VA Developed Reporting Metrics for Appeals Modernization Act Decision Reviews but Could Be Clearer on Some Veterans’ Wait Times

The Veterans Appeals Improvement and Modernization Act of 2017 (the Appeals Modernization Act (AMA)), was designed to offer veterans faster resolution of disagreements with VA decisions. It established three review lanes: a direct appeal to the Board of Veterans’ Appeals (not covered in this report); a higher-level review by a senior technical expert in which no new evidence may be presented; and a supplemental claim. Higher-level reviews and supplemental claims each have a completion goal of an average of 125 days. VA must report its performance to Congress and on a public website. The OIG found that VA developed reporting metrics for AMA decision reviews but could be clearer on some veterans’ wait times. Specifically, veterans who submit a claim for a higher-level review of a benefits decision and where a processing error is identified will have a new supplemental claim established—each with a completion goal of 125 days. VBA reports these separately. However, when the veteran is notified that a new claim has been established, there is no mention that they may need to wait for its completion, with a stated goal of another 125 days for a final decision. The cumulative wait time for higher-level reviews finalized as supplemental claims is not fully transparent to veterans. The OIG interprets the AMA to mean that for decisions under VBA’s jurisdiction, VA also must report the average duration from when a veteran files an initial claim through one year after VBA’s closure of the last decision on the AMA claim. VA omits the initial claim and one year. The OIG recommended VA update the reporting methodology to reflect veterans’ total wait for a final claims decision on higher-level claims completed as supplemental claims and revise and clearly state how it calculates the average duration of these AMA claims.