VA Disability Benefits Appeals Would Benefit from Improved IT

The Veterans Benefits Administration (VBA) pays disability benefits to veterans who develop disabling conditions during their military service.  If veterans are dissatisfied with a claims decision, they can appeal the VBA decision. In FY 2015, veterans waited over three years on average for claims appeals decisions, and more than 427,000 appeals were pending.  

GAO examined the appeals process and VA’s approaches to reduce the number of appeals and wait times. GAO’s analysis showed that additional planning would enhance efforts to improve the timeliness of appeals decisions. In particular VA should do the following, according to GAO:

• Apply sensitivity analyses when projecting staff needs.
• Develop a more timely and detailed workforce plan.
• Develop a robust plan for monitoring process reform.
• Develop a strategy for assessing process reform.
• Create a schedule for IT improvements that takes into account plans for potential process reform.

VA Secretary Shulkin stated during his Senate confirmation hearing that “we need to update and modernize the process for appeals to eliminate the backlog.” He also stated that the legislation necessary to do this is pending.

Part of the problem involves the legacy technology supporting appeals processing. “VA determined that the computer system supporting its appeals process is outdated, prone to failures, and does not adequately support electronic claims processing’” GAO stated in its report. VA proposed a new IT system and developed a solid IT plan to include scope, purpose, risks, and risk mitigation strategies for IT upgrades.  However, VA did not provide a detailed implementation timeline nor a plan to align the new IT system with any appeals process changes that might be implemented.  

During a February hearing before the House Veterans Affairs Committee, Dave Powner, Director of IT Issues at GAO, stated that VA’s benefits management system (VBMS) was partially deployed in 2013.  Powner stated that the system is getting continuous updates and records in the system are almost entirely automated now.  But VBMS still cannot process appeals or all types of veterans’ claims. VBMS was supposed to be finished in 2015, and it still needs a firm completion date, Powner stated at the hearing. The department said it will be able to pay off claims through VBMS by the end of the year.

VA concurred with GAO’s recent appeals process recommendations in principle, but “believes it has met the intent of those recommendations and does not need to take additional action.”