HR 6236 - Veterans Disability Benefits Claims Modernization Act of 2008

HR 6236

110th CONGRESS
2d Session

H. R. 6236

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to modernize the disability benefits claims processing system of the Department of Veterans Affairs to ensure the accurate, consistent, and timely delivery of compensation to veterans and their families and survivors, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

June 11, 2008

Mr. CHABOT (for himself, Mr. LAMBORN, Mr. JORDAN of Ohio, Mr. HOBSON, and Mr. TURNER) introduced the following bill; which was referred to the Committee on Veterans' Affairs

A BILL

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the `Veterans Disability Benefits Claims Modernization Act of 2008'.

(b) Table of Contents- The table of contents for this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Readjustment of schedule for rating disabilities.

Sec. 3. Study on employee work credit system of Veterans Benefits Administration.

Sec. 4. Study on work management system.

Sec. 5. Certification and training of employees of Veterans Benefits Administration responsible for processing claims.

Sec. 6. Enhancement of use of information technology at Veterans Benefits Administration.

Sec. 7. Treatment of claims upon death of claimant.

SEC. 2. READJUSTMENT OF SCHEDULE FOR RATING DISABILITIES.

(a) Study-

(1) IN GENERAL- The Secretary of Veterans Affairs shall conduct a study on adjusting the schedule for rating disabilities adopted and applied by the Secretary under section 1155 of title 38, United States Code, so as to base the schedule on standards, practices, and codes in common use by the medical, mental health, and disability professions that are current as of the date of the enactment of this Act.

(2) CONTENTS- In conducting the study under this subsection, the Secretary shall--

(A) determine how the schedule could be adjusted to take into account the loss of quality of life and loss of earnings that result from specific disabilities;

(B) examine the nature of the disabilities for which disability compensation is payable under laws other than laws administered by the Secretary;

(C) examine whether disparities exist between the rating of physical and mental disabilities, especially with respect to how the severity of mental disabilities should be adjudicated to ensure parity with physical disabilities whereby a veteran can be rated totally disabled while maintaining some level of employment;

(D) measure the effect of disabilities on the psychological states, physical integrity, and social adaptability of veterans with such disabilities; and

(E) examine the effect of a veteran's injury or combination of injuries on--

(i) the average loss of the veteran's earnings capacity, including the veteran's inability to work in certain occupations;

(ii) the veteran's quality of life, including activities of independent living, recreational and community activities, and personal relationships, including the inability to participate in favorite activities, social problems related to disfigurement or cognitive difficulties, and the need to spend increased amounts of time performing activities of daily living; and

(iii) the extent to which benefits for veterans may be used to encourage veterans to seek and undergo vocational rehabilitation.

(3) CONSULTATION- In conducting the study under this subsection, the Secretary shall consult with appropriate public and private entities, agencies, and veterans service organizations, and shall employ consultants.

(4) DEADLINE FOR COMPLETION- The Secretary shall complete the study under this subsection by not later than 180 days after the date of the enactment of this Act.

(5) REPORT TO CONGRESS- Not later than 60 days after the date that the study under this subsection is completed, the Secretary shall submit to Congress a report on the study. The report shall include--

(A) the results of the study on quality of life and the payment of compensation for service-connected disabilities for which the Secretary entered into a contract on January 28, 2008;

(B) the Secretary's findings and conclusions with respect to adjusting the schedule for rating disabilities adopted and applied by the Secretary under section 1155 of title 38, United States Code, to account for the loss of quality of life and loss of earnings that result from specific disabilities;

(i) the report of the Veterans' Disability Benefits Commission;

(ii) the report of the President's Commission on the Care for America's Returning Wounded Warriors;

(iii) the report of the Institute of Medicine entitled `A 21st Century System for Evaluating Veterans for Disability Benefits'; and

(iv) any other independent or advisory commission report on matters relating to such schedule that the Secretary determines is appropriate;

(D) the Secretary's recommendations with respect to the appropriate disabilities for inclusion in the schedule;

(E) the Secretary's recommendations with respect to the amount of compensation payable to veterans for the loss of quality of life and the basis for such recommendations;

(F) the Secretary's recommendations with respect to the amount of compensation payable to veterans for average loss of earnings capacity and the appropriate standards for determining whether a disability has caused a veteran to incur a loss of earnings capacity;

(G) the Secretary's assessment of the effect of the treatment of mental disabilities under the schedule for rating disabilities, as in effect on the date of the enactment of this Act; and

(H) the Secretary's determination with respect to whether the regulations prescribed pursuant to section 1154 of title 38, United States Code, are consistent with providing, to the maximum extent possible, the benefit of the doubt to veterans covered by that section in the absence of official military records pertaining to the service-connection of a veteran's disability, and in particular, of post-traumatic stress disorder, when a determination of service-connection would be consistent with the duties, conditions, and hardships of service in the Armed Forces.

(b) Submission of Plan-

(1) PLAN REQUIRED- Not later than 120 days after the date on which the Secretary submits the report required under subsection (a)(5), the Secretary shall submit to Congress a plan to readjust the schedule for rating disabilities adopted and applied by the Secretary under section 1155 of title 38, United States Code. In developing the plan required under this subsection, the Secretary shall consider the report submitted under subsection (a)(5) and shall provide for the readjustment of such schedule for rating disabilities to--

(A) align the schedule with medical concepts considered best practices as of the date of the enactment of this Act, including those provided in the Current Procedural Terminology Manual, International Classification of Diseases, the Diagnostic and Statistical Manual of Mental Disorders, and applicable American Medical Association Guides;

(B) bridge the gap between the schedule, as in effect on the date of the enactment of this Act, and medical understandings, as of such date, of injuries and diseases and the affects of such injuries and diseases on the ability of a person suffering from them to function;

(C) prioritize such readjustment with respect to post-traumatic stress disorder, other mental disorders, neurological disorders, traumatic brain injury, orthopedic disabilities, and digestive disabilities;

(D) ensure that the schedule is automated in accordance with the review and comprehensive plan of the Secretary under section 110 of this Act; and

(E) ensure that a transition plan is provided to ease the transition from the schedule for rating disabilities, as in effect on the date of the enactment of this Act, to the implementation of the schedule for rating disabilities, as proposed to be readjusted by the plan under this subsection.

(2) TIMELINE FOR READJUSTMENT- The Secretary shall include in the plan submitted under the subsection a proposed timeline for when the Secretary intends to readjust the schedule. Such proposed timeline may not exceed three years.

(c) Authorization of Appropriations- There are authorized to be appropriated such sums as may be necessary to carry out subsections (a) and (b).

(d) Advisory Committee on Disability Compensation-

(1) ESTABLISHMENT- Subchapter III of chapter 5 of title 38, United States Code, is amended by adding at the end the following new section:

`Sec. 546. Advisory Committee on Disability Compensation

`(a) Establishment- (1) There is in the Department the Advisory Committee on Disability Compensation (in this section referred to as the `Committee').

`(2) The Committee shall consist of not more than 18 members appointed by the Secretary from among individuals who--

`(A) have demonstrated significant civic or professional achievement; and

`(B) have experience with the provision of disability compensation by the Department or are leading medical or scientific experts in relevant fields.

`(3) The Secretary shall seek to ensure that members appointed to the Committee include individuals from a wide variety of geographic areas and ethnic backgrounds, individuals from veterans service organizations, individuals with combat experience, and women.

`(4) The Secretary shall determine the terms of service and pay and allowances of the members of the Committee, except that a term of service may not exceed two years. The Secretary may reappoint any member for additional terms of service.

`(b) Responsibilities of Committee- (1) The Secretary, on a regular basis, shall consult with and seek the advice of the Committee with respect to the maintenance and periodic readjustment of the schedule for rating disabilities under section 1155.

`(2) In providing advice to the Secretary under this subsection, the Committee shall--

`(A) assemble and review relevant information relating to the needs of veterans with disabilities;

`(B) provide information relating to the nature and character of disabilities arising from service in the Armed Forces;

`(C) provide an on-going assessment of the effectiveness of the schedule for rating disabilities; and

`(D) provide on-going advice on the most appropriate means of responding to the needs of veterans relating to disability compensation in the future.

`(c) Annual Report- (1) Not later than March 31 of each year, the Committee shall submit to the Secretary a report on the programs and activities of the Department that relate to the payment of disability compensation. Each such report shall include--

`(A) an assessment of the needs of veterans with respect to disability compensation;

`(B) a review of the programs and activities of the Department designed to meet such needs; and

`(C) such recommendations (including recommendations for administrative and legislative action) as the Committee considers appropriate.

`(2) Not later than 90 days after the date of the receipt of a report under paragraph (1), the Secretary shall transmit to the Committees on Veterans' Affairs of the Senate and House of Representatives a copy of the report, together with any comments and recommendations concerning the report that the Secretary considers appropriate.

`(3) The Committee may also submit to the Secretary such other reports and recommendations as the Committee considers appropriate.

`(4) The Secretary shall submit with each annual report submitted to the Congress pursuant to section 529 of this title a summary of all reports and recommendations of the Committee submitted to the Secretary since the previous annual report of the Secretary submitted pursuant to that section.

`(d) Applicability of Federal Advisory Committee Act- (1) Except as provided in paragraph (2), the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the activities of the Committee under this section.

`(2) Section 14 of such Act shall not apply to the Committee.'.

(2) CLERICAL AMENDMENT- The table of sections at the beginning of such chapter is amended by adding at the end of the items relating to subchapter III the following new item:

`546. Advisory Committee on Disability Compensation.'.

SEC. 3. STUDY ON EMPLOYEE WORK CREDIT SYSTEM OF VETERANS BENEFITS ADMINISTRATION.

(a) Study Required- The Secretary of Veterans Affairs shall conduct a study on the employee work credit system of the Veterans Benefits Administration of the Department of Veterans Affairs, which is used to measure the work production of employees of the Veterans Benefits Administration.

(b) Contents of Study- In carrying out the study under subsection (a), the Secretary shall consider the advisability of implementing--

(1) performance standards and accountability measures to ensure that--

(A) claims for benefits under the laws administered by the Secretary are processed in an objective, accurate, consistent, and efficient manner; and

(B) final decisions with respect to such claims are consistent and issued within the average amount of time required to process a claim, as identified by the Secretary in the most recent annual report submitted by the Secretary under section 529 of title 38, United States Code;

(2) guidelines and procedures for the prompt processing of such claims that are ready to rate upon submission;

(3) guidelines and procedures for the processing of such claims submitted by injured veterans, as determined by the Secretary; and

(4) requirements for assessments of claims processing at each regional office for the purpose of producing lessons learned and best practices.

(c) Report to Congress- Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under this section and the progress of the Secretary in implementing the new system for evaluating employees of the Veterans Benefits Administration required under subsection (d).

(d) Evaluation of Veterans Benefits Administration Employees-

(1) NEW SYSTEM REQUIRED- Not later than 180 days after the date on which the Secretary submits to Congress the report required under subsection (c), the Secretary shall establish a new system for evaluating the work production of employees of the Veterans Benefits Administration. Such system shall--

(A) be based on the findings of the study conducted by the Secretary under this section;

(B) focus on evaluating the accuracy and quality of ratings decisions made by such employees; and

(C) not resemble or be based on any concept on which the system in effect as of the date of the enactment of this Act is based.

(2) SUSPENSION OF AWARD OF WORK CREDITS- If the Secretary of Veterans Affairs does not implement the new system for evaluating work production under paragraph (1), the Secretary may not award a work credit to any employee of the Veterans Benefits Administration until the Secretary has implemented such system.

SEC. 4. STUDY ON WORK MANAGEMENT SYSTEM.

(a) In General- The Secretary of Veterans Affairs shall conduct a study on the work management system of the Veterans Benefits Administration of the Department of Veterans Affairs, which is designed to improve accountability, quality, and accuracy, and reduce the time for processing claims for benefits under laws administered by the Secretary that are adjudicated by the Veterans Benefits Administration.

(b) Contents of Study- In conducting the study required under subsection (a), the Secretary shall consider--

(1) accountability for claims adjudication outcomes;

(2) the quality of claims adjudicated;

(3) a simplified process to adjudicate claims;

(4) the maximum use of information technology applications;

(5) rules-based applications and tools for processing and adjudicating claims efficiently and effectively; and

(6) methods of reducing the time required to obtain information from outside sources.

(c) Report to Congress- Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under this section.

SEC. 5. CERTIFICATION AND TRAINING OF EMPLOYEES OF VETERANS BENEFITS ADMINISTRATION RESPONSIBLE FOR PROCESSING CLAIMS.

(a) Employee Certification Required-

(1) IN GENERAL- Subchapter II of chapter 77 of title 38, United States Code, is amended by adding at the end the following new section:

`Sec. 7735. Employee certification

`(a) Development of Certification Examination- The Secretary shall develop a certification examination for appropriate employees and managers of the Veterans Benefits Administration who are responsible for processing claims for benefits under the laws administered by the Secretary. The Secretary shall develop such examination in consultation with examination development experts and such employees, employee representatives, managers, and public and private entities, including veterans service organizations and other service organizations, as the Secretary determines appropriate.

`(b) Employee and Manager Requirement- The Secretary shall require appropriate employees and managers of the Veterans Benefits Administration who are responsible for processing claims for benefits under the laws administered by the Secretary to take a certification examination.

`(c) Limitation- The Secretary may not satisfy any requirement of this section through the use of any certification examination or program that exists as of the date of the enactment of the Veterans Disability Benefits Claims Modernization Act of 2008.'.

(2) DEADLINES FOR IMPLEMENTATION- The Secretary of Veterans Affairs shall--

(A) develop the certification examination required to be developed under section 7735 of title 38, United States Code, as added by subsection (a), by not later than one year after the date of the enactment of this Act; and

(B) implement procedures for administering the certification of employees under such section and begin administering the certification examination required under such section by not later than 90 days after the date on which the development of such certification examination is complete.

(3) CLERICAL AMENDMENT- The table of sections at the beginning of such chapter is further amended by adding at the end of the items relating to subchapter II the following new item:

`7735. Employee certification.'.

(b) Evaluation of Training-

(1) EVALUATION REQUIRED- The Secretary of Veterans Affairs shall enter into a contract with a private entity with experience evaluating training processes, continuing education needs, and centralized training requirements, under which that entity shall--

(A) conduct an evaluation of the items required to be included in the annual report of the Secretary by section 7734 of title 38, United States Code, that were included in the last such report submitted before the date of the enactment of this Act, that relate to the training and performance assessment programs of the Department of Veterans Affairs for employees of the Veterans Benefits Administration who are responsible for matters relating to compensation or pension benefits under the laws administered by the Secretary; and

(B) submit, not later than 180 days after the date of the enactment of this Act, submit to the Secretary the results of such evaluation.

(2) SUBMISSION OF RESULTS TO CONGRESS- The Secretary shall include the results of the evaluation required under paragraph (1) with the first annual report required to be submitted to Congress under section 529 of title 38, United States Code, submitted after the date on which the Secretary receives such results.

(3) REPORT- Not later than 180 days after the date on which the Secretary submits the report referred to in paragraph (2), the Secretary shall submit to Congress a report on any actions the Secretary has taken or plans to take in response to the results of the evaluation required under paragraph (1).

SEC. 6. ENHANCEMENT OF USE OF INFORMATION TECHNOLOGY AT VETERANS BENEFITS ADMINISTRATION.

(a) Review- Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall conduct a study of--

(1) the use of information technology at the Veterans Benefits Administration; and

(2) the best practices and lessons learned within the Department of Veterans Affairs through the use of the technology known as `VistA' and by other Government entities and private sector organizations who employ information technology and automated decision support software in dealing with veterans and veterans benefits.

(b) Consultation- In carrying out the study, the Secretary of Veterans Affairs shall consult with information technology designers at the Veterans Health Administration, `VistA' managers, the Secretary of Defense, appropriate officials of other Government agencies, appropriate individuals in the private and public sectors, veterans service organizations, and other relevant service organizations.

(c) Report to Congress- Not later than January 1, 2009, the Secretary shall submit to Congress a report on the study under this section.

SEC. 7. TREATMENT OF CLAIMS UPON DEATH OF CLAIMANT.

(a) In General- Section 5121 of title 38, United States Code, is amended by adding at the end the following:

`(d) Substitution in Case of Death of Claimant-

`(1) SUBSTITUTION- If a veteran who is a claimant dies while a claim for any benefit under a law administered by the Secretary, or an appeal of a decision with respect to such a claim, is pending and awaiting adjudication, the person who would receive any accrued benefits due to the veteran under subsection (a)(2) shall be treated as the claimant for the purposes of processing the claim to completion, except that such person may only submit new evidence in support of the claim during the one-year period beginning on the date of the death of the veteran.

`(2) LIMITATION- Only one person may be treated as the claimant under paragraph (1).

`(3) DESIGNATION OF THIRD PARTY- If the person who would be eligible to be treated as the claimant under paragraph (1) certifies to the Secretary that the person does not want to be treated as the claimant for such purposes, such person may designate the person who would receive the benefits under subsection (a)(2) upon the death of the person who would otherwise be treated as the claimant under paragraph (1) to be treated as the claimant for the purposes of processing the claim to completion.'.

(b) Effective Date- The amendment made by subsection (a) shall apply with respect to the claim of any veteran who dies on or after the date of the enactment of this Act.

END