Request i want to thank you, mr. Chairman, for allowing me to ask that question in case i have to leave. Thank you. Senator heller. Thank you for your testimony and everybody thats here today. Its good to see you here. At 4 30 this afternoon i have the secretary coming into my office and im going to ask him a lot of questions. Im going to ask him obviously about the veterans backlog issue and progress if any are being made. The issue of lack of communication between my office and reno will be another question that im going to ask and hopefully get a good answer for. But there are other questions that you might think that i should ask him. Are there any questions, if you were talking to the secretary today, what question would that be, and im going to take notes and this is your chance to advocate. I wouldnt presume, sir, to tell you what to ask the secretary, although the secretary is an Airborne Ranger like me, so he is my friend. He has told me that he will reduce the backlog by 2015, put i would defer to members of my staff for any Additional Information they might want to share. Love to hear from them. Yes. You. We do believe that the va is making progress on the backlog. We obviously feel that advance appropriations is necessary because every year there is a lapse between the start of the fiscal year and when the budget is finally approved. That causes all kinds of problems in training, getting things accomplished and business efficient businessman business manner. We would like the secretary to support our efforts to get advanced appropriations for the rest of the va and for discretionary. He himself has indicated that its very important for his i. T. Budget and construction budget to be received on time because of the problems associated with those two issues. So we would like to know if secretary will continue to advance or to support our advanced appropriations . Anyone else . I certainly appreciate those comments and they will be well heeded. One of the issues that comes up in my Office Commander is the fully developed claims program. Its a new initiative by the va office. Veterans who submit a fully developed claim are able to receive a decision under 125 days. And suring that the claims do not become backlogs. What more can congress and va did to ensure that veterans do get a fully develop the claim . I would make just a general comment before i turn this over to my staff. We believe that the reduction of the backlog is a combination of a claim process and dbqs and then also accountability thats passed onto the review officers. We think those three things are exactly the types of answers to not only reduce the claims but to a manageable level but then reduce the backlog entirely. Let me if i can ask a followup question, i know they work hard to encourage veterans be served to file as complete a claim as possible, but i also recognize they need options to file any wayhey want. Whether that is on that forum or perhaps on paper. Is that accurate and can you explain why its important that veterans still have the option to file a claim any way they want . Ill defer that to the staff. Its important that veterans still have the opportunity to file a claim, paper on the standard or regular form. Currently they can take that regular piece of paper or as many people refer to as a map ka and sends it to the Va Regional Office and they have a duty to send the claimant the correct appropriate form to be completed and then they return it. But that starts to date the day they receive the claim. And vas proposal, they are recommending that you have to file it on that 526 ez in order for them to start to date. Thats what we dont agree with. Its very important that they still have the opportunity because not everyone has easy access to these forms and not everyone can do it electronically either. Still in the early stages and filing claims electronically so we feel its important to allow them to submit claims on paper for effective dates. You mentioned fully developed claims. In order to encourage people to develop their own claims, veterans, its very important to have that process so that they can establish whats called an informal claim and as mentioned, protect the effective date. They can then go out and develop the information thats needed to be a fully developed claim. That claim goes through the process much quicker. Without that protection, on their effective date, they will not be motivated to go out and develop that. Well leave it to the va which causes the claim to have a lot longer development time. Mr. Chairman, thank you, my time has run out. Its been a pleasure to participate in operation and keep the promise. Thank you. In your written testimony you talked about several initiatives that they find have had a positive effect on the backlog of disability claims and one of those initiatives that dav refers to is the Quality Control regimes or as va refers to them quality review team. I dont know if you or your team is aware that the despite the positive feedback, there was a memo that was sent out a week ago today basically saying that all staff would be working on for the quality review teams would be discontinued until further notice so that all hands could be on deck. To continue processing claims and what i would like to hear from you, is the effect that a temporary elimination of these review teams may have on a secretarys goal of 95 accuracy within 125 days. Turning numbers out is one thing but the accuracy is critical. And so again, you may or may not be aware of it and joe may be aware of it. But id like to hear from you what you think the potential effects, negative or positive could be. Ill let the staff answer that question. Thank you, mr. Chairman. Quality is our number one priority. Always has been. We were very supportive with the qrt teams. We are aware of this initiative. This was to go through the end of march and its important the va makes the decision right first time. Thats the only way we want it. We are going to monitor closely over the next 40 days or so to see how impacts we dont want to see this continue to happen. That was our concern in the beginning when the qrts were created that they would use folks when Initiative Came up. Weve been happy with the progress in the qrt teams locally there being able to do centralized training on particular issues they are seeing at the local regional va office. We feel its important that quality is a number one priority over quantity. [ applause ] also in your written statement, you stated that the most important factor driving vvas productivity gained was the policy put into place of mandatory overtime for claims processing. I think that over time the overtime initiative has been helpful. But it is not sustainable in the long term due to Employee Burnout and reduced accuracy rates. Indeed the benefits Program Portion of the independent budget recommends that we provide sufficient resources to ensure adequate Staffing Levels at the vva and it goes on to state that the vsos recommended increase Staffing Levels instead of sole reliance on mandatory overtime. What i would like to hear is a further explanation of the independent budget rationale for the positions that or the position that you take and the organizations took that hiring additional employees may prove more beneficial than overreliance on mandatory overtime. I would like to say a few general words before i defer to staff for the specifics of that. Over the years, the independent budget has been the bellweather of the actual requirements for what was needed in the va budget each and every year. Every time that budget is ignored, it always results in additional appropriations in order to meet the needs. We have confidence in our numbers and we have confidence in the quality of that product and we certainly believe that you all should Pay Attention and heed it. So with that, i will defer to the staff. Mr. Chairman, ill respond to that and just say in the independent budget, what we thought about was what happened several years ago when they brought on for temporary employees and trained them and put them into the workforce and through attrition either kept them off after the temporary period or let them go. We felt that that provided va number one with the resources with sufficient trained employees and also gave va the opportunity to make a determination as to who was successful and who they can keep on. So we feel that overtime is nice but after a while people do get burned out and we would rather see even if its temporary in the beginning, a core of people coming on board to take care of the needs and again, with automation and what va is doing, the needs for the numbers that weve asked may go down over the years. And that gives the va the ability to then decrease their workforce when necessary and just keep those that are productive. Thank you, my time has expired. Thank you, mr. Chairman. In this years independent budget you included a recommendation that they must develop a new metrics in Assessment Tool to measure the performance of every level of the claims Processing System based upon a scientific methodology of projecting workloads and resources requirements and allocations. Can you provide some examples of the Performance Measures that you believe that should be instituted at the vva . Ill defer that question to the staff. Thank you. We firmly believe they should be progressive methods with benchmark transparent so we as vsos can establish the va are meeting their needs and making sure that its more than just production goals but also quality goals. We will continue to watch them closely and make them accountable for those benchmarks. Theres an old saying, if you cant measure it, you cant manage it. What part of the claims process in your view should be counted in order to be measured . Clearly you can get a lot of claims out the door but the accuracy rate might be terrible. What part of the claims process do you think should be measured . Theres no doubt that the vas making sure that Everybody Knows about their production metrics. So of course, we are very concerned about the quality of those claims being done. And for all of the claims that we represent, we take a look at the claims before they are promulgated to make sure there are no mistakes and take them back to the va before they are finalized. However there are many veterans not represented so its very important to make sure that quality across the board is being done and that they do it right the first time. [ applause ] having that said, that would also reduce the appeals because if they get it right the first time, then youre not going to have as many appeals. That was my next question, as they move down the lower the backlog, the amount of appeals are actually as concerning is actually going up. What are you recommending as far as we should do as far as the appeals process . Because that is a huge concern as a backlog claim comes down the appeals process, is going higher. Theres no doubt. Appeals are even a longer time frame than the regular adjudication of regular claims. The more we can do to fix it at the front end and i believe that about fdcs, those will help the appeals process. Not only will the evidence be there at the very beginning that they need to do it right the first time but the time frame for those claims are much shorter. And i believe veterans would be much more satisfied to get a claim in a matter of weeks as opposed to months or years, knowing the evidence they submitted and all of the evidence was considered as opposed to starting a claim, getting an exam, and then not having a claim add jude indicated to months later when it can change we the time they had their exam and ajude kate the claim. I have no doubt that that bill was brought to the floor, it would Pass Congress overwhelmingly. What are you doing to get leadership to bring the bill to the house floor for a vote on it. Actually yesterday our the department of ohio had a meeting to discuss that fact in bringing advance appropriations forward. Today along with operation keep the promise, we had thousands of call made into the capitol hill switch board at the time we were at the rally. We hope that with those phone calls and emails that well be generating today and business that our members are making that you get the message to bring the bill to the floor for a vote. Thank you very much and thank you very much, mr. Chairman. Thank you very much. I thank the chairman, i got the message. [ applause ] in the dav, hold your hands up, any of my tennessee colleagues that are here. As commander, i want to thank you for your leadership for the dav. I want to briefly tell you a very quick story about how much i appreciate why youre here and about a year and a half ago i got to back to korea where i was stationed and colonel, mine is still straight after 40 years, people as civilians might not understand that, you do. I got a chance to go back to korea. And i was there in 1973. And i saw a country that was digging its way out of a war. They were never recovering from one end to the other. In 1960 they the fourth poorest economy in the world. Today because of what you men and women did and people like you, there are 50 million free people and the leadership of that country said every time you get in front of a group of veterans, you thank them for us and were doing that today. Youre seeing the largest Christian Church in the world in seoul, korea. Its a methodist church. Thanks to what the American People did, saw what happened after world war 2 roemtz. I cannot thank you enough for what youve done and made us a free nation. I could never do enough for our veterans in this country. We have a va hospital a mile from my front door in Johnson City Tennessee and you have my commitment and i wrote down your advanced appropriations. I couldnt see why we wouldnt do it. I think it makes absolute sense to do it with a whole budget, get it done in one years. The va was a good start and it shows us that the veteran shows the way advanced appropriations work. I support that and the frustration i have here is the billion dollars we spent. Last year about this time chairman remembers this very well, where we couldnt have an integrated Electronic Health record where the va and dod we flushed a billion dollars and still cant make it work. Thats something that i think this is my sixth year here. I cannot understand in todays technology why a veteran Service Member cant lead and electronically transfer their record. It hasnt been explained to me. It is coming down. I salute the secretary on that. He has a real commitment to that. The two things that i really am passionate about are Homeless Veterans. I think its heartbreaking when you see a veteran sleeping under a bridge that honorably served this country. We had the hud vouchers and that has come down. I salute general shinseki for that. Thats one of our problems at home. Weve got to work on a place to house Homeless Veterans and people to go ahead and get the folks integrated into society. We cochaired the invisible wounds caucus. When you have more veterans dying of suicide than combat, something is wrong. We need programs and look into that and find out what the causes are and put resources behind preventing that. We have so many veterans in need right now. I think thats one i certainly feel passionate about. I think the other one ive seen a local level is to bring the va to the Community Outpatient clinics that we have, we just opened one up in tennessee, its going to have to be expanded in a year and a half, it was that successful. I think im going to encourage john and i are having breakfast with the secretary in the morning. If you want to give us any other questions, well be glad to take them in the morning. We have breakfast with the secretary. I think it is a tremendous success and way to get the care instead of elderly veterans having to drive miles and miles to care have it in their own community. Ill stop there and thank you for your service. I hear all of it and i think we can support everything and thank all of you for your service. [ applause ] youre recognized for five minutes. Thank you, mr. Chairman. Well, on behalf of i think the five californians, three of us here, myself, congresswoman Gloria Mccloud and congresswoman julia brownly, paul cook, who is not here and also dr. Raul ruiz, im sorry, theres actually six of us i guess. Id like to acknowledge the californians in the room. If you are here from california, please stand and let us know your presence. [ applause [ applause ] we make that trip back and forth between washington and california and we know what a journey you made and we appreciate that youve come all that way to let us know your agenda. Its a great honor to serve on this committee and do what we can. I represent the eighth largest veterans population in the country. I met with my Veterans Advisory Council last week. They are doing tremendous work in my county to reach out to Homeless Veterans to find out where they are living along the Santa Ana River and in different encampments in the valley, just to get a count. And im fully aligned as i think all of us carefully aligned, with ending veterans homelessness. I have one question that i want to ask you commander, its my understanding that the va has published new regulations that establish presumptions for veterans living with severe traumatic brain injury. Who also have a parkinsons disease, certain types of dementia and depression and unprovoked seizures or certain diseases of hype thalt mus and pit tu teary glands. Is it your organization aware of any planning or analysis that va has done that relates to the possible impact on veteran administrations backlog of claims . I defer that to the staff, sir. Thank you for the question. Were not aware of any planning that the va has and how they are going to implement that but weve seen an overwhelming increase in claims at this time at this point. So because of that rule change were not seeing tremendous impact as of now. You havent seen a spike in the backlog or any discussions about initiatives to address those particular questions added as presumptive conditions. Were not