Veterans Benefits Administration: Review of the Disability Claims and Appeals Processes

November 2016 – At the request of Congress, the National Academy of Public Administration (the Academy) conducted an independent review of the progress of VBA in reducing the disability claims backlog since 2010 and examined the increased appeals inventory over the past two years. 

VBA reached an important milestone on August 25, 2015, overcoming a backlog peak of 611,000 claims in March 2013, when the number of backlogged claims fell below 100,000. Since that time, the backlog has remained at around 70,000-80,000 claims.  Alongside these successes, however, there has been a large increase in the appeals inventory, which effectively doubled from 2014 to 2016.  As of January 2016, over 443,000 Veterans were waiting for final appeal adjudication. 

The Academy assembled a Panel of seven Fellows, many of whom are Veterans, with broad experience in a variety of fields, including process reform, information technology, healthcare, and the military. The Panel took guidance from a study team of seven who carried out the review based on a structured study approach.

Key Findings and Recommendations

This report, which includes 10 recommendations to further enhance VBA disability claims and appeals processes, contributes to VA’s efforts to manage its disability claims backlog and the appeals inventory.  Based on its review, the Panel has three principal observations:

  1. VBA succeeded in reducing the backlog of disability claims by implementing an integrated set of defined process modernization initiatives and by imposing mandatory overtime for three years. These solutions were significant first steps to prepare the way to further optimize claims processing and improve the quality of disability determinations.
  1. VBA continues on its aggressive course of modernization, including developing a comprehensive plan for further enhancing its disability determination processes.  In addition, VBA can use advanced technology and tools, including data analytics, to increase its understanding of the outcomes resulting from these improvements and to use that information to drive the next level of process efficiencies and quality improvements.
  1. The claims and appeals adjudication processes need to be fundamentally transformed. VBA cannot accomplish the needed transformation of the claims and appeals processes by itself (that is, in isolation from other stakeholders). Improving the claims and appeals adjudication processes will also require more effective engagement among all stakeholders, including VSOs, the Department of Defense, Congress, Veterans, and other interested parties.

The Panel views this report as an opportunity to inform decisions to be made and actions to be taken by Executive Branch and Congressional leaders, especially in the pivotal timeframe of a transition to a new Administration.  The report outlines key areas on which to best focus efforts to maximize short-term, medium-term, and long-term opportunities to improve services for Veterans and achieve measurable outcomes.