The VA — a decade in review

The VA — a decade in review
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The past decade was undoubtedly an important one for the U.S. Department of Veterans Affairs (VA). Unfortunately, if anyone word could define it, it would be backlogged. From 2010 to 2019, VA confronted backlogs of disability compensation claims, backlogs of medical appointments and backlogs of whistleblower complaints. 

With that being said, VA found itself overwhelmed and under-resourced when the decade began. By 2010, the nation had been at war for nearly a decade, creating a new generation of veterans for the Department to care for, while simultaneously adjusting to an aging cohort of older veterans from the previous conflicts in Vietnam, Korea, and World War II. 

Accordingly, with an increase in the number of veterans in need of services, the past decade saw VA’s budget receive unprecedented growth, beginning with a 15.5 percent increase to $112.8 billion in 2010. At the time, this was the most substantial percentage increase for VA in over 30 years. By the time the decade was drawing to a close, VA’s budget had nearly doubled from this amount to $217 billion for the fiscal year 2020.

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Despite the massive increase in spending, VA remained plagued by various backlogs for most of the decade. As recently noted by Dr. Jonathan M. Metzl, “history also teaches us that it’s best to avoid knee-jerk assumptions that more government, money, or health care are automatically good . . . I’ve spent enough time working in hospital systems such as the [VA] to realize that more investment in healthcare does not automatically result in better healthcare outcomes.”

For example, one of the first challenges VA confronted during the 2010s was a growing backlog of disability benefits claims. The increase during this time was attributed to the addition of several Agent Orange-related presumptions, increasing medical complexity of claims, as well as an influx of claims from OEF/OIF veterans. As the decade began, VA set a goal of processing all disability claims in an average of 125 days. Like many bureaucratic challenges, the backlog of disability claims got worse before it got better. The backlog peaked at 611,000 claims in March of 2013. However, by the end of 2019, the backlog was reduced to 63,783 claims

Although VA made great strides addressing this issue over the past decade, as we look ahead toward the next 10 years, stakeholders must continue to pay close attention to the disability claims and appeals process. For example, in 2018, the VA Inspector General issued a report concluding that the backlog of disability claims was longer than VA officials acknowledged. Moreover, in 2017, Congress passed the Appeals Modernization Act, which went into effect in 2019. 

Despite promises of streamlining the appeals process, recently retired Chief Judge Robert Davis of the U.S. Court of Appeals for Veterans Claims, testified before Congress in March 2019 that he remained skeptical of the new law. 

“I’m cautiously optimistic that this modernization act may help the system, but in my view... .it is tinkering around the edges when a larger fix is needed,” he stated. Accordingly, critical oversight of the VA appeals process must remain a priority in the years ahead.

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By 2014, VA-related news was quickly dominated by news of a different type of backlog – appointment wait times for medical care. Leading up to that point, in 2012, the Government Accountability Office (GAO) warned VA that its reporting of outpatient medical-appointment wait times was “unreliable.” In 2013, GAO testified before Congress that “long wait times and inadequate scheduling processes at VAMCs have been persistent problems.”

The problem came to a head in April 2014 when, during a hearing before the House Veterans’ Affairs Committee, then-Chairman Jeff MillerJefferson (Jeff) Bingham MillerAs VA's budget continues to Increase, greater oversight is required Committee on Veterans Affairs sends important message during tense Senate time Trump is misinformed about traumatic brain injuries MORE (R-Fla.) confronted VA with whistleblower evidence that dozens of patients at the Phoenix VA had died while awaiting medical care, and that the staff kept two sets of records to record appointment wait times.

Despite the initial public outrage surrounding the appointment wait-time scandal, including the resignation of then-Secretary Erik Shinseki, by 2019, VA still struggled with scheduling issues and tracking wait times, according to the GAO. During a July 2019 hearing, GAO testified that while VA had “taken action to ensure its facilities provide timely access to medical care,” it still must do more to eliminate the problem, including the fact that VA’s data on wait times remained unreliable.

As the decade drew to a close, the final backlog confronting the Department centered around employees who tried to blow the whistle around the issues discussed above, such as appointment wait times and errors in claims processing. Despite the 2017 creation of the VA Office of Accountability and Whistleblower Protection, as revealed in an October 2019 VA Inspector General Report, VA had a sizeable backlog of whistleblower complaints. 

As noted by Rep. Will HurdWilliam Ballard HurdGarth Brooks accepts Library of Congress's Gershwin Prize for Popular Song Texas kicks off critical battle for House control Gun control group plans to spend million in Texas in 2020 MORE (R-Texas) during a Congressional hearing in November 2019: “The whistleblower is a symptom of a larger problem . . . what is the larger problem that’s not being addressed that’s driving so many whistleblowers?” This is a question that must guide the VA as it enters the next decade.

A decade that began shortly after then-President Obama announced that he was sending in an additional 33,000 troops to Afghanistan now concludes with the Afghanistan Papers revealing that 18 years of failed political leadership has caused several hardships to veterans, many of which could have been avoided with more transparent and honest conversations about our foreign policy.

Even though VA concluded, despite these hardships, that 2019 was “a year of improvements and continued progress,” the decade was dominated by various backlogs, all to the detriment of veterans. 

In looking ahead to the next decade, we must focus less on merely increasing funding and more on proactive policies to improve the lives and well-being of our nation’s veterans. 

Rory E. Riley-Topping served as a litigation staff attorney for the National Veterans Legal Services Program (NVLSP), where she represented veterans and their survivors before the U.S. Court of Appeals for Veterans Claims. She also served as the staff director and counsel for the House Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs for former Chairman Jeff Miller (R-Fla.). You can find her on Twitter: @RileyTopping.