Forward Observer — VBA Claims Initiative Aims at Reducing Processing Time and Adding Convenience – Is it Possible?

Published by LVMAC on

No More In-Person Exam Requirement for Some?

LVMAC Poster Art 2005On 31 January 2013, the Department of Veterans Affairs announced it had begun a new initiative which will reduce the requirement for an in-person medical examination for some veterans when applying for a service-connected disability compensation rating – when sufficient information is in the individual’s records.  The intent is to shorten processing times. It is a product of the Veterans Benefits Administration’s (VBA) Transformation Plan – a five-year effort to improve its processes with the goals of eliminating the widely reported backlog in claims and processing all claims within 125 days with 98 percent accuracy by 2015.

This initiative is called the Acceptable Clinical Evidence (ACE) and was developed through a joint effort of the Veterans Health Administration (VHA) and the Veterans Benefits Administration (VBA) to provide a more veteran-centric approach to disability examinations.  Under ACE practices, a VA medical provider completes a Disability Benefits Questionnaire (DBQ) by reviewing existing medical evidence.  This evidence can be supplemented with information obtained during a telephone interview with the veteran, also.  If the VA medical provider determines VA records already contain sufficient medical information to provide the needed documentation for disability rating purposes, the requirement for the veteran to travel to a medical facility for an examination may be eliminated.

The Undersecretary for Benefits, Allison A. Hickey, believes this improvement in procedures will help towards eliminating the backlog of claims, which has risen since the start of the current war; and in addition to providing more prompt decisions and timely benefits, will save some veterans inconvenience, scheduling wait times, and potentially the cost of a medical examination (if private medical examinations are being considered).  The new policy is also a potential boon to survivors.  Finally, it will also save the VA the cost of unnecessary examinations, a problem in the medical business nationwide.

During a 15-month pilot test at one VA regional claims processing office, 38 percent of claims submitted were eligible for ACE. The return on investment for this new way of doing business is therefore enormous.

Like the DBQ and new processing team lanes, ACE is a step in the right direction, but it will also require an upgrade in the training of VA physicians who, as the Vietnam Veterans of America organization has implied, sometimes do not properly review a patient’s records as well as they might.  And we would like to add that the sharing of medical records – through electronic medical records agreements between civilian medical community and the VA, in both directions — would also help the VBA in achieving its processing time goals while saving taxpayers (which includes veterans) unnecessary costs.

To learn more about VBA Transformation initiatives, click here.




As of 13 February 2013