GAO reviews how the VA is training its claim processors

The Veterans Affairs Department recently announced that three-quarters of the way through the fiscal year, it has granted benefits to 1.1 million veterans and their survivors, an all-time record. However, there is always room for improvement, especially when you’re talking about providing for our nation’s veterans. The Government Accountability Office recently checked back in on how VA is training its claim processors. To learn more about what they found, Federal News Network executive producer Eric White spoke with Elizabeth Curda, director of GAO’s Education, Workforce, and Income Security team, on the Federal Drive with Tom Temin.

Interview transcript: 

Eric White  Ms. Curda, thank you for joining us.

Elizabeth Curda  Thanks for having me.

Eric White  All right. So, this audit kind of started a few years ago. Why don’t you just give us a the lay of the land of what this originally was looking at?

Elizabeth Curda  Well, originally, you know, we had observed at GAO, a lot of our audit work had found problems with the quality in the claims processing system. And that the root cause of some of these issues, and a lot of our recommendations had to do with training. And, so, at talking to the Hill about this, a comprehensive look at the system for for providing trading at VBA would be a good way to get at a lot of these issues more systematically than sort of these one-off cases of looking at this issue or that issue. And, so, this was a wide-ranging look at how VBA provides training to its claims processors. And, you know, we looked at it through a lens of leading practices.

Eric White  And, just give me a brief synopsis on what those issues were. I won’t make you run down the gamut because it’s a complicated system, I’m sure, with a few flaws. But what were some of the general problems that you all were hearing about and seeing?

Elizabeth Curda  Well, it wasn’t just at GAO, but also the IG. And, I mean, I couldn’t give you each exact example. But it was things like errors and decisions, not taking into account evidence, problems with medical exams that are used to make decisions about whether an illness or injury is service-connected, things like that.

Eric White  All right. And, so, how did that coincide with issues that you all were seeing with training? I guess, what flaws in the training system were causing those issues?

Elizabeth Curda  Well, that said, we looked at this very comprehensively, bumped up what VBA was doing against leading practices. And these are things like, how do they design the training? How do they plan the training? And how well do they implement it? And, then, how well do they evaluate it? So, kind of you think about it, like a cycle. You know, we’re onboarding thousands of new claims processors, and how do we plan for that? How do we make sure the content is what, you know, this population needs, and it will be delivered well? Prioritize across all the different training needs of this organization. We looked at, you know, implement of design, we looked at, you know, how do they deliver the training? You know, is it in person? Is it virtual? Is it recordings? Is it printed material? Is it the right mode? So, we looked at these kinds of issues, and pretty much found problems across the board.

Eric White  We’re speaking with Elizabeth Curda. She’s the director with the Government Accountability Office. Yeah, so you talk about design, and you had recommendations for all four of those areas that you mentioned. I guess we could, if we could just summarize what each of the issues were. What was exactly wrong with the VBA’s design of its training for claims processors?

Elizabeth Curda  Well, one of the issues we found there was there was no policy around how to select the mode of training delivery. Pre-pandemic times, I think there was a lot of bringing people into a central location, providing a lot of in-person training, very costly. So, they, even before the pandemic, but certainly in the pandemic, everybody had to kind of rethink how they did things, lots more virtual trainings. And, as frequent policy changes come out, you can’t provide in-person training for everything. So, more written materials, the PowerPoint slide decks, things like that. But they didn’t think through, like, what was the best mode for a particular type of training. And, so, so we had recommended they develop a policy for determining what is the right kind of mode for any given type of training and have something that they could follow consistently, which they did implement, and they now have criteria for deciding on the mode of delivery.

Eric White  It’s hard enough just to remember to turn your mute button off, I can’t imagine having to train somebody through the claims processing at Veterans Affairs via virtual platform. Alright, so in implementation of the training program, it seems as if that may have been the area where they made the most improvements since the last time you all checked. What is the status there?

Elizabeth Curda  Well, there we found two key issues. One was that people who were providing the instruction did not all have training in how to provide instruction. So people were just doing it as kind of a side thing along with their regular workload and didn’t weren’t necessarily trained to be instructors. And, so, we pointed that out and VVO has addressed that by establishing minimum requirements for people who provide training in terms of what their level of skill is and their preparation for that. The other big thing was we found that claims processes weren’t completing all of their required training. VBA was tracking some of the training that the headquarters required component. But there was a regional office set of training that they were supposed to take, and no one was tracking if they were. You did address that.

Eric White  In what seems to be a backdrop of all of this is a little bit of lack of planning on training efforts. You said that some people were just kind of doing it as almost a side project. Has VBA gotten its act together and actually set down some set times to actually do this training and make sure that folks have it on their agendas?

Elizabeth Curda  They do a pretty good job of making sure everybody knows what training is supposed to take every year they they’re required to take a minimum amount of training every year. In terms of the planning there, we did find some other issues where they had several components involved in the design and the deployment of training, but they weren’t coordinating well. And it wasn’t clear who had authority to make decisions about policy for training and the kinds of things we’re talking about, like having minimum requirements, or how would you evaluate the training. And, so, we recommended improving or developing a governance structure around the training program to ensure there was accountability for establishing goals for the training, tracking, whether the training was working, you know, is it achieving the desired result? And, ensuring there’s coordination across these different components. So, you know, and that’s where we still see some need for progress. They do have this governance structure on paper, but they still haven’t filled some of the positions, haven’t actually started doing anything, as far as we can tell. And they haven’t always had clear goals for their training. And so these are some things that we want them to kind of keep working on.

Eric White  Yeah, and to establish whether or not the training is worth it or not, you need to have people who are there just analyzing the training itself. And that brings us to the fourth and final area that you all looked at, which was evaluation. How are they determining whether this training is effective or not? And what can we do better?

Elizabeth Curda  So, this was a big, big problem area. If you think about it, you spent all these resources, and it’s so critical to the success of the mission. And yet, at the end of the day, they didn’t know if the training was always effective, they had a very kind of low level of evaluation that was going on. And, so, we recommended, they established a policy for evaluating their training and implementing policy. And the other thing they weren’t doing was they weren’t always getting feedback from the people who are on the ground experiencing the training, the actual claims processors and their supervisors who could see whether, you know, the training was actually delivering what it needed to deliver. And, so, we recommend that they make greater efforts to get feedback from that population on whether the training was any good or not. And, and I mean, we heard one example where a claims processor said, you know, every year, they would provide feedback on the training, you know, on a form, that there were inaccuracies in the training. And they’d be required to take the same training the next year, and the inaccuracy would still be there. And, so, are they taking that feedback and feeding it back into the training to improve it? So, that’s what we’re looking for.

Eric White  Do you all plan on continuing this monitoring of the VBA claims process or training? Things seem to be trending in the right direction. I mean, if they’ve set a record now for the amount of veterans and survivors that they’ve served, now, something has to be working, right?

Elizabeth Curda  Well, there’s a tension there, right, with productivity and quality, you know. You can be churning out lots of claims. And then, you know, you’ll always have to have those measures of quality. And in fact, in recent months, quality has gone down in terms of what they measure. And, so, we do have some continuing concerns, we’re going to continue to monitor these recommendations. There was a hearing on this report yesterday in the House’s Veterans Affairs Committee. And I heard at that hearing that VBA is going to be revamping and modernizing its training program. So, some things are already changing. And I did suggest in the hearing that if they’re going to embark on a new initiative in this area, that they start out with leading practices that they plan that they, you know, have a way to evaluate, you know, that they know how they’re going to roll this thing out. So, you know, it was a good opportunity to kind of get in at the front end of something and say, hey, you know, let’s get this off on the right footing.

Eric White  So, you continue to monitor and we’ll continue to have you on to tell us what you found. Deal?

Elizabeth Curda  Sure. Let’s do it.

Eric White  Elizabeth Curda is the director of the Government Accountability Office, thank you so much for joining us.

Elizabeth Curda  Thanks so much. My pleasure.

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