THE CHALLENGES AND

OPPORTUNITIES FACING DISABILITY 

CLAIMS PROCESSING IN 2006

Hearing

before the

Committee on 

Veterans’ Affairs

House of Representatives

one hundred ninth congress

first session

December 7, 2005

Printed for the use of the Committee on Veterans’ Affairs

Serial No. 109-28

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Committee on Veterans’ Affairs

Steve Buyer, Indiana, Chairman

Michael Bilirakis, Florida Lane Evans, Illinois, Ranking

Terry Everett, Alabama Bob Filner, California

Cliff Stearns, Florida Luis V. Gutierrez, Illinois

dan burton, Indiana Corrine Brown, Florida

Jerry Moran, Kansas Vic Snyder, Arkansas

richard H. baker, Louisiana Michael H. Michaud, Maine

Henry E. Brown, Jr., South Carolina Stephanie Herseth, South 

Jeff Miller, Florida Dakota

John Boozman, Arkansas Ted Strickland, Ohio

Jeb Bradley, New Hampshire Darlene Hooley, Oregon

Ginny Brown-Waite, Florida Silvestre Reyes, Texas

Michael R. Turner, Ohio Shelley Berkley, Nevada

 Tom Udall, New Mexico

JAMES M. LARIVIERE, Staff Director

(II)
CONTENTS

December 7, 2005

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1

55

2

57

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3

4

58

4

5

59

6

61

63

122

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68

19

74

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91

 

The Challenges and Opportunities Facing Disability Claims

 Processing in 2006 .................................................................

Opening Statements

Chairman Buyer ........................................................................

Prepared statement of Chairman Buyer ..................................

Hon. Lane Evans, Ranking Member .........................................

Prepared statement of Mr. Evans .............................................

Hon. Henry E. Brown, Jr. .........................................................

Hon. Michael E. Michaud ..........................................................

Hon. Jeff Miller ..........................................................................

Prepared statement of Mr. Miller .............................................

Hon. Stephanie Herseth ............................................................

Hon. Shelley Berkley .................................................................

Prepared statement of Ms. Berkley ..........................................

Hon. Cliff Stearns ......................................................................

Statements for the Record

Hon. Luis V. Gutierrez ...............................................................

Hon. Tom Udall .........................................................................

Bascetta, Cynthia A., Director, Edcuation, Workforce, and Income Security Issues, U.S. Government Accountability 

  Office  ........................................................................................

Witnesses

Jones, William B., M.D., United States Air Force (Retired) ...

Prepared statement of Dr. Jones ..............................................

Aument, Ronald R., Deputy Under Secretary for Benefits,

 U.S. Department of Veterans Affairs ....................................

Prepared statement of Mr. Aument ..........................................

Terry, James P., Chairman, Board of Veterans’ Appeals .......

Prepared statement of Mr. Terry ..............................................

Mooney, Donald L., Assistant Director, Veterans Affairs and

 Rehabilitation Commission, The American Legion ............

Prepared statement of Mr. Mooney ..........................................

(III)
Doran, James W., National Service Director, AMVETS ......

Prepared statement of Mr. Doran .........................................

Lawrence, Brian E., Assistant National Legislative Director,

 Disabled American Veterans ..............................................

Prepared statement of Mr. Lawrence ....................................

Ortner, Blake C., Associate Legislative Director, Paralyzed

Veterans of America ............................................................

Prepared statement of Mr. Ortner .........................................

Kinderman, Quentin, Deputy Director, National Legislative

 Service, Veterans of Foreign Wars of the United States ..

Prepared statement of Mr. Kinderman .................................

Information for the Record

Elapsed processing time for fiscal year 2005  ........................

Chairman’s Memorandum No. 01-05-09 (May 25, 2005) .....

Questions for the Record

VA Questions from Chairman Buyer .....................................

VA Questions from Hon. Jeff Miller ......................................

VA Questions from Ranking Member Evans ........................

VA Questions from Hon. Darlene Hooley ..............................

PVA Questions from Chairman Buyer ..................................

VFW Questions from Chairman Buyer .................................

 

(IV)

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(1)

THE CHALLENGES AND

OPPORTUNITIES FACING DISABILITY CLAIMS

PROCESSING IN 2006

Wednesday, December 7, 2005

U.S. House of Representatives, 

Committee on Veterans’ Affairs,

Washington, D.C.

 The Committee met, pursuant to call, at 1:10 p.m., in Room 334, 

Cannon House Office Building, Hon. Steve Buyer [Chairman of the

Committee] presiding.

 Present: Representatives Buyer, Stearns, Brown, Miller, Evans, 

Snyder, Michaud, Herseth, Hooley, Berkley, Udall.

The Chairman. Good afternoon. The Committee will come to order.

 Today we will receive testimony on the challenges and opportunities facing the Veterans Benefit Administration’s claims processing

system.

  In fiscal year 2005, the Department of Veterans Affairs paid monetary benefits to 3.5 million service disabled veterans, eligible survivors, and, in some instances, disabled children of Vietnam era veterans, an obligation of more than $32 billion. This represents an 

83 percent increase in the past ten years. In 1995, the mandatory 

payments were just shy of $18 billion.

 When you look at it from 1995 to 2005, you have to take into account the increased operational tempo of the United States military, 

whether it was the post-Gulf War, Somalia, Bosnia, Kosovo, Gulf War 

II, or Afghanistan; training; or other commitments to regions and 

countries around the world, the force has experienced a great deal of 

stress, and there are consequences.

VBA has 8,918 dedicated employees processing disability and pension claims at regional offices across America. As reflected in Admiral Cooper’s November 3rd testimony before the Disability Assistance and Memorial Affairs Subcommittee, VBA in 2005 made over 

763,000 disability determinations, performed more than two million 

award actions, handled over 6.3 million phone calls, conducted over 

a million interviews, and conducted nearly 70,000 hours of outreach 
2

to military members, former prisoners of war, homeless veterans, minorities, female veterans, and other targeted groups.

 What we need to know is whether this system is buckling under 

pressure. As of two days ago, there are more than 370,000 compensation and pension claims pending, with more than 85,000 claims 

pending over 180 days.

 In October, rating-related claims were pending on average 124 

days, and it was taking another 155 days to complete a decision.

 There are almost 40,000 appeals pending at the Board of Veterans’ 

Appeals and about 32 percent are remanded to the original regional 

office or the Appeals Management Center for further development. It

is no surprise that the backlog is consistently cited as a major concern 

among the Committee members, among our colleagues, and VBA’s 

stakeholders.

  VA estimates that in fiscal year 2006, it will receive more than

725,000 compensation rating-related claims, an increase of three 

percent over fiscal year 2005. The most time-consuming claims are

original, or first-time filings, because the entire record needs to be

developed; VA estimates it will receive a little more than 206,000 new 

claims in fiscal year 2006.

 The most common claims, however, are those reopened by veterans filing for an increased rating or a new disability altogether. VA

estimates it will receive more than 464,000 reopened claims in fiscal

year 2006.

  By September of 2003, VBA had significantly reduced the number

of pending claims to 253,000 from a high of 450,000 in 2001. The 

average days pending was reduced to 111 days. 

 I look forward to today’s testimony as we begin to understand what 

has happened in the last several years that has led us to the vast 

inventory of claims.

  [The statement of Steve Buyer appears on p. 55]

 The Chairman. I would now like to recognize the Ranking Member, 

the gentleman from Illinois, Mr. Evans.

 Mr. Evans. Thank you, Mr. Chairman.

 I also am concerned about the continuing problems with poor quality and large backlogs that are due to VA’s insufficient funding for

appropriate numbers and type of staff.

 Last Spring, Democrats on this Committee urged for additional 

funding for staff to process claims for veterans and appeals at the 

Board. That request was rejected by the Budget Committees.

 The VA cannot be expected to provide decisions of acceptable quality and timeliness without adequate resources. More veterans are 

applying for benefits. More veterans who appeal decisions are waiting years for hearings before the Board.

 Staff who process claims feel overwhelmed and under-trained. The 
3

results are predictable: longer delays and more errors as well.

 The Administration and Congress must work together to provide 

the resources VA needs to decide claims fairly and accurately in a 

timely manner.

 I want to thank you all. And I want to thank you, Mr. Chairman, 

and all of our witnesses, and yield back the balance of my time.

  [The statement of Mr. Evans appears on p. 57]

 The Chairman. Thank you, Mr. Evans.

 Mr. Brown, you are now recognized, and I understand you have 

had a significant loss in the State of South Carolina.

 Mr. Brown. Yes, Mr. Chairman. Former Congressman Carroll 

Campbell, former governor of our state, passed away today. And I

know we all want to express our sympathies to his family. Thank you 

for allowing me this privilege.

 Mr. Chairman, as a member of this Committee for many years, I

have been deeply involved working with VBA to improve the Disability Compensation and Pension Claim Program which our deserving 

veterans rightfully depend.

 I was encouraged in 2003 when we were beginning to see VBA

make significant progress in reducing the number of claims pending.

However, recent reports are very troubling because they demonstrate 

the VBA claims process has again taken a turn for the worse, and the 

number of claims pending are once again on the rise.

 In addition to those that have been in the system for some time, I

am also extremely concerned about our new generations of war veterans coming home with injuries and disabilities that are not always 

physical. This was reflected in the dramatic increase in veterans filing for disability compensation for posttraumatic disorder.

 It is our duty to see that each and every veteran is given an accurate, appropriate, and timely determination on their disability claims 

to ensure they receive the benefits they deserve.

 Mr. Chairman, I appreciate you holding this very important hearing today to dig deep into how VA’s Disability Compensation and 

Pension Claim Programs are designed, how they are currently operating, and allowing us the opportunity to examine ways to, number 

one, update the programs to account for development in medicine and 

technology and change in our job market; number two, to improve the 

handling of disability claims; and, number three, strengthen administrative oversight.

 I look forward to hearing from our expert witnesses, and yield back 

the balance of my time.

 The Chairman. Mr. Brown, appreciate your contribution and that 

of your counterpart, the Ranking Member of the Health Subcommittee.

 Mr. Michaud, you are recognized.
4

 Mr Michaud. Thank you very much, Mr. Chairman. I would like to 

thank both you and the Ranking Member for having this hearing.

 I think it is also extremely important that we deal with these claims 

and their process in an efficient manner and that we do everything

as a Committee in this Congress to make sure that the resources are 

there so that we can process in an efficient manner.

 I yield back to my colleague.

The Chairman. Thank the gentleman for his leadership. 

 Also Mr. Miller is Chairman of the Disability Assistance and Memorial Affairs Subcommittee. You are now recognized for an opening 

statement.

 Mr. Miller. Thank you, Mr. Chairman. I do have a full statement 

I would like entered into the record, but I would say -- 

 The Chairman. It shall be entered into the record.

 Mr. Miller. -- that throughout the Second Session of the 109th 

Congress, our Subcommittee intends to hold a series of hearings on 

the challenges and issues that face VBA in the 21st century.

 We will include a review of the policies and laws that affect claims 

processing, the impact of the “Veterans Claims Assistance Act,” 

training and performance standards for claims adjudicators, the role 

of national and county service officers in claims development, and

VBA’s outreach efforts to veterans and survivors.

 We all know that Congress cannot just simply continue to throw 

money at a problem and expect that problem to go away. As reports, 

studies, and experience have shown, there are a variety of factors 

which have a significant impact on the timeliness and quality of the

claims process. I believe we -- and by we, I mean Congress, the VSOs, 

and VA -- must put this all on the table as we work to improve the 

system.

 I look forward to learning more today and working on this issue in 

the coming year.

  [The statement of Mr. Miller appears on p. 58]

 The Chairman. I thank the gentleman for his continued leadership.

 Ms. Herseth, the Ranking Member on Economic Opportunity, is 

now recognized.

 Ms. Herseth. Thank you, Mr. Chairman, and to Ranking Member 

Evans for having this important hearing. And I would like to thank 

in advance all of the witnesses that will be testifying today.

  I look forward to hearing about the Veterans’ Benefits Administration’s effort to reduce the backlog of pending claims and the amount 

of time it takes to process the claims. And while I understand our 

focus here today is on the disability claims, I will be posing questions 

as it relates to pension claims as well.

 I would like to thank the VA for the tremendous work they do on 
5

behalf of our nation’s veterans; however, I do share the concern of 

many of my colleagues regarding the extraordinary amount of time it 

takes to process certain claims and appeals.

  We must ensure our veterans receive the benefits they have earned

and deserve in a timely manner. The soldiers returning from Iraq 

and Afghanistan along with service members from previous wars deserve the best available service we can provide.

 So, again, I thank you for being here. Thank you, Mr. Chairman. 

Look forward to hearing the witness testimony and working with you 

to resolve the claims backlog.

The Chairman. I thank the lady for her leadership.

 Ms. Hooley, do you have an opening statement?

 Ms. Hooley. No thank you.

 The Chairman. Ms. Berkley.

 Ms. Berkley. Yes.

 The Chairman. You are now recognized.

 Ms. Berkley. Thank you, Mr. Chairman.

 It is critically important that we explore this issue from the perspective of veterans who have waited years for their VA claims to be 

resolved.

  In fiscal year 2005, the VA received more than 16,000 more claims

than in fiscal year 2004, yet the number of staff at regional offices to

process these claims is 7,053 on duty as of September 30, 2002.

  So, I am particularly concerned that the Reno regional office may

not have adequate staffing given the large number of veterans moving to Nevada.

 In 2000, there were 3,042 claims and 712 appeals pending in Reno. 

As of September of 2005, there were 3,677 claims and 1,082 appeals 

pending in Reno.

 Even though these numbers are shocking to me, it appears from 

the information that I have that Reno is faring better than other regional offices in terms of staffing. However, I am still concerned with

the wide variation in the number of staff and the appellate caseload. 

In fact, Reno has 30 more claims per FTE than the office with the best

ratio of pending claims and appeals, which is Salt Lake City.

  My Las Vegas office is currently assisting a Gulf War veteran who

has numerous medical conditions and has been waiting for a decision on his appeal since 1999. That is the year that I started serving 

in Congress. For six years, this veteran has been waiting to hear a 

decision.

 However, the national average for appeals decided by the Board 

in fiscal year 2005 was 983 days, over two and a half years. Many

claims are remanded by the Board adding even longer to the time 

veterans must wait for a decision.

 Mr. Chairman, I cannot stress enough the importance of adequate 

staffing levels to ensure timely and accurate decisions of VA claims.
6

 And I want to thank you for holding this hearing. I look forward 

to hearing from the witnesses on this very important subject. Thank 

you.

The Chairman. Thank you, Ms. Berkley.

 Mr. Stearns, you are recognized for an opening statement.

 Mr. Stearns. Thank you, Mr. Chairman, and my other colleagues. 

I want to thank you for having this hearing.

 I will tell my colleague, Ms. Berkley, that she would be interested 

to know that it is ironic that the original use of the word red tape in 

the United States began with the Civil War veterans’ records. So you 

can see it goes back that far.

  They were bound in red cloth tape and there was great difficulty in

accessing them. And so that led to the current term of red tape, going 

all the way back to the Civil War.

 I think we have progressed quite a bit since then, but obviously 

there remains a lot more red tape and that is why we are having the 

hearing.

 The most time-consuming process would be processing new claims 

and with the VA anticipating more than 206,000 new claims in the 

year 2006, we need to consider ways to make the process of developing new records more efficient while retaining thoroughness in the

claims review.

  And, secondly, Mr. Chairman, filing frequent claims or rating

claims, as they are called, takes an average of about 155 days to process. Some of these claims go to 180 days. And with the anticipated 

growth in rating claims of three percent to over 725,000 claims, I

suspect that it will be even higher.

 So this represents an incredible administrative burden and probably portends even longer delays. So that is why this hearing is so 

timely.

  And, lastly, I finally would say the appeals process for claimants to

the Board of Veterans’ Appeal is extraordinarily lengthy. For example, in 2005, an average processing time of over 820 days at regional 

offices with an additional 160 days of process at the main Board of

Veterans’ Appeal.

 Obviously this means that some veterans are left waiting over two 

and a half years as a result of their appeal. And this obviously is not 

satisfactory.

 So it is clear that we need streamlining procedures. I think if this 

Veterans’ Affairs Committee can come up with some solution here, it 

would be monumental. Veterans have suffered under the weight of 

this bureaucracy, this amount of red tape.

 So I thank you, Mr. Chairman, for holding this hearing and I look 

for a solution.

 The Chairman. Thank you very much.

 Dr. Snyder, you are recognized for opening statement.
7

 Mr. Snyder. Thank you, Mr. Chairman. I looked forward to the 

witnesses.

The Chairman. Thank you very much for your brevity.

 Dr. Jones of South Carolina, not Indiana, Henry.

 Dr. William B. Jones is a retired Air Force colonel who served as a 

chief flight surgeon and orthopedic surgeon with over 3,000 hours of

flight time. He is here to discuss his own personal experiences with

the claims processing system.

 Dr. Jones, I am most appreciative that you would travel here from 

the warmth of South Carolina. I have read your statement and I am 

familiar with your resume. You, sir, have had a good life.

 Every day I am meeting extraordinary people and you have had 

quite a life. You have given a lot to your service of your country in 

two wars. And for that, we are appreciative and respectful and we 

are anticipating your testimony.

 You are now recognized.

STATEMENT OF WILLIAM B. JONES, UNITED STATES AIR

 FORCE (RETIRED)

 Dr. Jones. Thank you very much, Mr. Chairman.

 Ladies and gentlemen of the House Committee on Veterans’ Affairs, let me state in the beginning what a privilege it is to be able to 

be here today and to testify before this august body on a very memorable day, Pearl Harbor Day.

 I feel that in this endeavor, I am speaking not just for myself but 

for the thousands of veterans who have experienced similar or greater 

frustration and challenges in attempting to deal with the Veterans’ 

Administration.

 To no avail, I have spent the last six and a half years in an attempt to have the Veterans’ Administration recognize my claims, and 

it seems we are now at a point where we are getting ready to begin 

all over again.

 The experience I will outline for you today highlights a system that 

promotes second-class medical care in a bureaucracy that is uninformed about military matters, programmed to procrastinate and inefficiency and non-caring with whom you cannot communicate.

  Subsequent to finishing orthopedic residency, I returned to active

duty with the Air Force at Keesler Air Force Base in Biloxi, Mississippi, and then spent two years at Hunter Air Force Base in Savannah, Georgia.

 Since 1966, I have been practicing orthopedic surgery in Greenville, 

South Carolina. During these years, I have maintained my affiliation

with the Air Force. Tours of active duty, I have served in Japan, 

Alaska, Germany, Spain, Greenham Commons in the UK. Additionally, I have spent time in Libya, Korea, Vietnam, and my last tour of 
8

active duty was at Andrews Air Force Base here in Washington and 

Dhahran Air Base in Saudi Arabia during the first Gulf War.

 I have logged combat time both in Vietnam and the Persian Gulf 

War. All tolled, this has amounted to 33 years of Air Force service, 

concluding as chief flight surgeon and orthopedic surgeon with over

3,000 hours of flying time with the rank of colonel.

 Arriving in France in excellent health in 1955 with a completely 

normal physical exam, by 1957, I had developed a pterygium, which 

is an overgrowth of the veins of the eye covering portions of the cornea, of each eye, diagnosed to be secondary to irritation of the sun 

and sandstorms in North Africa.

 The worst eye was operated upon not once but twice at the U.S. Air 

Force Hospital in Wiesbaden, Germany in late 1957. These facts are 

documented in my physical exam records.

 Unfortunately, the growth recurred and over the years, my local 

ophthalmologist has monitored these growths closely. I have used 

a variety of drops in attempt to control the irritation, which creates 

an itching of the eyes with tearing. Sometimes blurring of vision accompanied by diminished visual acuity occurs with reading or night 

driving.

 The Veterans’ Administration had requested exams, which have 

been conducted at a hospital in Columbia, South Carolina, by a resident in training on two occasions. The VA Board has referred to this 

as no evidence of onset during active duty in the right eye, which 

is completely false and contrary to the documents, including in my 

physical exam and all of my records.

 Had the evidence presented been appropriately reviewed and accepted, this grossly inaccurate judgment should not have occurred. 

Both eyes experienced simultaneous trauma in the desert and simultaneously developed a pterygium.

  Jet engine noise experienced during flight line operations to which

air crews, including the flight surgeon, are exposed can be productive

of very serious hazardous noise levels to hearing. At that time, it was 

not recognized and the measures now in effect to protect one from 

excessive noise were not utilized.

  Also, the seat of the flight deck of the C141 and 124 transport aircraft utilized by the flight surgeon has been noted to be in medical

research studies in more recent times to be excessively hazardous 

noise levels of a high pitch whine with the port inboard engine being 

the cause of this. This is the seat that I occupied in accumulating in 

excess of 3,000 hours of flying.

  These facts are all corroborated and verified in scientific data that

I presented at a board hearing. In the data accumulated for the regional office, I presented a great deal of research material, pointing

out the unhealthy nature of this exposure. This was from the medical 

research publications of many authors and from medical school facul-
9

ties, textbook authors, and Air Force research labs, especially those 

at Wright-Patterson Air Base in Ohio, all recognized authorities in 

their field.

 Again, the VA evaluators at the Board of Appeals commented upon 

this as evidence of minimal exposure to aircraft jet noise. Clearly this 

statement was contrary to the research of the material that I quoted 

and presented relating to jet engine noise. Three thousand hours of 

flight time can hardly be glossed over as minimal exposure.

 The substance of my testimony was not given the weight of an expert as prescribed by the regulations and by the Court of Appeals 

based on my status as a physician and a flight surgeon with special

training and expertise in otology, or hearing problems.

 Data was also presented relating to my evaluation by Dr. Joseph C. 

Farmer, Professor and Chief of Otolaryngology, Department of Surgery, Duke University Medical Center. His summarizing statement 

of September 2001 visit was “bilateral sensory hearing loss secondary 

to excessive noise exposure during Air Force duty, and I recommend 

hearing aids.”

  The Board hearing officer referred to this as minimal exposure.

This is a marked contradiction to opinions regarding medical information between a judge and a recognized outstanding scientific authority and medical professors.

 Flying cargo from Savannah, Georgia and Charleston, South Carolina to Vietnam frequently required three days to get there and three 

days to get back home while in the company of bombs, tail fins, Agent

Orange, and who knows what else. This was one of the primary missions of the 63rd Airlift Wing at Savannah and 437th Airlift Wing in 

Charleston.

 From 1964 to 1975, I developed an enlarged prostate that eventually produced urethral stenosis and the inability to void. This required 

a TUR operative procedure of the prostate.

 Since then, the prostate has continued to enlarge with multiple 

surgical biopsies in an attempt to rule out the development of a tumor 

because of an accompanied considerable elevated PSA, which is a lab 

study that is indicative of that.

 This has also been accompanied by several episodes of extensive 

urethral bleeding and, on occasion, requiring hospital admissions to 

control this.

 Now the situation has progress to that of urinary incontinence and 

dysfunction with dribbling, requiring the wearing of absorptive devices. This, you can imagine, is a real problem and bother.

 The last urologic evaluation requested by the VA was performed by 

a very junior general surgical resident in Columbia who told me that 

he did not care about my post exam grossly bloody urine specimen. 

As a junior general surgical resident, he is unqualified for evaluating

the complex urinary dysfunction and prostate problem.
10

 If the VA desires a valid opinion of a problem, they must have a 

valid specialist to evaluate the situation. This inadequate treatment 

is an insult and something that most veterans resent.

 The medical issue is thought to be most likely due to Agent Orange 

exposure, and I am hopeful that this is not an indication of impending 

prostate cancer development. Medical literature and research studies were also presented to the regional offices and the Appeal Board

to support this conclusion.

 The comments of the Board was “manifest during RC with no evidence during ADT,” which is also false. True, the episode of urinary 

retention occurred while in Greenville and not in Vietnam, but the 

enlargement was occurring over the preceding several years, which 

was noted on digital examinations over a time frame when multiple 

periods of active duty were served.

 Now my internist points out with a blood sugar of approximately 

140, he considers me to be a type-2 diabetic. Exercise and diet have 

so far done very little to accomplish resolution of the problem. I now 

understand that this has been recognized as a complication of Agent 

Orange exposure, and Congress has passed a resolution relating to 

such. This was published in a recent issue of the DAV magazine.

 While on active duty in Charleston and during Desert Storm, it 

was recognized that my cholesterol and lipids were elevated and increasing on routine physical exam and lab studies. I was placed on 

cholesterol lowering medications in Charleston probably during the 

early 1980s, obtaining my medicine at the Charleston Air Force Base 

pharmacy.

 This has controlled the elevation of these harmful levels to some 

degree as long as I remain on medications, though the VA will not 

provide me with the most recently developed and most effective medications prescribed by my internist.

 It seems that veterans were good enough to go to war with the best 

equipment, but not to get the best medication for promotion of good 

health once they get home.

 Because of the elevated cholesterol, I have developed considerable 

plaque formation and narrowing of the carotid arteries. These arteries are in the neck on either side. These are now requiring frequent 

monitoring with ultrasound screening.

 Should these continue to progress, cerebral ischemic episodes or 

strokes are likely. Dizziness and vertigo with instability are provoked by transient and brief episodes of ischemia and risk prone surgical intervention is a possible consideration.

 Working with the system for consideration of these medical problems beginning at the regional office in the spring of 1999, through

the Veterans’ Board of Appeals and the Court of Appeals, has gotten 

significantly nothing accomplished.

  At the regional office, it is impossible to talk with the director or
11

any of the evaluators. Apparently, this is a hard and fast rule. You 

present yourself at the office. Someone is called down from upstairs

to talk to you, but cannot answer any questions or take down any new 

information.

  It is impossible to find out what is going on or if they have the

correct or most recent data in your chart. This recently has been 

improved with the addition of a receptionist who can at least tell you 

if they have the records, but nothing else.

 After a period of six to twelve months, you receive a letter that you 

must reply to or report for an additional physical exam that in my 

case was performed by a surgical resident in training status without 

regard to training in the applicable specialty.

 Finally, a judge was provided in October of 2002 who the Disabled 

American Veterans’ representative and I appeared before and presented my case. The judge insisted that all duty -- if I might have just 

a few more minutes to conclude. Thank you.

 The judge insisted that all duty conducted while a reservist was 

considered inactive duty status. As most military personnel are 

aware, I tried to explain to her that reservists were called to active 

duty for periods of time from a few days to several months.

  Crews flew all overseas missions, which were numerous, on an active duty status, which was a requirement by NATO. Active duty 

was also required on any mission when possible exposure to hostile 

fire or flying in the combat zone, such as Vietnam and the Persian

Gulf, was required.

 This information was never accepted as a fact by the judge. Due 

to the lack of the judge’s understanding of these facts, the nature of 

my medical problem was not addressed and the hearing wound up 

accomplishing nothing.

 I was directed to contact the Air Force Personnel Center at Randolph for further confirmation of my facts. With the lack of understanding by the judge of the facts presented, what faith can one have 

in the fairness of the system or accuracy of the judgment?

  When the matter after appeal finally got to the Board of Appeals

some six months later, I had a very well-prepared slide and document 

representation. Judge Joy McDonald dismissed this and I was allowed only a hurried verbal presentation.

 I had documents and medical research treatise from the literature 

as well as copies of my physical exams supporting my case. Again, 

the medical facts and authoritative research evidence was treated 

with casual disregard. Judge McDonald did not consider my testimony that of an expert as required by regulations and as directed 

by the court. I do not understand how the judge could ignore the VA

regulations and the direction of the Court of Appeals.

  As a chief flight surgeon, a physician has special training in aerospace medicine, emphasizing ear, eye, and cardiopulmonary physiol-
12

ogy. It would appear self-evident that she was dealing with a veteran 

with some medical knowledge.

 The judge also recently requested a cardiologist review my case 

involving the carotid arteries. Again lacking medical expertise, she 

obviously is not aware of the difference between the coronary artery 

and the carotid artery.

 The coronary arteries are in the heart and the carotid arteries are 

in the head. A cardiologist is not a physician to make determinations 

on the carotid artery, but should require a neurologist. This certainly 

does not reflect with credit upon the Board nor give one a sense of

security that they know what they are doing and one can be judged 

correctly and fairly.

 This case was then appealed to the Court of Veterans’ Appeal. 

There I had the good fortune of having an attorney representing me 

who pointed out the unfairness of the Board and glaring error on 

their part in not properly considering my testimony. With his assistance in pointing out this mistake, the court referred my case back to 

the Board of Appeals.

 This remand has now taken two and a half years, from March 19th 

of 2003, to October 11th of 2005, for my records to go from the location 

of the Board of Appeals to the Court of Appeals and then back to the 

Board of Appeals, about five blocks across the city of Washington.

  I was at the Board of Appeals’ office in D.C. on the 11th of October

and met with the DAV representative who was most knowledgeable 

and helpful. He was able to locate my records in the office almost immediately. He pointed out that as a patient over age 75, they should 

expedite my case and mark the records accordingly.

 Feeling that we would be given prompt attention by the Board of 

Appeals as directed by the court, upon returning to Greenville, I underwent a reevaluation by my internist of my cholesterol and vascular stenosis status.

 I also had a reevaluation by my urologist of my renal dysfunction 

and prostate status, and had copies of these sent to the Board. Here 

are copies of each one of these reports right now, which I understand 

should be in my records.

 Unfortunately, on 11/23/05, I was informed that the case had been 

referred back to the RO, regional office, for further development of

data.

 The Chairman. Dr. Jones, you are going to have to speed it up, 

please. We have three votes pending.

Dr. Jones. All right.

 The Chairman. Your written statement will be submitted for the 

record. If you can summarize your conclusion.

 Dr. Jones. Can I just read through the conclusion?

 The Chairman. Yes, sir.

 Dr. Jones. Okay. Thank you.
13

 In conclusion, I feel manipulated by a system of bureaucratic maneuvers. As described by my testimony, my case has gone from the 

regional office to the Board of Appeals, to the court over the course of

six and a half years only to be returned to the regional office.

 I am appealing to you today to hold this system accountable for 

ensuring that veterans who have fought for our freedom have an adequate and efficient means of resolving these problems in a timely

manner.

 Soldiers, sailors, marines, and airmen in harms way in Afghanistan and Iraq and other far-flung parts of the globe and their families

are enduring a great deal of hardship and grief in various areas of 

conflict. They have been led to believe that our country will stand

behind them and take care of them when they return home, many 

with broken bodies and mangled minds, and are not able to care for 

themselves.

 In conclusion, I would just like to say that I have not received any 

funds from any government agency, federal grant, or contract from 

the government relative to this subject matter and the testimony during the current year or previous other years.

 Before departing, I would like to share with you one brief but very 

pointed passage from the literature inscribed on a plaque at Parris 

Island which is very appropriate with the current calls for quitting 

before we finish the job in Iraq.

 War is an ugly thing, but not the ugliest of things. The decay and 

degraded status of moral and patriotic feelings which thinks that 

nothing is worth war is much worse. A man who has nothing for 

which he is willing to fight, nothing he cares more about than his own

personal safety is a miserable creature who has no chance of being 

free unless made and kept so by exertion of better men than himself.

 I thank you for your attention.

  [The statement of William B. Jones appears on p. 68]

The Chairman. Dr. Jones, we have asked you to come here and 

testify because you have had a very unique life. Graduate of the 

Citadel, and Duke University for your medical degree and your residency. You have had an extraordinary career and you are in a unique 

place to give testimony and answer the members’ questions because 

you also have these experiences with your military service. And you 

understand your body.

 And so we are interested in that frustration and the challenges you 

have as you go through an appellate process, a claims process, when 

people who are looking at them may not be as qualified.

 The Committee will stand at recess. We have three votes.

  [Recess.]

 The Chairman. The Committee will come back to order.
14

 Dr. Jones, would you please come back to the table. I apologize to 

you. Sometimes when we have votes and hearings are extended, my 

colleagues get pulled in many different directions. We had a good attendance and then the votes disturbed that.

 I want to thank you for coming and giving your testimony. Just 

before we broke, I tried to share with you one of the reasons we asked 

you to come here is because you are providing a voice for many veterans who do not have your medical expertise.

 How challenging it must be for you to have an understanding regarding your human physiology, and make a claim also based on your 

military experiences and then to have that claim sent to someone of 

whom you have no idea about their background, expertise, and begin 

to make judgments on that.

 Will you share some of that with me, what are your thoughts about 

having gone through that?

 Dr. Jones. Well, you get certainly provoked when you find that

your claim is being referred back down to the regional office to evaluate what is printed or the examiner calls the coronary arteries when, 

in effect, the arteries in question are the carotid, one being in the 

chest, the other in the head.

 And it makes you wonder if they are that uninformed about the 

human body or they do not seek some assistance to bring them up to 

speed or how fair are they going to really be able to judge your claim. 

And that is most frustrating.

 And then to be sent to the hospital for a detailed and comprehensive urologic examination and you find that the examiner is a very

junior surgical resident who is in training.

 And really most general surgical programs, there is very little emphasis on urology. It is certainly a separate and apart specialty of 

the field. So they are really not in any position to form an adequate

judgment.

 And, of course, I am afraid in so many cases a veteran who is not 

medically oriented might not realize that he is not really being offered a fair and adequate evaluation and winds up with an opinion 

from somebody who is not capable really of evaluating the situation.

 The Chairman. When you filed your disability claim in February of

2000, a decision was then made on August 31 of 2000. Was anybody 

from VA in touch with you during that time period? 

 Dr. Jones. I’m sorry.

 The Chairman. You submitted your claim and then a decision was 

made. Were they in touch with you during that process and, if so, 

what communication took place?

 Dr. Jones. Very little. I really initially -- and I realize those dates 

are in the records there -- but initially I started this process in the 

spring of ‘99. And, yes, I would periodically have a request for more 

information on this, that, or the other, or a request to come down for 
15

another hearing evaluation and so forth.

 And during that period of time that you were talking about, perhaps I was communicated with maybe three times.

 The Chairman. Did you have bi-directional communication or was 

it, “here is what I want,” you send it and you do not talk to anybody?

 Dr. Jones. No. That was it. They give you an 800 number, but 

you would call it and you never could get anybody on the phone to 

talk to.

 And you felt like in many cases if you could just talk to the person 

evaluating your claim, you could clear up some misunderstandings 

which might involve referring it back and forth to two or three different people in their agency. And if you could talk with them just to 

answer their questions, you feel like it would certainly be a big help 

to moving the claim along.

 And for that reason, I really think that in many cases if the VA could 

employ veterans or retirees who had service in the system and really 

understand that all people on reserve category or National Guard 

category are not always on reserve training duty. They certainly in 

many cases are called to active duty as they are quite frequently now. 

And I think that is going to be more the case in the future. And when 

they are on active duty and called up, they are placed on active duty 

and should be treated just as anyone else on active duty.

 The Chairman. Earlier you used the words “fair evaluation.” Often 

that is defined subjectively.

 As you examine your own experience going through this process 

and how long it has taken you, what are your recommendations to us 

about objectivity and how we make this a more fair process in evaluating disability claims?

 Dr. Jones. Well, that generally, I think, is a case where it involves 

someone evaluating the situation and making the decision. For instance, how in the world could they categorize one eye as being acquired as a result of military service and not the other? Both eyes 

were two inches apart and what trauma to one eye can do, the other 

did.

 And I think the mechanism there is to try to get people more familiar with the military system and I think just more attentiveness on 

the part of the person evaluating the claim should rectify such things 

as that. And such things as confusing the coronary and carotid artery, I think there, they just need to try to educate themselves a little 

bit better as to what those were.

 But they certainly need to have some emphasis on trying to push a 

claim along because in my case, six and a half years to start out and 

now it is going back down to the regional office again. You wonder if

it is ever going to reach a final conclusion.

 The Chairman. It is a challenging process whereby, you know, is 

one eye considered one, or are both eyes considered together? 
16

 Dr. Jones. The wind was blowing primarily from the left side and 

that is why you got all the sun and sand in that eye.

 But I realize the Veterans’ Administration is an expensive program 

and certainly with these days, you like to conserve as much of the 

government funds as you can.

  But at the same time, if we are going to be involved in these conflicts

and having people get their bodies bent up and mangled, we need to 

fully stand behind them so that when they come back home, they will 

be hopefully productive citizens again and at least adequately taken 

care of.

 The Chairman. May I surmise then from your statement that training of evaluators is key? That we should examine that in greater 

detail?

 Dr. Jones. I think that would be an excellent policy.

 The Chairman. I have some further questions, but at this moment, 

I will yield.

 Mr. Udall.

Mr. Udall. Thank you, Mr. Chairman, and I apologize for not being here earlier. I had another commitment. I move to put my statement in the record.

 The Chairman. No objection.

  [The statement of Tom Udall appears at p. 63]

 Mr. Udall. Dr. Jones, thank you for your testimony. 

 I hear the same story from veterans in my district whenever we 

meet with them. It appears that many of the measures used to measure productivity are not designed from the perspective of veterans 

who spend years waiting for hearings and decisions.

 Do you believe that the system would work better if only board 

certified physicians conducted compensation and pension examinations?

 Dr. Jones. Yes. I very definitely feel that that would speed the

process up.

 Mr. Udall. Why do you think that?

 Dr. Jones. Well, I think they would be more confident in making

a conclusive or definite decision when they perform an evaluation as

opposed to a resident in training. He is a little uncertain and unsecure in his position. And with the responsibility of making such an 

important decision, he may be hesitant just like in the case of the 

young man who evaluated me.

 He had done his evaluation and examination and he really did not 

want to get involved with the fact that there is blood in the urine 

after the evaluation. So I think more qualified people in performing

these medical examinations would certainly be of benefit.

 Mr. Udall. Should the VA pay to obtain private medical records for 

disability claims as the Social Security Administration does?
17

 Dr. Jones. I do not think really it should require that. I mean, 

most doctors’ offices formerly would have all the records on pieces

of paper which could be sent through a duplicating machine or fax 

now. And now the big emphasis to switch over from paper records to 

paperless records.

  Most offices are going to a computer program now where you just

dictate into the computer. So it should only be a matter of pressing a 

few buttons to send the records to the VA. So I do not think that they 

should really in fairness charge them for that.

Mr. Udall. We hope that is how it works.

 We appreciate, Dr. Jones, your testimony very much and hope that 

your efforts here today help many other veterans.

 Thank you, Mr. Chairman. Yield back.

 Dr. Jones. Thank you.

 The Chairman. Dr. Jones, I understand your appeal at the Board 

has been expedited based on your age.

 Has anyone at BVA given you any indication as to when a decision 

could be made?

 Dr. Jones. No. As a matter of fact, the Board had the remand 

clearly marked for it to be expedited. But then I got a couple of letters 

from the agency that facilitates the appeal process and it has a return 

address of Veterans’ Administration but had no telephone number, 

no address or anything on there.

 But they indicated in their correspondence that they had a heavy 

workload and it would be addressed in due time, but did not indicate 

that they were aware of or going to be in a position to in any manner 

expedite the process in spite of the fact I have got ten evaluations already of a recent nature from the urologist as well as an internist.

 And more recently, I guess the last evaluation I had of my eyes, 

they made colored photographs of the pterygiums and those should 

now be incorporated in the record.

 So really I do not see where there should be a need for any more 

referral evaluations. I would be happy to participate in those if they 

need them, but the chart and records should be in a situation now so 

they could make an informed decision with what is there.

 The Chairman. You testified that you believe that this process is

programmed to procrastinate. Why?

 Dr. Jones. Well, I do not think there is any urgency shown by any 

of the people that get involved to push the process along. For it to 

take months to go through the regional office, it must sit in some in

basket or out basket for a considerable period of time. And I do not 

think anybody really is concerned about that and nothing seems to be 

a stimulus to move it along.

 And that may be one of the reasons that you cannot communicate 

with them, just the fact, I guess, it would take some of their time in 

communicating. But at the same time, it might very well facilitate 
18

the process more than it would consume their time in talking with 

the clients.

 The Chairman. Do you have any further recommendations for us on 

how to change the process?

 Dr. Jones. Well, perhaps a bit more education of those people involved in terms of medical terms and some diseases and how they 

expect it to turn out and so forth might be helpful. And if more attention could be directed to getting people with previous background in 

the field of medicine and the military would be helpful.

 The Chairman. You also used the word “attitude” in your testimony. It is pretty important. It can move mountains. And you believe 

that they need an attitude change? This is sort of your synopsis of 

having gone through all this so long?

 Dr. Jones. Well, I think so, because when a veteran goes to the 

regional office, he is not really going to talk to anybody. The first

time there, he fills out the application. He has a little assistance with

that.

 But any other time that he is there, perhaps to bring information 

of a new physical exam that has been done or perhaps to just check 

on the progress of the case, the attitude is, you know, we are all too 

busy. We cannot spend any time talking with you.

 And if you call up, you cannot really get anybody on the phone. You 

talk to an answering machine. And you are very frustrated. What 

can I do to help the situation. Well, you cannot do anything. You cannot even talk to anybody about it. I think that is a bad attitude.

 I think anything involving medicine -- and I think in these evaluations, it does involve medicine -- that a caring attitude does a lot to 

reassure the patient or the person involved that he is really talking 

with someone who is concerned about his situation and attempting to 

try to move it forward to a successful, favorable conclusion.

 The Chairman. Well, at the end of your statement, you were hopeful that your presence here, while it may not eliminate your frustration, that you hope that it would be helpful. And I would submit, sir, 

that it is.

Dr. Jones. Well, thank you.

 The Chairman. Congress has chartered a Disability Commission 

and its charter has great latitude in its recommendations to Congress. We are most hopeful that we can come up with a claims system 

that treats people the way they deserve to be treated.

 I mean, they did not ask for much in the service of their country 

and we in turn as a country owe them more than a great deal of 

gratitude. It is to try to make them as whole as possible and to give 

them every opportunity to live full and complete lives. And we seek 

to do that. 

 I appreciate you being here; your testimony is valuable and important. Thank you, Dr. Jones.
19

 Dr. Jones. Thank you very much. I believe I read just the other 

day about the Commission. I think this was in an article from an Air 

Force magazine that it has taken them much longer than anticipated, 

though, to come up with a recommendation, has it not, to 2007 or 

2008 before they feel like they will be finished?

 The Chairman. Well, you are right on the edge. I have met with 

the Chairman and he has expressed some concerns. And we are going to address those issues. That charter that we have given him, Dr. 

Jones, is very broad.

 And we want to give this Commission support. The individuals 

who are serving on this Commission are highly decorated -- several 

are Medal of Honor winners. There are criteria with regard to their 

military status, but they are also very unique individuals in their 

own right.

 We have given them a pretty expansive charter. Not often in Washington, D.C., do we move in bold strokes. We are hopeful that they 

are going to come to us with some pretty significant recommendations on how to improve this process.

Dr. Jones. Well, that is most encouraging, and certainly they need 

the time to do a thorough job.

 The Chairman. I think so too.

 Thank you, Dr. Jones, for your testimony.

Dr. Jones. Thank you very much.

The Chairman. You are now excused.

Dr. Jones. My privilege.

 The Chairman. If the second panel will please come forward. We 

are pleased to have Mr. Ronald R. Aument, the Deputy Under Secretary for Benefits from the Veterans Benefits Administration, and the

Honorable James Terry, Chairman of the Board of Veterans’ Appeals, 

with us today as our second panel.

 Mr. Augment serves as second in command at the Veterans Benefits Administration, the branch of the Department of Veterans Affairs responsible for administering benefits programs for veterans,

including education, home loan guaranty, compensation, pension, 

vocational rehabilitation, employment, and insurance.

 Mr. James P. Terry was nominated to serve as Chairman of the 

Board of Veterans’ Appeals by President Bush on April 26, 2005. He 

was confirmed by the Senate on July 29, 2005.

  A former Marine Corps infantry officer in Vietnam, his final four

years of active duty were as the Marine Corps judge advocate, serving as legal counsel to the Joint Chiefs of Staff, and he retired as 

colonel in 1995.

 Mr. Terry’s military awards included the Bronze Star Medal, the 

Purple Heart, Defense Superior Service Medal, Legion of Merit, et 

cetera. I should say et al.

 Did you forget the Good Conduct Medal in there?
20

 Mr. Aument, will you please begin.

STATEMENTS OF RONALD R. AUMENT, DEPUTY UNDER SEC-

 RETARY FOR BENEFITS, VETERANS BENEFITS ADMINIS-

 TRATION; AND JAMES P. TERRY, CHAIRMAN, BOARD OF

VETERANS’ APPEALS

STATEMENT OF RONALD R. AUMENT

 Mr. Aument. Thank you, Mr. Chairman, and members of the Committee. It is my pleasure to be here today to discuss the Disability 

Compensation Program.

  The Veterans Benefits Administration, VBA, is responsible for administering a wide range of benefits and services for veterans, their

families, and their survivors. The heart of our mission is the Disability Compensation Program.

 In 2005, we produced over 763,000 disability determinations. We 

also performed more than two million decision actions of all types to 

address new claims and to maintain those already on the rolls.

 Additionally, we handled over 6.3 million phone calls, conducted 

more than a million interviews, briefed more than 330,000 service 

members, and conducted nearly 70,000 hours of outreach.

 Today I will discuss the challenges we face in providing timely, 

accurate, and consistent determinations on veterans’ claims for disability compensation.

 These challenges include the growth of the disability claims workload, the increasingly complex nature of the claims processing workload, the rise in appellate processing, and the continuing need to produce accurate benefit determinations.

 I will also discuss some of the actions we are taking to improve 

claims processing. We view these efforts as opportunities to provide 

more timely and accurate disability compensation determinations for 

veterans.

  The number of veterans filing initial disability compensation claims

and claims for increased benefits has increased every year since fiscal

year 2000. Disability claims from veterans returning from Operations Iraqi Freedom and Enduring Freedom, as well as veterans from 

earlier periods of war, have increased from 578,000 in fiscal year 2000

to more than 788,000 in fiscal year 2005. This increase represents

more than 200,000 claims or 36 percent over the 2000 base year. 

 The increase in claims receipts is not the only change affecting the 

claims processing environment. The greater number of disabilities 

veterans now claim, the increasing complexity of the disabilities being claimed, and changes in law and processes pose additional challenges to the claims processing workload. The trend towards increasingly complex and difficult to rate claims is expected to continue.
21

  A significant portion of VBA’s workload comes from the appeals of

regional office decisions, remands by the Board of Veterans’ Appeals

and the courts, and from account maintenance activities for beneficiaries already receiving benefits. As overall claim determinations

increase, so do appellate and nonrating related workloads.

  The compelling requirement to produce accurate benefit decisions

represents both a challenge and an opportunity. VBA has established 

an aggressive and comprehensive program of quality assurance and 

oversight to assess compliance with VBA claims processing policy 

and procedures, and to assure consistent application.

VBA is engaged in numerous initiatives aimed at better managing the disability claims workload and improving benefits processing. 

The efforts include changes to the organization and structure of the 

Veteran Service Center operations, the delivery of training for claims 

processors, the consolidation of specialized operations, and the redistribution of the rating workload.

 A product of the VA Claims Processing Task Force was the implementation of the Claims Processing Improvement or CPI model. CPI

was implemented in 2002 and established a consistent organizational 

structure and work processes across all regional offices.

 The changing workload and workforce have necessitated a review 

of the model to outline the most effective method of organizing work 

and resources to maximize performance.

  During fiscal year 2006, we will conduct a high level review of CPI

and identify modifications that will further augment efficiencies in

claims processing.

VBA has deployed new training tools and centralized training programs that support accurate and consistent decision making. New 

hires receive comprehensive training and a consistent foundation in 

claims processing principles through a national centralized training 

program. And local training is provided thereafter utilizing the standard curriculum.

 Standardized computer-based training tools have been developed 

and training letters and satellite broadcasts are provided to the field

on the proper approach to rating complex issues.

 We are currently developing a mandatory cycle of training for all 

C&P business line staff consisting of an 80-hour curriculum annually.

 The consolidation of specialized processing operations for certain 

types of claims has been implemented to provide better and more 

consistent decisions. Some of our efforts include the establishment 

of the Pension Maintenance Centers, the Tiger Team, the Appeals 

Management Center, and the Casualty Assistant Unit.

 Most recently, VBA has consolidated the rating aspects of our Benefits Delivery at Discharge initiatives, which will bring greater consistency on decisions on claims filed by newly-separated veterans.
22

 Additionally, we are exploring the centralization of all pension adjudication to the Pension Maintenance Centers.

 Through these initiatives, VBA is prepared to address the challenges facing our organization and improve claims processing. We 

will continue to assess our policies, processes, and approaches to 

take advantage of improvement opportunities and to ensure we are 

achieving the desired performance outcomes.

 Mr. Chairman, this concludes my testimony. I greatly appreciate 

being here today and look forward to answering your questions.

  [The statement of Ronald R. Aument appears on p. 74]

 The Chairman. Thank you very much.

 Mr. Terry, you are now recognized.

STATEMENT OF JAMES P. TERRY

 Mr. Terry. Thank you, Mr. Chairman, and good afternoon. Good 

afternoon, Mr. Udall. And thank you for the opportunity to discuss 

the operations of the Board of Veterans’ Appeals with you, the members of the Committee, and your staff.

 When the Board last presented testimony before the Subcommittee on Disability Assistance and Memorial Affairs on May 5th of this 

year, we contrasted our performance with that of past years, notably 

when we appeared before the Committee in February of 1994 and 

June of 1998.

 This comparison continues, sir, to be instructive in demonstrating 

where we are heading and how we will meet the challenges that the 

future may bring.

  In fiscal year 1994, the Board issued about 22,000 decisions. Our

pending caseload stood at 47,000 and was on its way to 60,000 cases. 

Our measure of timeliness then used, average response time, was 781 

days. By fiscal year 1998, we had significantly improved our timeliness and productivity.

 With 483 FTE, we issued 38,886 decisions, held 4,875 hearings, 

and our appeals resolution time, the time from the date a veteran 

files a Notice of Disagreement until he or she receives a final decision

on appeal either at the Board or in the field, was 686 days.

  In fiscal year 2005, this past year, the Board issued 34,175 decisions and conducted 8,576 hearings, a substantial increase in hearings from 1998.

 Appeals resolution time stood at 622 days. Our cycle time, the time 

that it actually takes the Board to issue a decision, excluding the time 

the case is with his veteran service organization, was 104 days. It 

was 159 days if you included the time the VSO had the case.

  Significantly, we accomplished these results with 434 authorized

FTE or 49 fewer FTE than we had in 1998 and 58 fewer than we had 
23

in 1997. Despite our efforts, we continue to receive more appeals 

than we are deciding.

  Case receipts at the Board for fiscal year 2005 were 41,816 and the

number pending at the end of fiscal year 2005 stood at 37,539. That

is 19,900 in backlog, 10,930 in working inventory, and a number of 

appeals in the field on their way to the Board.

  Our most significant challenge for the future is how to eliminate

the growing backlog within available resources.

 Mr. Chairman, we are fortunate to have received much help in 

achieving our success this past year and in future years as a result 

of the unqualified support that this Committee and your Senate colleagues have provided.

 And certainly we are mindful of the assistance of the veteran service 

organizations which represent about 85 percent of our appellants.

 We are also mindful of the strong support from VA’s leadership and 

certainly the Board of Veterans’ Appeals law judges and our support 

staff.

  Two of the most significant and persistent challenges, sir, we face

are eliminating avoidable remands and increasing our productivity to 

contain and reduce the appeals backlog.

 In regard to remands, we know that certainly veterans want timely 

and correct decisions on claims for benefits. For the Board to do that

and to improve our performance, we must have all evidence necessary to decide the claim and show that all necessary due process has 

been provided. If the record does not meet these requirements and 

the benefits sought cannot be granted, then a remand for further development is necessary.

 Remands, of course, lengthen the time of appeal. One remand, for 

example, adds about a year to the process. Remands also divert resources from processing other claims and appeals. And we are mindful that about 75 percent of the cases remanded are returned to the 

Board, so we have to see them twice and this doubles our workload.

 Hence, eliminating avoidable remands is a goal that will provide 

better service to veterans and their families and ultimately help to 

diminish the growing backlog.

  We are working with VBA, the Office of General Counsel, and the

Veterans Health Administration to identify and track the root causes 

of remands, provide training, ultimately to eliminate these avoidable 

remands. In this regard, our training efforts have been considerable.

 We have had several direct training sessions during the past year 

for all our VLJs and staff counsel on aspects of remand avoidance. 

We have held joint training sessions with the Veterans Benefit Administration, including a video broadcast on avoidable remands and 

on evidence development. 

 We conducted numerous sessions on a variety of medical and legal 
24

subjects within our jurisdiction and are planning new interdepartmental training initiatives, all designed to reduce remands and improve quality.

 In addition, we are working with VHA and VBA on the CPEP. That 

is the Compensation and Pension Examination Project which, by improving the quality of VA compensation examinations, will ameliorate a major cause of remands.

 We think these results are encouraging. We have a long way to go. 

But in the past year, our remand rate has dropped to 38.6 percent 

as compared to 56.8 percent in fiscal year 2004. So far this year in

fiscal year 2006, the first two months, the remand rate stands at 32

percent.

 Now, if nothing had been done, certainly our backlog was projected 

to grow to unacceptable levels. And although we have made many 

improvements, sir, we have a long way to go.

 Within existing resources, through incentives and sound management, we will continue to improve by doing a number of things.

 First, we will eliminate, as I mentioned, avoidable remands.

 Second, we will strengthen our intra-agency partnerships. Our 

joint training efforts with VBA, the Office of General Counsel, and

the Veterans’ Health Administration will improve decision quality 

and reduce these remands.

 We have asked our judges and counsel in their preparation to write 

shorter, clearer, and more concise decisions. We are training our veterans law judges and counsel to write shorter and more concise decisions so that we can get more productivity out of each of them.

 We are utilizing employee incentives and mentoring and training 

programs. And these programs certainly are designed to increase 

productivity and decision quality.

 And we are making judicious use of overtime in our shop. We will 

use overtime within existing resources to enhance productivity.

 We are also increasing the use of paralegals to do those things that 

some of our attorneys are doing now to ensure that they are freed up 

for work that is absolutely necessary to the Board.

 We are also providing improved on-line legal research tools and an 

analytical framework to aid timely and correct decision production.

 We believe these measures will work to reduce the backlog and 

shorten the time it takes for a veteran to receive a fair, well-reasoned 

Board decision. This reduction in time is important and it is even 

more significant in light of the fact that 61.4 percent of the decisions

issued in fiscal year 2005 were final decisions as opposed to 58.7 percent of the decisions in fiscal year 1998.

 While our decision quality has modestly improved to 89 percent in 

fiscal year 2005, the complexity that comes from drafting more final

decisions, addressing the merits of the claim as opposed to remands 

for more development, is significant. Notably, the Board’s own time-
25

liness, our cycle time, stands at a little over three months.

 I wish to assure you that we will continue to work together with our 

partners in and outside the department to develop new and creative 

solutions to the challenges we face in order to fulfill our statutory

mission to hold hearings and provide timely, high-quality decisions 

to our nation’s veterans and their families.

 I look forward to answering any of your questions.

  [The statement of James P. Terry appears on p. 86]

The Chairman. Thank you very much, Mr. Terry, for your testimony.

 Secretary Aument, what is the time frame for addressing the quality of your ratings, the accuracy of the ratings, and the accountability 

at the regional office level?

Mr. Aument. Would you repeat the question, Mr. Chairman.

 The Chairman. What is your time frame for addressing these issues 

on quality of the ratings, the accuracy of the ratings, and the accountability at the regional office level?

Mr. Aument. I believe our time is immediate, Mr. Chairman. We 

have established quality performance standards for each of our directors and it is one of the driving forces of judging station performance, 

whether or not they are capable of hitting the challenging quality 

targets that we put out there for them.

 The Chairman. Well, you gentlemen were in here when the first

panel testified. And Dr. Jones’ testimony is very similar to that which

I have heard from others going through this process.

 Over the years, veterans have expressed that there have been -

- they just want to be treated well. I mean, they already gave for 

their country. They recognize that something is not right with their 

health. They might be in an economic plight when they are making 

the claim. And how they get treated in that process by their own 

country is pretty important.

 There are so many things that the VA does right that when you do 

things wrong like this, you should not be surprised at all when someone of Dr. Jones’ esteem says this is all a matter of attitude. Not all, 

but, you know, it is pretty important.

 This issue about quality. My opening statement was based on 

numbers that you gave at the Subcommittee hearing, and you gave 

numbers. And pretty soon everybody is talking about all these big 

numbers and then it is a quantity push.

 As I listened to Dr. Jones’ testimony, it is about quality. Here is a 

doctor who knows what happened to his body. He gets evaluated by 

someone who is not making right medical decisions.

 It would be pretty challenging, would it not, Mr. Secretary?

 Mr. Aument. Indeed it is, Mr. Chairman. And I was struck by Dr. 

Jones’ testimony as well. It troubles me when anyone comes away 
26

from our system feeling as though they have been treated unfairly 

and that they perceive that there is an attitude problem.

 I also heard Dr. Jones saying how he thought it could be made better and that the fact that we need to have more veterans and people 

who have the same experiences that Dr. Jones has gone through involved in the process.

 You know, I am proud to say that over half of the employees in our 

service centers are indeed veterans and among the recent hires that 

we have made is over 60 percent are veterans.

 I was also struck by Dr. Jones’ testimony in that it was very illustrative of just how complex this system has actually become. If 

it is difficult for an educated and seasoned individual like Dr. Jones

to navigate through the system, we just know how difficult it is for

veterans who do not have that same level of experience. It is very 

challenging for us, Mr. Chairman.

 The Chairman. Complexities create inherent limitations, do they 

not?

 Mr. Aument. Indeed they do.

 The Chairman. What would they be?

 Mr. Aument. The complexity imposed again demands that we pay 

more attention to each and every claim that we produce. There are 

many forms of complexity.

 For example, the number of issues that are involved in an individual claim. Many of the claims that we are seeing from recently 

discharged service members come through the Benefits Delivery at

Discharge Program. We have been seeing typically -- and it is somewhat anecdotal, the data -- but we have been seeing these with an 

average of ten or more issues per claim.

 And that places an enormous burden on those who are actually 

trying to develop those claims. It poses not only an issue for the 

Veterans Benefits Administration to develop those claims, but those

typically translate into different types of medical exams that have to 

be separately addressed.

 So complexity is an enormous challenge for us.

 The Chairman. How about you, Chairman Terry?

 Mr. Terry. I feel exactly the same way. I find that the case that Dr.

Jones described to be one of very great concern for us.

  In his particular case, he had five different major issues, a hearing

issue and a bilateral issue that was quickly taken care of. But he had 

other issues that were not properly developed and had to be returned 

for their development, one involving a very significant prostate issue.

 And it is that type of thing that it is very, very important that we 

get right. And while I am distressed by what he described because he 

described the situation where we did not get it right and -- 

 The Chairman. Getting the stuff right the first time saves a lot of
27

anxiety, a lot of work, man hours.

 Mr. Terry. I know that the judge that heard his case, Joy McDonald, who is the daughter of Admiral McDonald, who is probably someone the doctor knows, is greatly concerned about ensuring that we 

get it right. And that is why she sent it back so that there would be 

sufficient evidence so she could give a fair hearing on his problem.

 And while I regret that it took longer than any of us would have 

hoped or expected, we can only hope that we can do better in the 

future.

 I have been on board now about four months and I have been looking at each of the things that we do well and those that we do not do 

as well as we should in the Board. And when I see a case like Dr. 

Jones, my heart goes out because I served a long time myself, and I

know that those individuals in the Marine Corps who served with me 

and who were not given the kind of service we would all hope they 

would get when they came into our system should have been treated 

well. And in my view, we have not treated Dr. Jones as well as he 

should have expected. And we are going to try to do better.

 The Chairman. Are there doctors on staff at the regional offices,

both your regional offices and at the Board?

 Mr. Aument. We have none, Mr. Chairman. Incidentally, we employ a handful of doctors that are working in the Compensation and 

Pension Service to provide some professional guidance and direction 

within the Compensation and Pension Service. But at a typical regional office, you will not find a doctor, a physician.

 The Chairman. Those are here in D.C., the advisors?

 Mr. Aument. They are either here in D.C. or out-stationed, but 

they are connected to our central office component, yes.

 The Chairman. Who do they advise?

 Mr. Aument. They advise the Director of Compensation and Pension Service in the development of regulation changes. They work 

together in developing some of the requirements for medical exams, 

those types of advisory activities.

 The Chairman. Chairman Terry, do you have any -- 

 Mr. Terry. Whenever an individual is being seen for a specific issue that they have brought forward, of course our medical centers 

are available and our veterans are referred to the medical centers 

for their evaluation and for an examination which addresses each 

specific concern they might have.

 It is our hope that we have the kind of expertise that can render the 

kind of decisions which allow us to look fairly at a specific issue or a

specific problem and render a decision which is fair.

 As Dr. Jones described, apparently his experience was such that 

the person or persons who examined him were not in his view qualified to do so. I do not have that information before me, but I will

certainly look into it, I assure you.
28

 The Chairman. I have one more question, Mr. Udall, and then I will 

yield to you.

 We look at this from a Congressional standpoint as we do our oversight of the executive function. Sometimes it could even be simply, 

and say, well, if you have this backlog and you have these kind of 

problems, do we either need to throw more money at it or more people 

or both. We often do that.

 You pick any agency, your department, for example. We have done 

that over the years, even on our budgetary processes on this Committee, do we increase your FTE or not, or what do we give you in your 

budget? Do we add back in what you took away?

 So in your testimony, you say since 2000, you have had a 36 percent 

increase in your claims, but have you increased your staffing, your

FTE at the same time?

 Mr. Aument. We have not increased staffing in absolute terms, Mr.

Chairman. But, I believe, part of the challenge to us as managers 

and leaders in the organization is to make sure that we are using the 

resources that you provide us as wisely as possible.

  We have directed over the course of that time interval more staffing

to the direct work done by the people at the regional office working

in our staffing centers. In some cases, we have done this by reducing

management overhead staff and, in some cases, trying to balance the 

staffing that is applied to some of the other business lines that VBA

is responsible for administering.

 But I agree with you that there is no simple answer by just throwing money at the problem. If you were to tell me today to go out and 

hire an additional thousand staff throughout the system, we would 

not see results that are going to immediately change things around 

because, again, we have to have competent, skilled, trained staff in 

the right positions.

 And I think the key for us is making sure that we provide them the 

right training, the right tools, and provide the right oversight on the 

system to make sure that things are being done uniformly and accurately across the system.

 The Chairman. Chairman Terry, when we submit our budgetary 

estimates, adding additional, for example, on FTE, it is dependent on 

the appropriators following suit. 

 Would that help you? Is that something we should be looking at?

 Mr. Terry. More resources are helpful to every organization. There 

is no question about that. We are looking at the many efficiencies we

can utilize this year to accomplish the mission within our budget that 

has been provided by the administration.

Certainly we are mindful that every department, every organization needs more resources. And we are also mindful, and I especially 

have been in government 38 years, sir, I know that when our secretary advocates strongly before OMB and OMB gives us what they 
29

give us, that is what happens. And we will work within that budget. 

We will do the very best we can, sir. We are mindful that it takes 

people to manage the system.

 We are also mindful, though, that eliminating avoidable remands, 

better training for our people, working more closely with VBA, working very closely with the Veterans Health Administration, and setting 

up better programs to examine our folks with protocols that actually 

are consistent each time so that, for example, in PTSD, we have the 

type of examination that allows us to be consistent.

 These are the kinds of things that will make a great difference for 

us. And we will certainly do that. I commit to you that we are. We 

are doing that right as we speak.

 The Chairman. As you formulated your budget, did you make a 

request for increases in your FTE?

 Mr. Terry. Sir, I can just tell you that our authorization for 2007 

is going to be 444, we believe. We are at 434 right now. We are 

certainly appreciative of whatever support we receive. And we are 

certainly aware that the administration is supporting us to the extent certainly that they can with the other priorities we have in this 

government.

 We are mindful of our responsibilities. We are trying to write 

shorter and more concise decisions. We are trying to get our people 

to do more with what we have and we will continue to do that.

 The Chairman. Secretary Aument.

 Mr. Aument. As far as 2007, as the Chairman knows right now, we 

are still in the predecisional phases of the 2007 budget process. I am 

not really at liberty to discuss what we have requested either from 

OMB or from the administration.

 I can tell you that we have committed this year to trying to make 

sure that we honestly and accurately tell the decision makers on the 

budget what we believe a certain level of resources is going to buy 

in the way of performance. And we have shown an array of options 

as to what performance to expect given the resource levels that are 

ultimately approved.

 Frankly, we would probably be happy. We believe that we can put 

a considerable dent into the backlog and into the current pending 

volume of claims if we sustain ourselves at the resource level that we 

have been given for the 2006 budget year.

 The Chairman. Let me try it this way. Do you anticipate an increase in your FTE or a decrease in your FTE in 2007?

 Mr. Aument. I don’t know what to anticipate, Mr. Chairman. As I

said before, the -- 

 The Chairman. All right. It is Christmas. What are you looking for 

in your Christmas package?

 Mr. Aument. Well, we would always use some additional staff under the tree under those scenarios, Mr. Chairman.
30

 The Chairman. Getting comfort with that.

Mr. Udall.

 Mr. Udall. Thank you, Mr. Chairman. That is one way to approach it, I guess.

 Secretary Aument, you point out in your testimony that the workload for original claims has increased by 25 percent over the last two 

years and reopened claims increased by two to three percent each 

year.

  Staffing has not increased as the Chairman has just pointed out.

It has not increased by the same amount. And as of September 30th, 

the VA had 173 fewer employees in regional offices to handle compensation and pension claims than on September 30th, 2002.

 The VA Inspector General reported earlier this year that regional 

office staff felt that they were not adequately staffed to provide accurate and timely decisions on claims. Unfortunately, the recently 

approved budget does not include a recommendation for an increase 

to meet the need.

 Isn’t the rising claims and appellate backlog due in part to insufficient staffing to make quality decisions? Since the average number of claims per case has increased, should VA revise its production 

standards?

 Mr. Aument. I see no reason at this point to revise our production 

standards. It is certainly our expectation, and I would assume it is 

the expectation of this Committee as well, that we expect our staff to 

become more productive, that I think it is a reasonable expectation 

that we provide training and tools to make staff gain productivity 

each and every year.

 With the 2006 budget that the Congress has given us, we are going to be able to put between 300 and 350 more staff into the compensation and pension claims process throughout the system in our 

regional offices.

  So we are confident that we are going to be able to increase the

staffing levels in 2006. And we believe that with those additional

resources we are going to make some real inroads on the backlog.

 Mr. Udall. So your answer to the question on rising claims and 

appellate backlog due in part to insufficient staffing, you would say

yes or no on that?

 Mr. Aument. Well, I would say right now that the rising workload 

speaks for itself, that the workload from 2003 to 2004 increased by 

five percent, from 2004 to 2005 by an additional three percent.

 We do not have the best way of looking at that and making future 

predictions, but it is certainly our hope and expectation that that 

workload is going to level off.

 But, again, we have more resources at our disposal this year. We 

believe that we can make some inroads on the backlog.

 Mr. Udall. I am also very concerned about the ratio of employees 
31

at regional offices to the pending workload. It appears that some offices, such as Salt Lake City, have twice as many employees as other

offices, such as New York City, to handle a comparable caseload.

  Is the VBA’s policy of starving poor performing offices and feeding

better performing offices contributing to the degradation of services

in some parts of the country?

 Mr. Aument. I do not believe so, Congressman. You are absolutely 

correct that we have been utilizing a resource model over the last several years that tends to push resources out to those offices that have

proved to be most productive in using those resources. And quite 

often that has resulted in some downsizing of some of the offices in

our larger urban areas.

 We have tried to counterbalance that impact because we do believe 

that is the best use of those resources, sending them where they are 

likely to be most productive. We have tried to counterbalance that by 

making sure that we make workload adjustments as well and move 

workload around so as not to penalize the veterans in those offices’

jurisdiction. But we do believe it makes the most sense to send the 

resources where they are going to be best used.

 Mr. Udall. Chairman Terry, veterans who requested a hearing 

before the Board waited an average of 607 days in 2005. I find that

waiting time unconscionable. We need to look at the time line from 

the perspective of veterans like Dr. Jones who are waiting for a decision.

 Mr. Chairman, I would like to include a copy of the elapsed processing time for fiscal year 2005 into the record, two sheets here.

Chairman Terry, are you familiar with this document?

 Mr. Terry. I am, sir.

The Chairman. All right. This will be entered into the record. No 

objection.

 Mr. Udall. Thank you.

  [The attachment appears on p. 65]

 Mr. Udall. And during a Subcommittee hearing earlier this year, 

Acting Chairman Garvin testified that the Board had adequate staff

to do its job. Now it appears that veterans who seek Travel Board 

hearings or video hearings may be waiting almost two years for a 

hearing. For decisions made last year for claims from the New York 

regional office, veterans waited over five years for a Board decision.

 How many additional staff and travel funding would be needed to 

provide veterans with a hearing within three months after the claim 

is certified to the Board as ready?

 Mr. Terry. Thank you for the question, Mr. Udall.

 Let me tell you how the Travel Board system works and it will help 

explain what we are trying to do to ameliorate the problem.

 As soon as a case is prepared and in VACOLS, which is our track-
32

ing system, we learn that this individual is awaiting a hearing, we 

arrange for a Travel Board to go to one of our 57 ROs. We have 106 

Travel Boards scheduled for this coming year. On Travel Boards, 

each judge on that Board will hear 43 cases a week.

 And so consequently, if you have two judges or three judges, it will 

be 43 times three or times two, whatever it is, but we will make allowances for additional Travel Boards as the cases become ready. As 

soon as a case is posted in our VACOLS system as being ready, we 

arrange for a Travel Board to take care of that particular docket.

 So while I agree that the system takes far too long from the standpoint of our Board when a docket is ready to go and when the VSOs 

have gotten their clients ready and have provided the representation 

of the clients and are ready to go, then that case is listed as ready on 

the docket. When we have 43 cases ready, that provides a docket for 

one judge to go out and handle those cases.

 We do it on a continuing basis, sir. I recognize those times are 

extremely long.

 In the preparation of a case in our system, which is open until the 

final decision is made, any new evidence can come in at any time.

This causes some delays and raises new issues. It may require new 

examination. It may require that we reinvestigate or get additional 

documents or data from the different medical facilities where the individual was previously treated or it may involve records from years 

before.

  Dr. Jones testified that he first applied in 1999. This is an individual who came into the service in 1950. We are dealing with records that are extremely old. We are trying to get everything we can 

to make decisions which really are helpful to the individual and that 

represent the complete database which represents his case.

  I admit when we look at these figures, we are distressed as well and

we are trying to shorten them to the extent we can.

 From the Board’s perspective, when we get a docket that is ready 

to go, we get a team out there to hear it. And we are very concerned 

about that.

 Mr. Udall. Now, you have given a good explanation in terms of 

how you handle it. But what I am trying to get at is if you have years 

that people are waiting, veterans are waiting, can you give me any 

idea today how many additional staff and travel funding would be 

needed to provide veterans with a hearing within three months after 

the claim is certified? Rather than waiting five years as the example

I gave or the two years, in three months, do you have any idea?

 Mr. Terry. Sir, I can only tell you that when a docket is ready to go, 

we have the people available now to get out and hear those dockets 

and provide a hearing for these individuals. And we will continue to 

do that.

 As I pointed out to you earlier, sir, we are part of an administration 
33

and the administration produces a budget each year. And we are 

determined to do within the resources that we have the very best job 

for each of our veterans that we can. And I make that commitment to 

you as Chairman of the Board.

Mr. Udall. I do not understand why it is taking five years --

 Mr. Terry. I don’t believe -- 

 Mr. Udall. -- in the New York regional office.

 Mr. Terry. In most cases, sir, it is not. I can tell you that. It really 

is not.

  For example, in Dr. Jones’ case, he filed his claim in late 1999. As

I recall, he had a hearing that he requested after the rating decision 

was made and after the Notice of Disagreement was filed. He had a

hearing, I believe, in 2002, but I do not believe that was too long after 

the Form 9 was filed. So we will have to take a look.

 Mr. Udall. Well, I believe the record that has been put into the file

shows the significant amount of time that is occurring. And I still do

not understand it.

 But I yield back, Mr. Chairman.

 The Chairman. Ms. Herseth, you are recognized.

 Ms. Herseth. Thank you, Mr. Chairman. I apologize to you and to 

the witnesses for not being here earlier. We had a markup in another 

Committee on which I sit. I know our witnesses are familiar with 

how that goes as are other Members of the Committee.

 And I look forward to reviewing your responses to the questions 

that my colleagues I am sure posed here in the last hour or so addressing the issues, some of which were raised by Dr. Jones, and trying to find the way that we work together to alleviate the backlog,

make this more timely for our veterans.

 And I know that the hearing is focused today on disability claims, 

but if I might, Mr. Aument, talk a little bit about the pensions.

 As you know, the pension services have been consolidated from the 

57 regional offices to three of the Pension Maintenance Centers.

 Now, I am starting to hear complaints from my constituents that 

the quality of the work at the PMCs is not nearly as good as the 

work done at the regional office. Part of this trend that we have seen

today, that we have seen in the past, that the further away you get 

from the local level, the less responsible perhaps the service that is 

being provided.

  The turnaround for awarding claims at the regional office was 30 to

60 days and the turnaround for awarding claims at the PMCs in St. 

Paul is more than six months.

 In addition, my constituents are too often asked to resend pension 

claim information to the PMC or, worse yet, the original correspondence is simply lost. Now, these are problems that occurred much 

less frequently when the work was done by the regional office.

  So I am wondering first why have the pension services been con-
34

solidated and is there a benefit to the consolidation of the pension

services besides reducing cost, if that indeed has actually been realized, and have you heard any similar complaints from other parts of 

the country?

 Mr. Aument. Congresswoman, I understand that some of the veterans in your state have voiced those concerns. I have seen some of the 

letter traffic on that and I do understand that there are concerns.

  Sioux Falls happens to be a very good office. And we find that we

have some of our best offices out in the heartlands of the country

where they have some of the most stable workforces. Those are some 

of the best performing offices in the country.

 Now, having said that, I do believe that the consolidation of our 

pension operations is the right thing to do. The intention here is to 

achieve both qualitative and quantitative benefits of productivity and

improved quality.

 Our pension claims are some of the most complex claims and some 

of the most error-prone claims in our system. And some of the expected benefits that we believe that we are realizing from the consolidation of these pension efforts will accrue not only to the pension 

program, but to the disability compensation program as well.

 This type of consolidation effort relieves us of some of the training 

that we would otherwise have to conduct for new staff coming into the 

system at the 57 different offices.

 So we believe that it is the right thing to do in order to make the 

best use of the resources.

 Ms. Herseth. But if I might, what are some of the benefits that you

think have been realized or will be realized with consolidation other 

than saving cost?

 Mr. Aument. We believe it is going to be improving quality as well 

at a national level.

 Ms. Herseth. And you mentioned that you saw some of the letter 

traffic coming from my constituents who it seems are being penalized

because they have got great folks out of the regional office who have

done a great job for them.

 And you just responded to Mr. Udall’s questions about getting resources to those areas that are efficiently using those resources. And

I know that there are some differences there.

  Have you seen letter traffic in other parts of the country, in other

districts where it suggests that veterans themselves are realizing the 

benefits from the consolidation?

 Mr. Aument. Not really. This concern with the pension consolidation is largely confined to the Sioux Falls area from what we have

been hearing.

 Ms. Herseth. But my question is, have you seen letter traffic suggesting that veterans feel in other parts of the country that they are 

being better served by the consolidation?
35

 Mr. Aument. Well, we rarely see that type of traffic where people

are writing to us -- 

 Ms. Herseth. Thanking for -- 

 Mr. Aument. Yes.

 Ms. Herseth. I have seen the correspondence thanking them for 

the timely handling -- 

 Mr. Aument. What I am saying pertains to the pension maintenance operations, which is the part of the pension programthat today 

has been consolidated.

 Ms. Herseth. Okay. And you have not seen any other letter traffic

in any -- 

 Mr. Aument. No, I have not.

 Ms. Herseth. -- other district like that that you have seen in South 

Dakota with folks that used to get timely service, but now are realizing significant delays?

 Mr. Aument. No, we have not, Congresswoman.

 Ms. Herseth. Okay. Thank you.

 I yield back, Mr. Chairman.

 The Chairman. I am going to turn to the Social Security Administration for a second.

 All of the members here in the House and in the Senate have caseworkers who deal with our constituents on Social Security Disability 

claims. We do everything we are supposed to do to help them in that 

process. The Social Security Administration stays in touch with our 

offices via computer, lets them know how the claim is going, and what

is happening. You do not do that with any of our offices.

 Would you consider taking a look at what the Social Security Administration does with regard to how they interct with all of our congressional and senatorial offices to help our staff as they also assist

these veterans on appeals? Would you please consider looking at 

that?

 Mr. Aument. Absolutely, Mr. Chairman. We certainly will. We 

will take that one on.

 The Chairman. All right. Thank you.

 Over the last ten years, the department has spent at least 600 million on VetsNet. What measurable outcomes have resulted from this 

investment, what other IT initiatives are underway at VBA, and at 

what projected cost?

 Mr. Aument. Okay. The $600 million figure having been spent on

VetsNet covers quite a bit of territory, Mr. Chairman. It includes not 

only money spent on the development of the application for Vets Net, 

but the purchase of desk top computers throughout the system, email systems, local area networks, actually putting any of the equipment it needed in place to facilitate day-to-day operations.

 It includes the amounts that have been spent in support of the 

Loan Guarantee Program, which is probably one of our most highly 
36

evolved technological business lines in VBA. So it covers quite a bit 

of territory.

 The VetsNet, if I could focus more particularly on the application of 

VetsNet, I will talk about that just for a moment.

 Really the heart and core of the VetsNet endeavor is to get ourselves 

off of the old Legacy payment system and better poise ourselves to become more modern in the future and adopt some of the practices such 

as Social Security and some other organizations have today.

 There are four primary applications that constitute the VetsNet 

suite of applications for the disability compensation and pension process.

  The first is the application used in support of development activities called Map D. That is currently in use at every office throughout

the country, 57 regional offices.

 The second application component is the RBA 2000 application. 

That supports the rating activity. That as well is in use at every office around the system.

 The last two components that are needed to get off of the Legacy 

system are the award component where they actually put the award 

made by the raters into place and the back office finance and accounting system component. Those are still in some stage of development, 

but are being tested at both our Lincoln and our Nashville offices.

  We believe that there have been good benefits that have accrued

from the first two components and we expect to see benefits from

the third. Productivity benefits are expected, for example, from the

award piece.

 Right now, as you are probably aware, many of our awards include 

some type of a retroactive component where a veteran has filed a

claim and the effective date may go back to some years in the past. It 

often requires some very complex calculations that can take an experienced authorizer some hours to compute.

 The VetsNet Award component will compute that automatically 

and it is going to be considerably more accurate as well. It is going to 

eliminate opportunities for errors.

 We have some built-in security features that will go along with 

Award that are going to be putting some computerized controls in 

place for large awards of over $25,000, that we believe are going to be 

reducing our vulnerability to any type of fraud.

 And we believe that there have been productivity achievements associated with the first two applications as well.

 The RBA 2000 application is going to give us a wealth of data that 

we can use to learn more about the nature of our claims, help us 

discover where we most need training, and discover errors. So we 

believe there are considerable benefits associated with it.

The Chairman. Let me ask a question of Chairman Terry with regard to this new evidence issue.
37

 You know, when you think about how we practice law out there and 

if the appellate courts on appeal, something comes up, obviously they 

remand it back for a new trial if the new evidence is substantial and 

material to the findings.

 We are going through an administrative process and if there is 

one piece of paper missing, you have got to remand the whole thing 

back.

 Have you ever considered whether or not we should change that 

at all or these are judgments that we can go ahead and make at the 

appellate level or -- 

 Mr. Terry. We are trying very hard to do just what you have indicated. We have a waiver process which we put in place through a 

Chairman’s memorandum earlier this year -- 

 The Chairman. Good.

 Mr. Terry. -- which basically provides us the opportunity to go to 

the veteran and say your case is in hearing. You provided this new 

information. Would you let us handle it and consider it during the 

litigation of the case rather than sending it back to the agency of 

original jurisdiction.

 Normally under our regulations, unless waived, it would have had 

to have gone back and start the process all over again, having the 

regional office take another look at it.

 This gives the veteran an opportunity to give us the chance to consider it at the appellate level and handle a claim. It is a very successful program.

 The Chairman. That is great.

 Mr. Terry. And it is just one way we are looking at the program 

and the process to try to make it more streamlined and give the veteran a better shake.

 The Chairman. Can you share with us a copy of that decision of 

what you have made?

 Mr. Terry. I will provide a copy of that memorandum, sir.

  [The information is found on p. 167]

 The Chairman. Yes. I would like to see that.

 What impact has that had on your remand rate?

 Mr. Terry. I think it certainly has helped. As you know, we went 

down from last year 56.8 percent to 36 or -- I think it is 38 percent 

last year. And the first two months of this year, we are down to 32.1

percent, sir. So we are looking at a lot of different things to help the 

process. This is one of those.

 The Chairman. All right. Congratulations, Chairman. That is very 

good.

 Any other questions of the panel?

  [No response.]
38

 The Chairman. All right. Gentlemen, thank you very much for your 

testimony.

 The second panel is now excused.

 The Chairman. Mr. Secretary, Mr. Chairman, I know you are really 

anxious to leave and get out of here. Would you mind listening to the 

oral testimony of the VSOs and then take off? Would that be okay? 

Our next panel is comprised of veteran service organizations. They 

have spent thousands of hours out there helping a lot of our veterans. 

And if you hear something that might be helpful to you -- okay? I appreciate you staying.

 If panel three will please come to the table.

 Representing The American Legion today is Mr. Donald Mooney. 

Mr. Mooney is the Assistant Director for Resource Development, Veterans’ Affairs and Rehabilitation Commission at The American Legion.

 Prior to his current position, he served as the 9th appeals representative team leader at the Board of Veterans’ Appeals in Washington, 

D.C.

 Mr. Mooney entered the United States Air Force in 1967 and as a 

result of his military service, he received the Air Force Commendation Medal, the Air Force Good Conduct Medal, Presidential Unit Citation, Outstanding Unit Ribbon, National Defense Service Ribbon, 

and the Vietnam Service Medal. 

 Representing AMVETS today is Mr. James Doran, the National 

Service Director of AMVETS. He joined AMVETS as the National 

Service Director on March 10, 2003. As the National Service Director, he oversees the operation of 44 AMVETS service offices located in

30 states and the District of Columbia.

  His staff of 61 provides assistance to veterans in filing claims for

benefits with the Department of Veterans Affairs. He also coordinates with many state departments, Veterans Affairs, and county 

veterans service offices nationally.

 He served in the United States Navy from January 1963 to 1983. 

His military awards include the Navy Commendation Medal for Heroism, the Combat Action Ribbon, the Navy Achievement Medal, and 

a number of other awards and decorations.

 Representing the Disabled American Veterans is Mr. Brian Lawrence, the Assistant National Legislative Director. Mr. Lawrence is a 

service-connected disabled veteran of the Persian Gulf War. He was 

appointed the Assistant National Legislative Director of the millionplus Disabled American Veterans in August of 2000. He is employed 

at the DAV National Service and Legislative Headquarters in Washington, D.C.

 We also have Mr. Blake Ortner representing the Paralyzed Veterans of America. Mr. Ortner is the Associate Legislative Director of 
39

PVA’s national office in Washington, D.C.

 A native of Moreland, Minnesota, he attended the University of 

Minnesota in Minneapolis on an Army Reserve Officer Training

Corps Scholarship. He graduated in 1983 with a degree in International Relations, commissioned as a regular Army infantry second 

lieutenant.

 While stationed at Ft. Lewis, Washington, he served with the 9th 

Infantry Division in the Army’s elite Second Ranger Battalion. He left 

active duty in September of 1987, and continues his military service 

as an infantry lieutenant colonel in the Virginia National Guard.

 In 2001, he served a nine-month deployment as part of S4-10 peace 

keeping mission to Bosnia and Slavenia. He returned in July of 2005 

after a year of commanding the Infantry Battalion Task Force in Afghanistan.

 Finally, representing the Veterans of Foreign Wars we have Mr. 

Kinderman, the Deputy Director of the National Legislative Service. 

Mr. Kinderman served in the United States Army during the Vietnam War, including 13 months with the 25th Infantry Division in 

Vietnam.

 Well, I thought there was going to be some more, but that is it.

Mr. Kinderman. That is enough, sir.

 The Chairman. Is that enough? I am sure there has got to be a lot 

more good stuff there.

 I appreciate the Deputy Secretary and Chairman for staying. They 

are going to be here for your testimony. And then, gentlemen, if you 

have to leave, I understand. But they represent organizations who 

have put in a lot of time and effort on behalf of a lot of our comrades. 

And I appreciate you being here to listen to their testimony.

 With that, Mr. Lawrence, you are now recognized.

STATEMENTS OF BRIAN E. LAWRENCE, ASSISTANT NATION-

 AL LEGISLATIVE DIRECTOR, DISABLED AMERICAN

VETERANS; DONALD L. MOONEY, ASSISTANT DIRECTOR

 FOR RESOURCE DEVELOPMENT, VETERANS’ AFFAIRS AND

 REHABILITATION COMMISSION, THE AMERICAN LEGION;

JAMES DORAN, NATIONAL SERVICE DIRECTOR, AMVETS;

 BLAKE ORTNER, ASSOCIATE LEGISLATIVE DIRECTOR,

 PARALYZED VETERANS OF AMERICA; AND QUENTIN

 KINDERMAN, DEPUTY DIRECTOR, NATIONAL LEGISLA-

 TIVE SERVICE, VETERANS OF FOREIGN WARS

STATEMENT OF BRIAN E. LAWRENCE

 Mr. Lawrence. Thank you, sir.

 Mr. Chairman, and members of the Committee, on behalf of the 1.3 

million members of the DAV, thank you for the opportunity to submit 
40

our views on the challenges and opportunities facing the VA disability claims processing system.

 As mentioned in my written statement, my perspective of the claims 

system is based on my tenure as a DAV NSO and also as a medical 

retired veteran with a service-connected claim.

 I saw a news article this morning that I thought was somewhat 

analogous to one of the problems I described in my testimony. The 

news story was about an emergency call to 911 that led to a tragedy. 

The tragedy occurred because the 911 operator took it upon herself 

to decide that the situation the caller described was not a true emergency. She refused to notify the police and a woman was murdered 

as a result of the operator’s complacency.

 Though the operator probably deals with dozens of calls in which 

circumstances have been overblown, personal judgment should not 

override protocol. As frustrating and irresponsible as useless calls 

to 911 may be, the greater outrage occurs when a legitimate call is 

disregarded by a bureaucrat who acts as a self-appointed judge.

 There are some VA employees who are also self-appointed judges. 

In some instances, I knew of situations where VA adjudicators would 

deliberately deny disability compensation claims, both increases and 

the establishment of service connection, based on their misperceptions rather than the evidence available or the controlling regulations.

 Never once was I aware of such an individual losing his or her job 

despite repeated blatant denials in the face of qualifying evidence. 

Rather, justice usually had to be sought at the next higher level, the 

BVA.

 Though the claims backlog does not exist solely because of it, elimination of this type of attitude would eliminate a lot of duplicated work. 

This can be accomplished through training and accountability.

Competent quality reviewers should review a random sample of 

work from each adjudicator and remedial training should be imposed 

when deficiencies are revealed.

VA leadership must enforce accountability through a willingness to 

replace individuals who are not succeeding.

 An effective training program requires knowledgeable and experienced instructors who have the time necessary to devote to their 

jobs.

 Accomplishing these objectives will require adequate resources 

which are essential to an efficient and effective benefits delivery system. Adequate resources will allow the VA to develop a training program to increase proficiency of existing adjudicators and bolster staff

to levels that allow for a reasonable amount of time to thoroughly 

develop and deliberate on compensation claims.

 The VA cannot overcome the problems it is facing without these adequate resources. Therefore, sir, we urge the Committee to consider 
41

the recommendations and funding levels presented in the Independent Budget.

 Mr. Chairman, this is the gist of my written statement, and I will 

be happy to answer any questions that are more specific.

The Chairman. Mr. Lawrence, do you offer your written statement 

for the record?

Mr. Lawrence. Pardon me?

The Chairman. Do you offer your written statement for the record?

 Mr. Lawrence. Yes, sir.

The Chairman. Hearing no objections, so entered.

  [The statement of Brian E. Lawrence appears on p. 102]

 The Chairman. Mr. Mooney.

 Actually, all of you, if you have written statements to submit, do 

all of you?

  Everyone answers in the affirmative. Therefore, your written

statement will be offered into the record. And you may present a 

five-minute oral summary.

 Mr. Mooney, you are now recognized.

STATEMENT OF DONALD L. MOONEY

 Mr. Mooney. Mr. Chairman, thank you for this opportunity to present The American Legion’s views on the challenges and opportunities 

facing VA disability claims processing in 2006.

VA has the responsibility to ensure the welfare of the nation’s veterans, their families, and survivors. Providing quality decisions in 

a timely manner will continue to be one of VA’s most daunting challenges in 2006 and beyond.

 I also have a litany of statistics which I will forego for the sake of 

brevity. But of the 763,000 determinations in fiscal year 2005, VA is

expecting three and four percent increases in 2006 and 2007 respectively, amounting to 826,000 claims in 2006 and 842,000 in 2007. If 

this trend continues, and there is no reason to believe it won’t given 

the ongoing war on terror, VBA will be swamped by over a million 

claims by fiscal year 2009.

  It is clear to The American Legion that current staffing and proficiency levels, VA backlog and processing time will only worsen.

 Additionally, following much media attention, a report by VA’s Inspector General, a provision in the “Enacted Military Quality of Life 

and Veterans’ Affairs Appropriations Act” for 2006, requires VA to 

conduct outreach to veterans in states with average annual disability 

compensation payments at less than $7,300.

 While we agree that it was necessary to cure inequities in the system, this, too, will add to VBA’s backlog.
42

  Whether simple or complex, VA regional offices are expected to consistently develop and adjudicate claims in a fair, legally proper, and 

timely manner. The challenges that BVA faces in 2006 in meeting 

these workloads are in staffing levels, training, and quality of decision making.

  The adequacy of regional office staffing has as much to do with the

actual number of personnel as it does with the training and competency of the staff.

VBA has lost much of its institutional knowledge base over the 

past four years because of the retirement of many of its 30 plus year 

employees. As a result, staffing in most regional offices is now made

up largely of trainees or employees with less than five years of experience.

  Concern over adequate staffing in VBA was addressed by the VA IG

in the same report, specifically recommending in view of growing demand the need for quality and timely decisions and the ongoing training requirements that VBA reevaluate human resources and ensure 

that their field organization is adequately staffed and equipped.

  Additionally, the Chairman of the Veterans’ Disability Benefits

Commission questioned the Under Secretary for Benefits about the

adequacy of current staffing levels at a meeting this past July. The

Under Secretary conceded that the number of claims’ workers has 

decreased over the past three years.

 The American Legion believes it is an extreme disservice to veterans, not to mention unrealistic, to expect VA to continue to process an 

ever-increasing workload while maintaining quality and timeliness 

with fewer staff.

 Over the past few years, The American Legion’s quality review 

team has visited almost 40 VA regional offices to assess overall operations, including reviews of recently adjudicated claims where The 

American Legion held Power of Attorney.

 Our site visits found that frequently there are too few supervisors 

or inexperienced supervisors to provide trainees mentoring, training, 

and quality assurance. At many stations, ongoing training for new 

hires as well as more experienced staff was suspended to focus maximum effort on production.

 That being said, we are encouraged by the Under Secretary’s public 

commitment to improve the training of VBA personnel, and we look 

forward to improvements in this area in 2006.

 For years, The American Legion has stated that the imperative in 

VA claims processing has been to process as many claims as possible 

as quickly as possible. The IG acknowledged that because the VA

often does not take the time to obtain all relevant evidence, there is a 

good chance that these claims are not properly developed, leading to 

premature adjudications, improper denials, under-evaluation of disabilities, and inconsistent decisions.
43

 The pressure on VA leadership to reduce a growing claims backlog 

and provide timely decision is often at odds with efforts to maintain 

or improve the quality of decision. Setting realistic production goals 

that take into consideration the number of cases and increasing complexity must be accomplished if VA is ever to reach a balance between 

production and quality.

 That concludes my statement, Mr. Chairman. I will be glad to answer any questions.

  [The statement of Donald L. Mooney appears on p. 91]

 The Chairman. Thank you, Mr. Mooney.

 Mr. Doran.

STATEMENT OF JAMES W. DORAN

 Mr. Doran. Mr. Chairman, Mr. Udall, on behalf of AMVETS National Commander, Edward W. Kemp, I would like to thank you for 

the opportunity to present testimony to this Committee.

 For almost 60 years, AMVETS has represented the needs of the 

American veteran, working with this Committee and the Department 

of Veterans’ Affairs to ensure that those needs are met.

 It is my unfortunate duty to report to you that in our opinion, those 

needs are not being met, not by the Department of Veterans’ Affairs, 

not by the Congress, and not by this Committee.

  As of 26 November, the Veterans’ Benefits Administration reports

that 117,766 claims have been pending for more than 180 days. That 

is almost 20,000 more claims pending than at this same time last 

year.

 There are, of course, reasons for that: Budgets that cannot stretch 

to meet the needs of the VBA; experienced employees retiring and 

being replaced by novices requiring years of training; and the Global 

War on Terrorism.

 However, none of these reasons are pertinent. General of the Army 

Bradley summed it up in 1947 when he said “we are dealing with 

veterans, not procedures, with their problems, not ours.” That has 

not changed.

 The Department of Veterans’ Affairs is tasked with dealing with 

the problems our veterans have, physical, emotional, financial, and

educational. Everything else is secondary in nature.

 The key issues that you are interested in are the challenges and the 

opportunities facing disabilities claims processing. The challenge is 

simple. How can VA adequately process disability claims with the 

funds they have been given? The answer is, they cannot.

 If you, the members of Congress having oversight over the department, cannot get them the funding they need to fully staff all VBA

benefits offices and regional offices, then VA will never be able to do
44

its job to the best of its ability.

 If VBA is going to reduce the claims backlog to zero, if VBA is going 

to have to process over three-quarters of a million claims per year, if 

VBA is going to deal with veterans and their problems, you need to 

do your part. You need to get them the funds they need to hire additional full-time employees.

 The opportunities are heavily keyed into the challenges. The funding for and creation of additional full-time equivalent employees for 

the VBA should provide additional employment opportunities for our 

veterans.

 Unfortunately, as of the most recent data published on the VA web 

site, only 27 percent of all DVA employees are veterans preference 

eligible. That is not something to be proud of. This is the United 

States Department of Veteran Affairs. The majority of all of their 

employees should be veteran preference eligible.

 An even more important issue within the veteran community hinges on partisan politics and trust. No one asked us which party we 

belonged to when you sent us off to war. Playing partisan politics 

with our lives now is inexcusable.

  This Committee needs to go on the floor with one face, not split into

party factions. As members of the House, you represent Congressional districts and political parties. As members of this Committee, 

you represent all American veterans.

 On Veteran’s Day, the Secretary announced that a pending review 

of 72,000 approved disability claims for PTSD had been cancelled. 

This announcement was highly publicized and joyfully received by 

the veteran community.

 On 27 November, we found out that less than a week later, the 

Secretary requested that the Institute of Medicine conduct a review 

of posttraumatic stress disorder diagnosis and treatment within the 

DVA.

 Is the IOM a recognized authority on posttraumatic stress disorder? 

Looking at the members of their Committee that may be assigned this 

task, I find there are no military physicians, no DVA physicians, no

individuals with any apparent background in combat-related PTSD.

 One member of the Committee did serve on the task force that 

wrote the DSM-IV. However, he specialized in eating disorders.

  A 27-member task force worked five years to develop the DSM-IV

in a process that involved more than 1,000 psychiatrists and other 

mental health professionals. Now Secretary Nicholson wants IOM to 

reexamine and repudiate the validity of this publication. Why?

 A second Committee will review, among other items, the compensation practices for PTSD and the criteria for establishing the severity of PTSD as published in the VA Schedule for Rating Disabilities. 

Again, I ask why? Isn’t this part of the mandate you have given the 

Veterans’ Disability Benefits Commission?
45

  If the goal is to find ways to reduce the amount of money spent

on veterans’ disability compensation, all you need to do is ask us. I

can tell you without reservation that the only way to effectively reduce that expense is to stop committing our young men and women 

to combat.

 In the meantime, you as members of the Congress of the United 

States have a constitutional duty to raise and support armies, to provide and maintain a Navy, to provide for calling out the militia. We, 

the veterans you created, are a part of that cost, and the bill is fast 

becoming past due.

 That concludes my statement, Mr. Chairman.

  [The statement of James W. Doran appears on p. 99]

 The Chairman. Mr. Ortner, you are recognized.

STATEMENT OF BLAKE C. ORTNER

 Mr. Ortner. Mr. Buyer, Mr. Udall, on behalf of Paralyzed Veterans 

of America, I would like to thank you for the opportunity to testify 

today on the challenges and opportunities facing the Department of 

Veterans’ Affairs as it processes disability claims in 2006.

  PVA maintains a Veterans’ Benefits Department with offices across

the country which provides assistance and representation at no cost 

to veterans seeking health care and benefits for which they are eligible.

  Our service officers undergo extensive training, including on-thejob training, prior to being released to assist PVA members, their 

families, and other veterans.

 To properly address the issues today, we contacted our national 

service officers and asked for comments. Their responses focus on

four themes. Timeliness and accuracy of ratings decisions and training and accountability of VA claims adjudication personnel. These 

are not new issues and we find it disconcerting that the same problems are continuing.

  The most important concern voiced by our service officers was accuracy of ratings decisions. This problem is not new.

 Following the VA Claims Processing Task Force recommendations 

in October 2001, VA placed added emphasis on reducing the claims 

backlog.

 PVA believes that the accuracy of decisions was negatively impacted by the race to cut the pending workload. Our NSO’s stated that 

VA is concentrating more on the backlog and not on the quality of the 

decisions.

 Furthermore, the VA continues to recognize effectiveness of regional offices through the workload that it completes and not through

quality decisions. Some service officers believe that it is less punish-
46

able to make a wrong denial than to make a wrong award of benefits.

And this is unacceptable.

  However, this is not a universal theme. Some of our officers explained their offices seemed to be operating slower than others because of an effort to ensure that a veteran receives more accurate decisions. Quality decisions should trump expediency. But this cannot 

be used as an excuse for a large backlog.

 Timeliness continues to be a challenge. As you indicated in your 

opening statement, Mr. Chairman, a large percentage of claims have 

been pending for over 180 days. It is unacceptable for veterans to 

wait so long to receive benefits they have earned.

  And, in fact, our service officers indicated that the time it takes to

develop claims seems to be getting longer. They recommended that 

VA create a fast track for claims that have the information necessary 

for a rapid ratings decision.

 Another issue is the time it takes in many locations processing 

claims regarding simple issues. These issues include adding or removal of a dependent from a claims file, approving a housing or automobile grant, or reducing a veteran’s aid and attendance benefits

when the veteran remains hospitalized.

  Service officers voiced great frustration with a VA regional office

staff who do not take action quickly on simple decisions and that addressing these simple issues can take up to a year.

 A bright spot was generally favorable reviews regarding handling 

of claims for disability benefits of veterans injured in Iraq or Afghanistan. VA is putting its best foot forward to help these young men and 

women. However, we must reiterate the need for the VA to provide 

this type of service universally.

VBA needs to continue to improve its training program and follow 

up the activities of its personnel through adequate accountability of 

ratings staff at all levels.

 One of the immediate problems facing VBA is the impending retirement of many of its staff. VBA believes the VA is addressing 

this problem in a way that is adversely affecting ratings decisions. 

New ratings personnel are being rushed through training and then 

plugged into staff holes to begin immediately rating claims.

 We believe these individuals should be required to undergo more 

extensive training before being released to make decisions.

 PVA believes that accountability may be one of the most important 

aspects in the claims adjudication process. We are concerned that 

VBA distorts accountability by basing performance on processing 

workload with little or no focus placed on making quality decisions. 

Regional office managers will continue to do business in this fashion

as long as there are no repercussions for bad decisions.

 The Claims Processing Task Force addressed this concern in a report by recommending that funding of regional offices be tied to the
47

performance of those offices with greater resources allocated to the

highest performers. The poorest performing offices would receive no

additional staff or increase in resources. This seems to be a backwards approach to the problem and represents continued acceptance 

of failures in the management structure of those offices. 

 The VA should focus more of its energy and resources on improving 

the operations as well as the quality of decisions of under-performing 

regional offices. Sanctioning these offices in this manner only punishes veterans who live in the jurisdiction of the offices.

  Our service officers also made a recommendation regarding the

role of the Veterans’ Health Administration in the claims process. 

Specifically they emphasized the need for a universal link between

VBA and VHA facilities. This would allow VBA to have instant access to health records and information for a veteran who files a claim.

It would ensure that accurate information is available for compensation and pension examinations.

  These are specific observations from our field service personnel,

dedicated individuals who deal with these issues on an ongoing basis.

 We look forward to working with the Committee to ensure that veterans’ claims are processed in a timely manner and that they receive 

the most accurate rating decision possible.

 Thank you again for the opportunity to testify, and I would be happy to answer any of your questions.

  [Statement of Blake C. Ortner appears on p. 106]

 The Chairman. Thank you.

 Mr. Kinderman.

STATEMENT OF QUENTIN KINDERMAN

 Mr. Kinderman. Thank you, Mr. Chairman, Mr. Udall. The Veterans of Foreign Wars appreciates this opportunity to present our 

views on claims processing in VBA.

 I think it will come as no surprise to you that we think the basic 

problem is poor quality decision making. The VFW supports providing adequate resources to the VBA to provide highly accurate and 

timely benefits decisions.

 We think the resources should be linked to the improvement of 

quality of claims decisions, a strong commitment by VA leadership, 

and an effective improvement plan.

 The emphasis from the top of the VA has persistently been on just 

moving the cases along to reduce the overall count and to bring down 

the backlog.

 Productivity increases are mandated by OMB. This is a euphemism for arbitrary cuts. This is not conducive to either better than 
48

mediocre performance or risk taking by the VA leadership to improve 

the situation.

 We cannot understand the logic of cuts in discretionary GOE resources that result in poor decision quality in the much larger compensation entitlement program. These cuts discourage competent 

administration of the entitlement program which requires much better quality control than they have now.

Compared to the compensation program of a decade or more ago, 

the work is much more complicated. The system assumes that unless 

something different is justified that what is done is adequate. VBA

may set goals to improve quality above a 15 percent error rate, but 

they lack a plan to get there. This is not adequate.

 Until VBA has an overall plan to improve the situation and ask for 

the resources to fix things, little will change for the better.

VBA operates a quality monitoring system, acronym for which is 

STAR, which finds on a sampling basis that about 15 percent of the

cases have a significant error. STAR looks at only 100 cases per office. VBA knows things are wrong, but lacks the specifics to act on

them.

Very few other cases are reviewed, and with the exception of the 

very small STAR centralized reviews, the reviews are tempered by a 

higher priority to move the workload.

 We think 15 percent is a very high error rate. It suggests that every 

VBA decision maker makes a significant error approximately every

other day. Veterans and their survivors after waiting many months 

or even years may receive a decision that is significantly flawed.

  Out of 700,000 or more cases done per year, 100,000 are flawed. Issues aren’t all addressed, VCAA is violated, the decision is wrong or 

the payment is wrong. Nothing trivial is counted as an error.

 The IG found higher average compensation payments with representation by veteran service organizations. This may reflect the

VSO’s success in identifying rating decision makers’ errors and insisting on their correction either locally or on appeal. We have serious concerns for those veterans who file claims with VA without our

assistance.

 It seems clear that the VBA has no plan or methodology to eliminate or even accurately identify the serious errors that plague one 

out of every seven or eight claims. VBA must find the courage to

request the resources and commit to the goals that a get-well plan 

would require.

  Faulty decision making cannot be fixed by improved information

technology or program “reform” and its attendant complexity and duplication. It needs the commitment from the top down to do every 

claim properly, consistent with the letter and the spirit of the law, 

and the resources and tools necessary to ensure that that happens.

 Reform of this magnitude is only possible when all concerned are 
49

truly interested in improvement and not just putting a positive spin 

on the latest bad news.

 We think that VBA is capable of this kind of improvement and has 

the honesty necessary to accomplish it. We also think that there is 

no more deserving population of beneficiaries for this improvement

than the current generation of veterans who are returning from Iraq, 

Afghanistan, and elsewhere in the Global War on Terrorism.

 Thank you. I would be pleased to respond to any questions, Mr. 

Chairman.

  [Statement of Quentin Kinderman appears on p. 116]

 The Chairman. Thank you very much.

 Thank you, Mr. Secretary and Mr. Chairman, for sticking around. 

You may be excused if you like.

 Before I move to questions, I would like to ask Mr. Doran, so I can 

get a better understanding, are you setting forth a public objection of 

the VA to do this study with IOM so that we may better understand 

diagnosis, treatment, compensation? I mean, I do not understand 

what the objection is.

 Mr. Doran. Mr. Chairman, I am setting forth a public objection 

of VA spending over a million dollars to duplicate an effort that you 

have directed the Veterans’ Disability Benefit Commission to do and

that the Committee that wrote the DSM-IV spent five years using

over 1,000 professionals to write this publication. And VA is asking 

to repudiate it using 19 people who have no idea what PTSD is all 

about.

 I do not want my million dollars of tax money being spent on that 

when VA has other places they could use it more appropriately.

 The Chairman. All right. That might be a pretty strong statement 

-- 

 Mr. Doran. Yes, sir, it is.

 The Chairman. -- to say that IOM knows nothing about -- I will 

give you an opportunity to restate.

 Mr. Doran. I am looking at the list of members of their Mental 

Health Committee, which I am assuming is the Committee that will 

be investigating PTSD. There are no military physicians. There are 

no DVA physicians. There is nobody with any knowledge of combatrelated PTSD according to their own biographies.

 The Chairman. The more we conduct an introspection to obtain 

the greater understanding of physiologic, psychologic, psychosocial 

effects of stress is pretty doggone important, Mr. Doran, I believe.

 Now, you may disagree with that, and I respect the position that 

you are taking with AMVETS that perhaps we should just lock ourselves into present knowledge, but I disagree.

 Mr. Doran. I am not saying lock ourselves in the present knowledge, Mr. Chairman. I am saying use the professionals that have the 
50

knowledge. The people that make up this IOM Mental Health Committee do not apparently have that knowledge.

The Chairman. All right. You are correct about the charter to the 

Commission. We also recognize that that charter was so broad that 

they are questioning whether or not they can hit their deadline and 

whether we are going to have to extend.

 And there will be cooperation between the Commission and the VA

with regard to the study and so it will not be duplicitous. So I want 

you to know that. Okay?

 Mr. Doran. Oh, I understand that. I just do not -- no. I just do not 

think we should -- 

 The Chairman. I did not know if you understood that based on your 

statement.

 Mr. Doran. No, no. We are talking apples and oranges here.

 The Chairman. You just said they are being duplicative.

 Mr. Doran. I am talking about the second section of Mr. Nicholson’s 

commitment to the IOM of rewriting the veterans rating schedules on 

PTSD. That is something you have got the VDBC looking at.

 The Chairman. Right. I am not interested in being multiplicious at 

all either. There is something out there for us that we need to have a 

greater understanding of.

 I embrace boldly any effort to understand it much better because 

we are all dealing with our comrades who have some very difficult

stressors that also then have a physiological effect. The more we can 

understand that the better, I think.

  Each of you in your testimony referenced staffing issues at VBA

and I just want to make sure we get this consensus.

 Do you see additional staff right now a primary solution to attacking part of this workload? Am I hearing that as pretty congruent?

 Mr. Doran. Yes, sir.

 Mr. Mooney. Yes, sir.

 The Chairman. All of you?

 Mr. Ortner. Yes, sir. But that is only the case if they are -- I mean, 

if they are properly trained. You can throw any number of staff at 

it.

 The Chairman. Yeah. I get that from your testimony also about the 

supervision because obviously, even if we were to increase the FTE

going into next year, it is far much greater than that because if you 

have supervisors out there, too, who are not as qualified -- I mean,

this is going to take some time here, right?

 Mr. Kinderman. Mr. Chairman -- 

 The Chairman. Yes.

 Mr. Kinderman. -- I think we also would like to see management 

direction toward a better quality product rather than a rather myopic 

view that they just want to get the backlogs down.

 I think the day when we can solve the problem with just getting the 
51

backlogs down is over. I think we need to focus for the future and for 

now on getting these claims done right.

 The Chairman. When it takes two years to train a ratings officer,

doesn’t that sort of speak about the complexity of what we are dealing with?

 Mr. Kinderman. I think that speaks to the complexity. But I think 

when you have that kind of complexity, you cannot simply turn someone loose without any kind of controls on the quality of the product 

they are doing.

 If they are going off on their own and they are doing something 

wrong and you are only picking it up in 100 cases a year in that regional office, the damage is done. And the damage has obviously a big

number associated with it.

 A lot of those veterans will accept the decision. They will not appeal. They will go on. And what might seem like a small decision 

today can have massive effects on their lifetime later. I do not think 

there are any trivial decisions.

 The Chairman. I want to take a moment for you to tell a good story. 

Each of you represent organizations that do a lot of work out there on 

behalf of our comrades in the assistance and the filing of claims.

Could you speak to -- let us go right down the line -- the number of 

man hours that is and what type of training programs that each of 

you have to make sure that they are helpful with regard to the claims 

process.

 Mr. Lawrence.

 Mr. Lawrence. DAV has 260 national service officers and approximately 30 transition service officers. Our TSOs are situated primarily at Benefits Delivery at Discharge sites, which I would also like

to add we think are very efficient and also produce a higher quality

of decision. And that could hold a key to future problems to this increase in the number of BDDs.

 The Chairman. Okay.

 Mr. Lawrence. But with regard to the training is for a national 

service officers, they undergo a 16-month training, a year of which

is OJT.

 The Chairman. Are these paid positions?

Mr. Lawrence. Yes, sir.

 Mr. Mooney. Mr. Chairman, The American Legion has accredited 

to it by the VA IG over 750 service officers. Some of them work directly for The American Legion. Some work for state and county 

veteran service agencies. But they are all accredited through The 

American Legion.

 While our training program is not as regimented or rigorous as 

DAV’s, we do take care to see that we have competent people out 

there. We also have a staff at the Board of Veterans’ Appeals. And 

from my own experience, it takes about two and a half years to be-
52

come proficient in representing veterans in appeals at the Board.

 I would like to make one other comment and I am drawing on my 

prior career in the electrical construction business around the Washington area. And, you know, when you get behind on a construction 

contract, you are subject to liquidated damages, you know, meaning 

money. And what you do in that case is you go down to the union hall 

and you get more electricians and you bring them on the job. And you 

get caught up.

 And, you know, I understand federal hiring procedures and civil 

service regs are a lot more complicated than just going down to the 

union hall. But when you get in a hole like VA is about to get into 

with these annual increases in claims, they will collapse under their 

own weight after a while.

 And something has to be done to head that off even if it is temporary measures to bring down the workload because in the veterans’ 

business, the liquidated damages do not accrue to the contractor. 

They accrue to the veteran because, you know, while they are waiting 

for their benefits to come around to be paid, you know, things happen.

They lose their houses. They lose their families. And it is a situation 

that has to be dealt with.

 The Chairman. Thank you.

 Mr. Doran.

 Mr. Doran. Mr. Chairman, AMVETS as the Legion uses our own 

national service offices, department service officers, county service officers, and state employees of Veterans’ Affairs. We have accredited

through us about 385 individuals.

 Our own training program, which I can, unfortunately, only enforce on my own staff of national service officers, includes three days

of hands-on, one-on-one training with the regional director before 

they are allowed to be turned loose with the public.

 Now that the program is out, they have been going through the 

Challenge Program that the VA has on the computer system and we 

have them go through four days a year of continuing education.

 In addition to that, a few of the folks do attend the National Association of County Veteran Service Officers Training Course, wherever

they hold it from year to year. They go there at their own option, but 

we pay for them to do that.

 And I would like to make a quick comment about the BDD as well. 

You know, we talked about the staffing, and I agree with the DAV

that BDD working at the transition sites is outstanding. But VA has 

divided the country in the middle and all benefits due on delivery

claims this side of the Mississippi River go to Winston Salem. On the 

west side, they go to Salt Lake City.

  There are staffing problems in both of those areas. And I am not

quite sure myself whether they are sending them to two sites for a 

centralized adjudication center or because the sites in Seattle and 
53

Los Angeles and Bay Pines and so on are so overwhelmed that they 

cannot keep up with the local military folks getting out.

  I do know that it really makes it tough when the service officer is in

Seattle and the veteran is Puget Sound and the claim is in Salt Lake 

City. It is kind of tough to work out on this guy’s behalf.

 Mr. Ortner. Mr. Chairman, PVA is similar with DAV. A large 

number of service officers across the country, they are paid employees. They also go through a 16-month training program, which includes on-the-job training.

 In addition to that, they are trained in medical evaluations, trained 

on regulations and VA procedures. So they can tell what is going on 

and they can see when there is a problem.

 But in addition to that, they have ongoing evaluations to make sure 

they remain competent in the field as well as testing for any promotions as they move to a higher level of NSO positions.

 Mr. Kinderman. Mr. Chairman, unfortunately, I am from the legislative side of the House and I am relatively new. I do not really have 

the specific information you are looking for on our service officers. 

But I would be pleased to get that for the record for you. [The information provided is found on p. 162]

 The Chairman. NSOs, are they all veterans?

 Mr. Doran. Mine are mostly service-connected disabled, mostly 

military retirees. A few of them are VA retirees. And we have stolen 

some of them from DAV.

 Mr. Mooney. With The American Legion, it is a condition of employment if you are going to work directly with the veteran population.

 The Chairman. All the NSOs are veterans. All right. Thank you 

very much.

 Mr. Udall.

 Mr. Udall. Thank you, Mr. Chairman.

  Does the testimony of Dr. Jones reflect the experience of veterans

your organizations serve in seeking to obtain service-connected compensation benefits from the VA?

Mr. Udall. All of you indicating yes.

 And some of you are here that participate in the Independent Budget process and you heard the testimony earlier about the staffing

problems. You have very passionately, I think, talked about additional staffing.

 Are you in a position at this point to talk about what you think is 

needed in terms of additional staffing?

 Mr. Doran. Not really. Not without spending a little bit more time 

sitting down with the books and the paperwork. But off the top of 

my head, the OMB had a lot more claims adjudicators and a lot less 

administrators.

 Mr. Udall. A lot more claims adjudicators and a lot less -- okay.
54

 Thank you very much. We very much appreciate your testimony 

today and we are greatly appreciative of your advocacy for veterans. 

Thank you for being here.

 Thank you, Mr. Chairman.

 The Chairman. You know what we have in front of us is sort of this 

bridge in time. We have the Disability Commission and we have 

present problems in how we get to whatever the result is going to be. 

Okay?

 And when I look at that, if they are asking for an extension, we 

have got a two- to three-year window. What is the ramp-up? What is 

the training? How much are they going to change the system? You 

see what is in front of us?

 And I am challenged at the moment because I think there is going 

to have to be a consensus here between -- I think everyone on this 

Committee will go to an increase in FTE but at what number, I do not 

know. But my sense is that we are going to move in that direction, 

Mr. Secretary, Mr. Chairman.

 As I continue -- not just myself -- as all members of this Committee 

continue our work as we go into the 2007 budget process, it would 

probably be very prudent -- I will have a good conversation with Mr. 

Evans and we are going to explore this further.

 And if we need some more input from you gentlemen, please be responsive. I know you will be. I think this is one we are going to need 

to tackle. Okay?

 Thank you very much for your time and your testimony today. It is 

very important. Thank you.

 The hearing is now concluded.

  [Whereupon, at 4:25 p.m. the Committee was adjourned.]

 
(55)

APPENDIX
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Responses from the Department of Veterans Affairs
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