VA Appeals Modernization Appears to Be On Track

Published: January 17, 2019

Government PerformanceInformation TechnologyPolicy and LegislationVA

According to Cheryl Mason, Chairman of the Board of Veterans’ Appeals, her organization is already delivering on promises of a more efficient, effective and modernized appeals process.

During a radio interview on “The Business of Government Hour” on Federal News Radio this week, Mason explained the process, challenges and successes the Board of Veterans’ Appeals has experienced while implementing requirements of the Veterans Appeals Improvement and Modernization Act of 2017 (AMA). AMA requires that improvements to veterans’ appeals take effect next month. 

Mason was confirmed as the 4th Chairman of the Board of Veterans’ Appeals (the board) in November 2017. She leads a team of approximately 1050 personnel including Veterans Law Judges, approximately 800 attorneys and 120 administrative professionals. The board is charged with deciding appeals arising from veterans’ claims from all three administrations: Veterans Benefits Administration (VBA), Veterans Health Administration, and National Cemetery Administration. The most common appeals are for disability compensation claims stemming from VBA.

Mason stated that when she assumed the role, the board had been without a chairman for almost 7 years.  They also had four different acting managers at the time. Additionally, the organization moved from operating in a paper environment to a digital one.  And on top of that, efforts to modernize the appeals process came into play. “That's what I walked into almost a year ago” she stated.  From the start, Mason embarked on building what she calls “the Board 2.0.” She said she started by helping the staff build confidence in themselves, and she began to rebuild the team into a veteran-focused organization.

When asked about the evolution of the appeals process, Mason stated that “the current appeals process is complex, nonlinear, but is set in law with code and case law.”  The process is spread between the claims organization with pieces going to the board.  There are timelines that must be met for an appeal.  Another situation that causes complexity is that at any time during the process, the veteran can submit additional evidence, etc. that can completely change the case and the process.  The board then has to stop the case and let the claims organization relook at the claim.   “It's confusing to the veteran.  It also creates what we call churning, back and forth, with no resolution and the veteran waits and waits, for years,” according to Mason.  Mason says the core benefit of AMA will be to provide veterans with choices within the appeals process.

Under the new process, if the claims organization denies a claim, the veteran will receive instructions and options for next steps. Most of the appeals result from claims submitted to VBA. If a claim is denied, under the new process, VBA will send a letter to the veteran which explains in 8 points what is missing in their case to make it successful.  The veteran then has their first level of control.  Veterans who are dissatisfied with VBA’s decision on their claim have five options. Two of the options give the veteran an opportunity for an additional review of VBA’s decision within VBA, and the other three options give them the opportunity to bypass any additional VBA review and appeal directly to the board. Each of the options gives the veteran an estimated time period for resolution, which may influence their choice of direction.

AMA has required rethinking processes, reorganization of some of the board functions, as well as, IT upgrades.  Prior to the passage of AMA, the board was working with the VA Digital Service to update its case management system which was 40 years old. The partnership with the Digital Service gave them a head start on some on the collaboration that’s been necessary for additional IT upgrades to comply with AMA.  The board is also working with the VA Office of Information and Technology to implement modernization efforts.

In FY 2018 the organization rolled out new technology to include the Caseflow Reader, the Interactive Decision Template, and they are in the process of testing the Caseflow Cube. The Caseflow Reader allows the case to be dropped in from the VBA Veterans Benefits Management System (VBMS) in a format that is easier for the attorneys to review and analyze.  The effort started last November and was finalized in December.  According to Mason, it has had a major impact.  The Interactive Decision Template had not been modernized in 20 years. They needed to build something veteran-friendly and focused, but also easier for judges and attorneys to use to write decisions.  They worked with the judges and attorneys to build the new system which is more efficient and effective. 

The board and veterans are already experiencing fruits from their labor. The board managed to exceed their goal of 81,033 decisions in FY 2018.  They finished the year at 85,288 decisions which was 30,000 more than the year before. Mason credits their success to streamlining processes, technology implementation, change management, leadership and ongoing communication.

Although Mason did not mention contractor support in her interview, a recent RFI indicates VA’s need for contractor support in the areas of project management, training, and help desk for the appeals modernization Caseflow system. Responses were due January 14th.