Getting to backlog zero: Improving the appeals process

The VA has emphasized that the appeals process is different from the VA backlog. While the distinction is important because many issues causing long delays in the appeals process differ from those that created the backlog, it disguises the impact: to a veteran waiting for benefits it feels like the same process. The financial and emotional strain is no less real.

John Super is one veteran who has faced a lengthy appeals process. John is a Kansas resident who served in the Marines from 2004 to 2009 and was deployed twice to Iraq, in 2005 and 2006. While he was on active duty in Iraq, he developed a foot problem called prominent metatarsal heads, which causes painful callouses to develop on the soles of both feet. It makes it painful to walk and run and requires consistent care - more care than the VA provides.

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After leaving the Marines, John filed for a disability claim with the VA, only to reserve a 0 percent rating. He filed for his appeal in 2011, but only received an appeal hearing in January of this year. He hadn't heard back so he called the VA in August, but was told they were working on 2010 appeals right now.

Existing problems in the disability claims process has created the appeals backlog, which affects veterans like John. The first step to ending the appeals backlog is getting the decision right the first time. Claims processors should be rewarded for their accuracy and not just for how many claims they review. Quality Review Teams (QRTs) that review and train staff on common mistakes made in processing claims should be staffed with the most experienced raters. These steps will help to reduce the number of claims that even enter the appeals process.
 
The VA can make small, but important steps to streamline the appeals process for those who appeal. The VA should create a standard appeals form and include it with every decision on an initial claim.  When the VA has made a glaring error, such as misplacing paperwork or simply getting the decision wrong, the VA should allow their senior raters to make quick decisions to overturn an inaccurate decision. Bureaucracy has its place but we can’t ask our veterans to wait for almost three years for a decision on their appeal.
 
In a recent pilot program, the VA identified a series of steps that greatly reduced the wait time for appeals. The Houston Regional Office started by reviewing each case as if it was starting over. This cut down the wait for a decision on the appeals by 600 days. The office then allowed claims processors to communicate directly with veterans about their appeal, further cutting down the days to a decision. These ideas aren't revolutionary, and they should be explored beyond the pilot program in Houston.
 
Transparency and communication will also prevent other issues that delay the appeal of a disability claim. Veterans need to understand what can slow a decision on their appeal so that they can carefully weigh their options. For instance, a veteran could choose whether to submit evidence for a new condition during the appeals process, which often delays a decision on an appeal, or submit a supplemental claim later. If veterans understood the appeals process, they could make their own choice for what's best for their families.
 
The appeals process is a key part of the disability claims process because it has a large impact on each veteran. That's what all the public pressure and constant push for the VA to improve is about. Ending the VA backlog isn't about a political fight or scoring points for or against the VA. It is about the unemployed veteran who would benefit from the employment programs available to disabled veterans. It's about a Korean War veteran who may not have planned for rising costs of caring for his disability and now needs health and financial support. It’s the people – like veterans featured in TheWaitWeCarry.org - not the numbers, of the backlog that are the real story and the real reason to push the VA to do better. 

O'Gorman is political director of Iraq and Afghanistan Veterans of America.