Veterans' benefit? VA, buried under claims, says it's finally digging out.

Stories of US veterans streaming back from America’s wars and endeavoring to gamely navigate the Veterans Administration claims process have created a grim legend of wounded warriors waiting four years before the VA, buried under a mountain of paperwork, can even begin the process of looking into their benefits claims.

In fact, according to an August 2012 report from the VA’s Inspector General, the stacks of files grew so dense at the Winston-Salem, N.C., regional VA office that they “appeared to have the potential to compromise the [structural] integrity of the building.”

According to the report, some 37,000 claims were in chaotic stacks, leading to a predictable “increased risk of loss or misfiling” and also exceeding the load-bearing capacity of the building by 39 pounds per square foot.

In the wake of this and other reports over the years – and the ensuing outcry from lawmakers and veterans advocacy groups – the VA has been laboring to bring down its backlog of claims, which VA Secretary Eric Shinseki has promised to end by 2015.

And in recent months, the agency has reported some success.

Efforts to speed up care for vets have included bringing high technology to the VA, in the form of a much-heralded recent move to get rid of paper files and computerize the claims process.

Earlier this year, the VA also established its own Center for Innovation, which is exploring products like mobile apps for vets and has reached out to entrepreneurs such as Craig Newmark, founder of Craigslist, in an effort to, for example, improve customer service.

Still, making a dent in the backlog of claims at the VA is no easy task. The department currently reports more than 800,000 petitions for which veterans are awaiting an answer. 

More than half a million of them, roughly 525,000, are “backlogged,” meaning, by the definition Mr. Shinseki has put in place, that they have been pending for more than 125 days.

The hold-up in many cases has been complicated by the surge of veterans returning home with wounds from America’s decade-long wars in Iraq and Afghanistan. In the past four years alone, nearly 1 million veterans were added to the VA’s compensation rolls. 

“Veterans submitting claims today claim many more medical conditions,” says VA spokesman Randy Noller. This is “largely because of multiple deployments and the fact they are 10 times as likely to survive today’s wars – but with multiple medical issues for a lifetime.”

Then there was the decision made during Shinseki’s tenure to “right some old wrongs,” Mr. Noller adds. 

This includes making “the long overdue decision” to recognize for the first time what in military parlance is known as the “presumption of service connection” for diagnoses of post-traumatic stress disorder, Gulf War illness, and what the VA has determined to be Agent Orange-related conditions, including Parkinson’s disease.

This in turn has led to another million new claims, Mr. Noller says.

Other factors complicate the claims process, too, highlighted by a widely circulated exchange last week between Rep. Tammy Duckworth (D) of Illinois and a contractor who claimed a disability benefit for an injury he sustained in a military preparatory school – a case that grabbed the attention of veterans groups.

Disabled veterans who own small businesses receive preference when they bid for a government contracts.

The contractor, Braulio Castillo, president and CEO of Strong Castle Inc., in Washington, D.C., currently receives monthly checks for an ankle injury, which he says he sustained while playing football or orienteering. He was given a 30 percent disability rating by the VA, citing “the crosses that I bear in my service to our great country,” Representative Duckworth noted as she read Mr. Castillo’s letter aloud during the hearing.

Castillo did not return calls or e-mails for comment on this story.

A visibly angry Duckworth, a veteran Army pilot and double amputee whose helicopter was shot down over Iraq – and who was subsequently given a 20 percent disability rating by the VA – took Castillo to task for taking advantage of the system. 

“You broke the trust of veterans. Iraq and Afghanistan veterans right now are waiting an average of 237 days for an initial disability rating. It is because people like you who are gaming the system are adding to that backlog that young men and women who are suffering from post-traumatic stress, who are missing limbs, cannot get the compensation and the help that they need,” she told him.

“You, who never picked up a weapon in defense of this great nation, very cynically took advantage of the system.” 

Veterans groups applauded Duckworth.

“I think that Congresswoman Duckworth was right to take him to task, and I’m glad she did it,” says Tom Tarantino, chief policy officer for the Iraq and Afghanistan Veterans of America. “Obviously we don’t want to get into the game of saying, ‘My injury is ‘better’ than your injury,’ ” he adds, “but there have been problems of gaming the system in general.” 

Yet the contrast between a 20 percent disability rating for a double amputee helicopter pilot who was shot down in Iraq and a 30 percent rating for a person who injured an ankle playing sports in a military preparatory school illustrates the dilemmas that the VA must grapple with as well: make the process too easy and risk rewarding those who may be tempted to game the system, but make the process too complex and demanding and risk denying claims to a veteran who needs help.

“Speed is one value, but accuracy is perhaps more important,” says former Pentagon official Phillip Carter, a senior fellow and counsel at the Center for a New American Security (CNAS) think tank. “These claims decisions can last for a lifetime, and it’s really important that the VA gets it right.” 

The best way to navigate this tough terrain, VA officials say, is to have as much documentation made easily available through electronic means as possible, as well as giving private doctors the chance to weigh in on a complex process that until recently did not have a standardized form for physicians to fill out. 

In the past, the VA claims process “has been a fractured, disjointed, almost Kafka-esque terrain,” says Jonah Czerwinski, director of the VA Center for Innovation.

One of the center’s chief aims today is searching for “opportunities to demystify the VA process for the customer, and find ways to make it more accessible and useful for the veteran and the taxpayer,” he says. 

To this end, the center reached out to Mr. Newmark of Craigslist, whose job title at the company he owns is “customer service representative.” These consultations have in turn encouraged VA officials to “think through ways we weren’t breaking the back of the backlog, from the customer standpoint,” Mr. Czerwinski says.

“In a lot of ways, what we are is a customer service organization, more so than almost any other federal agency,” he adds. 

Every year, for example, more than 6.5 million vets receive health care through the VA, and more than 1 million submit claims to the VA for compensation. 

These new areas of focus for the VA have resulted in positive trends, in the form of “slow, grinding progress – but the direction of the progress is pretty clear,” says Mr. Carter of CNAS, who notes that the backlog numbers for the VA have “gone down for 11 straight weeks.” 

VA officials say they have at last reached a “tipping point,” having cut the department’s backlog of disability claims by 74,000 since last April. 

In the meantime, a handful of the VA’s 56 regional offices is beginning to meet the goal of processing all disability benefit claims within 125 days. 

VA officials say they are studying these “pockets of success” to glean lessons-learned for the rest of the VA’s regional offices.

“We’re in the home stretch for eliminating the backlog,” says Czerwinski.

Mr. Tarantino of the IAVA, which has been critical of the VA in the past, says he, too, sees progress. “I don’t think it’s going to be enough to get through the backlog by 2015, but we’re extremely pleased that the VA has rolled out its new electronic system.” 

He notes that in the past few weeks the VA has stopped accepting paper documents and now uses scanners. “They went from a completely paper-based system to a digital system in the space of a year.” 

“I hate to say that doing things electronically is revolutionary, but for them it is absolutely revolutionary,” he adds. “It is huge.”