How one Veterans Affairs employee’s ingenuity took a big bite out of VA’s appeals backlog

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In 2017, Congress created a new system for veterans to appeal their disability claims – replacing a process that sometimes dragged on for years. But even after the new system took effect, there were still hundreds of thousands of claims stuck in the “legacy” appeals system. Our guest was put in charge of speeding those claims along, and by all accounts, she was wildly successful. Mary Frances Matthews is an operations senior management and program analyst at the Veterans Benefits Administration. And for her work on streamlining that legacy appeals process and cutting the backlog, she’s been named a finalist in the Management Excellence category for this year’s Service to America Medals. She joined Federal Drive with Tom Temin to discuss.

Interview transcript:

Jared Serbu: Mary Frances, thanks for joining us and congratulations on being a finalist here. And before we start talking about some of the interventions you made to improve this process, can you talk about what that legacy process actually looked like and why there was a backlog in the first place that was as large as it was.

Mary Frances Matthews: So under the legacy appeals process, it was complex, and there were three stages of the legacy appeals process. And that jurisdiction was split between VBA, Veterans Benefits Administration, the office that I work for, and the Board of Veterans Appeals (BVA). And with the split jurisdiction, there can be back and forth between the two offices. And so that made the process a little bit more complex than it needed to be. As for the actual inventory of the legacy appeals, VBA over the years we have increased the number of decisions and complaint claims that we complete every single year. And as a result, the volume of the legacy appeals increased in tandem with the amount of claims that we were completing each year. So in many of our 56 regional offices, this really just led to a mismatch between the number of appeals received and the number of employees that they had specially trained to work this type of inventory. And so I would just say the greatest challenge I encountered was that mismatch between the number of appeals received and the capacity at each station to provide a timely response to the veterans who disagreed with our decisions.

Jared Serbu: And at that point where the individual regional offices just taking what was coming in from their region without any sort of…

Mary Frances Matthews: Yes, absolutely.

Jared Serbu: So some were overloaded and some had excess capacities is what I’m assuming.

Mary Frances Matthews: That is correct. Some states have a much larger veteran population. And so the offices in those states were receiving more than they necessarily had the capacity for. Whereas, as you mentioned, other states have smaller veteran populations. And those offices were receiving less appeals as a result.

Jared Serbu: Right. So talk about how you redistributed that workload.

Mary Frances Matthews: Sure. So the system for redistribution, it really analyzed the appeals workload that was assigned to each of the regional offices, as well as the number and the type of employees that were trying to process appeals. So specifically, I worked with a team of analysts to review the inventory and capacity every single day, at every regional office for each stage of the legacy appeals process. And then together, the analyst and I, we identified the greatest mismatches between inventory and capacity, and we made targeted workload read distributions multiple times per week, to maximize the number of veterans served. So additionally, we also created targets for each regional office that strategically focused resources towards specific stages of the appeals process in the logical and linear manner, because you can’t get to stage two or stage three if you don’t start with stage one. So we really wanted to have a very logical approach in terms of our focus of our workload. And so this really allowed, I think, our specially trained employees in the regional offices to make the greatest positive impact on our inventory and the veterans and family members that were awaiting our decisions.

Jared Serbu: And just curious prior to your interventions, was there any particular reason to have regional offices handle only claims that came in from their region or is the work basically the same no matter where you are?

Mary Frances Matthews: The work is basically the same no matter where you are. And I would say that the reason that regional offices were managing it in this way, it had just always been done that way. And so regional offices had close relationships with the veteran service organizations in their states. They also have a lot of outreach programs to veterans in their states. And so it was just natural for the office to intake those appeals from the veterans that lived in their states. And that was just kind of a past practice in the way that it had been done.

Jared Serbu: And you mentioned that bifurcated approach under the legacy system, part of which was administrative and part of which was BVA. Were you able to streamline any of that back and forth process at all or was this really just on the administrative side, not minimizing it, but was really just on the administrative side that you were able to make some improvements?

Mary Frances Matthews: It was really on the VBA’s administrative side that we were able to to make improvements. We continue to maintain a good relationship with the Board of Veterans Appeals, but we did not really change necessarily what the process was between Veterans Benefits Administration and the Board of Veterans Appeals. That process did not change.

Jared Serbu: So according to the numbers I’ve got, there were 268,000 appeals in the backlog as of February 2019 when you started. Talk a bit about how things have progressed and where that backlog stands now or where the inventory stands now.

Mary Frances Matthews: So the inventory currently stands at about 31,000 appeals. So clearly we have drastically reduced it. But I think one of the things that’s important to remember that during this time, not only did we reduce the backlog, we received in over 270,000 additional legacy appeals during that two year period as well. And so the employees were required to not only work on the existing inventory, but also address the appeals coming in every day. So the amount of work that the employees did in the field is just tremendous. I can’t can’t thank them enough for the effort that they put forth to make such a monumental task happen.

Jared Serbu: And you kind of alluded to earlier that that regionalized system was pretty well entrenched when you started and there were existing relationships. What did it take to get buy in from the individual regions to go along with this process of redistribution?

Mary Frances Matthews: Sure. Well, one of the great things I think about VA employees in general is that honestly, they truly love to serve veterans, and many of them are actually veterans themselves. So there already is a level of buy in just just because of the mission, and a personal connection many people feel with the mission. So I’ve honestly never encountered resistance to providing excellent service to veterans. However, as I’m sure you’re aware, anytime a new process is introduced or deployed, it is really important to us some change management strategies to improve buy in. So I tried my best to clearly communicate the strategic changes through my professional network that existed within VBA. And through monthly and ad hoc calls with the regional office personnel. I also provided avenues for regional office management to contact me and other analysts on my team directly with questions and concerns, to try to cut out as much of the bureaucracy as possible. If they had questions, concerns or ideas, they could come straight to us and ask them and we’re not going to turn them away, we want to be partners in this with them together. So I did work really hard to be as open and transparent as possible about the process, including why we needed to change our targets specifically, and also how that reader redistribution of workload is going to ultimately benefit the veterans that we serve. So I think the open and honest communication with the appeals employees and management teams is what really made the difference.

Jared Serbu: And other than moving more quickly, did the outcome of the process for veterans really change at all? I mean, was the approval slash denial rate really any different before you started compared to after you started?

Mary Frances Matthews: No, there really was no significant difference in the rate at which we resolved appeals during each stage of the legacy appeals process. So that I think is a positive, just to show that we continue to provide the same level of good service. We were just providing it in a more timely manner.

Jared Serbu: Yeah. And I’ve got to imagine that from the veterans perspective, even if they get an adverse decision in the end, it’s good to not be in limbo forever, so they can at least have some finality and or move on to the next stage of the appeals process. Right?

Mary Frances Matthews: That is correct. We have received absolutely the same feedback as what you just stated.

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