Congressional Record Statement of Senator Daniel K. Akaka
Mr. President, as Chairman of the Senate Committee on Veterans’ Affairs, I introduce the proposed “Claims Processing Improvement Act of 2010,” to focus on enhancements that can be made to adjudicate veterans’ disability compensation claims in a more timely and accurate manner.
VA has seen a dramatic rise in the number of claims, driven by a number of factors, including the aging of the general veteran population and our prolonged involvement in two overseas conflicts. Further complicating matters, many claims are increasing in complexity, as veterans seek service-connection for multiple disabilities and for disabilities that are difficult to diagnose, such as traumatic brain injury and post traumatic stress disorder.
Claims adjudication is an intricate process that has seen many piecemeal changes in recent years. Unfortunately, these changes have yet to produce the results that veterans deserve. Mr. President, my goal, a goal that I am sure is widely shared, is to ensure that veterans are provided accurate and timely resolution to their claims.
This legislation I am introducing today would make several improvements in the claims adjudication process. Provisions in title I of the bill would establish a pilot program that would utilize ICD codes to identify disabilities of the musculoskeletal system. Over fifty percent of Operations Iraqi and Enduring Freedom veterans that the Department of Veterans Affairs has had some health care contact with have a possible musculoskeletal diagnosis. ICD codes are standard medical condition identification codes used in electronic records that have been adapted by the Secretary of Health and Human Services for electronic transmission of medical data.
This proposed pilot program would take place in six to ten regional offices and require VA to develop a new method of rating claims, which would consider the frequency, severity, and duration of symptoms of the disability in rating the claim, rather than the current rating schedule published in the Code of Federal Regulations. The current rating schedule adds to the complexity of claims adjudication, because many disabilities claimed are not exactly as described in the regulation and several rating codes may need to be considered. The new rating schedule would focus on the impact of the disability, for example, an inability to walk normally, rather than a particular VA rating code classification. All limitations resulting from all disabilities of the musculoskeletal system would be combined to provide one rating, rather than separate ratings for each individual disability. This information would be placed into an organized and searchable electronic record. A veteran could elect to not participate in the pilot program. I believe that such an approach will result in fairer, comprehensive ratings for the entire musculoskeletal system.
Title II of the bill includes a number of provisions that are intended to yield some near-term changes to the claims processing system and should help reduce the overall time a claim is under consideration by VA. During the last several years, the Committee has held oversight hearings on the claims processing system. Many of the provisions in this legislation were first suggested by veterans service organizations and other interested parties in connection with those hearings. Others have been recommended by the Administration. The legislation I am introducing today serves as a starting point to move forward in our effort to improve VA’s claims adjudication process.
Provisions in title II would allow for VA to issue partial ratings of claims that include multiple issues for those issues that can adjudicated expeditiously; give equal deference to private medical opinions during the rating process; and clarify that the Secretary is required to provide notice to claimants of additional information and evidence required only when additional evidence is actually required. It would also modify filing periods for notices of disagreement from one year to 180 days and require a claimant to file a substantive appeal within 60 days of the Department issuing a post-Notice of Disagreement decision – both of these modifications would contain good cause exceptions to the filing deadlines.
Other provisions in title II would automatically waive the review of new evidence by the agency of original jurisdiction, usually a Regional Office, so that any evidence submitted after the initial decision would be subject to initial review at the Board of Veterans’ Appeals unless the claimant or the claimant’s representative requests in writing that the agency of original jurisdiction initially review such evidence. This legislation would also replace the Secretary’s obligation to provide a Statement of the Case with an obligation to provide a post-Notice of Disagreement decision. The post-Notice of Disagreement decision would be in plain language and contain a description of the specific facts in the case that support the decision including, if applicable, an assessment as to the credibility of any lay evidence pertinent to the issue or issues with which disagreement has been expressed; a citation to pertinent laws and regulations that support the decision; the decision on each issue and a summary of the reasons why the evidence relied upon supports such decision under the specific laws and regulations applied; and the date by which a substantive appeal must be filed in order to obtain further review of the decision. The Secretary would also be required to send, with a rating decision, a form that if completed and returned, would suffice as a notice of disagreement.
Mr. President, this is not a comprehensive recitation of all of the provisions within this important veterans’ legislation but does, I hope, provide an overview of the changes encompassed in this bill.
Everyone involved realizes that there is no quick fix to solving the myriad issues associated with disability claims processing, but the Committee intends to do everything within its power to improve this situation. To bring optimal change to a system this complicated and critical, we must be deliberative, focused, and open to input from all who are involved in this process.
Mr. President, I ask unanimous consent that the full text of this bill appear in the Record, following my statement.