VA’s Appeals Plan

The Act also requires VA to submit to the appropriate committees of  Congress and GAO, within 90 days of the date of enactment, a  comprehensive plan for (1) processing appeals under the legacy process  until there are no more to process, (2) implementing the new appeals  process, (3) processing of claims under the new appeals process in a  timely manner, and (4) monitoring implementation of the new appeals  process. VA’s Plan Addresses Most of the Act’s Required Elements for the New and Legacy Disability Appeals Processes

VA’s appeals plan addresses 17 of the Act’s 22 required elements,  partially addresses 4 related to monitoring implementation and workforce  planning, and does not address 1 element related to identifying total  resources. VA’s Appeals Plan Reflects Certain Sound Planning Practices, but Could Improve on Others

VA’s appeals plan reflects certain sound planning practices, such as  convening a working group on performance tracking; however, the plan  could benefit from including important details related to three key planning  areas:  1.  articulating a balanced set of goals and related measures to monitor  and assess the performance of the new appeals process, in  conjunction with the legacy process;  2.  developing a high-quality and reliable implementation schedule to  manage key steps and activities of the project; and  3.  assessing key risks in a comprehensive manner, including respective  mitigation strategies, articulating clear criteria and an assessment  plan for RAMP, and more fully testing or analyzing all appeals options. VA’s Appeals Plan Indicates Steps to Assess Process Changes, but Should Also Include Goals and Measures to Provide Full Picture of Success

VA’s appeals plan reflects steps taken to track performance, but it could  improve its planning practices related to monitoring and assessing  performance on a range of key dimensions of success. Further, VA’s fiscal year 2018 annual performance plan  includes an overall customer satisfaction score for veterans’  benefits. The master schedule VA provided in its appeals plan should have  included other sound practices for project management related to a  reliable schedule. Also, VA’s master schedule  submitted with its November 2017 appeals plan did not include the  Rapid Appeals Modernization Program (RAMP) activities, even  though this pilot test is occurring at the same time VA is preparing for  full implementation of appeals options at VBA and the Board. Until VA has a robust integrated master  schedule, supported by detailed project plans that adhere to sound  practices, VA’s appeals plan does not provide reasonable assurance that  decision makers have the essential program management information  needed for this complex and important effort. However, as designed, RAMP does not include features—consistent with  a well-developed and documented pilot test program—that would provide  VA with an opportunity to evaluate fully the soundness of new processes  and practices on a smaller scale. However, RAMP was not designed to test how  many veterans would choose to appeal directly to the Board and,  therefore, it will not provide comparable information on the Board  appeals options. As a  result, VA will lack data on scenarios in which veterans may  overwhelmingly choose options available at the Board over those at VBA  when the appeals plan is fully implemented. Until VA pursues an approach that identifies and mitigates significant  risks associated with implementing a new process, VA is taking a chance  that untested aspects will not perform as desired. Conclusions

In implementing appeals reform after the enactment of the Veterans  Appeals Improvement and Modernization Act of 2017, VA is undertaking  a complex endeavor that has the potential to affect the lives of hundreds  of thousands of veterans with service-connected disabilities. At  the same time, the plan partially addresses or does not address five of  the required elements called for by the Act, such as delineating the total  resources required by VBA and the Board to implement and administer  the new appeals process and address legacy appeals. The plan also is  not fully responsive to our past recommendations and does not reflect a  number of sound planning practices that are essential for gauging  progress, establishing accountability, and linking resources to results. (Recommendation 1)
The Secretary of Veterans Affairs should clearly articulate in VA’s appeals  plan how VA will monitor and assess the new appeals process compared  to the legacy process, including specifying a balanced set of goals and  measures—such as timeliness goals for all VBA appeals options and  Board dockets, and measures of accuracy, veteran satisfaction, and  cost—and related baseline data. In its comments, reproduced in appendix II, VA  outlined its planned actions to address the recommendations. With respect to our second recommendation to articulate how it will  monitor and assess the new appeals process compared to the legacy  process, VA stated that it is working to develop a complete and balanced  set of measures for the new appeals process, and timeliness goals for all  appeals options. Appendix I: Our Assessment of VA’s Appeals Plan Against Required Elements in the Act

To assess the extent to which VA’s appeals plan addresses the required  elements in the Veterans Appeals Improvement and Modernization Act of  2017 (Act), we first identified and developed a checklist reflecting each  required element for VA’s appeals plan (including sub-parts) under  section 3(a) and (b) of the Act.
Why GAO Did This Study

VA's disability compensation program pays cash benefits to veterans with disabilities connected to their military service. In recent years, the number of appeals of VA's benefit decisions has been rising. For decisions made on appeal in fiscal year 2017, veterans waited an average of 3 years for resolution by either VBA or the Board, and 7 years for resolution by the Board. The Veterans Appeals Improvement and Modernization Act of 2017 makes changes to VA's current (legacy) appeals process, giving veterans new options to have their claims further reviewed by VBA or appeal directly to the Board. The Act requires VA to submit to Congress and GAO a plan for implementing a new appeals process, and includes a provision for GAO to assess VA's plan.
This report examines the extent to which VA's plan (1) addresses the required elements in the Act, and (2) reflects sound planning practices identified in prior GAO work. GAO reviewed and assessed VA's appeals plan and related documents against sound planning practices, and solicited VA's views on its assessments.

What GAO Found

The Department of Veterans Affairs' (VA) plan for implementing a new disability appeals process while attending to appeals in the current process addresses most, but not all, elements required by the Veterans Appeals Improvement and Modernization Act of 2017 (Act). VA's appeals plan addresses 17 of 22 required elements, partially addresses 4, and does not address 1. For example, not addressed is the required element to include the resources needed by the Veterans Benefits Administration (VBA) and the Board of Veterans' Appeals (Board) to implement the new appeals process and address legacy appeals under the current process. VA needs this information to certify, as specified under the Act, that it has sufficient resources to implement appeals reform and make timely appeals decisions under the new and legacy processes.
VA's appeals plan reflects certain sound planning practices, but it could benefit from including important details in several key planning areas:
Performance measurement : VA's plan reflects steps taken to track performance, but could articulate a more complete and balanced set of goals and measures for monitoring and assessing performance on a range of dimensions of success. Specifically, the plan reports that VA is developing a process to track timeliness of the new and legacy processes. However, contrary to sound planning practices, the plan does not include timeliness goals for all five appeals options available to veterans, does not include goals or measures for additional aspects of performance (such as accuracy or cost), and does not explain how VA will monitor or assess the new process compared to the legacy process. Unless VA clearly articulates a complete and balanced set of goals and measures, it could inadvertently incentivize staff to focus on certain aspects of appeals performance over others or fail to improve overall service to veterans.
Project management : VA's plan includes a master schedule for implementing the new appeals plan. However, this schedule falls short of other sound practices for guiding implementation and establishing accountability, such as articulating interim goals and needed resources for, and interdependencies among, activities. Unless VA augments its master schedule to include all key activities and reflect sound practices, VA may be unable to provide reasonable assurance that it has the essential program management information needed for this complex and important effort.
Risk assessment : VA has taken steps to assess and mitigate some risks related to appeals reform by, for example, pilot testing two of the five appeals options through its Rapid Appeals Modernization Program (RAMP). However, as designed, RAMP does not include key features of a well-developed and documented pilot test. For example, VA has not articulated how it will assess RAMP before proceeding with full implementation. In addition, RAMP is not pilot testing three options and, as a result, VA will not have data on the extent to which veterans will appeal directly to the Board when given the option. Unless VA identifies and mitigates key risks associated with implementing a new process, VA is taking a chance that untested aspects will not perform as desired.

What GAO Recommends

GAO recommends that VA (1) fully address all legally required elements in its appeals plan, (2) articulate how it will monitor and assess the new appeals process as compared to the legacy process, (3) augment its master schedule for implementation, and (4) address risk more fully. VA agreed with GAO's recommendations and outlined its planned actions to address them.