The Department of Veterans Affairs has been understating its benefit claim backlog, according to a watchdog report released this week.
The backlog — defined as claims awaiting decisions for more than 125 days — has sat between 70,000 and 100,000 cases each week for the past three years, with 70,537 by the end of May.
The reported numbers cover only about 79 percent of cases that should be considered part of the backlog. Many claims have been ignored, omitted, or misclassified, the VA inspector general said, and some cases were only marked as overdue months after they had already been processed.
The average wait time for a pending claim hovers at 90 days, but more complex cases can take almost 150 days.
Approximately 63,000 overdue cases that required rating decisions were left out of a review of cases in the first six months of 2016, and another 10,000 cases were not correctly reported by Veterans Benefits Administration staff.
In March 2013, the Obama administration received criticism for the 611,000 overdue cases in the backlog. The VA, in 2010, set a goal of eliminating the backlog by 2015. The number of overdue cases reported in September 2016 went down to 71,690. The decrease was originally attributed to the hiring of more staff, new processing systems, and new electronic medical records, but part of the decrease is also due to underestimation of backlog cases.
The Veterans Affairs Office of the Inspector General says in its report that, “Ineffective oversight and training due to lack of national performance and training plans for claims assistants resulted in inaccuracies that also affected the backlog.”
The rules for oversight of disability claims have not changed much since 2009. The watchdog group recommends that “the under secretary for benefits implement a plan to provide consistent oversight and training of claims assistants through national performance and training plans” as part of the solution.
Another issue the report found was that there was a lack of clarity on which cases should be considered part of the backlog. Their second recommendation was for the VA to “consider revising which claims are included in VBA’s reported disability claims backlog and provide a clear definition to all stakeholders.”
The VBA responded in agreement with the watchdog group’s advice. They plan to incorporate a new training curriculum over the next year, and they are “currently reviewing how best to supplement or adjust reporting on the rating-related backlog.”
