How automation is showing a lot of promise in approving veterans’ survivors dependency claims

Jared Serbu: Kevin, thanks for doing this and wanted to start by getting a little bit of an update on where you are with automation. VBA automation has been a little bit in the news lately with the disability compensation part of the administration, Getting in on some pilots, but you all in the pension and fiduciary service have been working on automation for quite a bit longer. Tell us how robust, how mature all your automation efforts are, what kind of progress you’ve made so far.

Kevin Friel: Yeah, Jared, thanks for your question. Just to be clear, we are separate from compensation service. So our automation, as you said, is a lot different. We’ve actually been automating since about 2014. There was a public law 114-315 that Congress passed that basically told us, as it relates to surviving spouses, we should pay them the benefits they’re entitled to based on the evidence or record. So in the past, if a veteran passed away, the spouse would have to submit an application to us. And we would have to go through that process. When that law was passed, what we looked at is what we could do so the two things we made out that we could do is we could pay burial benefits.

So VA helps to offset burial benefits for veterans who pass away and are in receipt of VA benefits at the time of their death or have a claim pending where they would have been or if the remains are unclaimed, right, for unclaimed remains. So with that, if we have we have the surviving spouse on record, once we get that notification, and the spouse calls us, we can process the burial claims and burial awards and get them out to the spouse without even getting an application just because we know we have identified the spouse and linked them to the veteran. And then we have for, DIC, dependency indemnity compensation, right, typically that is meant for to be payable to the surviving spouse for the veteran’s death was related to a service-connected condition.

However, there’s a law that says if the veteran was rated 100% compensable, right, for service-connected for periods of time, that we can go ahead and pay that administratively. So we also look at that in the automation process. And if the veteran meets those criteria, we will go ahead and initiate DIC to the surviving spouse automatically, once again, without an application. We also do some automation, State Veterans cemeteries, who in turn into our veterans, right who are eligible for burial in the National Veterans Cemetery. They do that at no cost to the beneficiary, or the survivors. The VA will, however, reimburse them, the cost of plot and plot benefit, which is about $832 – I may be a little off on the money, but it’s over $800. We went through that process and looked at it to see how we can improve it. And we’ve automated that process, too. So now when the state submit us, we can run those through automation and get them done quickly. And then we went to our next level, which was how do we do something where we get a claim report from a survivor or for … a DIC. And over starting in 2019, we started to work on automation, we have been looking at it and trying to get it implemented over a period of time. In 2019, we finally got everything lined up. And we started to roll that out.

So today, we’re seeing an application for burial claim or for a DIC claim (dependency indemnity compensation claim), we extract the data from that, and then we run it through our automated processes. If automation can process that claim to completion, which is normally the award, right, always an award or benefits, it’ll run that through all the rules, and it’ll pay that out. With our current processes if the surviving spouse or gives us all the information we need, which is typically the form is completed the way that it needs to be completed, all the blocks are filled in that need to be filled in. And we have a copy of the veterans death certificate, we have been able to process those claims in as little as four hours. From when it comes in, it’s it’s automatically established, the data is automatically extracted from the form and then it it is run through our automation thing. And it’s processed out. If we don’t have that if the information isn’t clean, or if we don’t have the death certificate, it just delays the process.

So getting all the information up front is where we’re going to be. However, what we don’t want is somebody to hold off on applying. Because, we know we understand that there’s there’s many times delays in getting a death certificate, right? They’re not always readily available. Typically you have a year to apply for the benefit, which will go back to the date of the veteran’s death. So our thing is get the application in, if you don’t have the death certificate or you’re waiting for it, get that application in. At least we have your benefit, your claim established, as as you work to get that death certificate. Once we get the death certificate automation, we’ll go through and extract that just like it already has the form and if we have everything we need once the death certificate comes in, automation will pick that up and run it. So it’s not like a one-and-done, we look at these claims every evening. And if there’s a change in status, we will go ahead and work that out.

Jared Serbu: In a best-case scenario, if the claim has been submitted with everything that VBA needs to process it, does a human ever need to touch it , or is it automated end to end?

Kevin Friel: In the best case scenario, right now, no a human doesn’t need to touch it. We have done it, we have an automatic claims establishment, we have criteria around that. So if we the information is within our system, we could establish that claim right away based off of the form and the information we have on the form, then we do accept we do the automatic data extraction from it. And so if the data extraction, it comes in clean, we run those likely. And if if everything’s there, it’ll it’ll go right through.

Jared Serbu: And we were mentioning a little bit off the air that pension automation is coming a little bit later. Is that just a more complex process? And and tell us how that’s been going? If you could,

Kevin Friel: it is pensions a little more complex, because basically, we have to look at all the income that a beneficiary has, we have to look at the medical expenses they have. And in the pension program, we use medical expenses as a means to reduce income. It’s a needs-based program, right, so it’s an income-based program. And the income levels are are set by Congress, the thresholds, but we are allowed to use a medical expense to do reduction of the income to potentially get them below the threshold. So just to use round numbers, say that we say a veteran can have $14,000 a year in income. If they have $17,000 or $18,000 or $20,000, but they have, $7,000 or $8,000 or $9,000 [in] medical expenses that they have paid, we would, eventually we can reduce that income down based off of their medical expenses to get them below the $14,000 threshold and then be able to pay them benefits.

Jared Serbu: Similar objectives on the pension side to get to somewhere in the four-hour area, or at least inside a day?

Kevin Friel: There are. I mean, and I’d say I like the four hours, the best case scenario, we don’t get many of those. But we do get a few every every evening. Typically we have to send these out because we don’t get all the information. But yeah, the goal would be to get as many of these through as quickly as we can. Because when the beneficiary comes into us for what we see within the pension world, because we have responsibility for burial and DIC and pension. So as I said, pension’s needs-based. So when they come in to us, they’re really in need of this benefit, right? Financially, they’re struggling, and the faster we can get money into their hands, so that we can help them meet their day-to-day living needs and stuff like this is where we want to be. And with the survivors benefits the DIC and burial, typically, these are people who’ve been married to the veterans, veteran and spouse have been married for years. It’s typically not like, a short period of time. But you’re talking, 20, 30, 40 years, and so they’re going through the worst time of their life. So if I can do anything I can to get their, A) is to get them the money to help reimburse for the funeral and then B) is, if they’re eligible for DIC to get that flow where they can help offset the loss income, we want to do that as quickly as we possibly can. That’s why even like with the first automation, as I said, we do that without getting any application. We get a call, we send a letter out. And then six days later, we don’t have anything that says we shouldn’t pay. We pay that benefit.

Jared Serbu: Regardless of whether the application is being processed manually or going through automation, veterans still need to submit essentially the same thing, or veterans or survivors still need to submit essentially the same documentation.

Kevin Friel: Correct, yes.

Jared Serbu: Can you give us just what was some of the most important things that VBA needs to ensure that they’ve got the best chance of getting through that automation process as quickly as possible?

Kevin Friel: Sure. So for the veterans’ purposes, when we get a pension claim, one of the things that we – two things actually that kind of slow us down. One is the application not being completely filled out, right? So for the application to be eligible for pension, whether it be a survivor or veteran, we need to know their income. We need them to put down and tell us what income they have. Typically, it’s only for our population. It’s a small, it’s either social security and maybe retirement or annuity or things like that. But that all has to be listed. And we need to narrow history and we need the medical expenses. And if they’re in a nursing home, we need specific forms filled out. So filling out the application completely, right, as completely as possible will help us expedite it.

Also, if they’ve never filed a claim with VA before, submitting their proof of their service verification, right, so the 214 or the 215, whatever they have for service verification, because one of the requirements is you have to be a veteran, right? So we need to validate that they are a veteran. For the population that we look at, like when you go back to like Vietnam, Korea, World War II where we get the veterans and survivors within that population, they’re typically, we don’t have their electronic records. So we’re totally tied to paper on these people. So for all these veterans and their survivors of getting that form 214 in and we’ve actually recently in November of 2021. We changed our rule, right? Previously that 214 had to be certified, had to be stamped by a VSO (veteran service organization) or it had to come right from the Department of Defense or the branch of service.

We have now said, if we get one that comes in from the beneficiary, from the applicant, and there’s no indication that it’s been altered or adjusted or whatever, we will accept that. So we won’t delay the claim anymore. Because I’m sure we’ve all heard about the federal records delays that we’ve had because of COVID. Right now, with our new rule, if it comes in, and it says it looks good, we’re going to take that and move that forward. But having that as part of the package, too. And then on the survivor side, when we get a DIC claim, one of the big things is having the death certificate. To be eligible for DIC, [the] veteran had to have passed away from a service-connected condition, whether it be a primary or secondary cause of death. So, having the death certificate is the only way we can make that link.

Now, one of the things that I will tell everybody is, do not make the decision on your own whether or not you’re eligible for our benefit. If the veteran passed away, and you believe it’s service-connected, or you think it may be just send it in, let us make the determination, I can’t tell you that we’re going to grant it to everybody, but allowing us to make the decision, and allowing us to review the data is probably the best scenario for anyone, even if we deny it. And at least you know that VA has looked at it, and you haven’t been told by some third party “don’t apply because you’re not eligible,” right? Let us make the decisions and submit the applications to us.

Jared Serbu: And then the lesson in our last couple minutes here, Kevin, I do want to emphasize that there is third-party help out there for folks who want to use it. VSOs, attorneys, others, can you talk a little bit about what VBA generally recommends, if someone’s gonna go that route and some of the red flags for people who may be a little bit less honest about helping veterans?

Kevin Friel: Sure, thank you. That’s a great, great lead. And so I will tell you that for our purposes, the veterans service organizations are our biggest advocates, right? For VA, they are our frontline. They are actually out, working with different communities and being available to them, especially like rural areas where you have VFW’s and American Legion posts and things like that. That’s where you should be going if you need assistance,. Or you can call the 1-800-827-1000 number, right? Which is our VA call centers, and we have representatives there who will assist in filling out a form and providing guidance in there. And then if you’re close enough to a regional office, you can schedule an appointment and walk into a regional office and they will sit down and help you fill that all out.

And it’s really important that if you’re going to need to seek assistance, seek something from these organizations, these are these are all representatives. Veteran service organizations have all been that validated by the VA and they they’ve all been certified to do the work that they do, and they don’t charge. We even tell it on our forms. Individuals cannot be charged to submit an original claim. So a lawyer fee can’t be charged, shouldn’t be charged for submitting an original claim. Now, on a subsequent claim, or where they are appealing something and they want a legal representative, that’s a completely different story. But for their original application, there should be no fee. VSO will help fill that in help submit it. And the other thing with the VSOs, that’s beneficial to the beneficiary or the claimant is the VSOs have direct contact with the VA. They have lines that they can call, they can talk to us. So they have the ability to follow up on your claim, even if the circumstances changes.

So if someone is terminally ill, or if they’re about to become homeless … the VSOs can let us know that and we will work to expedite the claim, and make sure that we can help these veterans out and their survivors as quickly as possible. But you have third-party companies out there that are coming in and and saying we’ll help you with these medical expenses and we’ll help offset these, we’ll give you a loan and then you can repay it or we’ll take a percentage of whatever your payment is for this period of time. And that shouldn’t be happening. So our thing is to stay with the VSOs. Like I said they’re certified by the VA, right, and we work closely with them. So that’s probably the best benefit.