VA Regional Office AFGE LOCAL 520 PO BOX 1778 COLUMBIA, SC 29202 September 22, 2013 Chairmen, Ranking Members,

Members of the US House and Senate Committees of Veterans Affairs Dear Committee Members: Local 520, the exclusive representative of the bargaining unit of VARO Columbia, SC, wants to address the forgotten 40+ transformation initiatives to improve the claims process. Please refer to the USB Rickey's testimony on June 19, 2012, at 02:49:00 HVAC webcast hearing on Reclaiming the Process: Examining the VBA Claims Transformation Plan as a Means to Effectively Service our Veterans for details regarding the transformation. Here is what VA have implemented so far, The New Challenge Training Course, The Disability Benefit Questionnaires (DBQs), Acceptable Clinical Evidence (ACE), The Specialized Lanes, Cross-Functional Teams, Rating Calculators and Evaluation Builders, Simplified Notification Letters (SNL), Contracting Out of Claims Development to a Xerox subsidiary Affiliated Computer Services (ACS), Quality Review Teams (QRT), New Performance Standards, Fully Development Claims to include new forms that include 5103 Notice, Fast Track of New Agent Orange Presumptions Claims, Issue based quality reviews, the resurrection of the Fully Developed Claims, E-benefits, a form for NODs and last but not least the savior - The Veterans Benefit Management System (VBMS). The Congress asked for a plan on June 19, 2012, and there was none. Another request was made on July 18, 2012, and the excuse that VA used for not presenting the plan was that the budget numbers had to be removed from it before it could be released. There was a third request on September 20, 2012. On January 25, 2013, VA published a 20 page VA Strategic Plan to Eliminate the Claims Backlog. The GAO testified before the Senate VA Committee and said, "We have noted that VA's ongoing efforts should be driven by a robust, comprehensive plan; however when we reviewed VBA's plan documents, we found that they fell short of established criteria for sound planning. Specifically, VBA provided us with several documents, including a PowerPoint presentation and a matrix that provided a high-level overview of over 40 initiatives, but, at the time of our review, could not provide us with a robust plan that tied together the group of initiatives, their interrelationships, and subsequent impact on claims and appeals processing times." GAO-13-453T, Mar 13, 2013 The bottom line is the transformation plan was several documents and a power point presentation.

How effective have these transformation initiatives been and how have they contributed to the VBA progress? How does this line up with the USB's testimony on June 19, 2012? The Veterans Benefit Management System (VBMS) - On June 12, 2013, Mr. Thomas Murphy, Director, Compensation Services gave this testimony to the US Senate VA Committee, "There is no single system that is going to come in that will be a silver bullet - VBMS and make everything work. VBMS if left alone without other change will just make a bad system worst...." Pending Benefits Legislation, US Senate Veterans Affairs Committee SR-418, June 12, 2013 i Simplified Notification Letters (SNL) was implemented on March 12,2012. - SNL shifted the workload from Rating Veterans Service Representative (RVSR) to Veterans Service Representatives (VSR). A VSR who did not prepare the rating was charged with transcribing codes and narratives in a notification letter. The VFW testified that after it raised serious concerns about SNL, and after VBA took action to address the issue there was 50 to 60% error rate in April and May 2012 of the claims they reviewed. Moreover, the Atlanta VARO piloted the SNL in June 2011. At that time, their claims inventory was 32,941. As of July 23, 2012 their claims inventory was 32,415 (less than 2% decrease). A far cry from the 15% claimed at the hearing by the USB on June 19, 2012. Her statement regarding SNL said, "Design-Team testing of this initiative at the Atlanta and St. Paul Regional Office resulted in productivity increases of 15 percent, while sustaining accuracy rates, and reductions of 14 days in average processing time." HVAC Hearing, Reclaiming the Process: Examining the VBA Claims Transformation Plan as a Means to Effectively Service our Veterans. The time wasted on training and implementation of the SNL only set the claims processing back. It does not exist today. The New Challenge Training Course -The RVSR position is too complex to be grasped in 8 weeks of training and the curriculum that is scheduled to be followed after returning to the VARO is always pre-empted because of production quotas. The Specialized Lanes - This is not a new concept. If the veterans are claiming more disabilities per claim, then the express lane will quickly dry up. Furthermore, employees on the special operation lanes will quickly burn out. There is also the issue of who will be assigned to each lane and how will inexperienced employees receive the necessary training to become proficient in their jobs. Specialization has failed the VSR for the past decade of the CPI model. Cross Functional Teams - This concept did not work under Business Processing Reengineering (BPR) and it is not working now. The reason it did not work under BPR was because of the numerous amount of tasks required to be accomplished by one employee.

Quality Review Teams (QRT) - Locally, there is a problem when errors that are called are overruled based on a manager's preference and on VA regulations and directives. Furthermore, the National STAR team uses a different criterion to call errors nationally than the QRT uses locally. The change to issue based quality reviews and the National criteria for reviewing claims only serves to boost VBA quality numbers. New Performance Standards - There has never been a time and motion study completed in VBA. If quality is measured by each issue of a claim why is production not and is still measured by each individual claim? At the hearing on June 19, 2012, Rep Michuad, now ranking minority member, asked whether quality and production were measured the same. The answer is no. The reasons are obvious - 98% quality by 2015 and to disadvantage employees when it comes to production. / Rating Calculators and Evaluation Builders continue to provide inaccurate information and work arounds are becoming normal and time consuming. What employee can keep up with all the changes? The Disability Benefit Questionnaires was implemented in earnest on March 16, 2012. It was audited by the IG for private providers and the internal control process was been found to be inadequate. Furthermore, the DBQs can exceed 100 pages as VBA moves to a paperless environment, and they have created more inadequate examinations because of their voluminous content. The VBA was supposed to fix the program to eliminate none essential information, but still has not. Furthermore, why are Veterans paying for examinations? How many Veterans use the private provider's DBQ? Our experience shows that the volume of private providers' DBQ is too small to make a difference. Acceptable Clinical Evidence (ACE) was implemented on October 3,2012. "VBA and VHA have collaborated to implement the Acceptable Clinical Evidence (ACE) program. Under ACE, VHA clinicians complete a DBQ by reviewing existing paper and/or electronic medical evidence and can supplement it with information obtained during a telephone interview with the Veteran. This alleviates the need for the Veteran to report to an in-person examination. The ACE process is not available for use by non-VHA Compensation and Pension (C&P) examiners, such as QTC, because those individuals do not have electronic access to VHA treatment records." Fast Letter 12-22 Contracting Out of Claims Development to a Xerox subsidiary Affiliated Computer Services (ACS) - "VBMAP is a professional services contract with ACS Federal Solution LLC (ACS), to address the claims backlog and advance the Veterans Benefits Administration (VBA) Transformation Vision. In conjunction with the Veterans Benefits Management System (VBMS) and Veterans Relationship Management (VRM), VBMAP will help jump-start the move of the claims application process from a paper-based model to a paperless one." Fast Letter 12-12 On March 21, 2012 the HVAC via a letter to the USB Hickey requested a response to questions raised at the February 15, 2012 budget hearing regarding this matter. However, this initiative is

now out of commission and so are our taxpayer's dollars. However, hundreds of thousands of claims were left unprocessed. Contracting out the collection of private medical evidence There was a pilot program. However, the results and whether it is still in operation are unknown. Agent Orange Fast Track Claims - "To address the anticipated claim receipts for the new presumptive conditions, the Department of Veterans Affairs (VA) sought a technology solution. Utilizing the VA Acquisition process, a contract award was made to IBM of Bethesda, MD, on July 2, 2010. IBM, in collaboration with VA subject matter experts, developed the "Fast Track" claims processing system. VA will deploy the full production system on October 29, 2010. Fast Letter 10-47 "The Fast Track process is designed to expedite the processing of Vietnam Veterans' claims for service connection for any of the three new herbicide-related presumptive conditions: ischemic heart disease; Parkinson's disease; and, hairy cell and other chronic B cell leukemias. Expedited review will allow for faster release of funds to the Veteran and provide timely access to Department of Veterans Affairs (VA) medical care." Fast Letter 11-31 The IBM built over 1 million dollars electronic paperless system that has proven to be ineffective and has been discontinued. How may claims are stuck in the system that is not being counted and how many taxpayer's dollars have been spent? eBenefits - is a joint VA/DoD web portal that provides resources and self-service capabilities to Veterans, Service members, and their families to research, access and manage their V A and military benefits and personal information. Since active duty members are required to enroll in eBenefits, how many Veterans are enrolled and how effective is it? Veterans send in documents complaining that they cannot upload them in eBenefits. Furthermore, eBenefits will provide the same status month after month if the claim is not moving. The Resurrection of the 2008 Fully Developed Claim Statute - "VA is aggressively pursuing expansion of the FDC program, and has conducted a number of outreach initiatives to encourage participation." Implementation Update: Fully Developed Claims, Statement by Thomas Murray, Director, Compensation Service, Subcommittee on Disability Assistance and Memorial Affairs (DAMA) September 11, 2013 Since the FDC was a part of the initial 40+ transformation initiatives, the hearing results should be interesting. We have provided some examples of the unplanned transformation initiatives for context. However, taking in consideration the new of ADHOC procedures (2 and 1 year old claims initiatives, 20 hours mandatory and voluntary overtime, all hands on deck, provisional ratings, the deliberate neglect of appeals and other claims), the manipulation of the MMWR (excluding

rating End Product 930s, 190s (death pension), and 400s associated with provisional ratings) from the C&P rating bundle and the new ADHOC initiatives (another push for FDCs claims, Law students pilot to assist Veterans with their claims, an agreement signed by the California Department of Veterans Affairs (CalVet) and VA for 36 State DVA reps to help to review claims pending for 125 days or longer (Note: How is that same program working in Texas? As of September 14, 2013, Houston VARO had 31,581 claims pending and 22,216 (70.3%) were over 125 days and Waco VARO had 29,567 claims pending and 18,283 (61.8%) was over 125 days), and soliciting Craigslist's founder for customer service help) only prove that VBA is continuing to make ADHOC procedures because of no planning and using public relations gimmicks in an attempt to give the perception that the VBA is making progress. A reduction in numbers does not mean progress. If you look at individual VAROs, you will see the real numbers. As explained in a previous letter, there are thousands of claims not in the system and languishing in the Intake Processing Centers (IPC) of VAROs. What are the real numbers is the question? This is another reason a review is needed of each VARO. Moreover, this is a clear indication that the unplanned transformation initiatives have not worked. The VBA cannot improve claims processing on ADHOC procedures, public relations gimmicks, and a VBMS that is not ready for "prime time." Excerpts from the article Veterans benefit backlog rising Disability claims shifted to Del. Office, Delawareonline, August 26, 2013 also shade some light on the "brokering of claims." > The move has helped the two larger offices show substantial reductions in their respective backlogs - one of which, Baltimore's, remains the worst by percentage in the nation. Cases listed as backlogged have been pending longer than 125 days, which is VA's own measuring stick. 5> Wilmington's total has risen, as has its percentage of backlogged cases. > As a result, the amount of time some veterans from Delaware and surrounding states are waiting in line is growing - at the same time the Department of Veterans Affairs trumpets a near-20 percent reduction in backlogged cases nationwide over the past five months. Excerpts from another article Hagan pushes VA on benefits claims backlog, fayobserver.com, September 18, 2013 shows another negative side of this perceived progress at the expense of other claims. > But Hagan, a member of the Armed Services Committee, pointed out that a backlog of nearly 11,000 appeals of disability claims in Winston-Salem causes some veterans to wait four years or longer to get a decision. "I am very concerned that no similar plans are in place to handle the backlog of appeals that is growing by the day," Hagan said in her statement." > Sharon Sanders, director of Cumberland County Veterans Services, praised the efforts Hagan and others have made to reduce the claims backlog.

> But as a result, Sanders said, paperwork has slowed for veterans who want to add or delete dependents or those who are seeking retroactive retirement pay. > Sanders said one veteran has waited 19 months for the VA to reinstate his daughter as a dependent after she turned 18. She became eligible for benefits again after reaching that age because she enrolled in college. > Sanders said her office does everything it can to discourage veterans who want to appeal decisions on their disability claims because of the length of time it will take to get the appeal heard. Despite the VA"s declarations that they have reach a "tipping point" and "the backlog has been reduced by 20%", and "VBMS" is making a difference", however the MMWR numbers since the initiatives started are as follows: > the overall compensation C&P bundle has only been reduced by 101,883 claims; > the number of claims over 125 days has been reduced by 137,745; > appeals have increased by 9,199; > other claims have increased by 35,012 to include compensation dependency claims which have increased by 17,230 and now totals 209,341; > EP 400 which now is associated with provisional rating has been increased by 41,410. On June 12, 2013, Mr. Thomas Murphy, Director, Compensation Services gave this testimony to the US Senate VA Committee, "Yes, it does Mr. Chairman I got to point out some numbers showing that we are making progress in that regard. The backlog reduction of appropriately 74,000 cases our overall inventory reduction in 44,000 cases adjusting in the last 45 days. What is significant about those numbers when we are talking about such a large volume of cases it not... but does indicate that we are at a 'tipping point'..." Pending Benefits Legislation, US Senate Veterans Affairs Committee SR-418, June 12, 2013 In the light of the numbers given by Mr. Murphy on June 12,2013, the progress is even more disturbing. Therefore, since June 12, 2013, the overall compensation C&P bundle has only been reduced by 57,883 and the number of claims over 125 days has been reduced by 63,745. In 3 months and 10 days, the number of claims over 125 days processed is less than the first 45 days. You cannot put a "Band-Aid" on a sucking chest wound and expect the patient to live. The patient needs surgery. However, the VA leadership is being allowed to perform claims processing malpractice. Local 520 will continue to take its responsibility given by law to safeguard the public and to contribute to the effective conduct of public business, seriously. Therefore, we will continue to chime in weekly on this most critical subject with "objective evidence" because Veterans have earned the right to have a claims processing system that works for a#_of them and employees can only effectively serve them if they are provided with the

leadership, processes, people systems and work place culture that are conducive to providing timely and accurate decisions. We tend to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency, and demoralization." Petronius Arbiter, 210 B.C. Ronald Robinson President (803) 647-2385 (Ofc) (803) 239-7682 (Cell) rbnsnrnld(q),vahoo.com www.seniorvsr.com Enclosure: Weekly Analysis of VBA Progress - MMWR
CF: President Obama VA Secretary Shinseki President AFGE President NV AC 60 Minutes NY Times Washington Post Center for Investigative Reporting The Washington Examiner VA Watchdog

C&P RATING BUNDLE

(RB)
010 110 140 020 320 681 687 405 409 310 120 180 TOT C&P RB *190

M/27/2013 70,277 231,946 9,796 478,092 1,616

471 0 2,165 269

9/7/2013 55,981 183,237 8,674 442,402 2,304 2,730

3 109 110

9/14/2013 54,526 179,254 8,601 439,056 2,343 2,747

1 Week DIFF -1,455 -3,983

-73
-3,346

Initiatives DIFF -15,751 -52,692 -1,195 -39,036

o
89 97 25,927 18,183 13,517 744,340 38,034 782,374 26,814 257,211

TOT C&P ENT

**930 APPEALS

17,167 19,704 14,720 846,223 50,868 897,091 28,923 248,012

24,149 18,015 13,650 751,364 38,548 789,912 27,406 256,081

39 17 -3 -20 -13 1,778 168 -133

-7,024

727
2,276

0
-2,076

-172
8,760 -1,521 -1,203 -101,883 -12,834 -114,717 -2,109

-514
-7,538

-592 1,130

9,199

GRAND TOTAL

1,174,026 1,073,399 1,066,399

4/27/2013 9/14/2013 DIFF 209,341 87,368 52,639 65,871 8,564 38,317 12,349 19,335 47,639 15,196 556,619 17,230 3,723 7,605 41,410 -1,650 -15,631 -5,447 789 -13,211 194 35,012 >125 %

-7,000

-107,627

Other Claims
130 290 600

*400 **137 **150 **297 **607 ***160 ***165 Totals

192,111 83,645 45,034 24,461 10,214 53,948 17,796 18,546 60,850 15,002 521,607

72.2% 82.7% 51.9% 29.5% 48.4% 71.0% 33.9% 22.8%

* Associated with Provisional Ratings **Pension Maintenance Center (PMC) claims ***Death Claims at the PMC

C&P RB >1 25 010 110 140 020 320 681 687 405 409 310 120 180 TOTRB>125 *190 TOT ENTITLEMENT 930

4/27/201 3 51,015 169,997 3,511 334,813 647 115 0 2,161 224 8,058 8,319 5,056 583,916 32,609 616,525 25,754

09/07/1 3 34162 119654 2063 278093 1067 537 0 100 92 9289 6784 5537 457378 24798 482176 22917

09/14/13
32585 115072 2036 272171 1106 616 0 74 82 10431 6630 5368 446171 24275 470446 22257

*DIFF
-1,577 -4,582 -27 -5,922 39 79 0 -26 -10 1,142 -154 -169

**DIFF 4/27/2013
-18,430 -54,925 -1,475 -62,642 459 501 0 -2,087 -142 2,373 -1,689 312 72.6% 73.3% 35.8% 70.0% 40.0% 24.4% 0.0% 99.8% 83.3% 46.9% 42.2% 34.3% 69.0% 64.1% 69.9% 86.3%

09/14/13
59.8% 64.2% 23.7% 62.0% 47.2% 22.4% 0.0% 83.1% 84.5% 40.2% 36.5% 39.7% 59.9% 63.8% 76.3% 86.4%

DIFF -12.8% -9.1% -12.1% -8.0% 7.2% -2.0% 0.0% -16.7%

1.2% -6.7% -5.7% 5.4%

11,207 137,745 -523 -8,334 1 1 ,730 146,079 -660 -3,497

-9.1% -0.3%
6.4% 0.2%

GRAND TOTAL

642,279

505093

492703

12,390

149,576

78.6%