Friday, August 08, 2014

VA Proposes Removal of Employees Who Manipulated Data

July 29, 2014 – The Department of Veterans Affairs (VA) today proposed a series of disciplinary actions against six employees at Department facilities in Cheyenne, Wyo., and Fort Collins, Colo.  These actions are a part of VA’s effort to rebuild the trust of America’s Veterans.
“Employees who have been found to have manipulated data, withheld accurate information from their supervisors, and affected the timeliness of care Veterans receive do not reflect VA’s values, and their actions will not be tolerated,” said Acting Secretary Sloan D. Gibson. “VA must earn back the trust of Veterans.  Part of earning back that trust is holding people accountable when there is documented evidence of willful misconduct and management negligence.  We depend on the dedicated service of VA employees and leaders who live by our core values.  Those who have not delivered results honestly have and will be held accountable.”
Based on a review by the Inspector General and other Department investigations, VA today proposed disciplinary actions against six employees at the Cheyenne VA Medical Center and Fort Collins Community-Based Outpatient Clinic.
As a result of these findings, VA proposed disciplinary actions against the Director of the Rocky Mountain Network (VISN 19), and the Director and Chief of Staff of the Cheyenne VA Medical Center.
Certain supervisors in these facilities were found to have personally manipulated data, instructed their subordinates to manipulate data, and withheld accurate information from their superiors.  VA today proposed two of the supervisors be removed from Federal service.
Additional proposed penalties for other supervisors include two proposed suspensions, a demotion, and admonishments.

Tuesday, July 15, 2014

Veterans Benefits Administration Processes One Millionth Claim in FY 2014


July 14, 2014
Agency Expects to Process 1.3 Million by Year’s End
 The Department of Veterans Affairs (VA) today announced that the Veterans Benefits Administration (VBA) has completed its one millionth disability claim in fiscal year 2014, and is on track to complete more than 1.3 million claims this year – ensuring that nearly 200,000 more Veterans will receive decisions on their disability claims than fiscal year 2013.  Since 2011, VBA has been implementing the largest transformation in its history, fundamentally redesigning and streamlining the way it provides benefits and services to Veterans, their families and survivors.
“VBA has made significant progress toward eliminating the backlog, but there is more work to be done to reach our goal of processing all disability claims within 125 days at a 98-percent accuracy level in 2015.” said Allison Hickey, Under Secretary for Benefits. “VBA’s employees, half of whom are Veterans themselves, believe that Veterans should not have to wait for the benefits they have earned and deserve.  While we work to drive down the backlog of disability claims, we must also improve productivity on other categories of non-rating work.”
In the past four fiscal years, VA surpassed one million completed claims by the end of each year.  Passing the one-million mark this year in early July represents major progress in providing more Veterans and their family members with timely, accurate decisions.  VBA has reduced the claims backlog by more than 55 percent from its peak of 611,000 in March 2013 – and Veterans with pending claims have been waiting, on average, 128 fewer days for a decision on their claim.  At the same time, the accuracy of rating decisions continues to improve. VA’s national “claim-level” accuracy rate is currently 91 percent – an eight-percentage-point improvement since 2011.
These rating decisions often determine eligibility for other VA benefits and services, including non-rating claims, which are tracked and managed in other categories on the Monday Morning Workload Report.  These categories also have increased as more rating claims are completed, but VBA has not lost focus on non-rating work.  VBA has taken the following actions to automate and improve the timeliness and accuracy of non-rating claim decisions:
Online Dependency Claims – VBA developed a new Rules-Based Processing System (RBPS) to automate dependency claims.  Since inception, self-service features in RBPS have enabled over 75,000 Veterans to add or change the status of their dependents online.  Over 50 percent of the dependency claims filed through RBPS are now automatically processed and paid in 1-2 days.
Dependency Claims Contract – VA recently awarded a contract for assistance in entering data from paper-based dependency claims into VA’s electronic rules-based processing system.  The contractor is entering the information from the paper-based dependency claims just as a claimant would enter information if filing the claim online.  The contract calls for 40,000 dependency claims to be processed per month when operating at full capacity.  The contractor is currently ramping up to that capacity.
Up-front Income Verification for Pension – A new data-sharing initiative with the Social Security Administration and the Internal Revenue Service enables VBA to verify the income of pension applicants before awarding benefits and eliminates the annual income reporting requirement for pension beneficiaries.
Burial Claims – VBA published a new regulation, effective July 7, 2014, that allows automatic payment of the one-time burial allowance to a Veteran’s spouse without requiring the surviving spouse to apply for the benefit.  Under this new regulation, as many as 62,000 surviving spouses will now receive timely burial benefits each year.
Drill Pay Adjustments – Veterans cannot legally receive VA benefits and drill pay concurrently.  VBA is working to streamline and automate the drill pay offset process through an upfront agreement from National Guard and Reserve members.
National Call Center Initiative – Effective July 14, employees at the St. Louis and Phoenix National Call Centers are now also processing dependency claims.  The initiative begins on July 14 at the St. Louis and Phoenix Regional Offices and will be expanded to all of our Call Centers shortly thereafter.
Hiring Temporary Employees – VBA is in the process of hiring 200 temporary employees, who will be provided specialized training in processing the less complex non-rating claims and work actions.  
VBA posts data on the disability claims backlog, the non-rating workload, and other publicly available data on our performance on a weekly, monthly, and annual basis through our reports web site: www.vba.va.gov/reports.

Tuesday, June 10, 2014

June 10, 2014

VA Meets With Healthcare Industry to Discuss Best Scheduling Practices
Kaiser, Gartner, Mayo Clinic to Share Insights on Access Innovation, Modernization

WASHINGTON – Acting Secretary of Veterans Affairs Sloan Gibson today announced that the Department of Veterans Affairs (VA) will meet with private healthcare industry leaders to discuss best practices and policies for scheduling patients.

“Our top priority is to get our Veterans off wait lists and into clinics,” said Acting Secretary Gibson.  “We need to continue to examine the best practices of healthcare systems across the country to find immediate solutions for timely delivery of quality healthcare.  VA must be at the forefront of access and innovation.  Our Veterans deserve nothing less.”

Today, VA officials will meet on state-of-the-art health care access with industry leaders including Kaiser Permanente, Gartner and Mayo Clinic.  Discussions will focus on improving Veteran access to quality health care and innovating measurement approaches to gauge short- and long-term access to care.  Topics will also include recommended strategies and tools to help managers and providers best serve Veterans and provide a consistent patient experience.

The above is a press release from the Veterans Administration.  As anyone who has been through the VA disability process knows often VA disability cases are delayed due to waiting on VA examinations.  Hopefully, with improvement in scheduling in the VA health system there will also be some improvement in VA disability wait times.

Tuesday, April 29, 2014

Disability Claims Backlog Reduced by 44 Percent

WASHINGTON – One year after the backlog of pending disability compensation claims peaked at over 611,000 in March 2013, the Department of Veterans Affairs (VA) has reduced that number by approximately 44 percent to 344,000 claims – a reduction of more than 267,000 – while at the same time improving the accuracy of the decisions being made on Veterans’ disability claims.  Additionally, on average, Veterans are waiting 119 days less for a decision than they were at this time last year.

“No Veteran should have to wait to receive earned benefits.  Through a combination of transformation initiatives and the hard work of our employees, we are making significant progress toward our goal of eliminating the claims backlog in 2015,” said Secretary of Veterans Affairs Eric Shinseki. “We still have more work to do, and no one is more committed than our Veterans Benefits Administration employees, over half of whom are Veterans themselves.”

The current backlog, defined as claims pending more than 125 days, is at its lowest point since March 2011, when the backlog spiked in part because of the need to readjudicate 150,000 previously decided cases involving exposure to the Vietnam-era defoliant, Agent Orange.  The readjudication of these claims was mandated under the Nehmer court decision and followed the Secretary’s decision to add ischemic heart disease, certain leukemias, and Parkinson's disease to the list of conditions presumed to be related to exposure to Agent Orange. During this same time period, VA also received and processed over 100,000 new claims for these three conditions from Vietnam Veterans and survivors newly eligible for VA benefits as a result of this decision.

“We knew taking care of this ‘unfinished business’ for Veterans of previous wars would initially drive up the number of claims in our system.  But it was the right thing to do,” said Secretary Shinseki.

Since establishing the goal in 2010 of processing all disability claims within 125 days at a 98-percent accuracy level, VA developed and is implementing a plan that transforms the decades-old, manual paper claim approach into a state-of-the-art electronic process that leverages digital data transfer and automated calculators to reduce processing time and input errors.

VA has also increased the productivity of its claims processing workforce through enhanced training, streamlined business processes and other initiatives such as mandating overtime and prioritizing the oldest claims, allowing VA’s 56 regional benefits offices to exceed monthly production records four times in fiscal year 2013.

At the same time, the accuracy of rating decisions continues to improve. VA’s national “claim-level” accuracy rate, determined by dividing the total number of cases that are error-free by the total number of cases reviewed, is currently 91 percent – an eight-percentage-point improvement since 2011.  When measuring the accuracy of rating individual medical conditions inside each claim, the three-month accuracy level is 96.5 percent.  VA’s accuracy measures are statistically valid and the process has been independently verified by the Institute for Defense Analyses.

Tuesday, March 25, 2014

VA Removes Annual Income Reporting Requirement

March 24, 2014 – The Department of Veterans Affairs (VA) is eliminating the annual requirement for most Veterans enrolled in VA’s health care system to report income information beginning in March 2014. Instead, VA will automatically match income information obtained from the Internal Revenue Service and Social Security Administration.
“Eliminating the requirement for annual income reporting makes our health care benefits easier for Veterans to obtain,” said Secretary of Veterans Affairs Eric K. Shinseki. “This change will reduce the burden on Veterans, improve customer service and make it much easier for Veterans to keep their health care eligibility up-to-date.”
Some Veterans applying for enrollment for the first time are still required to submit income information. There is no change in VA’s long-standing policy to provide no-cost care to indigent Veterans, Veterans with catastrophic medical conditions, Veterans with a disability rating of 50 percent or higher, or for conditions that are officially rated as “service-connected.”
VA encourages Veterans to continue to use the health benefits renewal form to report changes in their personal information, such as address, phone numbers, dependents, next of kin, income and health insurance.

Thursday, February 20, 2014

New Compassionate Allowances Conditions

The Social Security Administration just released the following press release about the compassionate allowance program.  This program allows those with very serious medical conditions to get their benefits faster.

This month, Carolyn W. Colvin, Acting Commissioner of Social Security, announced 25 new Compassionate Allowances conditions, including a dozen cancers. This brings the total number of conditions to 225.

The Compassionate Allowances program expedites disability decisions for Americans with the most serious disabilities to ensure that they receive their benefit decisions within days instead of months or years. To date, almost 200,000 people with severe disabilities have been approved through this fast-track disability process.

“We are dedicated to providing vulnerable Americans with faster access to disability benefits through our Compassionate Allowances program,” said Acting Commissioner Colvin. “Social Security disability benefits are a vital lifeline for individuals who are facing severe diseases and we must ensure that they receive the benefits they rightly deserve.” 

Learn more by reading the press release, where you’ll find a list of the new Compassionate Allowances conditions.  www.socialsecurity.gov/pressoffice/pr/compassionate-allowances-0114-pr.html

For more information on the Compassionate Allowances program, including a full list of conditions, please visit www.socialsecurity.gov/compassionateallowances.

New Compassionate Allowances Conditions


Angiosarcoma
Atypical Teratoid/Rhabdoid Tumor
Chronic Idiopathic Intestinal Pseudo Obstruction
Coffin- Lowry Syndrome
Esthesioneuroblastoma
Giant Axonal Neuropathy
Hoyeaal-Hreidarsson Syndrome
Intracranial Hemangiopericytoma
Joubert Syndrome
Leptomeningeal Carcinomatosis
Liposarcoma- metastatic or recurrent
Malignant Ectomesenchymoma
Malignant Renal Rhabdoid Tumor
Marshall-Smith Syndrome
Oligodendroglioma Brain Tumor- Grade III
Pallister-Killian Syndrome
Progressive Bulbar Palsy
Prostate Cancer - Hormone Refractory Disease - or with visceral metastases
Revesz Syndrome
Seckel Syndrome
Sjogren-Larsson Syndrome
Small Cell Cancer of the Thymus
Soft Tissue Sarcoma- with distant metastases or recurrent
X-Linked Lymphoproliferative Disease
X-Linked Myotubular Myopathy

To see the rest of the compassionate allowance medical conditions you can visit the SSA website or my page on Social Security compassionate allowance.

Monday, January 13, 2014

Change to Hematological Listings (proposed)

The Social Security Administration is proposing changes to the Hematological Listings which have not been updated since 1985.  The proposed changes include:  Expansion and reordering of introductory text, section 7.00.  Using broad categories of hematological disorders.  Four Categories will be included. Listing 7.05:  Hemolytic anemias; Listing 7.08:  Disorders of hemostasis; Listing 7.10:  Disorders of bone marrow failure; and Listing 7.17 Hematologicl disorders treated by bone marrow or stem cell transplantation.  Also a new functional-based listing, 7.18 would be added.
The new proposed functional listing 7.18 requires a marked level of functional limitations in one of the following areas.  Limitations of activities of daily living, or limitations in maintaining social functioning, or limitations in completing tasks in timely manner due to deficiencies in concentration, persistence, or pace.
It should be interesting to see how the final listing comes out after SSA receives comments from the medical and legal community.  The proposed listing change will not impact any present Social Security Disability cases until a final version is released.  To see the present medical listing of impairments you can visit the SSA website listing page.  You should also visit my web page on the medical listing of impairments.