The wait in Baltimore, which serves nearly a half-million veterans living in Maryland, is longer than in any of VA’s 56 offices except the one in Oakland, Calif., figures show. And the Baltimore office’s 73.8 percent accuracy rate, measuring the percentage of disability claims completed without error, is the country’s worst.
The Obama administration has made a pledge to break the agency’s backlog by 2015, with all claims processed within 125 days at a 98 percent accuracy rate. VA has introduced a parade of changes nationwide to attack the backlog, including a new paperless claims system that Baltimore will get this year.
But Baltimore’s ills demonstrate how entrenched the backlog problem is and how difficult it will be to reach the 2015 goals.
“Why does it take so long to give people something they’ve earned?” Jonathan W. Greene, an Army veteran from Annapolis who served in Vietnam, asked during a visit to the federal building on Hopkins Plaza, a few blocks from Baltimore’s Inner Harbor. It was one of many trips he has made over the past year to sort out a problem over disability payments dating to 2010.
The answer to Greene’s question is a multilayered one. Baltimore offers a case study of what has happened in a system overtaken in the past decade by a flood of claims — more than 1 million a year — and what can happen when the challenge is compounded by what critics call VA mismanagement.
The increase in compensation requests has been fed by troops leaving the service as the wars in Iraq and Afghanistan have wound down, liberalized rules governing claims related to Agent Orange and post-traumatic stress, and enormous growth in the average number of medical conditions claimed by veterans.
Baltimore’s problems, veterans’ representatives say, also illustrate the role that poor planning and neglect — such as allowing extended vacancies in critical positions — have played in the crisis, which in this case left the office without adequate resources.
VA officials say the leadership team now directing Baltimore will make a difference. “Not to say we don’t have a big job in front of us, but I think we have the right folks to lead the effort,” said Diana Rubens, VA deputy undersecretary for field operations.
“I want to be a lot better than where we are,” said Michael Scheibel, who has been director of the Baltimore office since 2011.
‘Expanded too rapidly’
The problems did not develop overnight. “Baltimore has been a somewhat troubled office for decades,” said Gerald Manar, who worked 30 years in the VA benefits system before becoming deputy director of National Veterans Service for the Veterans of Foreign Wars. “It’s been on a roller coaster, depending on the quality of the management.”
Like offices in other big cities, Baltimore’s has had difficulty retaining its best employees, who can be lured away by better-paying or less-demanding jobs. The problem is accentuated by Baltimore’s proximity to VA’s Washington headquarters, which tends to poach the best supervisors.
During the earlier years of the wars in Iraq and Afghanistan through 2007, the number of pending claims in Baltimore hovered at or below 5,000, a manageable load, while nationally the figure stayed below 400,000.
The real crisis began in 2007, when Baltimore was selected to help pilot a joint VA-Defense Department integrated disability evaluation system, an effort aimed at eliminating red tape that ensnared service members at Walter Reed
Army Medical Center and other military hospitals.
Eager to move forward with the program, VA officials overlooked the Baltimore office’s lack of preparedness for the project. “It was expanded too rapidly — the resources weren’t in place,” Manar said. “That was an office that was on the edge anyway.”
Baltimore’s top rating specialists were assigned to the project, leaving inexperienced employees to process complex claims.
“We hired persons at the same time the work actually hit,” Scheibel said. “It put the office behind from the get-go.”
The number of pending claims in Baltimore began to rise, reaching 6,200 by 2008 and 7,000 in 2009.
Then, in November 2009, VA Secretary Eric K. Shinseki made veterans eligible for compensation for three major ailments linked to Agent Orange, prompting a flood of new or renewed claims by Vietnam veterans exposed to the toxic herbicide. The department’s Veterans Benefits Administration assigned 37 percent of its rating staff, including many of its most-experienced workers, to handle Agent Orange cases, which reached 260,000.
Nationally, total pending claims, which stood at 391,000 when President Obama took office in January 2009, reached 886,000 by 2012.
Special VA teams that had previously assisted Baltimore with its growing backlog could no longer help. The Baltimore office was soon in a free fall as its number of pending claims, which stood at 8,900 at the beginning of 2010, reached 12,100 by 2011 and 16,600 by 2012. Nationwide, about 3.4 million veterans received more than $48 billion in 2012, an average monthly payment of about $1,162.
Baltimore’s accuracy rating on the disability status it assigns veterans fell from 84 percent in 2008 to 65 percent in 2011. An error could mean overlooking a critical piece of medical evidence that would establish a claim’s legitimacy or miscalculating the proper rating that should be assigned an injury. Many mistakes end up meaning some veterans are denied full compensation for injuries, while others might be paid too much.
Even as the backlog in Baltimore was exploding, VA left critical vacancies unfilled.
After Baltimore’s director left in July 2010, a succession of five people served as acting director through September 2011, when Scheibel was promoted from acting to official director. The position of assistant director, empty since September 2011, was occupied only last month.
“The ability to attract talented candidates was challenging due to the high cost of living in the Baltimore commuting area,” VA said in a statement.
The veterans service center manager was reassigned for poor performance in 2009, and the critical position was left vacant from October 2010 until February 2011.
“There was no continuity of supervision,” said Dominique Maestas, assistant supervisor for the Disabled American Veterans office in Baltimore. “It was a rotation of people coming in. We would take a claim to a supervisor, and the next day they weren’t on the team.”
For veterans seeking resolution to their claims, the lack of answers has been infuriating.
“I’d come in every two months, and they’d say, ‘We’re still processing your application. We apologize,’ ” recalled Greene, the 64-year-old veteran from Annapolis, who filed for post-traumatic stress disorder.
Vacancies at the top positions are a recurring problem at the most-troubled VA regional offices. A 2011 VA Office of Inspector General report found that the worst offices were the ones with prolonged vacancies. Baltimore met VA standards in only one of 15 areas inspected, failing in areas that included handling of PTSD and traumatic brain injury cases. The office’s 7 percent compliance rate was tied with Anchorage as the lowest in the country.
Many numbers remain bleak
For now, Baltimore remains a paper-bound office. Connie Smith, an intake analyst, processes veterans’ claims arriving daily before they are sent to the office’s service center to be assigned to a rating specialist. Smith has a son serving in Afghanistan and is herself an Army veteran.
“They can get kind of thick,” she said, lifting a hefty file off the table. “This is one veteran.”
“We try to keep the claims rolling,” she added, picking up another file. “This is a veteran, and I want him taken care of as well as my son.”
Robert Raymond, who has worked in Baltimore 25 years, said the office’s problems in recent years have been deflating. “Morale’s been bad, but it’s getting better,” he said. “Communication’s improved, and the changes are starting to work.” The office’s quality rating exceeded 80 percent in the last three months of 2012, Scheibel said.
But many numbers remain bleak. Pending claims in Baltimore reached 20,129 as of Jan. 19, almost 4,000 more than a year earlier. Nearly 84 percent of the claims have been pending over 125 days, higher than in any other office.
“Quite frankly, I haven’t seen any change,” said Phil Munley, who runs a Maryland Department of Veteran Affairs office that assists veterans with the Baltimore VA.
A few days after Christmas, Greene was notified that he would receive the back disability compensation owed for his PTSD. “Maybe I just got lucky,” he said.
For many others, the wait continues. Andy Titsworth, a 26-year Army veteran, filed a claim in November 2010 seeking disability compensation for joint pain he thinks is connected to two tours he served in Iraq. An initial decision reached in May was never released, because VA found that it had made an error, he said. More than two years after he filed, the case remains under review. “I don’t know what’s being done — they haven’t given me any indication,” Titsworth said.
“I’m used to bureaucracy, but I didn’t expect it to be like this,” he added. “At some point, I expected somebody to say, ‘This is taking way too long.’ ”