Subcommittee on Disability Assistance and Memorial Affairs Oversight Hearing

success of the PCT act and to respond to that demand they've hired and onboarded thousands of claims processors seemingly overnight even the most robust operation would be strained but all systems must be continuously re-evaluated VBA employees face tremendous challenges in processing complex disability claims these challenges are only exacerbated by changing policies and processes that are disconnected from the workforce claims processors need to have the training and support from management to meet the needs of veterans especially under incre increasingly demanding production quotas and quality metrics so today I want to explore the disconnect between the processes put in place by VBA leadership to meet claims processing volume and quality requirements and the daily experience of Frontline VA employees a yield back thank you ranking member our panel of witnesses today include our lead witness from the VA Mr Ron Burg Deputy under secretary for policy and oversight and the veterans benefit Administration good to see you again sir Mr Ken Smith assistant Deputy under secretary for field operations in the VBA good see you again Mr Smith Miss messenger Deputy executive director operations compensation service at VBA Mr your pleasure Mr Steven brochi director of the compensation programs inspection divisions for the VA office of Inspector General Mr broch a pleasure and Miss Elizabeth Cura Director of Education Workforce income security at the government accountability office thank you for joining us and Miss Linda Parker Cooks president of the local 138 American Federation of government employees Miss Miss Cooks thank you for joining us I ask the Witnesses in our panel please stand and raise your right hand do you solemnly swear that the testimony you're about to provide is the truth the whole truth and nothing but the truth the help you God thank you and let the record reflect that the witnesses have answered in the affirmative thank you all for being here today Mr Burke you're now recognized for five minutes SED to deliver your opening statement thank you chairman Latrell ranking member papus and members of the subcommittee thank you for inviting us here today to discuss the efficacy of the Department of Veterans Affairs quality assurance and training programs joining me today are Mr Kenneth Smith assistant Deputy under secretary for field operations and Miss Christina messenger Deputy executive director operations compensation service both from VBA VA is committed to providing outstanding customer service to the nation's veterans their families and survivors and VA is steadfast in its commitment to provide accurate decisions for all veterans and survivors VBA has a robust training and quality Rie program holding employees Regional Offices and program offices to the highest standard for producing quality claims decisions while also promoting continuous learning and performance Improvement we appreciate the subcommittee's interest in this topic and I know we share the same goal of collaboration and continuous Improvement I would like to focus on a few efforts that I believe are Innovative and have the potential to transform business as usual my office the office of policy and oversight in partnership with offices such as compensation service and the office of field operations has created a suite of quality related programs to facilitate greater collaboration and better focus on root causes in fisc year 2022 VBA established the overdevelopment reduction task force for the purpose of reducing overdevelopment in the compensation and pension claims process this task force includes a diverse group of subject matter experts from both VBA central office and the field and is charged with analyzing the claims development process to streamline procedures that particular effort led to more than 30 improvements including guidance on requesting exams and preventing redundancy VBA is currently in the second phase of this task force which is now focusing on several large scale initiatives that will have lasting positive impact on claims processing with more than 60 improvements identified and underway as far as implementation is concerned additionally since November 2021 VBA implemented work groups focused on both quality and training where subject matter experts can share insights Lessons Learned and Innovative methodology used for both quality and training programs across the benefits Administration this exchange of knowledge not only enhances the proficiency of claims processors but also cultivates a culture of accountability and high standards within the organization by leveraging Collective expertise VA adapt swiftly to changes in policy or procedures keeping the VA Workforce well equipped to deliver timely and accurate decisions for Veterans as a further example of vba's commitment to continued process Improvement of quality programs at the start of fy2 23 my office established an overarching program for special focused reviews or sfrs which help identify gaps in performance and address identify areas of improvement while individual program offices conduct their own sfrs this additional oversight facilitates a consistent method to measure the efficiency and validity of procedural and policy actions I'm proud to let the committee know in just under two fiscal years VBA has completed 58 sfrs on topics ranging from CMP exam clarification request to Camp leun claims processing in addition to immediate corrective actions taken to improve policies processes and performance BBA has made 190 recommendations of which 138 have been completed as of the end of June 2024 additionally as part of our larger effort to provide the best possible service to Veterans and survivors on June 6th of this year VBA held the First Quality standown and employee Wellness day this day met two important goals improving the quality of our work across Ross all business lines from the central office to the field and improving employee wellness and experience by addressing burnout and mental health nearly all of vba's 34,000 employees participated on that day finally we acknowledge that there is always room for improvement in terms of training VBA has taken a long hard look at our current training programs and the efficiency of those programs we've asked ourselves what can we do better how can we better prepare our claims processors we've been out in the field actively talking to claims processors Nationwide and Gathering feedback we've also been talking to our veteran service center managers vsos and afg partners to get their comments and ideas and then we're listening listening to ideas listening to criticisms and we're listening for ways we can improve based on this feedback I'm proud to announce that in June of 2024 BBA kicked off a massive training modernization project for all vsrs and rvsr ours which will completely revamp and transform what training looks like with the aim to significantly overhaul and transform the VBA training process VBA has scrutinized the current training for claims processors and will be immediately tack tackling some effective short-term improvements which can be implemented within the next 3 to six months simultaneously we've established work groups to completely revamp the training process with ambitious plans for long-term monitorization of claims process or training the training overhaul will result in a more effective process and better prepare claims processors to complete claims for veterans more efficiently with exceptional quality we are excited for this next era of training for VBA Mr chairman this concludes my statement my colleagues and I are prepared to respond to any questions that you or other members of the subcommittee may have thank you Mr Burke the written statement of Mr Burke will be entered into the hearing record Mr brochi you're now recognized for five minutes or to to deliver your opening statement chairman Latrell ranking member papis and members of the subcommittee I appreciate the opportunity to discuss the oig's oversight of vba's quality assurance and training programs related to disability claims while VBA has made enhancements to its quality assurance program there is still work to be done that program is intended to help ensure timely accurate and consistent claims decisions and vba's training program must prepare new and current employees to follow complex and frequently changing guidance given that millions of veterans and family members will receive over $150 billion in disability benefits this fiscal year the oig is committed to continuing its independent oversight to provide VBA with meaningful recommendations for improvements as detailed in my statement we have persistently identified challenges to both programs four oig reports from the last few years address such critical areas as one processing errors made on Veterans individual unemployability claims two inconsistencies implementing changes to the disability rating schedule three issues with claims Automation and four unwarranted medical reexaminations of veterans in the individual unemployability claims report released last week we found that vba's training did not provide staff adequate examples to equip them to adjudicate these complex claims we estimated that claims processing errors resulted in at least $100 million in improper payments during the 12 during the one-year review period including both underpayments and overpayments earlier this year A Team assessed the effectiveness of vba's implementation of disability rating schedule updates in 2021 for hip ande KNE replacement claims we estimated that inaccurate decisions made by claims processors resulted in at least $3.3 million in improper payments as a result we recommended VBA Implement claims accuracy monitoring when rating schedule revisions are made and update the training accordingly our findings reflect the larger concern that without thorough quality assurance processes BBA cannot gauge the effectiveness of its training to make requisite changes that address the staff's training needs we also issued a report last year that evaluated vba's effort to implement an an automated decision support tool that extracted and summarized blood pressure readings and hypertension related medication data from veterans records the team found the summary sheets did not provide accurate and reliable evidence resulting in incorrect decisions we recommended VBA improve its quality assurance process and monitor the results to ensure the accuracy of summary sheets and final decisions another report published last year revealed that veterans were being required to attend unwarranted medical re-examinations although VBA may require veterans to be reexamined to verify disabilities existence or severity unnecessary reexaminations subject veterans to undo hardship waste money and slow claims processing we found vba's practices were inconsistent with procedures and estimated that staff were erroneously establishing dates for re-examinations about 66% of the time we recommended that VBA update training materials and ensure claim processors meet all training requirements we will continue to track all recommendations from these reports until they are fully implemented concerns about vba's quality assurance program predate these reports are six Nationwide reports published from 2020 to 20122 detail issues we found with vba's governance structure for the program the compensation service which administers the program and assesses accuracy Nationwide lacks the authority to remediate the issues and errors identified that Authority lies with the office of field operations ofo which manages the day-to-day operations of vba's Regional Offices therefore it's critical that these offices coordinate effectively we found issues with vba's National Quality Assurance review program called star we also reported on concerns with the local quality review teams in place at Regional Offices lastly we determined ofo did not ensure all claims processing errors were corrected although VBA has made progress in implementing action plans that address our recommendations its leaders must continue to improve internal quality assurance and ensure high-risk claims are monitored in closing we continue to take on complex oversight projects to help VBA improve claims processing accuracy for veterans their caregivers and survivors while making the most effective use of taxpayer dollars our ongoing work includes packed act claims accuracy as well as training for claims processors and medical examiners Mr chairman and members of the subcommittee I am happy to answer any questions that you may have thank you Mr baroi the red stat will be entered into the hearing record Miss Cur you're now recognized for five minutes to deliver your opening statement good afternoon chairman lutrell ranking member papus and members of the subcommittee I'm pleased to be here to discuss gao's work regarding vba's training program for disability claims processors veterans who have been injured in service to their country deserve timely and highquality disability compensation decisions and claims processors play a vital role in responding to their needs VBA is filled with dedicated claims processors who work hard to make numerous daily decisions on disability and other claims which is often a complex undertaking VBA faces well-known challenges with processing processing large volumes of disability claims and issues with the quality of decisions in fact one measure of accuracy for claims decisions has fallen from a high of 93% to 77% more recently to help VBA manage increasing workloads with the influx of pack de claims Congress has provided additional funding to help VBA hire thousands of new staff however hiring a loan is not a guarantee of success an effective training program is needed to one help new claims processors become fully proficient and two for season staff to maintain their Knowledge and Skills in an everchanging complex environment the focus of this hearing is appropriate because training and quality have a clear connection that is training helps prevents errors from occurring in the first place my testimony focuses on vba's progress in implementing the 10 recommendations in our June 2021 report our report examined wide- ranging aspects of vba's training program for claims processors against a framework of leading practices for training overall our report highlight highlighted shortfalls in vba's management of its training such as directing and coordinating training across VBA monitoring whether claims processors complet Ed required training and assessing training results to remedy these shortfalls in how VBA planned designed implemented and evaluated its training for claims processors we made 10 recommendations as of today six of our 10 recommendations have been addressed and four have not been fully implemented I'm pleased with the progress VBA has made on addressing our recommendations particularly in the past several months for example VBA has taken steps to enhance training for instructors who teach CL processors and to ensure that all assigned training is completed however VBA needs to fully address the four remaining recommendations for example we recommended that VBA establish performance goals with targets for vba's training program VBA has established performance goals for some aspects of its training but lacks goals and targets for some of its annual required training further vba's plan for its training program lacks important details such as how VBA train training will help claims processors improve decisions accuracy in addition although VBA is collecting more feedback from Frontline staff about its training it's not clear how that feedback is being incorporated into Improvement efforts to some this talk of planning and evaluation can seem quite dry and Technical however effective management of vba's training program can help claims processors meet veterans needs by providing timely and accurate decisions it can also save taxpayer dollars by reducing mistakes and rework of the claim if it is appealed so in closing noted quality assurance Guru Edward Deming once observed that a bad system will beat a good person every time developing a good system for training vba's claims processors would Empower staff to process disability claims more accurately and efficiently this concludes my prepared statement and I'm happy to address your questions thank you m CA your statement will be entered into the hearing record Miss Parker Cooks you're now recognized ask for 5 minutes for your opening remarks chairman latral ranking member papis and members of the subcommittee afg and his National VA Council appreciate the opportunity to testify today my name is Linda Parker cooks and I am the President of afg local 138 representing the BBA regional office in Detroit Michigan I am a 20-year US Army veteran and a service connected disabled veteran after my military service I have continued to serve my fellow veterans at VBA for the past 18 years and currently serve as a decision review officer and a certified VBA Elite Master instructor on behalf of thousands of Frontline BBA workers over half of whom are veterans themselves it is a privilege to offer afg Frontline perspective on how BBA trains its employees VBA faces many challenges in effectively training its employees to process claims I want to highlight several of these issues and offer specific changes that would better enable VBA employees to serve Veterans for decades BBA used in-person and interactive challenge train challenge training that lasted several weeks today BBA uses inferior virtual Anders training including instructor-led web training and classroom training to train employees the primary problem with iwt is that new employees have not yet mastered the basics of VBA new employees in iwt do not understand the claims process or the VA lingual that is critical for employees to do their job this is an easy problem to fix iwt does not use the actual tools that employees will use in their jobs in particular new trainees do not have access to vbms core until after iwt iwt provides examples in PDF format traines will not use the actual technology for weeks employees are not trained on if they can grant or deny service connection or the elements required to Grant on a direct secondary aggravated or presumptive basis furthermore iwt does not train employees to analyze anal analyze the claim and review evidence including VA medical records dbqs and what this evidence says about having a current diagnosis again they have only seen PDF examples to improve iwt employees must have access to bbms core and review claims in the system instead of looking at PDFs additionally VBA must teach new employees the basics including learning the claims process VA terminology and what a claim looks like it must also give employees hands-on experience with the technology they will actually use every day afg also recommends that the current size of 100 Bel lower to more than no more than 35 smaller groups allow for more interactive environment and more questions to be addressed during class VBA has trainers available to them but are not using them effectively following iwt trainings shift into several weeks of classroom training to refine their skills afg urges to BB to be more strategic and reorder the curriculum to allow the employees to better learn the information currently classes are taught in a halfhazard order instead of sequence to inhance on the building of Concepts training should be reordered to allow instructors to reference the material that was just taught reinforce the concepts and use this to teach higher level Concepts following the completion of iwt and classroom training there are still significant gaps on critical issues employees will need to perform their their Duty successfully afg recommends bba's training to include modules on weighing evidence due process and denials of service connection that will help employees confidence performance and retention as a result of the current curriculum and schedule of VIP and classroom training Regional Offices have been forced to provide supplemental training to fill in the learning gaps in the lag in starting National Training with VBA using the national work C and relying on the idea that each employee regardless of station is trained the same way afg strongly recommends standardizing this supplemental training lastly the pack act training primarily consists of prepared PowerPoint presentations in the talent management system and self-review of the everchanging SOP this training is not interactive and is there more to check the box than actually help the employees do their job afg again urges BBA to consult with afge to understand the problems Frontline employees are facing and what training would help to improve performance afg and nbac stands ready to work with the committee and BBA to improve training and quality thank you and I look forward to answering your questions the written statement Miss Cooks will be entered into the record we now move to questioning Miss Parker cook sounds like you got it figure it out who's on the receiving end of what she just said on this is that is that you Mr Mr Burke yes sir I was hanging on every word she just said I'm hoping that you were too and given the I the Mr bro's report is any those Communications happening between afg and you guys yes sir as a matter of fact um got a very good working relationship with uh my partner in afg here um we are that's true yes this is the time you can be totally honest in here you're I'm not going to lie to you I'm not going to lie to you I appreciate you say Li okay they got a very good relationship with not only afg but also our partners in IG that's also true um what I can tell you is most of what you just heard is being incorporated into a massive training monitorization process that we are that we're it's already underway we are looking at how we improve the training to employees we're looking how we capitalize and maximize more inperson uh smaller class sizes uh more access to real cases earlier access to vbms all of the things that was just discussed or were just discussed those are part of four massive work groups that we have right now that are chiseling away at revamping the way that we modernize the training you agree with that stav Miss Cooks I hope that's happening I hope it's happening we do too I'm you seem to be the subject matter expert in what you just your in your opening statement I'm hoping that what he just told me is being confirmed by you that it's happening is that true I have not seen um the change yet I have not seen the changes yet I do know that again what I I have shared here has been shared with Mr Burke and so I hope that they did take um our input to actually um Implement those changes I would hope before we have you in front of this committee again I can I can look directly at Miss cooks and say thank you Mr Burke that's exactly what probably should have happened I would hate to think that you come back in here and she says they didn't pay any attention to me whatsoever that wouldn't happen could I add to that sir absolutely so we're at the early stages of working groups what's early mean early means we just formed them in uh a month and a half ago we established working groups um and in my written testimony my oral testimony rather we talked about I talked about we are we've identified items that can be implemented in the next 3 to six months I have the pleasure of going to Labor Management Forum next week in Chicago with a friend of mine where a briefing will be on the training monitorization effort so if we had had this meeting or this heing in next week you would have a better feel that we're on the same page okay I'm going off of what Mr brochi told us that it's been the past three or four years I believe you said three or four years of kind of of a repeated report so I'm good to see there's traction and that you're moving moving on this Mr brochi and I'm I I I kind of missed it but you said the operations officer doesn't have authorities that that he or she may need the the compensation service is that Miss messenger does that belong to you what he he speaking on as far as authorities go ahead Mr brochi the the compensation service which actually falls under Mr Burke's um Authority okay um it oversees the quality assurance program they conduct reviews they have analyst that conduct reviews and report on quality Nationwide but they they don't have the authority to REM to remedy and make sure their erors are correct please explain to me what authorities he needs so if it's something that we can address or is it secretary driven currently that Authority lies with the office of field operations so they oversee Regional Offices and claims processors and they drive decisions on um priorities on they have to ensure that training is completed have to ensure that um errors are corrected so that's the office that that has the authority to make sure that um errors are supposed to have the authority they have the authority under the organization okay maybe I misunderstood what's going on they do yes okay so just to be 100% clear you do have the authority that you need the answer is yes to that question sir and in fact the office of field operations has recently stood up a compliance office that is not only helping to ensure that required training is met it is the one that is connecting information to our performance standards group to ensure that in our employee performance standards there are expectations on timeliness of corrective actions um and that also is a new office that was stood up year and a half maybe two years ago I don't have the exact date um to address the Gap that IG just spoke about okay thank you Mr papis your recommend sir thank you I I want to First focus on an issue that came out of uh the oig reports uh rating schedule update for hip and knee injuries oig found that an estimated 38% of claims had an improper payment so Mr Burke is VBA initiating a special Focus review uh to address these errors and if not why not and if so what's your timeline for completing it so yes sir we will be doing a special Focus review we actually reviewed the ig's findings um we have taken um much like the tdiu cases uh where there are uh claims that need to be corrected we'll take corrective action but we're also trying to figure out if there are gaps in our training to the field and so we go back with those finds in we can improve the training update policies and procedures um and then again we use the special Focus reviews to do targeted after we do big releases like manual changes vardy changes we'll do a short period of time go back and pull cases see if we're compliant and and our findings are similar with what uh what the IG found how do you make that assessment about whether or not there's a gap with respect to training uh as you undertake one of these special Focus reviews in some instances it's pretty clear that the mistakes are pretty common and we'll go back to the training and see that the training was either vague or contradictory and so basically the policies the training materials is really the guide what we expect employees to follow when we find the outcome of the employees work is consistently going down a path that it was not intended to go that is normally not an employee issue that is normally a policy or training issue and so seeing those consistent Trends allow us to tra trace it back and say we have a gap in what we've provided the field so when VBA hears about a pervasive quality issue from oig or GAO what criteria do you use to decide whether or not to initiate a special Focus review is it a monetary value involved is it a percentage what do you looking at to trigger that or is it subjective so typically with special Focus reviews we allow all of vba's business lines to recommend to my office the the focus in advance typically it's time to the release of something new something sub itive that we want to make sure that uh employees have grasped the training and the training was adequate so most of our special Focus reviews have to do with something that we've released relatively recently A change in law change in a process or a procedure and then we will approve the um selected special Focus review the results of the special Focus review then come into my office and the recommendations and findings are tracked until closure so we do give our lines of business um some leeway if you will to to pick those themes we approve them and then track the results okay Miss Parker Cooks I appreciate your testimony as well you you identified a long list of uh issues that could be uh looked at with respect to improving training I'm wondering if you could just talk more broadly about uh the quality of training itself and how that impacts Frontline employees and our need to focus on Recruitment and Retention thank you so what I would like to say is that when you're looking at the training and the quality of it and I specifically talked about the VIP and it's interesting that you brought up about the changes with the muscular skeletal conditions VIP really focus on uh those and that's our largest category we're always getting claims for back condition knees hips and so in VIP they cover the back and maybe the knee but they're not getting detail training so it's interesting that that's a high level erors that you're seeing because they're not focused on um that training but I think when you're looking at it the clear thing is is that we're starting them out and they're not getting the basics they don't understand what they're supposed to do so by the time they end training they're frustrated they don't feel that they're prepared to do the job they've been hired to do um their confidence level is low and then of course you're seeing a revolving door where people are leaving if we change and restructure the training of course where we're giving them the basics they need to start out and build on that Foundation you're going to find that the employees are more um comfort comtable confidence trained and then they're going to also of course is going to result in more positive quality decisions so I think if we focused on and I'm glad to hear that they're saying that we're going to be making uh changes to the training program but that's what we need we need to train our employees to do the job right from the beginning so that you don't see the rework that's what you're seeing now when you're coming out of training is folks are doing the doing the work but because they weren't trained well and they're not confident in what they're doing we're having more errors and you're having that work have to be redone we certainly shouldn't be setting people up to fail we should be setting them up for Success so appreciate that feedback and I yield back Mr chairman thank you rank member Mr self sir you recognized uh thank you Mr chairman first of all uh we and I make this comment almost every hearing we hear a lot about inputs from VA inputs we established this Mr Burke and your testimony established established established lots of inputs very little about outputs and uh Miss Curtis uh I'm not sure I got it entirely right made the statement uh we don't know how training will help I think it was employees but in several times in your written testimony uh you said basically the same thing so I think I found the sentence that you were referring to specifically and I quote from the GAO written testimony the training program goals and measures do not address how VBA training will help achieve the desired accuracy of benefits decisions made by claims processor which means your inputs are not working to change the outputs is the way I read that sentence so I want to hear more in the in the in the future how what the outputs of all these things that you're establishing all these bureaucracies that you're establishing now my first question is to you Mr Burke and I'm asking this on on behalf of my Navy SEAL brother in-arms Mr Crane I have heard from VA employees in Arizona 2 that they received inadequate training on processing packed act claims and GAO stated that VA has not provided GAO with va's evaluation plan or reports for packed act training so Mr Crane asks within the next two weeks will you provide us with va's plan for packed act training and reports on the trainings VA has already provided yes or no no sir I cannot commit to two weeks I will commit to going back and coming back to this committee with an actual firm date the reason I can't commit to two weeks I'm not exactly sure where we are in that process okay I would ask you to get back with Mr Crane to tell him when you will have that report yes sir uh now Mr Burke let's stick with you um oig estimates there's been between 100 million to 250 million million in improper payments in tdiu claims processing errors alone these are errors alone what is your plan to recoup These funds and prevent such significant losses in the future 100 million to 250 million is a significant amount of money in anyone's budget yes sir I'm reviewing that tdiu report it's important to reflect that the findings were both overpayments and underpayments obviously underpayments are as bad as an over payment right somebody's entitled to something they're not getting paid for that we have taken corrective action on uh 95% of all the cases identified in that report we should have the remainder done here shortly um and then it is important to also note that um the amounts and and my partner from IG can correct me if I'm wrong that that that's that's not the actual overpayment there's a they use a different calculator they project that that so there's not really that much in actual overpayments today but to your question any wait a minute I'd like the oig to address that 100 million to 250 million that's not an actual figure 100 million is we we use statistical sampling so we look at a sample of claims and then we project to that Universe of claims so that that's how we come up with the 100 million seem seems fair enough to me so uh you mentioned a report Mr Burke will you uh when will you have that report ready for chairman L tril which report I know that we're I know I mentioned uh a report on these overpayments and underpayments you just mentioned it we're 95% through with the corrective actions that doesn't necessarily result in a report but we are happy to come back to the chairman to notify him when that when all 100% have been I was just using your word okay Mr brochi what are the underlying reasons for these joint errors um what are the underlying reasons 3.3 million in this case not quite as big as the tdiu but uh what's what are the reasons yes sir um relevant to this hearing we found issues with um quality assurance and with training um in this case we found that there was a targeted quality assurance that looked at these specific claims um Mr Burke mentioned that they are now doing a special focused review that will cover that so they are addressing the recommendations that we've made um and we found that about um in the training there's a post assessment after the training is completed and we determined that about 75% of the employees who took the training initially failed that training so it calls into question the um the adequacy of that training um so we we also made recommendations to make improvements to that uh my time is up Mr chairman I yield back Mr BR I'm sorry explain to me the how you're taking a statistical valuation to present this committee with 100 million to 250 million and if that's not the exact number yes sir we we we do almost all of our work based on statistical sampling so we we looked what's our and our end value is what that you're taking these numbers from in in in the tdiu report we looked at 200 claims 200 claims so you got an nvalue of 200 yes and your valuation of plus plus payment minus payment is almost $250 million 100 million in improper payments uh we sorry I thought there was a 250 in there somewhere too no the the 100 million is is what we determined was the the the improper payments for that Universe of claims What's the total number you took an nvalue of 200 out of what's our our gross statistical number I I don't have that I can I can come back to you with that number I don't have the I don't have the number in front of me I know that there are 375,000 veterans who are receiving tdiu benefits okay so how much of that 100 million is overpayment uh not not very much the vast majority were under payments to Veterans I think we identified um we projected about 85 um million to be to be under payments I'd like to see that I'd like to see those how that equations processed please if you don't mind absolutely Mr Burg since the oig's March 23 report showing that 44% of disability compensation exams were unnecessary what's the VA doing to reduce unnecessary exams for our veterans yeah thank you for this question sir we we have actually spent a lot of energy in reducing unnecessary development specifically the overdevelopment reduction task force version two which wraps up at the end of this month was specifically focused on exams we focused on vendor exams private dbqs automation exams and also the the utilization and the effectiveness of a new exam request tool this working group alone uh has been operating for most of FY 24 they've already identified more than 60 manual change needs improvements to tools and Technologies partnership with the IG on how to detect and Report fraudulent dbqs how to strength the me strengthen the messaging of using acceptable medical evidence and reducing unnecessary exams because as you're aware and we're aware calling a veteran into an exam that's not necessary is expensive it's inconvenient can be confusing and it delays the process so we have focused significant efforts this year on the second version of the overdevelopment reduction task force and I will commit now there will be a third one uh in fy2 okay so when this this task force is finished and the next one ramps back up at what point are you going to push this out to the to the V to to all the VA facilities and this problem will be remedied because that seems like a pretty heavy lift and that that is an extremely heavy lift that's why we are on version two and there will be a version three how many are we going until we fix it oh man until we fix it okay um and I I would assume there's not a kind of a time frame at which that's going to hit Conroe Texas and I can tell all my folks that they we're good to go every year I'm in this role there will be one until we fix it okay it's a big issue we've got a lot of work to do Mr B thanks maybe just a couple more Mr broch if I can turn to you it's always good to have a fellow Granite stator here so welcome uh but you know you reported on so many acute quality issues uh in your reports uh you reviewed root causes in the office of field operations do you agree with va's assessment about these quality issues um generally generally yes um we we find we we acknowledge that um disability claims processing is a complex process constantly changing guidance um it's a difficult job to do um as we do identify issues um VBA does take action to to address our recommendations so we agree with the action that they that the action that they take is responsive to the intent of our recommendations so Mr Burke there's no question that VBA can adequately identify acute quality assurance issues we're here because there's a structural issue limiting ofo's ability to implement and oversee policy changes to include action on quality deficiencies uh understand that there's going to be a major update to vazard D in the late summer or fall um so taking this specific issue how can you assure the committee that the update will not result in the same sort of quality uh concerns that we've had over the last five years um I will give a sharance that we've learned from uh issues in the past uh we are now including in the creation of materials more subject matter expertise from the field more inclusion more feedback we are allowing folks in the field to kick the tires if you will on significant policy changes before we push them out to the field at large uh we have excellent collaboration with the office of field operations and the new compliance entity all the entities within ofo we're collaborating with our partners in afg and oig and I will say this the one thing that I want to make sure that I uh leave with this committee is the fact that the VBA Workforce is incredible I've said this in previous hearings prior to this year VBA has never completed 10 10,000 claims in a day never completed 10,000 claims in a day this year alone this amazing Workforce has done it 87 times and so we continue to ride the strength of our Workforce and invest in the training and the improvements and learn from some of the mistakes from the past so once again it it would be helpful to leave this hearing with a clear indication of what your training priorities are because that's such an important piece of this puzzle so can you go over that again for me um where are we going with training and uh what resources are you bringing to Bear to address this problem I can yes sir in fact what I want to describe and set up for a briefing here in the near future is our focus on the training modernization we're really looking at we've established four key groups for working groups um one is to focus on the things that we do before formal training how we onboard employees how we equip them how we screen them better to ensure they're the right people to do this job that's the before formal training then we have work group that is focusing on a complete redo of what we currently call VIP VIP was done to replace the old challenge training that was outdated we've modernized everything within our organization except training so now we're modernizing and VIP will be a thing of the past once we do this so the second phase of that or the second work group is the formal training this goes to the tools the technology the types of cases the types of topics the microlearning instead of dumping everything in front of an employ employe that's the focus of that group the third one is the continued employee development because it's not just about training new employees it's about refresher training it's about consistency training and then the fourth would be the resources the roles responsibilities that goes to the class size the instructor Cadre how we actually ensure we have the right people training our trainees and the right people that maintain their skill set to continue to train and do refresher training we have a plan we have a documented plan we have a vision and now we're executing with the work groups to get something that we can come back to this committee and brief on in much greater detail well we're eager to see more progress there that's a pretty robust outline and um once again just to underscore you can't get there without folks like Miss Parker Crooks and others um who I think have really terrific insights and recommendations and are going to be tasked with helping you refine this over time um so you've got to have an open mind and an open door with respect to those employees Miss curta if I could just go to you within the time I have remaining uh you mentioned that your open recommendations related to training have to do with program strategy goals and evaluations is it safe to say that as it stands now vba's overarching training program is uh reflexive and reactive on an ad hoc project by project basis is that how you'd characterize it yes okay any else there you would like to leave us with with respect to training I think our recommendations I mean taking a step back from some of the micro issues you know we're talking about the system they have in place to ensure training works and so just taking a step back from them getting out of that reactive mode um planning for what you want to accomplish setting goals priorities um having a way to evaluate your progress so if you don't have a goal going into it how are you going to know if you're accomplishing it at the end of the day how are you going to monitor whether you're achieving the goal you set out to to achieve and that's what we were seeing missing um back in 21 when we did this report um no clear goals no clear um strategy um they've improved some of those things but I mean this is what I'm hearing today is kind of new so um you know we hadn't seen uh goals and evaluation plans for the existing training program so now they're going to introduce a new program so I would just recommend that they think about doing this in a disciplined way um I think you brought up um our reform initiatives report earlier and that's a road map to have to set up a program for Success you know establishing goals checking in with stakeholders getting feedback from the people that have to implement the the training and do the progr and take the training um and having um Milestones um and measures of success I think are all really really important and uh that's an open recommendation that we have to Va Va as well and we'd love to see them uh take some action on that report yep Mr Burke how do you feel about that one uh we generally agree I mean as Miss Curtis said I think there were 10 recommendations uh six already closed out the four they're partially addressed we're continue to kind of make Headway with that but I do agree in order to gauge the success of some something you have to have some milestones and some measurements and we're we're working to get to that point that will be incorporated in the new training modernization as well we are surveying with all of our training we're doing surveys we're getting feedback from folks we are getting better in this realm um but noted that we need to continue to make some improvement there well I think her remarks were just an important cautionary note as you launch into this new effort um for some important ways to be thinking about how you structure it uh how you build in feedback loops and what sort of benchmarks we can have along the way so I hope you'll continue listening uh to those folks outside the department within it that can help guide the process we'll do yes sir thanks I yield back thank you Mr RIS keep leaning forward you're never going to I'm I'll never wire brush you if you're leaning forward and thinking outside the box you're you you all are the subject matter experts you're leaning forward to take care of guys like me and the rest of us in this room okay if I have to come in here and listen to another oig report that says the same thing over and over again just negative so by you unpacking that thing and I get what Miss Curtis saying with the ranking member saying yeah put your guard rails up on your left and right flank and move forward effectively and efficien efficiently Miss Parker cooks are you happy with what you're hearing in here let's see what happens in three to six months they said they have some things that can be implemented in 3 to six months I'm looking forward to seeing what that is I can assure you we most certainly are going to have every one of you back in here in front of us to see and hear just that okay I think that is a very fair statemente because we're hearing what she's saying and she is is the subject matter expert when it comes to boots on the ground that's a fair statement yes chairman okay okay so thank you all for coming for us today and speaking on the important issues ensuring that the VBA implements effective quality assurance and Training Method so that the VA claims processors can provide our veterans and their families with accurate timely decisions on the VA claims for VA benefits with that I yield to you Mr ranking member just just want to thank our panelists I really appreciate your Reflections today and uh this stuff is so important to how we deliver the benefits that veterans deserve so uh we've got to move forward in a way where we can set VA up for success and just really grateful for um the opinions that we heard here today we want to work with you to get this right um so let's stay engaged and I'm sure we'll be revisiting this pretty soon thanks Mr yeah and please keep up we may we may wire brush you I use that term I use that term but you're doing you're doing your jobs and you're doing great work you have to get up every morning and take care of unsavory people like myself and the rest of the veterans right that's just I mean that's an incredible job that you do um just get better every day okay I ask unanimous consent that all members have five legislative days to revise and extend their remarks and include extraneous material without objection soord this hearing is adjourned e e e e for