Actions Needed to Better Manage Appeals Workload Challenges, Efficiency, and Data Technology

What GAO Found In March 2018, GAO designed suggestions to address gaps in the Division

What GAO Found

In March 2018, GAO designed suggestions to address gaps in the Division of Veterans Affairs (VA) designs for reform of its appeals procedure for disability payment promises. This reform was meant to provide veterans who are dissatisfied with VA’s preliminary determination on their claim extra well timed possibilities to enchantment.

Given that then, VA has implemented new choices for appeals in February 2019, lessened the backlog of preexisting appeals from 425,445 in fiscal year 2019 to 174,688 in fiscal year 2020, and resolved factors of GAO’s recommendations. Nonetheless, alternatives exist for VA to a lot more totally handle GAO’s recommendations and therefore superior (1) take care of workload threats (2) keep track of and assess general performance and, (3) system for further more development of info engineering (IT). Specifically:

  • Taking care of workload hazards totally. Due to the fact 2018, VA has manufactured strides to deal with appeals and handle GAO’s suggestions. For example, VA has taken methods to monitor workloads and calibrate its staffing demands. On the other hand, even more attempts are required to sustain development and deal with workload challenges. Specially, VA has not totally designed mitigation methods for sure threats, this sort of as veterans using the new listening to appeals selection at larger fees than the options that do not call for a listening to. The lack of a possibility mitigation approach is substantial simply because in mid-June 2021, VA documented that this resource-intensive new hearing possibility accounted for just about 60 % of the new appeals inventory, but VA has produced comparatively few hearing solution decisions in fiscal yr 2021. This could indicate veterans have lengthier hold out periods and growing backlogs beneath the new listening to possibility. VA’s means to correctly control workloads lies, in portion, in setting up ahead and in proactively addressing threats that may perhaps influence timeliness of choices.
  • Monitoring and assessing effectiveness. VA has produced development to tackle GAO’s tips, but it is not monitoring or assessing important areas of general performance. VA lately recognized timeliness ambitions for all new appeals options, which greater positions VA to watch this factor of performance and determine sources required to procedure appeals. Having said that, VA lacks a top quality assurance program and connected steps to assess the accuracy of its appeals decisions.
  • Scheduling for further know-how improvement. Considering that 2018, VA has deployed a new IT system to help its new appeals course of action, but has nevertheless to address issues GAO determined with VA’s IT arranging, these as specifying a lot more fully how and when the new IT method will obtain all wanted performance. VA executed appeals reform in February 2019, but continues to report that the new IT system offers “minimum functionality” and to recognize operation nevertheless to be carried out. Also, a May possibly 2021 VA report itemized about 35 troubles with the new IT technique, such as the require to reconcile documents contained in various IT systems. VA officers explained to GAO that they are functioning on a strategy to deal with the recognized IT shortfalls. These shortfalls and VA’s response propose prospects exist for VA to discover all essential and necessary IT pursuits, obligations, interdependencies and sources, as GAO formerly proposed.

Why GAO Did This Review

In fiscal year 2020, VBA paid out about $88.5 billion in incapacity payment rewards to in excess of 5 million veterans injured in services to our country. Prior to 2018, veterans who appealed conclusions on their preliminary statements for rewards usually experienced very long waits for resolution of their appeals—up to 7 yrs on common. These extensive waits are one motive GAO selected VA’s incapacity workloads as a superior possibility challenge.

The Veterans Appeals Improvement and Modernization Act of 2017 built variations to increase VA’s appeals procedure. The act essential VA to submit to Congress and GAO a approach for employing a new appeals process (which VA submitted in November 2017) and periodic development studies. The act also involved a provision for GAO to assess VA’s original plan.

In March 2018, GAO discovered that VA could enable make certain productive implementation of appeals reform by addressing gaps in preparing and created many recommendations, with which VA agreed.

This testimony examines the extent to which VA (1) manages workloads and associated threats for processing appeals, (2) monitors and assesses overall performance, and (3) ideas for even further growth of info technological know-how.

For this statement, GAO reviewed its prior studies on incapacity appeals VA’s progress reviews to Congress and facts VA supplied for GAO’s ongoing checking of this superior-risk issue and about measures VA has taken to apply GAO’s prior tips.

For more information and facts, speak to Elizabeth H. Curda at (202) 512-7215 or [email protected]