This news would be shocking if it didn’t relate to the Department of Veterans’ Affairs (VA).
Last week a News21 investigation revealed that quotas set by the VA effectively encourage claims adjusters to finish the “easy” claims first and push claims requiring an ounce of mental sweat to the bottom of the pile.
These more complex claims are often set aside by workers so they can keep their jobs, meet performance standards or, in some cases, collect extra pay, said VA claims processors and union representatives in a Washington Post article released on August 25. The sad thing is this practice makes sense from a practical standpoint – if a claims processor’s bonus is based on the number of claims processed, it is in the claims processor’s best interest to focus on the claims that require less effort and a shorter period of time. Also, it’s simply easier.
The VA’s valuing of quantity over quality is well-documented. In fact, in 2010 the VA stopped giving its employees performance credit for “supplemental development,” which included tasks such as calling and sending follow-up letters to veterans and follow-up requests for military documents and medical records. As you may note, all of those tasks contribute to the expedient and accurate resolution of a claim.
In 2008, Congress ordered the VA to review its work-credit system, which is used to evaluate employee performance. A 75-page report produced by the Center for Naval Analysis in 2009 recommended the VA address perceptions that quantity receives more emphasis than quality, by changing the tasks that receive points to better reflect the actual work.
Unfortunately, the points still reward those claims processors who have the numbers, not those who tackle and resolve the more difficult claims. A claims processor in the Reno, Nevada Regional Office told News21 that the work-credit system “breeds cheating” and that he has seen employees who aren’t making enough points go into “survival mode” and process only easy claims. Shifting performance points to reward backlog-related work would be more effective, said the worker.
The consequences of these practices are all negative. It is a negative consequence that veterans are punished when their claims require additional effort (such as the scheduling of a medical examination). It is a negative consequence that claims processors are pressured to produce work of higher quantity than quality, as many of these workers genuinely care about the plights of these veterans but are constrained by the VA system and its processes. And it is a negative consequence that because of the imposition of quotas, many rating decisions contain errors. According to the Washington Post, the Board of Veterans’ Appeals (which processes appeals from Regional Office decisions) found that in 2012 almost three out of four appealed claims were wrong or based on incomplete information.
As a veterans advocate, I was ashamed to learn of the findings from News21 investigation. Our veterans deserve much, much better than this. Unfortunately, this story contains more of the same information that has been published for years. I know the VA is incredibly backlogged, and I know many individuals in the VA care about making the process better. But stories like these make me wonder if it could possibly be any worse.
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