2015.
The report's author, research director Jacqueline Maffucci, worried that might not be possible without a long-term plan for improvement. Her concerns echo a November policy brief released by the Center for New American Security, which said the VA's mental health efforts are insufficient to keep pace with the influx of veterans expected to hit the health care system in the next decade.
"This isn't just about ending the backlog," Maffucci wrote in the report. "It's about ending it and maintaining that steady state; it's about ending it and seeing a decrease in the number of claims appealed because the initial system by which ratings are determined is efficient; it's about restoring faith in the VA."
VA Secretary Eric Shinseki said late last year that the department's next focus would be addressing the growing number of claim decision appeals, which has topped 266,000.
The report makes 20 recommendations for the VA, DOD and Congress in evidence collection, automation and improvement of accuracy, evaluation and anticipation of veterans' needs.
It urges VA officials to reassess customer service protocols and analyze the viability of a VA certification program that would allow veterans to see and be diagnosed for certain conditions by outside providers.
It also said a plan should be devised to continuously solicit feedback, build in improvements, update VA manuals on quality control and adjudication of disability claims, revise the employee incentive program to integrate accuracy and determine the geographic distribution of veterans, and perform a manpower analysis of VA staffing needs.
The IAVA recommended that the Defense Department deliver on joint electronic medical records and adhere to its timeline to develop and fully implement an automated system to transfer service treatment records.
Members of Congress were asked to consider legislation requiring federal agencies to respond to VA requests for veterans' records and to align requests for federal records outside the VA system with similar requests for private records.
All three agencies were asked to continue to fund research to better understand the health risks and long-term care needs of post-9/11 veterans.
"The backlog may end in FY 2015, but the disability compensation process will continue," the report states. "If the VA does not learn from its mistakes, it is bound to repeat them."