Thursday, January 27, 2022

VA Tests New Automated System that Could Speed Up Claims Decisions


Department of Veterans Affairs officials are hoping a new automated system that helps render decisions on disability claims will accelerate the process and decrease the backlog of claims applications.

The automated system being considered by the VA has proven to shorten the disability claims review process from 100 days to two under certain circumstances and conditions, according to the agency.

A pilot run of the VA Automated Benefits Delivery System, launched in December, looked at claims filed by veterans seeking upgrades to their disability ratings for hypertension and cut 98 days from the process for those with complete files.

VA officials said the program is part of a plan to address 260,000 current disability claims, including 59,000 that are older than 125 days and are considered backlogged.

"We saw an opportunity to look at our traditional disability claims process and see how we can better leverage the data we have ... to introduce business-process automation," explained Rob Reynolds, acting deputy undersecretary for the VA's Office of Automated Benefit Delivery, during a press conference with reporters Tuesday.

The system takes electronic or paper claims and uses algorithms to determine whether the file contains enough data and information to render a decision. It then weighs the information against the rules that govern disability claims and makes a recommendation whether to approve or disapprove the claim.

The system's recommendation is reviewed and validated by a rating veterans service representative. If at any time the system decides that more information is needed -- the veteran needs a comprehensive medical exam or more data is required to render a decision -- the claim is sent to a claims reviewer for traditional processing, Reynolds said.


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