“[At the start], I was more optimistic. I knew it wasn’t going to be a two month ordeal, but then after all this time … my optimism flat left.”
That’s what one Veteran told us about the appeals process for Veterans’ claims. To better understand how Veterans experience the process – how the process fits into the context of their lives – a group of six researchers spoke at length with 92 Veterans whose service spanned the periods from World War II, Korea and Vietnam, to the conflicts in Iraq and Afghanistan.
Today, that report prepared by VA’s Center for Innovation is being released. What it found is consistent with a process that is 80 years old – the length and amount of labor is cumbersome and frustrating.
The current appeals process was established in 1933 when hospitals were few, most care was provided by house call, and medical records were virtually non-existent. Today, increases in medical knowledge, clinical practice and the acceleration of the modern world have slowed the appeals system to a crawl as it struggles to keep up with expanding mandates, legal requirements and documentation.
Researchers used human-centered design methods to understand the needs, behaviors and experiences of Veterans during the appeal process. The team spoke to Veterans at every stage of the process, from those receiving their initial decision to those with final and complete results from the Board of Veterans’ Appeals (BVA). Some were new to the process. Others, such as those who had just had their hearings with the Board, were years into the process.
Their research identified five key themes surrounding Veterans’ needs, perceptions and expectations during the appeals process:
- The length and labor of the process takes a toll on Veterans’ lives.
- Like in the military, Veterans care deeply about the outcomes of other Veterans.
- Veterans feel alone in a process they don’t understand.
- The appeals process feels like a fight.
- Veterans want to be heard.
These insights from this report can serve as a guide across VA for a redesign of appeals and related services to better meet the needs of Veterans and their families.
The status quo isn’t acceptable for Veterans or for taxpayers. As VA has increased claims decision output over the past five years, appeals volume has proportionately increased. Between 2012 and 2015, the number of pending appeals climbed by 35 percent to more than 440,000 and that number is projected to continue to increase throughout 2016.
The appeals process should, in theory, be one of the most applicant-friendly systems in the world. Instead, it ranges from depersonalized and arduous, to hostile and belittling. Absent new approaches that permit appellate review to be conducted in a complete and timely way, even the best efforts of VA and VSO employees are unlikely to be able to meet the challenge of tomorrow.
The time to modernize the appeals process is now. We must begin an open and honest dialogue about what it will take for stakeholders to provide Veterans with the timely, fair and streamlined appeals decisions they deserve.
With challenges to the current model only increasing over time, we have an opportunity and an obligation to contemplate a future that meets Veterans needs and expectations in a timely and customer friendly way. While none of us may have the answer on our own, we believe that together, we do.
The VA Center for Innovation identifies, tests, and evaluates new approaches to efficiently and effectively meet the current and future needs of Veterans through innovations rooted in data, design-thinking and agile development. Find out more at http://www.innovation.va.gov/.