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Bearing witness: Shinseki does right for vets

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),

USE!!!

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:

(Before…)

W-S files

(After…)

W-S clean

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.

 

Tags: , , , , , , , | 19 Responses »

19 Responses to Bearing witness: Shinseki does right for vets

Willie Clark says:

Mr. Newmark, thank you for your staunch support of VA and for helping us get our story out. And the reason this is so important is not so the VA won't look bad, rather it puts in true perspective what a proud nation is doing for those that have served their country so well. I appreciate your efforts in getting out the "other side of the story" while better informing our citizenry of what their government does with their tax dollars. Thanks!

harold d mcrae says:

you can process all you want to when you turn it over to the U.s.veterans affairs in Milwaukee wis or the regional office's across the us they will deny benifits and find a dozen excuses including destroying their medical records and asking for more im a service connected veteran of the korean war i applied in 1957 when i got out of the service in 1960 they denied my claim m
Mr. Frank Lavender My state v.a. repersentive in Ozark al. sent more copies theyVeterans adm in milwaukee lost those and ask for more 10 years had passed Mr. lavender sent more copies of my medical records milwaukee wis veterans affairs lost them they claimed the warehouse in St louis Mo. had burned Mr lavender sent more and this has been going on until 2008 My state Veterans adm had records stored in montgomery warehouse they did not trust the U.S veterans adm at all Senitor Shelby of Alabamasent me a form requesting permission to see my medical records and i signed it and clearely stated do not give these medical records to Milwaukee wis Veterans Affairs he called the veterans affairs and told them i was service connected and to pay me everything they owed me they wanted to see proof so Senitor Shelby sent the medical records to milwaukee it did not take but 2 weeks for the Veterans Administration in Milwaukee wis to loose the last copie's i had so they can finally say im not service connected and refused my claim so now im going to find out if i can sue Senitor Shelby and the democratic party wants all my paper work to use in the up coming election's since the republicans have been in charge for so long and i hope the administrators in the Veterans dapt get whats coming and take their punishment like any one of the men they have done dirty did on the front lines fighting to keep America Free

ERROL R BRUMM says:

I am amazed at what has transpired and the overall lack of concern for my p lite. I spent 26 years 4 months in the service with the US Army. You would think I spent 1 year. From 1961 to 1973 my records OMPF and Medical are missing. Although I was beaten and badly injured during the bad racial years in Europe there is no documentation other than my word. I was on a appeal which had been in effect over 3 years and it disappeared. The OR at Louisville told me I withdrew the Appeal. I was scheduled the go before the travel board and the television system both and it never happened. I asked several times to see the 4138 where I withdrew my appeals and was only told you withdrew the appeals. Nothing in writing. This in my humble way is how this back log will be cut. Get rid of the Vietnam Vet by dumping his claims. I can show Mr Shiniski my self so many abuses of title 38 by the RO at Louisville he would not be so quick to BOAST . Yes there have been some improvements but they have been miniscule in nature and only the easy cases. My records and what the VA has done to me is so bad the VSO a state officer says he has never seen such abuse in his entire career. I have enough proof to show a mass of incompetency. The RO at Louisville is a Gang of thugs. I was found with PTSD years ago Depression even noted on my retirement physical and the VA after years of fighting approves MDD and a backdate of 5 years.I retired 1987. Got approval 03/2013. I suffer every day. Pain from Costeochrondritis, Along with the pain of the Anxiety attacks for which I have been taking clonazepam and am addicted to it. It has destroyed my life. 15 years I have been taking this mind destructive drug. No help from VA.No Sir until a person sets down with me and what I have as proof of the negligence and lying I will never believe a word the VA has to offer. I understand the size of the problem but I do not understand what the VA has done to and continues to do to me.Please recognize title 38 BENEFIT OF THE DOUBT! The Louisville RO does everything it can to demoralize the Veteran until he gives up. It has certainly shortened my life's expectancy.The investigative unit at Roanoke VA. Found my Stress-or Letter to be factual and I have a DSM 4 Diagnosis with a Gaf of 44 yet the RO disapproves and makes me a trade . "Drop the other existing claims and we'll give you MDD". Cop a plea so I could get something.I'm sorry to go on like this but I am screaming for justice not asking for anything else.I wrote the President and they even lied to him.I have written proof. From them. No I will not give in although this has cost me one marriage and perhaps going to cost me another. I have been diagnosed with Diabetes, Tinnitus and MDD.I was in 11th Armored Cavalry 7/67 to 7/68 fough in the

      ERROL R BRUMM says:

      Just as soon as you tell me where you got the idea DOD lost the records. Then I'll tell why I know the VA had them.You have no business in my affairs as I can see it.

      ERROL R BRUMM says:

      Marie is that all you take from this post? Thank you for your service. I take it you work for the VA. THANK YOU.

        ERROL R. BRUMM says:

        Marie I AM SO SORRY IF I CAUSED A MISUNDERSTANDING WHICH OBVIOUSLY HURT YOUR FEELINGS. NO I do not work for the VA . I am 69 years old soon 70 and been fighting VA most of my life it feels. Update. I pressured the Rep from State I had about the disappearance of my Appeals of 2011. Closed on 26 Jan 2011. He finally produced a document which indeed is a 4138 for old claims and had a statement printed on the bottom I wish all and any appeals to be withdrawn? I was amazed Where did this come from? My printing? NO. Someone at the VA obviously wants things to disappear quickly. The Rep told me this. My records are the worse mess he has ever seen. He could not figure out what happened on the Appeal thing. However after2 years of hounding him for the documentation he presented the afore mention form. It was not done by me. However the VA tells me I can start all over. The State service officer retired a couple of days later?? Once again sorry if I caused confusion. I have no idea who lost my records. However I also after 10 years and several thousand dollars came up with my assignment orders VA wanted so badly. To the 11th Armored Cavalry. Now their not interested. Hope you understand. And once again I apologize for confusion.

Mike Seiler says:

After dealing with the VA for a few years in reference to a rare throat cancer, I cannot say one bad thing about them. I've always received prompt and excellent medical treatments, including 3 separate surgeries and 33 radiation treatments. I have never been treated so well by civilian doctors. I'll admit it took a while for the agent orange claim to go through, but I totally understand why. I've been declared 100% service connected disabled, which I've been thankful for every day since! I'll never be able to say enough good about the VA, they are GREAT!!!

John Moore says:

I am a Vietnam vet and I am in need of help/direction relating to a service connected claim I am filing. I have been denied numerous times and I feel that my VFW rep has thrown in the towel.

    Mr. Pancake says:

    Get a lawyer. Try Bergman & Moore in Bethesda MD. If they take your case they get 30% of back pay. Future pay is all yours. Very good lawyers and good people.

Gregory Merena says:

Great article Craig! " For whatever reason, the press has largely neglected good work, and emphasized bad news." That may be a bit of an understatement, not only in regard to the VA backlog story, but journalism in general, (with exceptions to men of integrity like Charlie Rose). It seems that there is still a problem but headway is being made; thankfully.

On a distant side-note, unrelated to the importance of the issues at hand, I have a question for you. Are you trying to see if ANYONE AT ALL pays attention to details as the chief "nerd in residence?" Your posted clip from the "Raiders of the Lost Ark" rolls the credits from STAR WARS listing "Mark Hamill as Luke Skywalker, Harrison Ford as Hans Solo, and Carrie Fisher as Princess Lea" all the while playing the Raiders theme song and keeping the still photo of the warehouse! You made me chuckle!

Marie says:

Thank-you so much for appreciating what we do. We work very hard to give every Veteran any benefits they are entitled to. If the evidence is not there, well, it's not there. Sorry Veteran's, if you say it happened in service, you have to provide evidence that it did! If DoD can't provide documentation, it is on you! And yes, I am a Veteran.

    ERROL R BRUMM says:

    Marie at first I thought you worked for the VA. I cannot explain the problems with my records and the on going VA battle. I will tell you that the newer filed claims are far from the non existent system we had in Vietnam.If you were not in a combat unit in Vietnam then you have no idea what I am talking about.If you never wrote home on a c ration box top you have no idea. No phone calls at the flip of a phone. You relied on your buddies. Records were and still are a mess. 1973 fire for one thing. Conspiracy theories run heavy about that incident. I'll leave it at that. Merry Christmas.

ERROL R BRUMM says:

I want to apologize for the posts I made on this site. I also want to make it short. It is the nature of the Beast which I cannot control at times. Please forgive me. I know the VA is doing the best they can and then some. It is appreciated. I swear I'll never go on a link again that has to do with VA else the same thing can happen.
Marie you obviously are a VA employee and I thank you for your dedication. That is all I am going to say. Sorry to all involved. I told no lies in these posts.But I should use a different venue. Thank you once again I hope you understand.

Bert says:

Hopefully, the problems the VA has been up against will start to yield to combined goodwill and hard work. It's a big job, trying to see after the needs of the veteran community. I think, though, that teaching self-help will be the strongest thing that the VA can do. With veterans, you're talking about people with a learned dependency on a centralized government apparatus, known as the military. It's basically trained into you, right in basic training. Government/military, is your 'mommy', and mommy says this, mommy says that, mommy provides, and you'll do what mommy tells you. What happens to these folks, when they walk through the gates, and 'mommy' no longer responds? I think maybe they could consider improving on the transition process, so that fewer vets end up lost at sea or basically forgotten/under the rug, on their way out. We're not letting you go, until we see that you've learned at least a marketable trade skill, passed a final physical, and a drug test, then released back into an unsuspecting public.

Veteran's organizations external to the VA can also help to reinforce that, by 'passing the word', when you leave the military, you need to have some skills under your belt, and you need to get healthy, if you're not already, and be healthy, and be gainfully engaged, somehow. Transitioning out of the military doesn't mean sit down, start drinking, and start complaining. To some degree, some members of the veteran community have become authors of their own misery. That needs to change/be changed. I don't know if Shinseki can do anything, in that dept.

James Charron says:

DEEP BREATH –
I found this blog rather enticing, and intriguing, and anyone can tell you things are getting better, and if that were true, then where are all the complaints coming from. I did note a positive paragraph in this blog, that Mr Shinseki, has seen the errors of his predecessors, and Mr Shinseki, has now accepted the reality of Agent Orange-related diseases as "PRESUMPTIVE", conditions. The problem, in my opinion, is there is a lack of EDUCATION, with the processing claims functions. The horse and buggy days are over, but lets face the reality of the Government, aka Veterans Affairs, works very hard to not have to pay out ANY claims. It's referred to as Budgeting, and the lack of funding from Congress.
"PRESUMPTIVE" – The whole key to Education and Reality
"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."

Daniel says:

Is the back log being "cleared"? VA says it is…by awarding "Provisional Awards". What that means (and VA says this!) is that V will rate claims on informatio9n already available and that can rate a claim (then why isn't that being done already instead of the delays and requests for more and more information????) However, "Provisional Awards must be re-evaluated and finalize at some point (VA is not specific about when exactly, but we are told "within one to two years". That being the case, all VA is doing is "kicking the can down the road" bewcause these claims must be adjudicated anyway….it is simply postponing the inevitible. Additionally, "Provisional Awards", if accepted, canno be appealed until a final adjudication is made!

Progress? Hardly! But an age old technique of "smoke and mirrors"!

Richard says:

Look, it is no secret that the VA exist to serve the veteran and they should be doing anything reasonable to expedite veteran claims. Many regional offices are not doing the job required Waco, and Houston Regional offices come to mind. I am retired and rated 100%, but I do have a claim concerning Bradley v Peake that was denied about three years ago, I appealed and requested the claim be sent to the BVA, it still sits in Houston and I have never received a statement of the case. It should never take this long to process an appeal to the BVA. I am luck, I original claim was approved years ago, but many more veterans are waiting in some cases years to get their original claim approved. Many claims are stuck in limbo for one reason or another, it is no joke Veterans are literally dying, while waiting for their claims to be adjudicated. as to the Medical side of the VA, I recently moved, and I was not able to get a medical appointment for over three months at Temple Texas VA, remember I am rated 100% and in priority group 1, the problem as I see it is too many non-service connected veterans seeking care at the VA because the doors were thrown wide open by a congress of mostly non-veteran members. The Category 8 veteran those with no service connection is competing for the same appointment time as the Category one veteran… that just isn't right. If you do get medical care often times it is adequate, but far too many immigrant doctors are employed by the VA, often their accents are so thick that the veteran cannot understand them. Finally, for those of you who love Obama care, watch our what you ask for, because Veterans care is the model of what to come……

Michael P. Oliver says:

Craig, I appreciate Your consistent and enduring interest in Veteran's. You've been forthright in your support however augmented that support with reality overall. I "wish" Mr.Shinseki well, and that he'll be successful with the critical caveat that I'll believe "it" when I (personally) see "it". 1. My Own "Case"; 25-941-846 goes back to Filing Date of October 2006. Seven years later "it" remains Unresolved!!! 2. My/this "Case" goes back to discharge of 1970!!!I'm confident there are others. 3. To compound injury, my late Mother filed through me for her late husband; interred at Ft. Rosecrans, CA. and from service in WW2! They(V.A.) stonewalled her to her death-bed; so consider me a doubter, thank you.