NY times article
By JAMES DAO
To hear wounded veterans tell it, there are few things more daunting, infuriating or soul-crushing than dealing with the Veterans Benefits Administration, the agency that decides whether they will receive disability benefits for injuries and illnesses incurred during war.
As the inventory of unprocessed claims has grown — to more than 900,000 nationwide — so has anger with the agency. On Tuesday, in what has become an annual ritual, Congress will hold hearings on the V.B.A.’s chronically poor performance.
But in one small pocket of the sprawling benefits agency, a branch of the Department of Veterans Affairs, front-line workers are taking the unusual step of going public about the dysfunction within their own bureaucracy, making common cause with some of their loudest critics.
On Saturday, workers from the benefits agency’s regional office in Columbia, S.C., will picket outside their workplace, hoping to spotlight what they consider root causes of their system’s breakdown: lack of accountability, inadequate resources, hopelessly complex policies and demoralizing work conditions.
“We want to take care of veterans; many of us are veterans,” said Ronald Robinson, a protest leader, president of the union local and an Army veteran. “We can’t sit any longer and be blamed for things that are beyond our control.”
The backlog in the disability compensation system has steadily worsened since the wars in Iraq and Afghanistan began, having more than doubled in the last decade. The department defines its backlog as claims that have been awaiting decisions for more than 125 days, the department’s benchmark for timeliness.
Almost no regional office has been immune from problems, with the office in Oakland, Calif., now sending new claims to other offices because its inventory has grown so large. Yet even the Columbia office, considered by some veterans advocates to be relatively good, had a backlog of about 15,000 claims last month and did not accurately process one out of three claims last year, according to a report by the department’s inspector general.
Leaders of the Department of Veterans Affairs and the protesters in Columbia agree on some of the causes of the backlog: a flood of claims by recent Afghanistan and Iraq war veterans as well as aging Vietnam veterans seeking compensation for old injuries or Agent Orange-related illnesses; a weak economy; and the growing complexity and number of injuries and diseases now recognized as service-related.
But on the issue of how to fix the problem, the two sides sharply diverge. The department says its efforts to digitize records, update computer software, hire 4,000 workers, extend overtime to process claims and make changes intended to speed the processing of claims will begin shrinking inventory by next year.
In a statement, the V.A. said those initiatives had put it on track to process all claims in less than 125 days by 2015. “Change can be challenging, and we recognize that our dedicated employees are critical to providing veterans with timely, quality benefits,” the statement said.
In the trenches in Columbia, however, the protest leaders say those efforts had made little difference, and in some cases had made matters worse.
One reason, they said, is that some new procedures have added complexity to an already complex process. For instance, they said, a questionnaire created to allow veterans to use private health providers to do physical examinations is longer and more complicated than the forms used by government providers.
When questionnaires are returned with mistakes or unchecked boxes, reviewers must return them, delaying decisions. “They’ve implemented so much stuff, no human can keep up with it all,” said Cindy Indof, a decision review officer who has been with the department for 20 years.
Workers also said processing a claim had become increasingly segmented, with files passing through several hands before being denied or approved. As a result, files are more likely to be misplaced, communications garbled and decisions slowed, they said. And no one is held accountable for mistakes because so many people are involved.
“No one has ownership over anything,” said Mr. Robinson, a veterans service representative.
The employees also complained about the performance review process used to measure their productivity, saying it reduced the quality of work and hurt morale. The process requires claims processors to complete a certain number of files per day. People who fall short can be denied promotions or fired. Those who meet or exceed quotas become eligible for bonuses.
The workers said those quotas encourage processors to take shortcuts that often lead to mistakes, or to focus on easier cases over complex ones. And when in doubt, processors tend to deny claims, the workers said, because denials are generally faster.
Though the Columbia protest might seem isolated, James Strickland, a Vietnam-era veteran and retired health care manager who runs a popular Web site, VAWatchdog.org, said he had heard similar complaints from V.A. offices across the country. The Columbia workers are different, however, because they have gone public.
“They aren’t looking for more money or vacation,” said Mr. Strickland, who plans to attend the protest. “I heard them say, ‘I want the system to change so I’m allowed to do my job.’ And I hear that all the time.”
Mr. Robinson said about 8,300 cases were ready to be processed in the Columbia office, which has about 100 claims raters, many of whom already have more than 140 cases on their desks.
“Do the math,” he said. “There is nothing we can do to catch up.”