THE VETERAN EXPERIENCE AND THE FUTURE OF APPEALSMARCH 12, 2016

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Overview of VA Appeals Process

• Process takes too long – there is no defined endpoint or timeframe.

• Process is too complex – veterans do not understand the process, and it is very challenging to explain it to them in a way that is understandable.

*The VA Appeals Process is Broken*

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Dec-12

Feb-13

Apr-13

Jun-13

Aug-13Oct-

13

Dec-13

Feb-14

Apr-14

Jun-14

Aug-14Oct-

14

Dec-14

Feb-15

Apr-15

Jun-15

Aug-15Oct-

15

Dec-15

Feb-16

0

50,000

100,000

150,000

200,000

250,000

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

163,102

238,509

62,03354,796

15,467

44,37737,91338,638

15,189 25,62019,541 26,769

12,38410,972

1,258 5,472

326,887

445,437

Notice of Disagreement (NOD) Form 9Certified, Not Docketed (Original) BVA Active Docket (Original and Post Remand)Remand (RO) Statement of the Case (SOC)Remand (AMC) Remands Returned Not ActivatedGrand TotalA

ppeals in Process

Grand Total

VA Appeals Pending

Percent Change since Dec 2012Grand Total +36.27%

NOD +46.23%Form 9 -11.67%

*Certified, Not Docketed (Original) +186.91%BVA Active Docket (Original and Post Remand) +1.91%

SOC +36.99%Remand (RO) +68.67%

Remand (AMC) -11.40%*Remands Returned Not Activated +334.98%

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Board Hearings

Central Office Travel Board Video0%

10%

20%

30%

40%

50%

60%

4.5%

35.8%

59.8%

Breakdown of Hearings Held During FY 2015

FY 2015 53%

FY 2014 58%

FY 2013 59%

FY 2012 58%

FY 2011 55%

FY 2010 54%

Central Office: VLJ & Veteran sit at Board Offices in Washington, DC

Travel Board: VLJ & Veteran sit at local ROVideo Conference: VLJ sits in DC; Veteran sits at local RO

Percentage of Form 9 Hearing Requests Received During FY

Total Pending Board Hearing Requests 65,267

Appeals in Transfer SEAM* with a Pending Board Hearing Request 33,298

Appeals at VBA with a Pending Board Hearing Request 31,969

*Transfer SEAM appeals are appeals that have been certified to the Board but have not yet been activated / docketed.

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Actual Veteran Experience with Current VA Appeals Process

VeteranNotice of

Disagreement (NOD) Date

Date Resolved

Veteran Wait Time from NOD to Conclusion

Summary

A 1987 2011 25 years(9,073 days)

Since January 1987, this appeal has addressed 6 issues. The Veteran has been receiving a total disability rating based on individual unemployability (TDIU) since February 2006.

Over the course of the appeal, the Veteran has received 27 decisions: • 16 VBA adjudications (4 rating decisions, 2 SOCs, and 10 SSOCs) • 10 Board decisions • 1 Court of Appeals for Veterans Claims (CAVC) decision

B 1988 200618 years

(6,687 days)

Since July 1988, this appeal has addressed 31 issues. The Veteran has been rated at 100 percent for his service-connected disabilities since January 2002.

Over the course of the appeal, the Veteran has received 46 decisions:• 38 VBA adjudications (1 decisional letter, 14 rating decisions, 10 SOCs, and 13

SSOCs)• 7 Board decisions • 1 CAVC decision

C 1990 2010 20 years(7,425 days)

Since October 1990, this appeal has addressed 26 issues. The Veteran has been rated at 100 percent since February 2006.

Over the course of the appeal, the Veteran has received 63 decisions:• 50 VBA adjudications (18 rating decisions, 9 SOCs, and 23 SSOCs; • 9 Board decisions • 3 CAVC decisions• 1 Administrative Review of a Retroactive Award by the Director, Compensation

and Pension

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Current VA Appeals Process

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• http://www.blogs.va.gov/VAntage/25331/listening-to-the-voices-of-veterans-and-their-journey-in-the-appeals-system/

Veteran Appeals Experience

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1. The length and labor of the process takes a toll on Veterans’ lives.

2. Like in the military, Veterans care deeply about the outcomes of other Veterans.

3. Veterans feel alone in a process they don’t understand.

4. The appeals process feels like a fight.

5. Veterans want to be heard.

Key Themes

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• “After going through all these, I’m wore out. I’m 68 years old, by the time I got an answer [on a new appeal] I’d be dead....There’s a point in time when it’s just not worth it.”

• “You know I have been disappointed for so long going through this situation, I don’t think whatever decision they make is going to hurt me because I’ve been hurt already and I’m about to get teared up thinking about it.”

• “My wife however didn’t want me to [appeal]. Because there’s so much stress in waiting and waiting and waiting and waiting.”

• “The whole time, you’re waiting, just like me, your ailments are growing, they’re getting worse. And you can’t go back and renew your claim now, and say it’s getting worse because then you’re pushing that first claim back and you’re [basically] starting a whole new claim. It’s a really stressful process.”

The length and labor of the process takes a toll on Veterans’ lives.

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• “That’s all I want, is to be heard, to be treated with respect, to have other Veterans not be so scared to file a claim.”

• “I get help from other Veterans who have been through the process before. It is confusing though when we have similar issues, but get different ratings.”

• “It changes your life – it can cause you to be depressed, incapacitated, but I can’t let that stop me from helping others. I advise them: ‘Do you have the time and mental commitment to appeal?’ This is my first time going through an appeal and I wouldn’t wish that on anybody.”

• “It’s horrible, I know of other Veterans who’ve just given up. I hear it all the time.”

Like in the military, Veterans care deeply about the outcomes of other Veterans.

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• “I’ve been doing this on my own, with zero help, nothing. I mean I think I’ve become an uncertified medical doctor and an uncertified lawyer.”

• “Tell me where I’m at: ‘They’re at this stage. They just went over this evidence. This is where you’re standing now.”

• “I don’t understand the whole claims process, appeals process. I don’t understand it at all. It makes no sense.”

• “I wouldn’t even know who to try to get a hold of [at VA].”

Veterans feel alone in a process they don’t understand.

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• “[The process] needs changing, no question. Veterans should be treated with respect and dignity. Veterans need to know VA is on their side.”

• “It just seems like you’re fighting a losing battle. And its like insurance, they just hope you give up.”

• “They are just waiting for me to die, then they can close my case and forget about me.”

• “Twelve years, they deny, deny, deny [bangs table].”

The appeals process feels like a fight.

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• “I just wanted to tell my story. I just want them to hear me.”

• “I just want them to hear what I got to say because I tried to tell them years ago how simple it was.”

• “Last night, we were talking about it, about today’s hearing and everything. And we were saying a prayer and in the prayer it wasn’t that we were praying that ‘Oh I pray you get the highest disability rating and you get that check and all that money.’ No, it was ‘I am praying that your voice is finally heard after all these years.’”

• “Somebody needs to hear it even if it’s just that gentleman [the judge], somebody needs to hear it. Because it’s not nothing. It’s his life, it’s our life, it’s our kids’ lives.”

Veterans want to be heard.

142016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027

-

500,000

1,000,000

1,500,000

2,000,000

2,500,000

0

500

1,000

1,500

2,000

2,500

3,000

518,220

2,167,106

241,505 264,731

2,165

2,2782,435

1,432

2,592

228% increase in pending

inventory from FY 2017 to FY 2027.

Appeals decisions and FTE essentially

flat-line (nominal annual increases of 2% respectively).

By FY 2027 VA appeals

processing time is 610% longer

than 365 days.

P e n d i n g I n v e n t o r y

A p p e a l s D e c i s i o n s

F T E

P r o c e s s i n g T i m e

Volume FTE

2,165 2,187 2,224 2,273 2,286 2,278 2,302 2,372 2,353 2,379 2,407 2,435

2,167,106

Long Term Impact of No Legislative ReformStatus Quo Legal Framework & No Radical Change in Resources

Analysis of Alternatives Total Cost Comparison

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By FY 2027, Total Cost Savings of $727M per

year for Simplified Process as

compared to Non-

Legislative option.

2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 $-

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$317,337

$559,983 $627,023

$493,109 $462,055

$409,259

$188,410 $198,634 $208,977

$940,140

$1,044,944 $994,796

$1,019,868

$898,813 $872,273 $879,919 $935,814

$304,132 $315,348

$392,725 $438,872

VA Budget Requirement (VBA + Board)

Simplified Process Non-Legislative No Radical Change

thou

sand

s

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The current VA appeals process is broken and is providing a frustrating Veterans experience. We are failing veterans.

The status quo isn’t acceptable for Veterans or for tax payers.

Veterans deserve an timely, simple, transparent, and fair, appeals process.

The time to modernize the appeals process is now.

Summary of the Current VA Appeals Process