VA’s Disability Claims and Appeals Processing Has Improved in Some Aspects and Worsened in Others

Over the past several years, the number of disability compensation claims  has increased, and VA’s performance in processing such claims has  improved in some areas and worsened in others. VA Has Increased Its Output of Claims Decisions but Continues to Experience Some Challenges with Timeliness and Accuracy

From fiscal years 2000 to 2008, the number of claims completed annually  by VA has increased but not by enough to keep pace with the increasing  number of compensation claims it has received, and, as a result, the  number of pending claims has grown. However, VA has also  received significantly more claims in recent years. VA has also experienced mixed results in improving the timeliness of its  claims decisions. Since then, this average has increased, and in fiscal  year 2008, VA took about the same amount of time—196 days—to  complete a claim as it did in fiscal year 2000. One factor that has contributed to VA’s lack of significant improvement in  claims processing performance is the substantial increase in VA’s  disability workloads. VA Has Reduced the Number of Pending Appeals and Improved the Accuracy of Some Appellate Work, but Appeals Processing Timeliness Has Worsened in Recent Years

Since fiscal year 2000, the number of pending appeals has declined, and  the accuracy of appeals processing has improved in some areas. Several factors have contributed to the worsening trend in appeals  timeliness. received (in thousand)

	VA Has Taken Some Actions That Have the Potential to Improve Claims Processing, but Their Impact Is Not Yet Known

VA has taken several steps to improve claims processing, including  increasing claims processing staff, redistributing certain workloads,  piloting alternative approaches to processing certain claims, and  increasingly leveraging information technology to process claims. For example, over the past few years, VA has  hired a significant number of disability claims staff to process disability  workloads. Although this expansion could improve the  timeliness of its decisions, VBA has not collected data to evaluate the  effect of this practice. Appendix I: Objectives, Scope, and Methodology

The objectives of our review were to examine (1) trends in the Department  of Veterans Affairs’ (VA) disability compensation claims processing at the  claims and appellate levels and (2) actions that VA has taken to improve  its disability claims process. To examine these actions, we analyzed VBA and  Board staffing data; reviewed VA’s budget submissions, internal  processing guidance, and other documents such as external studies and  VA’s Office of Inspector General reports; and interviewed VA officials and  veteran service organization representatives. In addition, the calculation methods  differed. Veterans Benefits Administration: Problems and Challenges Facing  Disability Claims Processing.
Why GAO Did This Study

For years, the disability compensation claims process has been the subject of concern and attention by the Department of Veterans Affairs (VA), Congress, and veteran service organizations (VSO), due in part to long waits for decisions and the large number of claims pending a decision. As GAO and other organizations have reported over the last decade, VA has also faced challenges in improving the accuracy and consistency of disability decisions. GAO was asked to examine (1) trends in VA's disability compensation claims processing at the initial claims and appeals levels and (2) actions that VA has taken to improve its disability claims process. To do this, GAO reviewed and analyzed VA performance data, budget submissions, program documents, and external studies and interviewed VA officials and VSO representatives.

What GAO Found

VA's disability claims and appeals processing has improved in some aspects and worsened in others. In recent years, the number of claims completed annually by VA has increased but not by enough to keep pace with the increasing number of compensation claims received, resulting in more claims awaiting a decision. In addition, the average days that VA took to complete a claim--196 days in fiscal year 2008--has varied over time, but was about the same in fiscal years 2000 and 2008. Several factors have challenged claims processing improvements, such as the increase in the number and complexity of claims submitted to VA, laws, and regulatory changes. VA has reduced the number of pending appeals and improved the accuracy of some appellate work, but the time that it takes to resolve appeals has worsened in recent years. For example, in fiscal year 2008, VA took on average 776 days to process appeals; 78 days longer than in fiscal year 2004. One factor that has contributed to worsening appeals timeliness is the increase in the number of appeals received by VA. VA has taken several steps to improve claims and appeals processing, but their impact is not yet known. VA has hired a significant number of disability claims staff to process disability workloads. VA's Veterans Benefits Administration (VBA) has also expanded its practice of workload redistribution, which could improve the timeliness and quality of its decisions. VA is also testing new claims processing approaches--such as shortening response periods for certain claims and appeals through Expedited Claims Adjudication (ECA) and reorganizing its claims processing units. However, VBA has not established plans to evaluate the effect of some initiatives. In addition, VA has taken other steps to improve claims and appeals processing, such as expanding its quality assurance program; upgrading claims processing software; and moving toward paperless processing, which remains elusive in part due to technical challenges.