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Hearing of the House Veterans Affairs Committee - VBA and VHA Interactions: Ordering and Conducting Medical Examinations


Location: Washington, DC

Thank you, Mr. Chairman for holding this hearing today on behalf of our nation's veterans.

Mr. Chairman, I appreciate you taking the time during our extensive oversight of the VA to focus on something that the VA is improving upon: processing claims.

As of today, the VA has reduced the backlog by more than 50 percent from its highest point in March of 2013.

We are not even close to the finish line, but we are starting to see increases in productivity as a result of VBA's long overdue shift from paper to an electronic processing system.

All 56 offices have moved into this electronic processing system and into a new organizational model that appears to be showing positive results.

Some of our high-performing regional offices are nearing the point at which the backlog will be eliminated.

While we have heard of the scheduling challenges that veterans face in receiving clinical appointments, I am happy to hear that VA has been providing timely medical examinations to determine a veteran's entitlement for VA benefits.

Currently VA's national average for medical examinations for benefits purposes is 24 days, which is six days better than their goal of 30 days.

VA seems to believe that they have a solid handle on their mix of contract versus non-contract examinations.

We have heard VA suggest that in an ideal world they would prefer non-contract examinations over contract examinations because they believe it provides a better continuum of care for veterans.

We have generally heard the same thing from veterans, who suggest that when they have access, VA quality of care is second to none.

However, with regards to contract examinations, it seems that the logical way forward continues to be a mix based on clear standards as to when and where they should or should not be used.

That said, I have some overarching concerns with VBA's transformation efforts.

Foremost, the "all-in" focus on the backlog is starting to come at the cost of increased delays for other benefits.

Management-by-crisis is not a long-term viable solution - We cannot afford to solve one critical issue by taking our attention off another.

I urge VA to reallocate resources to process non-rating claims and appeals in a timely fashion.

Appeals and non-rating claims are also part of the backlog and deserve to be adequately resourced to provide timely and accurate decisions to our veterans.

There will be no victory laps here until VBA has eliminated their entire overdue inventory.

If we have learned anything from this healthcare debacle, it should be that serving veterans, not performance metrics, is the way to do business.

Along these lines, I would encourage VBA to ask itself, are we oriented toward a specific set of performance metrics at the expense of identifying how to best serve our veterans?

These are the types of questions we must answer as we move forward, and I hope to hear them discussed in today's hearing in a bit more detail.

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