II

Calendar No. 452

103D CONGRESS

2D SESSION S. 1908

[Report No. 103–280]

To provide for a study of the processes and procedures of the Department

of Veterans Affairs for the disposition of claims for veterans benefits.

IN THE SENATE OF THE UNITED STATES

MARCH 8 (legislative day, FEBRUARY 22), 1994

Mr. ROCKEFELLER (for himself, Mr. DECONCINI, Mr. GRAHAM, Mr. AKAKA,

Mr. DASCHLE, Mr. WELLSTONE, and Mr. BINGAMAN) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs

JUNE 7, 1994

Reported by Mr. ROCKEFELLER, with an amendment

[Strike out all after the enacting clause and insert the part printed in italic]

A BILL

To provide for a study of the processes and procedures

of the Department of Veterans Affairs for the disposition

of claims for veterans benefits.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
2

•S 1908 RS

1 SECTION 1. STUDY OF SYSTEM OF DEPARTMENT OF VETER2 ANS AFFAIRS FOR DISPOSITION OF CLAIMS

3 FOR VETERANS BENEFITS.

4 (a) IN GENERAL.—The Administrative Conference of

5 the United States shall carry out a study of the Depart6 ment of Veterans Affairs system for the disposition of

7 claims for veterans benefits. The Administrative Con8 ference shall carry out the study in accordance with this

9 Act.

10 (b) PURPOSE OF STUDY.—The purpose of the study

11 required under this Act shall be to evaluate the Depart12 ment of Veterans Affairs system for the disposition of

13 claims for veterans benefits in order to determine—

14 (1) the efficiency of processes and procedures

15 under the system for the adjudication, resolution, re16 view, and final disposition of claims for veterans

17 benefits and means of increasing such efficiency, in18 cluding the effect of judicial review on such system;

19 (2) means of reducing the number of claims

20 under the system for which final disposition is pend21 ing; and

22 (3) means of enhancing the ability of the De23 partment of Veterans Affairs to dispose of claims

24 under the system in a prompt and appropriate man25 ner.
3

•S 1908 RS

1 (c) CONTENTS OF STUDY.—The study of the Depart2 ment of Veterans Affairs system for the disposition of

3 claims for veterans benefits under this Act shall include

4 an evaluation and assessment of the following:

5 (1) The historical development of the system,

6 including the effect on such development of the pro7 vision under the Veterans’ Judicial Review Act (divi8 sion A of Public Law 100–687; 102 Stat. 4105) of

9 authority for judicial review of claims disposed of

10 under the system.

11 (2) The preparation and submittal of claims by

12 veterans under the system.

13 (3) The processes and procedures under the

14 system for the disposition of claims, including—

15 (A) the scope and nature of the respon16 sibility of the Secretary to assist veterans in the

17 development of claims;

18 (B) the scope and nature of the hearings

19 provided for at each stage in the claims disposi20 tion process under the system (including hear21 ings de novo, hearings before travelling mem22 bers of the Board of Veterans’ Appeals, hear23 ings that are expedited for reason of illness or

24 financial need, and hearings that permit the
4

•S 1908 RS

1 transmission of evidence or testimony by elec2 tronic means);

3 (C) the scope and nature of the review un4 dertaken with respect to a claim at each stage

5 in the claims disposition process;

6 (D) the number, Federal employment

7 grade, and experience and qualifications re8 quired of the persons undertaking such review

9 at each such stage;

10 (E) the effect on such review of the obliga11 tion of the Secretary to afford claimants with

12 the benefit of the doubt when there is an ap13 proximate balance of positive and negative evi14 dence with respect to a claim;

15 (F) opportunities for the submittal of new

16 evidence; and

17 (G) the availability of alternative means of

18 disposing of claims.

19 (4) The effect on the system of the participa20 tion of attorneys, members of veterans service orga21 nizations, and other advocates on behalf of veterans.

22 (5) The effect on the system of actions taken

23 by the Secretary to modernize the information man24 agement system of the Department, including the

25 utilization of electronic data management systems.
5

•S 1908 RS

1 (6) The effect on the system of any work per2 formance standards utilized by the Secretary at re3 gional offices of the Department and at the Board

4 of Veterans’ Appeals.

5 (7) The extent of the implementation in the

6 system of the recommendations of the Blue Ribbon

7 Panel on Claims Processing submitted to the Com8 mittees on Veterans’ Affairs of the Senate and

9 House of Representatives on December 2, 1993, and

10 the effect of such implementation on the system.

11 (8) The effectiveness in improving the system of

12 any pilot programs carried out by the Secretary at

13 regional offices of the Department and of efforts by

14 the Secretary to implement such programs through15 out the system.

16 (9) The effectiveness of the quality control

17 practices and quality assurance practices under the

18 system in achieving the goals of such practices.

19 (d) CONSULTATION WITH NON-DEPARTMENT ENTI20 TIES.—Notwithstanding any other provision of law, the

21 Administrative Conference of the United States shall,

22 upon request, provide opportunities in the conduct of the

23 study under this Act for consultation with appropriate

24 representatives of veterans service organizations and of
6

•S 1908 RS

1 other organizations and entities that represent veterans

2 before the Department of Veterans Affairs.

3 (e) COOPERATION OF SECRETARY.—(1) Not later

4 than 90 days after the date of the enactment of this Act,

5 the Secretary shall submit to the Administrative Con6 ference of the United States, and to the Committees on

7 Veterans’ Affairs of the Senate and House of Representa8 tives, such information as the Chairman of the Adminis9 trative Conference shall determine necessary to carry out

10 the study required under this Act.

11 (2) The information referred to in paragraph (1)

12 shall include information on the claims disposed of by the

13 Department of Veterans Affairs during the 5-year period

14 ending on September 30, 1993, including the following:

15 (A) The total number of claims finally disposed

16 of during that period.

17 (B) The number of claims finally disposed of

18 during each fiscal year of that period.

19 (C) The number of claims referred to in sub20 paragraph (A) that were allowed by the Secretary

21 solely on the basis of information contained in the

22 initial claim for benefits.

23 (D) The number of claims referred to in sub24 paragraph (A) that were allowed by a regional office
7

•S 1908 RS

1 of the Department at each of the various stages in

2 the claims disposition process.

3 (E) The number of claims referred to in sub4 paragraph (A) that were allowed by the Board of

5 Veterans’ Appeals.

6 (F) The number of claims referred to in sub7 paragraph (E) that were reopened after a final deci8 sion by the Board of Veterans’ Appeals.

9 (f) REPORTS ON STUDY.—(1) Not later than 1 year

10 after the date of the enactment of this Act, the Adminis11 trative Conference of the United States shall submit to

12 the Secretary and to the Committees on Veterans’ Affairs

13 of the Senate and House of Representatives a preliminary

14 report on the study required under subsection (c). The re15 port shall contain the preliminary findings and conclusions

16 of the Administrative Conference with respect to the eval17 uation and assessment required under the study.

18 (2) Not later than 18 months after such date, the

19 Administrative Conference shall submit to the Secretary

20 and to such committees a report on such study. The report

21 shall include the following:

22 (A) The findings and conclusions of the Admin23 istrative Conference, including its findings and con24 clusions with respect to the matters referred to in

25 subsection (c).
8

•S 1908 RS

1 (B) The recommendations of the Administrative

2 Conference for means of improving of the Depart3 ment of Veterans Affairs system for the disposition

4 of claims for veterans benefits.

5 (C) Such other information and recommenda6 tions with respect to the system as the Administra7 tive Conference considers appropriate.

8 (g) AUTHORIZATION OF APPROPRIATIONS.—There is

9 authorized to be appropriated $150,000 to the Depart10 ment of Veterans Affairs for payment to the Administra11 tive Conference of the United States under section 1535

12 of title 31, United States Code, of the cost of carrying

13 out the study and report required under this Act.

14 (h) DEFINITIONS.—For the purposes of this Act—

15 (1) The term ‘‘Administrative Conference of the

16 United States’’ means the Administrative Conference

17 provided for under subchapter V of chapter 5 of title

18 5, United States Code.

19 (2) The term ‘‘Department of Veterans Affairs

20 system for the disposition of claims for veterans ben21 efits’’ means the processes and procedures of the

22 Department of Veterans Affairs for the adjudication,

23 resolution, review, and final disposition of claims for

24 benefits under the laws administered by the Sec25 retary.
9

•S 1908 RS

1 (3) The term ‘‘Secretary’’ means the Secretary

2 of Veterans Affairs.

3 (4) The term ‘‘veterans service organizations’’

4 means any organization approved by the Secretary

5 under section 5902(a) of title 38, United States

6 Code.

7 SECTION 1. SHORT TITLE.

8 This Act may be cited as the ‘‘Veterans’ Claims Adju9 dication Improvement Act of 1994’’.

10 TITLE I—STUDY OF CLAIMS

11 ADJUDICATION

12 SEC. 101. STUDY OF SYSTEM OF DEPARTMENT OF VETER13 ANS AFFAIRS FOR DISPOSITION OF CLAIMS

14 FOR VETERANS BENEFITS.

15 (a) IN GENERAL.—The Administrative Conference of

16 the United States shall carry out a study of the Department

17 of Veterans Affairs system for the disposition of claims for

18 veterans benefits. The Administrative Conference shall

19 carry out the study in accordance with this title.

20 (b) PURPOSE OF STUDY.—The purpose of the study re21 quired under this title shall be to evaluate the Department

22 of Veterans Affairs system for the disposition of claims for

23 veterans benefits in order to determine—

24 (1) the efficiency of processes and procedures

25 under the system for the adjudication, resolution, re-
10

•S 1908 RS

1 view, and final disposition of claims for veterans ben2 efits and means of increasing such efficiency, includ3 ing the effect of judicial review on such system;

4 (2) means of reducing the number of claims

5 under the system for which final disposition is pend6 ing; and

7 (3) means of enhancing the ability of the Depart8 ment of Veterans Affairs to dispose of claims under

9 the system in a prompt and appropriate manner.

10 (c) CONTENTS OF STUDY.—The study of the Depart11 ment of Veterans Affairs system for the disposition of claims

12 for veterans benefits under this title shall include an evalua13 tion and assessment of the following:

14 (1) The historical development of the system, in15 cluding the effect on such development of the provision

16 under the Veterans’ Judicial Review Act (division A

17 of Public Law 100–687; 102 Stat. 4105) of authority

18 for judicial review of claims disposed of under the

19 system.

20 (2) The preparation and submission of claims by

21 veterans under the system.

22 (3) The processes and procedures under the sys23 tem for the disposition of claims, including—
11

•S 1908 RS

1 (A) the scope and nature of the responsibil2 ity of the Secretary to assist veterans in the de3 velopment of claims;

4 (B) the scope and nature of the hearings

5 provided for at each stage in the claims disposi6 tion process under the system (including hear7 ings de novo, hearings before travelling members

8 of the Board of Veterans’ Appeals, hearings that

9 are expedited for reason of illness or financial

10 need, and hearings that permit the transmission

11 of evidence or testimony by electronic means);

12 (C) the scope and nature of the review un13 dertaken with respect to a claim at each stage in

14 the claims disposition process;

15 (D) the number, Federal employment grade,

16 and experience and qualifications required of the

17 persons undertaking such review at each such

18 stage;

19 (E) the effect on such review of the obliga20 tion of the Secretary to afford claimants with the

21 benefit of the doubt when there is an approxi22 mate balance of positive and negative evidence

23 with respect to a claim;

24 (F) opportunities for the submittal of new

25 evidence; and
12

•S 1908 RS

1 (G) the availability of alternative means of

2 disposing of claims.

3 (4) The effect on the system of the participation

4 of attorneys, members of veterans service organiza5 tions, and other advocates on behalf of veterans.

6 (5) The effect on the system of actions taken by

7 the Secretary to modernize the information manage8 ment system of the Department, including the utiliza9 tion of electronic data management systems.

10 (6) The effect on the system of any work per11 formance standards utilized by the Secretary at re12 gional offices of the Department and at the Board of

13 Veterans’ Appeals.

14 (7) The extent of the implementation in the sys15 tem of the recommendations of the Blue Ribbon Panel

16 on Claims Processing submitted to the Committees on

17 Veterans’ Affairs of the Senate and House of Rep18 resentatives on December 2, 1993, and the effect of

19 such implementation on the system.

20 (8) The effectiveness in improving the system of

21 any pilot programs carried out by the Secretary at

22 regional offices of the Department and of efforts by

23 the Secretary to implement such programs throughout

24 the system.
13

•S 1908 RS

1 (9) The effectiveness of the quality control prac2 tices and quality assurance practices under the sys3 tem in achieving the goals of such practices.

4 (d) CONSULTATION WITH NON-DEPARTMENT ENTI5 TIES.—Notwithstanding any other provision of law, the Ad6 ministrative Conference of the United States shall, upon re7 quest, provide opportunities in the conduct of the study

8 under this title for consultation with appropriate represent9 atives of veterans service organizations and of other organi10 zations and entities that represent veterans before the De11 partment of Veterans Affairs.

12 (e) COOPERATION OF SECRETARY.—(1) Not later than

13 90 days after the date of the enactment of this Act, the Sec14 retary shall submit to the Administrative Conference of the

15 United States, and to the Committees on Veterans’ Affairs

16 of the Senate and House of Representatives, such informa17 tion as the Chairman of the Administrative Conference

18 shall determine necessary to carry out the study required

19 under this title.

20 (2) The information referred to in paragraph (1) shall

21 include information on the claims disposed of by the De22 partment of Veterans Affairs during the 5-year period end23 ing on September 30, 1993, including the following:

24 (A) The total number of claims finally disposed

25 of during that period.
14

•S 1908 RS

1 (B) The number of claims finally disposed of

2 during each fiscal year of that period.

3 (C) The number of claims referred to in subpara4 graph (A) that were allowed by the Secretary solely

5 on the basis of information contained in the initial

6 claim for benefits.

7 (D) The number of claims referred to in sub8 paragraph (A) that were allowed by a regional office

9 of the Department at each of the various stages in the

10 claims disposition process.

11 (E) The number of claims referred to in sub12 paragraph (A) that were allowed by the Board of Vet13 erans’ Appeals.

14 (F) The number of claims referred to in subpara15 graph (E) that were reopened after a final decision

16 by the Board of Veterans’ Appeals.

17 (f) REPORTS ON STUDY.—(1) Not later than 1 year

18 after the date of the enactment of this Act, the Administra19 tive Conference of the United States shall submit to the Sec20 retary and to the Committees on Veterans’ Affairs of the

21 Senate and House of Representatives a preliminary report

22 on the study required under subsection (c). The report shall

23 contain the preliminary findings and conclusions of the Ad24 ministrative Conference with respect to the evaluation and

25 assessment required under the study.
15

•S 1908 RS

1 (2) Not later than 18 months after such date, the Ad2 ministrative Conference shall submit to the Secretary and

3 to such committees a report on such study. The report shall

4 include the following:

5 (A) The findings and conclusions of the Admin6 istrative Conference, including its findings and con7 clusions with respect to the matters referred to in sub8 section (c).

9 (B) The recommendations of the Administrative

10 Conference for means of improving of the Department

11 of Veterans Affairs system for the disposition of

12 claims for veterans benefits.

13 (C) Such other information and recommenda14 tions with respect to the system as the Administrative

15 Conference considers appropriate.

16 (g) AUTHORIZATION OF APPROPRIATIONS.—There is

17 authorized to be appropriated $150,000 to the Department

18 of Veterans Affairs for payment to the Administrative Con19 ference of the United States under section 1535 of title 31,

20 United States Code, of the cost of carrying out the study

21 and report required under this title.

22 (h) DEFINITIONS.—For the purposes of this title:

23 (1) The term ‘‘Administrative Conference of the

24 United States’’ means the Administrative Conference
16

•S 1908 RS

1 provided for under subchapter V of chapter 5 of title

2 5, United States Code.

3 (2) The term ‘‘Department of Veterans Affairs

4 system for the disposition of claims for veterans bene5 fits’’ means the processes and procedures of the De6 partment of Veterans Affairs for the adjudication, res7 olution, review, and final disposition of claims for

8 benefits under the laws administered by the Secretary.

9 (3) The term ‘‘Secretary’’ means the Secretary of

10 Veterans Affairs.

11 (4) The term ‘‘veterans service organizations’’

12 means any organization approved by the Secretary

13 under section 5902(a) of title 38, United States Code.

14 TITLE II—IMPROVEMENTS TO

15 CLAIMS ADJUDICATION

16 SEC. 201. ELIMINATION OF REQUIREMENT FOR ANNUAL IN17 COME QUESTIONNAIRES.

18 Section 1506 of title 38, United States Code, is amend19 ed—

20 (1) in paragraph (2), by striking out ‘‘shall’’

21 and inserting in lieu thereof ‘‘may’’; and

22 (2) in paragraph (3), by striking out ‘‘file a re23 vised report’’ and inserting in lieu thereof ‘‘notify the

24 Secretary’’.
17

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1 SEC. 202. DOCUMENTS TO BE ACCEPTED AS PROOF OF RE2 LATIONSHIPS.

3 Notwithstanding any other provision of law, the Sec4 retary of Veterans Affairs shall accept from a claimant a

5 photocopy of an appropriate document as proof of the exist6 ence of a marriage, the dissolution of a marriage, the birth

7 of a child, or the death of any family member for the pur8 pose of acting on such individual’s claim for benefits under

9 any law administered by the Secretary. The Secretary may

10 require the submission of additional documentation in sup11 port of any document submitted pursuant to this section

12 if the document on its face raises a question as to its valid13 ity, or there is reasonable indication, in the document or

14 otherwise, of fraud or misrepresentation.

15 SEC. 203. ACCEPTANCE OF PRIVATE PHYSICIAN EXAMINA16 TIONS.

17 Notwithstanding any other provision of law, for pur18 poses of establishing a claim for disability compensation

19 under chapter 11 of title 38, United States Code, or a claim

20 for pension under chapter 15 of such title, a medical exam21 ination report of a private physician provided by a claim22 ant in support of a claim for benefits may be accepted with23 out confirmation by an examination by a physician em24 ployed by the Veterans Health Administration if such re25 port contains sufficient clinical data to support the diag-
18

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1 nosis of a disability or to provide a reliable basis for an

2 evaluation of the degree of any such disability.

3 SEC. 204. TRANSFER OF MILITARY SERVICE MEDICAL

4 RECORDS.

5 Not later than 90 days after the date of the enactment

6 of this Act, the Secretary of Veterans Affairs shall submit

7 to the Committees on Veterans’ Affairs of the Senate and

8 House of Representatives a report setting forth the status

9 of an agreement between the Secretary and the Secretary

10 of Defense to provide for the immediate transfer from the

11 Department of Defense to the Department of Veterans Af12 fairs of the medical records of members of the Armed Forces

13 upon the separation of such members from active duty.

14 TITLE III—MISCELLANEOUS

15 SEC. 301. SERVICE CONNECTION FOR CERTAIN DISABIL16 ITIES RELATING TO EXPOSURE TO IONIZING

17 RADIATION.

18 Section 5 of the Veterans’ Dioxin and Radiation Expo19 sure Compensation Standards Act (Public Law 98–542; 98

20 Stat. 2725; 38 U.S.C. 1154 note) is amended by adding

21 at the end the following new subsection:

22 ‘‘(d) The regulations prescribed under this section may

23 not prohibit, or be construed to prohibit, a veteran from

24 establishing pursuant to section 1110 or 1131 of title 38,

25 United States Code, service connection for a disease or dis-
19

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1 ability that the veteran claims to be the result of the veter2 an’s exposure to ionizing radiation during a period of serv3 ice referred to in subsection (a)(1), notwithstanding that

4 such regulations do not specify that the disease or disability

5 is a radiogenic disease.’’.

6 SEC. 302. ADJUDICATION AND RESOLUTION OF CERTAIN

7 CLAIMS RELATING TO MEDICAL MAL8 PRACTICE.

9 (a) ADJUDICATION AND RESOLUTION OF CLAIMS.—

10 The Secretary of Veterans Affairs shall—

11 (1) take appropriate actions to determine wheth12 er the injury (or aggravation of an injury) of any

13 veteran as the result of the treatment of the veteran

14 was the result of medical malpractice on the part of

15 the Department of Veterans Affairs (and not of the

16 veteran’s own willful misconduct); and

17 (2) in the case of any injury so determined, pro18 vide appropriate compensation to the veteran in ac19 cordance with section 1151 of title 38, United States

20 Code.

21 (b) STATEMENT OF INTENT AND CONSTRUCTION.—

22 Congress enacts the requirement set forth in subsection (a)

23 in order to ensure the adjudication and resolution of certain

24 claims following the decision in Gardner v. Derwinski, 1

25 Vet.App. 584 (1991), aff’d, sub nom. Brown v. Garnder, 5
20

•S 1908 RS

1 F.3d 1456 (Fed. Cir. 1993), cert. granted, 62 U.S.L.W.

2 3657 (U.S. Apr. 4, 1994) (No. 93–1128). The requirement

3 may not be construed as an expression of Congressional in4 tent to limit the claims subject to adjudication under sec5 tion 1151 of title 38, United States Code, to claims related

6 to injuries resulting from medical malpractice.

7 (c) DEFINITIONS.—In this section:

8 (1) The term ‘‘treatment’’, in the case of a vet9 eran, means any examination, hospitalization, medi10 cal or surgical treatment, or course of vocational re11 habilitation under chapter 31 of title 38, United

12 States Code, that is provided to the veteran by the De13 partment of Veterans Affairs.

14 (2) The term ‘‘medical malpractice’’ means any

15 carelessness, negligence, error in judgment, lack of

16 proper medical skill, or similar instance of indicated

17 fault in the treatment of a veteran.

S 1908 RS——2

Calendar No. 452

103D CONGRESS

2D SESSION S. 1908

[Report No. 103–280]

A BILL

To provide for a study of the processes and procethe disposition of claims for veterans benefits. dures of the Department of Veterans Affairs for

JUNE 7, 1994

Reported with an amendment