Introduction to the Veterans Benefits Management System (VBMS)
The Veterans Benefits Management System, or VBMS, is a workflow and claims management software solution custom-built for the Veterans Administration.
Prior to the VBMS, veterans were struggling with excessive wait times for pension and disability compensation claims. The VA system was entirely paper-based until the 1990s. At their peak, the massive claims backlog resulted in wait times stretching to nearly 300 days before receiving the benefits to which they were entitled.
In fiscal year 2010, the federal government contracted with defense contractor firm Booz Allen Hamilton to create a modern computer claims processing and workflow system. The plan was to fully digitize the existing disability claims management process, and make it much easier and faster for VA employees to access and work with veterans’ benefits documents and files.
Veterans Benefits Administration Planners had two mammoth tasks: First, they had to fully digitize all existing veterans’ claims documents, creating an efolder for each one. Simultaneously, they had to create a paperless claims software backbone to store and track every veterans’ claims file (c-file), monitor and track the status of pending claims, and efficiently route new documents and files to the appropriate federal employee for disposition.
The VA successfully rolled the system out to all of its regional offices by June of 2013.
The new VBMS represents a major improvement over the antiquated paper-intensive system previously in use. Once the system was fully online and implemented, the VA was able to reduce wait times from 282 days down to just three months.
VBMS and Accredited Representatives
The use of the VBMS isn’t limited to VA claims employees. The system also allows access to outside veterans advocates and attorneys – known as accredited representatives – to help move the claims process along.
An accredited representative is a. veterans advocate, such as a veterans’ benefits attorney or veteran service organization (VSO) employee who has undergone special screening and is recognized by the VA as qualified to assist veterans with their Veterans Administration-related affairs.
These advocates undergo a rigorous process before being granted system access. Applicants must pass a detailed examination and undergo a thorough background check and apply for a VA email account. This process can take months.
If approved, applicants may get a personal identity verification (PIV) card – and then jump through more hoops in order to be granted system access on top of that. This process can take months to complete. Even then, PIV cards expire every two years. Veterans advocates must then get them renewed, which requires more effort and scrutiny. Meanwhile, they must continue to meet demanding continuing education requirements.
Accredited representatives can help you understand and apply for any VA benefits you may be entitled to, including compensation, education, vocational rehabilitation and employment, home loans, life insurance, pension, health care, and burial benefits.
Note: Only a formally-accredited representative can legally represent a veteran, dependent, or survivor before the Department of Veterans Affairs. Other advocates can provide information, but they cannot act as a formal representative.
Once veterans’ advocates are fully accredited, however, the VBMO enables them real-time access to each claimant’s c-file. This allows them to review each pending claim’s status and help advise veterans how best to proceed with further documenting their claims so they can be approved as soon as possible.
The system has vastly improved communication between VA claims adjudicators and veterans, guided by their VBO advocates and veterans’ attorneys. Previously, veterans and their advocates were always a step behind the process: They could only get an update on the claim status by requesting it from VA employees. With the VBMO in place, veterans’ advocates have exactly the same visibility as VA claims adjudicators. As a result, veterans advocates can act proactively to help document claims before they are adjudicated. They can submit arguments on the veterans’ behalf, and can help identify missing or incomplete documents needed to help the veteran make his or her case. They can also submit additional documentation necessary to get veterans’ benefits claims approved.
Before the VBMS system came online, it could take six months or more for the VA to send a claims file to a VBO or other representative. Because claims and appeals have deadlines, these lengthy processing times for VA appeals worked against the veteran. The VBMS system substantially reduces the communication time needed, which frees up time for advocates to actually work on providing documentation needed to help veterans get their justified claims approved.
Ongoing VBMS Issues
Structurally, the VBMS is a massive database of veterans’ c-files. While the improvement has been substantial compared to the situation a decade ago, the VA continues to struggle with implementation. Occasionally, VA employees fail to properly scan in medical documents, vocational rehabilitation documents, and financial records.
There were many teething problems earlier in the VBMS implementation, as well. For example, when the system was first coming on line prior to 2016, it was prone to frequent crashing.
Even today, the system is still clunky and slow compared to many other large databases. It can take 30-40 seconds for the VA Regional Office VBMS claims queue to populate.
Furthermore, the VBMS development and implantation resulted in hundreds of millions of dollars in cost overruns for the VA. According to a 2015 Inspector General’s report, the total estimated cost of implementation in September 2009 was $579 million. By January 2015, that estimate more than doubled, to $1.3 billion.
Contributing to the cost overruns: The failure of VA officials to prioritize and integrate adequate cost controls, unplanned changes in system and business requirements, and poor contract management practices.
The Veteran Appeals Modernization Act
The Veteran Appeals Modernization Act of 2017 required the Veterans Administration to modernize their claims and appeals processes. Prior to the implementation of the Veteran Appeals Modernization Act, veterans waited three years for resolution. Appeals to the Board of Veterans’ Appeals took an average of seven years.
The new law required improvements in VA decision notification procedures. It also provides for mechanisms for much earlier claim resolution. The law also mandated that the VA implement three review options for veterans who disagreed with VA administration claims:
- Higher-level review. This is the option to use if you believe a lower-level VA official ruled incorrectly in denying or reducing your claim.
- Supplemental claim lane. This is the best lane to use if you have additional information to support your existing claim.
- Appeals to the Board.
Each of these lanes should provide eligible veterans with streamlined appeal resolutions. Currently, the higher-level review and supplemental claim lane options are taking an average of about 125 days – a marked improvement over the years-long timelines that were the norm prior to the passage of the Act.
For more information about VA’s implementation of the Veterans Appeals Improvement and Modernization Act, go to: www.benefits.va.gov/benefits/appeals.asp.
Alternatively, you can 1-800-827-1000 or reach out to your local VA regional office. You can also go to towww.va.gov/claim-or-appeal-status/to check the status of your appeal using the Appeals Status Tool.
For more information about VA claims appeals, click here.
VBMS and the COVID-19 Pandemic
The Veteran Administration has temporarily closed all 56 regional offices to the public. But you can still file claims-related documents and get them inputted to the VBMS online or by mail. The VA is also still operating telephone and email help services.
Compensation and Pension Exams (C&P Exams)
After a temporary hiatus due to COVID-19, the VA recently resumed in-person compensation & pension exams (C&P exams) in-person in select locations. You can find a list of locations where you can get a C&P exam here.
According to the VA, no claim will be denied, and no final action will be taken until an in-person exam can be safely completed.