Bearing witness: Shinseki does right for vets
Posted on December 19th, 2013 by Craig Newmark
Sometimes people in Washington do a really good job, but take a lot of crap unfairly. Sometimes it takes a "nerd-in-residence" to start to set the record straight. This is the short version; every topic below deserves longer treatment.
In 2009, Eric Shinseki took over the Department of Veterans Affairs, with the mission of doing right for vets. Back then: VA didn't have the right software to process disability claims efficiently. Vets with Vietnam era-Agent Orange illnesses had a hard time getting claims judged properly. Some Vets and Vet Service Orgs (VSOs) felt they faced an adversarial attitude. VA line workers got a lot of unfair abuse. (Note to self: as a customer service rep, I get a lot of that also, almost every day, so I can identify.)
More and more Vietnam vets file disability claims, to get the benefits they deserve. However, it was really hard to get properly compensated for Agent Orange herbicide-related issues. Long story, but the bottom line is that Shinseki designated several Agent Orange-related diseases as "presumptive" conditions, and allowed claims to be made on that basis and approved fast.
However, that inflated the disability claims backlog, not only the current "inventory" of claims but also the "backlog." For that matter, in the effort to do right by vets, Shinseki insisted on faster processing overall, and imposed stricter standards on quality and what counted as backlog. That made the existing backlog jump in a huge way, creating major perception problems for Veterans Affairs, which have been widely reported.
So the good news, not so much reported, but the bad news got a lot of attention. By doing right by vets, the VA looked bad. For whatever reason, the press has largely neglected good work, and emphasized bad news. (A while back I wrote a thank you note for VBA workers.)
Here's the history of the claims backlog (courtesy of Brandon Friedman),
Most of the current backlog reduction is attributed to efforts like a lot of dedication and overtime on the part of VA line workers. (Thanks!) However, what VA has needed for a long time, at least since 2003, is an online system to expedite claims processing.
In 2009, Shinseki brought in Peter Levin as VA *Chief Technology Officer and others to make that happens.
Cutting to the chase, they started building the Vets Benefits Management System (VBMS.) The deal with VBMS is that claims could be processed online by VA workers, and entered by vets or VSO claims professionals. If entered by vets, the model is do it yourself, like TurboTax. If entered by a pro at a Vets Service Org,they can get to VMBS directly, or enter documents for the Vet via the Stakeholder Enterprise Portal (SEP). Pretty soon, if they have their own claim system like VetPro, they'll be able to send from their system to VBMS. It's like going to get help from H&R Block, or Earl, my CPA.
The first big task is to get the paper claims inventory converted to digits and put into VBMS, which involves scanning huge amounts of paper into the system. That's about 75% done. Here's before and after at the Winston-Salem VA RO:
The big shift to VBMS is just happening right now, and it also means first getting VSOs onboard with either the Portal or indirectly via a gateway called Digits to Digits (D2D).
Big software projects take time, but it looks like all this is happening very quickly for a large organization. At this point, the effort is in agile software development mode. I'm not using "agile software development" in the doctrinaire sense, rather, it's like I started for my own stuff:
1. ask people what they want and need
2. do it
3. ask people what to improve
4. go to 1
That's to say, people tell either their local VBMS coach (like Shannon who I met in Oakland) what's going on, or they tell Allison (that's actual Brigadier General (retired) Allison Hickey, who runs this part of VA) during her weekly calls with VBMS users. Then stuff gets fixed or deferred. (Note to VSOs: you got suggestions, tell Allison, or if you prefer, tell me, I'll get 'em to the right place.)
Shineki got lots more going on, like an Employee Innovation effort in 2009, where I helped judge entries. My favorite effort resulted in Disability Benefits Questionnaires (DBQs), which turn what doctors say into numbers that can be automated via disability rate calculators. DBQs need work, that's happening, largely due to the efforts of Beth the Enforcer. (I'll tell that story another time.)
Claims processing can also be delayed while Service Treatment Records are transferred from places like Department of Defense storage warehouses. (The Raiders of Lost Ark Warehouse is actually the VA warehouse…)
However, efforts are proceeding to get Defense to scan in and electronically transfer treatment records to VA. (More later.)
VA is a very large organization, maybe over 330,000 people serving around 22 million potential customers.
Whether private or public, large orgs are normally dysfunctional. Me, I've worked at or with large orgs, like IBM, GM, and Bank of America, and seen from the inside how bad things can be; however, public orgs are normally way more transparent than private orgs. I bear witness that Veterans Affairs does really good, with exceptions.
As a nerd, I'll help make the good better, and I'll stand up for good people getting a lot of unfair crap flung at them.
A nerd's gotta do what a nerd's gotta do.