Advocate: VA Must Reform Appeals Process 'Sooner Rather Than Later'

A director at the Veterans of Foreign Wars doesn't know if Congress will pass legislation aimed at fixing the VA appeals claims backlog before or after the November presidential election.

But given the problem has been growing for several years -- and a roughly 18-month implementation window, Gerald Manar is comfortable saying his organization "certainly supports addressing this problem and getting it done sooner rather than later."

In an interview Thursday with Military.com, the national services director for the VFW added, "but the problem is, this is a major election year."

With all 435 members of the House and 34 senators -- about a third of the Senate -- seeking re-election in the fall, there is little time to get a proposed appeals reform bill through the two congressional veterans' affairs committees and out to the two chambers for votes.

"The VA is pushing very hard to get both committees to do something this year," he said. "Whether it happens before July [when Congress goes into recess] or in the lame duck session, they understand that if it doesn't get done this year, it'll be another year before it gets done."

Manar also noted even if the bill is approved by Congress, about a year and a half will pass before the Department of Veterans Affairs can actually begin implementing it.

"I think 18 months is a realistic amount of time to gear up to take on the new claims processing initiative," he said. There will be changes required to VA information technology systems and a host of other modifications to the process, he said.

"We saw with the Choice Act that if you rush it, you don't do a good job," Manar said. He was referring to legislation intended to give veterans greater choice and more opportunities to go outside the the department for care. But the bill translated into different types of agreements for different providers, and thus problems for veterans trying to get treatment.

"The VA got burned on that once; they don't want to rush [this]." Manar said.

A key sticking point with the reform package the VA proposed to Congress is that it would not grandfather the 450,000 veterans with pending appeals.

Sen. Johnny Isakson, a Republican from Georgia and chairman of the the Senate Veterans Affairs Committee who sponsored a related bipartisan bill along with ranking member Sen. Richard Blumenthal, a Democrat from Connecticut, said Congress still needs to know "what we do with the 450,000 [veterans] that are waiting."

The bipartisan Veterans First Act already includes a pilot program for fast-tracking new appeals using a “fully developed claim” system. Here, veterans would submit all pertinent medical and health records at the time of their claim, certifying they have no further evidence to include. This would allow for a speedier disposition of the claim, they say.

But those who filed under the existing system cannot simply be moved into a new system.

The VFW and other veterans' service organizations, including The American Legion, have been meeting regularly with VA officials and lawmakers to come up with the reform package.

The initiative before Congress would modify the current appeals system by establishing three options for veterans dissatisfied with a claims decision.

Currently, a veteran may file an appeal that must wait with 450,000 others in the system. The advantage is the veteran may continue to add evidence to the claim along the way. The disadvantage is the time required for processing.

VA officials have testified that, on average, a claim adjudicated by the appeals board in 2015 had been in the system for three years, though at least one appeals claim has been in the system for 25 years.

The plan now being pushed by the department and drafted with the help of veterans' service organizations would add two new appeal options, or what some backers call lanes.

Lou Celli, national director of veterans affairs and rehabilitation at The American Legion, likens the proposed options to off ramps, getting the veteran off the crowded current lane and into faster ones.

One new lane would give veterans challenging a decision the option to have it looked at by a different reviewer simply based on the argument the initial decision was wrong. The second new path would allow the veteran to appeal directly to the court with only the information submitted already -- nothing added to it.

"The advantage to [these lanes] is the lines are very short and you can get a decision in a very short time," he said.

In both cases, the new paths preclude adding more evidence to the case file as it goes forward, something veterans have always valued.

Celli said the Legion is "100 percent behind the appeals modernization" being proposed. Along with other organizations, he said, they helped write it. Under the proposal being offered, veterans lose no rights and the VA is able to process claims in an expeditious manner, he said.

"We in good faith and in consultation with other VSOs and stakeholders sat down with [the Board of Veterans Affairs] and the Veterans Benefits Administration and went into closed-door meetings for three solid days about three months ago and been working together ever since," he said, "to hammer out details to make sure the final product is good for veterans."

-- Bryant Jordan can be reached at Bryant.jordan@military.com. Follow him on Twitter at@BryantJordan.