Part One in a National Journal series on the Veterans Affairs Department.
The failure of the Veterans Affairs Department to quickly compensate veterans for their disabilities is a moral abomination: It leaves soldiers wounded by war waiting in long lines for payments they need and believe they have earned.
And VA failures are under new scrutiny amid reports of a string of preventable deaths among veterans and a growing political controversy around them—and many in Congress are pointing a finger in the White House's direction.
So why has President Obama failed to fix the backlog of veterans' disability claims after five years in office? More than 300,000 claims to the VA have been pending for 125 days or more, a time stamp that puts them in the agency's official definition of "backlogged."
And why did a long line of Obama's predecessors—Republican and Democratic alike—end their own tenures without fixing the problem?
In short, because fixing the VA backlog isn't just a question of putting the proper resources into an overwhelmed agency. Solving it would require not only untangling a Gordian knot of dysfunctional bureaucracy surrounding the VA claims system and decades of neglect, it would also mean overcoming a perfect storm of factors in the past few years that has made the problem much, much worse.
Surge in Claims
The VA received 1 million new claims during Obama's first year in office—the most it had ever received at one time—and the count climbed from there. Annual claims peaked in 2011 at 1.3 million, falling to 1.04 million claims received in 2013.
What's driving the surging number of claims? In short, a pair of wars that have created more veterans and new Obama administration rules that have made veterans from all wars eligible for more disability compensation.
The VA is dealing with a sudden influx of Afghanistan and Iraq veterans as the U.S. draws down its troop levels. Nearly 970,000 Iraq and Afghanistan war veterans deployed overseas since 9/11 have filed a disability claim, according to a Freedom of Information Act request released to Veterans for Common Sense this month by the Veterans Benefits Administration.
And due to medical advances, many service members who would have died from their injuries in past wars are now being saved, but they are returning home with more numerous and more complicated injuries. Vietnam veterans typically claimed three or four injuries. Now a single veteran from Iraq or Afghanistan routinely submits a claim with the number of injuries in the double digits.
Meanwhile, the Obama administration has also changed the rules to give more benefits to veterans. In 2010, the administration expanded coverage related to exposure to Agent Orange, a Vietnam War-era defoliant that has created a vast list of health problems. Veterans have long tied an assortment of illnesses to Agent Orange, and now more of those illnesses are covered.
Additionally, the administration made it easier for veterans to get coverage for posttraumatic-stress disorder, a disease less easily diagnosed and adjudicated than physical injuries. Since 2010, service members no longer have to provide documentation that supports their PTSD claims. Instead, a doctor performs an exam to determine that the veteran's symptoms are related to PTSD and that the cause of the PTSD, such as being under attack, is consistent with the veteran's military duties.
A Broken Agency
Not all of the VA's problems, however, come from external factors. The agency is haunted by its painfully slow embrace of technology: It did not have a digital way to process claims nationwide until 2013, and it long handled claims with a paper filing system. Victoria Dillon, a spokesperson for the VA, acknowledged that "these offices used to be stacks of papers everywhere," with claim files "18 inches thick on average."
By comparison, the IRS rolled out its electronic filing system across the country—albeit with some problems—in 1990.
The VA also uses a complicated regulatory code for dealing with claims that slows down the process. "The regulation dealing with [traumatic brain injury] is so complicated that some people call it the 'Da Vinci Code,' " Ronald Abrams, joint executive director for the National Veterans Legal Services Program, told lawmakers late last year.
The VA attempted to solve the problem by hiring more claims workers to handle the influx, but it takes approximately two years to fully train a claims worker to handle the complex process.
"Thousands of new PTSD and Agent Orange claims starting in 2010 overwhelmed an agency with a history of poor planning, chronic understaffing, and a lack of training," said Glenn R. Bergmann, a partner at Bergmann & Moore, a former VA litigator who represents veterans with VA disability-claim appeals.
The Scope of the Problem
In his first years in office, Obama's VA was a disaster, as a flood of new claims overwhelmed an antiquated process for handling them. In 2009, there were about 423,000 claims at the VA, and the official backlog of claims that had been pending for more than four months sat near 150,470. By 2012, claims had exploded to more than 883,000—and 586,540 of those sat in the agency's backlog list.
But in recent years, the administration has made progress in getting veterans more timely answers. The backlog list was cut to more than 300,000 as of May 10. If the VA maintains the current average monthly rate, the backlog could be cut by mid-2015. That would meet Veterans Affairs Secretary Eric Shinseki's 2010 pledge to eliminate the backlog by the end of next year.
Critics, however, say the shrinking backlog is something of a farce, the result of an administrative maneuver that has not delivered results for the veterans in the backlog, but has instead moved them into a different waiting line. When taking into consideration all VA claims, including those were the veterans died waiting for a decision, those stuck in appeals, and award adjustments—often adding a spouse or child—the VA's inventory of claims is much higher still hovering just under a whopping 1.3 million. (By comparison when Obama took office in January 2009, the inventory of claims was about half that amount: 631,000.)
As of May 10, the VA's number of appealed claims stood at 274,660, almost 100,000 more than the 174,891 appeals in late 2009. Between 2012 and 2013 the number of claims that ended up in appeal grew 5 percent, and between the end of 2013 and March 31 the number of appeals kept rising 2.7 percent. Once in the appeals process, veterans can wait in limbo for an average of two and a half years.
Critics contend that list is growing because, as the agency endeavored to quickly work through the claims, it has made more errors.
The VA rejects that charge, and says it accurately processes 91 percent of all claims.
But the Office of the Inspector General for the Veterans Affairs Department has issued several reports since 2009 that say VA regional offices where claims are processed need to improve policy guidance, oversight, management, training, and supervisory review to improve the timeliness and accuracy of disability claims processing.
Findings in the OIG reports are damning. For example, in 2013 the OIG inspected 20 field offices it had previously inspected, and 17 continued to be noncompliant with Veterans Benefits Administration policies. In December, the OIG reported to Congress that it found errors in 29 percent of the traumatic brain-injury claims and 49 percent of the claims for a full disability rating. But the OIG does hedge its criticisms, acknowledging in some of its 2013 field reports that it "sampled claims related to specific conditions that we consider at higher risk of processing errors," and so the errors it identifies "do not represent ... the overall processing accuracy rate" at a specific field office.
But veterans groups contend it's even worse.
"We've gone back, and I would say somewhere in the neighborhood of 40 percent to 50 percent of the cases we found either conflicts or errors as far as the way they were developed or just inaccurately rating claims," said Zachary Hearn, the deputy director of benefits for the Legion, which represents hundreds of thousands of veterans' claims cases.
The Human Cost of Failure
Whatever the backlog's size, it isn't a list of numbers. It's a line of former soldiers waiting for a verdict from the VA on whether they will get help.
Jason Ayala was stuck in that line for nearly two years. The 31-year-old Iraq War veteran served two tours with the Army. After his tours, he says he suffered from headaches, neck and back pain, as well as PTSD—a result of time spent under constant gunfire and at risk of improvised explosive devices.
But when he came to the VA for help, Ayala says he gave up the first time he tried, and only succeeded after he returned from his second tour.
"I started the process, you know; I went in there, and you're just sitting there.… All of the sudden you feel like you're being categorized as someone who is complaining or whining," Ayala said. "It just wasn't right. I did my time, I did my service."
Coming next: Who Broke the VA?