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Lisa PozzebonAssistant Deputy Under Secretary for Field OperationsVeterans Benefits Administration (VBA)
FY 16-17: Agency Priority Goal
Improve Dependency Claims Processing
Priority Goal
Goal Overview
It is VA’s mission and responsibility to ensure Veterans receive the benefits and services they have earned accurately and within a reasonable amount of time. Since FY 2009, VA’s Agency Priority Goal (APG) for improving access to benefits was focused on eliminating the backlog of disability claims, defined as the number of rating-related claims pending more than 125 days. VA has made dramatic progress in reducing the backlog, improving the timeliness of decisions, and reducing the overall pending inventory of disability rating claims – while at the same time improving the quality of its decisions. To achieve these service improvements, VA defined the requirement, transformed claims processing through implementation of streamlined processes and systems, and accordingly focused resources on achieving the goal.
Veterans who are awarded disability compensation at the 30-percent level or higher are entitled to additional compensation for their eligible dependents. Approximately 70 percent of the 4.1 million Veterans currently receiving compensation are eligible for this additional benefit – nearly 45 percent more than those eligible for the same benefits just five years ago. As the status of these Veterans’ dependents change (through marriage, divorce, death, birth or adoption of children, step-children, and school attendance for children over 18 years of age), adjustments must be made to Veterans’ compensation awards. With VA’s record-levels of production of disability rating decisions (almost 1.4 million disability claims completed in FY15), more and more Veterans continue to be added to the compensation rolls. The result was an inventory at the end of FY15 of almost 227,000 pending dependency claims that have been pending, on average, nearly a year.
Ensuring that Veterans receive timely and accurate claim decisions is paramount. As VA continues to improve timeliness of disability claims decisions, VA will also focus on the dependency claims that are the direct result of the dramatic increase in completed disability rating decisions and growth in the number of Veterans receiving compensation at the higher disability evaluation levels.
Strategies
VA’s strategy for reducing the inventory and timeliness of dependency claims processing will require further enhancements to our automated, rules-based processing system, additional efforts from our people, and changes to processes.
VA has already taken steps to expand our capability to address this growing inventory, which is a direct result of our record-breaking achievements in reducing the claims backlog. Primarily,
VA engineered a rules-based processing system that is designed to complete most dependency claims. Veterans input data about their dependents into an automated form in eBenefits. VA has identified a set of exceptions that prevent automated processing and is reviewing the costs and functional requirements to eliminate these exceptions and expand Veterans’ self-service.
As VA began to automate processing of Veterans’ dependency claims, VA hired a contractor to take the data from its legacy, paper-based dependency claim inventory and input this data into the rules-based processing system. They input data for the entire current pending inventory of dependency claims. Those claims that are still pending could not be processed through automation due to the complex rules governing the addition of dependents. VA is developing plans to further expand the contract to maximize automation beyond the nearly 900 government employees who specialize in dependency and other actions in addition to those requiring a disability rating decision.
VA launched a pilot program in FY 2015 under which VA call center agents, who routinely receive calls from Veterans about the status of their dependency claims, obtained and input dependency claim data to enable VA’s rules-based processing system to automate dependency adjustments. The pilot proved successful as another method to expand automated processing to add a minor biological child, a spouse, a child in school between the ages of 18 and 23, and remove a spouse due to death or divorce. Since inception, more than 30,000 dependency claims were processed under the pilot. The pilot involved 140 agents nationwide and, based on its success, will be expanded to all call center agents (over 660) in FY 2016.
Progress Update
In FY 2016, VBA reduced the inventory of pending dependency claims from 226,874 claims to 114,789 claims. This is a cumulative reduction of 49.4 percent. VBA also outperformed its end of fiscal year inventory target of 190,000 claims by 39.6%.
In addition, VBA reduced the monthly average days to complete dependency claims from 207 days at the end of FY 2015 to 197 days at the end of FY 2016. VBA improved the overall age of the dependency inventory, as average days pending for the inventory fell from 359 days to 228 days.
VBA continues to make progress on workstream projects to improve dependency claims processing. These workstreams include utilization of the National Work Que, improving call center dependency resolutions, improving marketing for online dependency claim submissions, and enhancing automated processing.
National Work Queue
In May 2016, VBA fully deployed the National Work Queue (NWQ) to all 56 Regional Offices (RO) as an enhancement to VBA’s paperless processing system, the Veterans Benefits Management System (VBMS). NWQ dynamically distributes claims to ROs nationwide based on prioritized actions and the associated resource capacity of each RO. NWQ enables VBA to better manage workload distribution, match work assignments to RO capacity, and improve the timeliness and quality of decisions. Since deployment on 5/9/2016, NWQ has distributed 75,957 dependency claims to ROs in order to maximize capacity utilization.
In Q4 FY 2016:
VBA deployed NWQ to all ROs for rating claims processing and has begun to distribute some of its newest dependency claims through NWQ. In the third quarter, VBA shifted approximately 21,000 dependency claims, which could not be processed by our automated processing tool, to the Milwaukee and St. Paul Pension Management Centers in order to utilize additional production capacity at those stations. Approximately 70% of these claims were completed by the end of the fiscal year. In order to improve overall timeliness of claims processing, VBA has continued to focus regional offices dependency claim processing on the oldest claims in the inventory. In the fourth quarter of FY 2016, VBA reduced the inventory of pending dependency claims by 24.1 percent from the end of the third quarter of FY 2016, from 151,332 claims to 114,789 claims. This is a cumulative reduction of 49.4 percent since the beginning of the fiscal year , when the inventory was 226,874 claims. The monthly average days to complete dependency claims decreased from 241.4 days in June 2016 to 197.2 days in September 2016.
Improve call center dependency resolutions
VBA’s telephone call center agents speak to Veterans and provide answers to questions about dependency claims. Beginning in FY 2015, VBA began to train call center agents to input basic dependency claim information into the Rules-Based Processing System (RBPS) to allow the automated system to process changes to dependency status, to include marriage, the addition of minor children and the addition of children who are between the ages of 18 and 23 and in school.
Each agent was provided 40 hours of classroom instruction and practical training to ensure that they ask for the necessary information from the Veteran to allow the system to fully process the dependency claim.
In Q4 FY 2016
VBA has completed training for more than 900 call center agents who answer questions about disability compensation claims. This has increased the number of dependency claims taken over the telephone and completed in the rules based processing system from 4,500 claims in FY 2015 to 18,694 in FY 2016. Through the fourth quarter, VBA completed 22.5 percent of all dependency claim completions through either online input on the eBenefits site or telephone customer service-assisted dependency processing. Claims processed by call center agents saves manual processing and prevents simple claims from being added to the existing inventory.
Improve Marketing for Online Dependency Claim Submissions
VBA seeks to leverage past successful campaign efforts to encourage online claim submissions through eBenefits and the Fully Developed Claim (FDC) Program to expand use of the eBenefits portal for dependency claims. At the beginning of FY 2016, there were more than 5.4 million eBenefits users.
Fifty-four percent of disability compensation claims received in FY 2015 originated through the FDC program. For dependency claims, automated online processing provides 1-day completion times for new claims that are filed online and processed by the automated system. VBA plans to launch a marketing and outreach campaign which will include development of new educational and promotional materials to explain the significant benefits of online filing.
In Q4 FY 2016
VBA continued planning for a dependency benefit specific website resource, along with an outreach campaign for this resource utilizing social media engagement and VSO partnerships. The website and outreach campaign will further improve communication and promotion of the online dependency claim submission capability in eBenefits and the Stakeholder Enterprise Portal (SEP). This will further shift the culture of claims submission from paper to online submission.
Enhance Automated Processing
Some of VBA’s dependency claims are simple changes to dependency that can be implemented by a rules-based processing system. This program processes data received directly from Veterans through eBenefits, data input by call center agents and others and has contributed approximately 13 percent to VBA’s dependency claim completions through the fourth quarter. VBA plans to continue enhancing the rules-based capabilities to automatically process a greater share of dependency claims.
In Q4 FY 2016
VBA continues to work within VA to investigate and develop enhancements to the rules-based processing system.
Next Steps
In FY 2017, VBA plans to fully incorporate dependency distribution into the NWQ, through modification to the workforce capacity model to account for dependency claim and other non-rating claim capacity. In addition, further system updates are planned that will increase the quality of data submitted to Rules-Based Processing System (RBPS) and the efficiency of RBPS processing. VBA estimates that it will reduce the dependency claims inventory to approximately 109,000 claims by the end of first quarter FY 2017, well beyond the original 170,000 claims inventory target for the first quarter.
Training for VBA’s Public Contact Team (PCT) personnel on dependency claims processing is scheduled for completion in the first quarter of FY 2017. The PCT will be processing dependency claims at point of contact with Veterans, providing better service to Veterans and dependents.
Expand All
Performance Indicators
Inventory of dependency claims
Average days to complete (ADC) dependency claims
Contributing Programs & Other Factors
Contributing programs within the agency: Board of Veterans’ Appeals, Office of Information and Technology, and Office of Acquisition, Logistics, and Construction.
Contributing partners outside the agency: Veterans Service Organizations , Office of Management and Budget.
No Data Available
