Exclusive: Hundreds of Thousands of VA Electronic Disability Claims Not Processed

Hundreds of thousands of disability claims filed with the Department of Veterans Affairs’ eBenefits portal launched in February 2013 are incomplete and could start to expire this month, Nextgov has learned.

VA Undersecretary for Benefits Allison Hickey touted the new portal in June 2013 as simple as filing taxes online and a way to whittle down the claims backlog.   

“Veterans can now file their claims online through eBenefits like they might do their taxes online,” she said, including the documentation needed for a fully developed claim in cooperation with Veterans Service Organizations, or VSOs, such as the American Legion or Veterans of Foreign Wars. 

Gerald Manar, deputy director of the National Veterans Service at VFW, told Nextgov the Veterans Benefits Administration on June 26 briefed VSOs on problems with the eBenefits portal, including the fact that only 72,000 claims filed through eBenefits have been completed and approved since last June, with another 228,000 incomplete.

VA spokeswoman Meagan Lutz said since February 2013, just over 445,000 online applications have been initiated. Of those, approximately 70,000 compensation claims have been submitted and another 70,000 nonrating (add a dependent, etc.) have been submitted, leaving a total of 300,000 incomplete claims. Because a number of claims started are more than 365 days old, they have now expired, totaling an estimated 230,000 unprocessed claims.

Manar said he still is trying to understand why so many vets did not complete their online claims and whether they opted to file a paper claim. Lutz said an important element of the electronic claim submission process is the ability for veterans to start a claim online with limited information to hold a date of claim, while simultaneously providing 365 days to collect data, treatment records and other related information.

Lutz said a veteran simply hits "save" and any information provided is saved in temporary tables. During that 365-day period, a veteran may add additional data or upload documents associated with that specific claim. At any point during that timeframe, a veteran can hit the "submit" button and a claim will be automatically established within the Veterans Benefits Management System, designed to entirely automate claims processing by next year, and documents will be uploaded to the veteran’s e-folder. 

Claims submitted in eBenefits may be incomplete because “many users can potentially start a claim as part of their exploration of the system … The VA eBenefits team has no way of actually knowing which claims that might be started within eBenefits are valid and or have been abandoned for any number of reasons

After 365 days, Lutz said, the data is made inaccessible and the initiated claim date is removed from the system. The system was designed to provide the veteran as much flexibility as possible in preserving that start date as well as support the Fully Developed Claim initiative, which gives the veteran the opportunity to accrue additional benefits for providing all the data needed to rate the claim.

Lutz said if vets try to submit electronically hundreds of documents, such as PDFs of medical records, “that volume of documents makes electronic submission very difficult, and we always recommend that they work with a Veterans Service Organization, as the VSOs have the expertise to ensure that the right information is gathered and submitted.”

VSOs have little visibility into the claims filed to date through the eBenefits portal because of design problems with the information technology system set up, the Stakeholder Enterprise Portal, Manar said. That portal only allows for broad searches for claims at the state and the VBA regional office level, and limits any search to 1,000 claims. If the search results in more than 1,000 records, SEP returns a message that the system is not available, rather than the search went over the 1,000 file limit, Manar said.

SEP is also not set up to notify VSOs when a claim is filed through eBenefits, nor does it provide alerts when claims are due to expire, Manar said and urged VA to fix SEP to provide such notifications.

SEP, Manar said, was not “well thought-out” when fielded and “the whole system was not ready for prime time.”

Lutz said VA SEP design team is working as quickly as possible to help VSOs to review more than 1,000 files in SEP without getting an incorrect error message.

She said VA plans a new release of SEP this month to VSOs, which will allow VSOs to submit claims directly to VBMS for veterans who hold power of attorney. This update would eliminate the need for the veteran to submit from the eBenefits portal.

"This, we believe, will be a major milestone in the VSO community that will accelerate acceptance of the electronic process,” Lutz said. 

(Image via Mark Van Scyoc / Shutterstock.com)