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II
113th CONGRESS
1st Session
S. 928
IN THE SENATE OF THE UNITED STATES
May 9, 2013
Mr. Sanders introduced
the following bill; which was read twice and referred to the
Committee on Veterans'
Affairs
A BILL
To amend title 38, United States Code, to improve the
processing of claims for compensation under laws administered by the Secretary
of Veterans Affairs, and for other purposes.
1.
Short title; table of
contents
(a)
Short
title
This Act may be cited
as the Claims Processing Improvement
Act of 2013.
(b)
Table of
contents
The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—Agency of original jurisdiction
Sec. 101. Establishment of working group to improve employee
work credit and work management systems of Veterans Benefits
Administration.
Sec. 102. Establishment of task force on retention and training
of Department of Veterans Affairs claims processors and
adjudicators.
Sec. 103. Streamlining non-Department of Veterans Affairs
Federal records requests.
Sec. 104. Recognition of representatives of Indian tribes in
the preparation, presentation, and prosecution of claims under laws
administered by the Secretary of Veterans Affairs.
Sec. 105. Pilot program on participation of local and tribal
governments in improving quality of claims for disability compensation
submitted to Department of Veterans Affairs.
Sec. 106. Quarterly reports on progress of Department of
Veterans Affairs in eliminating backlog of claims for compensation that have
not been adjudicated.
TITLE II—Board of Veterans' Appeals and Court of Appeals for
Veterans Claims
Sec. 201. Modification of filing period for notice of
disagreement to initiate appellate review of decisions of Department of
Veterans Affairs.
Sec. 202. Determination of manner of appearance for hearings
before Board of Veterans' Appeals.
Sec. 203. Disclosure of certain medical records in appellate
proceedings in certain courts.
TITLE III—Other matters
Sec. 301. Extension of authority for operations of Manila
Department of Veterans Affairs Regional Office.
Sec. 302. Extended period for scheduling of medical exams for
veterans receiving temporary disability ratings for severe mental
disorder.
Sec. 303. Extension of marriage delimiting date for surviving
spouses of Persian Gulf War veterans to qualify for death pension.
Sec. 304. Making effective date provision consistent with
provision for benefits eligibility of a veteran's child based upon termination
of remarriage by annulment.
Sec. 305. Extension of temporary authority for performance of
medical disabilities examinations by contract physicians.
I
Agency of
original jurisdiction
101.
Establishment
of working group to improve employee work credit and work management systems of
Veterans Benefits Administration
(a)
In
general
Not later than 90 days after the date of the enactment of
this Act, the Secretary of Veterans Affairs shall establish a working group to
assess and develop recommendations for the improvement of the employee work
credit and work management systems of the Veterans Benefits
Administration.
(b)
Composition
The
working group shall be composed of the following:
(1) The Secretary or
the Secretary's designee.
(2) Individuals
selected by the Secretary from among employees of the Department of Veterans
Affairs who—
(A) handle claims for
compensation and pension benefits; and
(B) are recommended
to the Secretary by a labor organization for purposes of this section.
(3) Not fewer than
three individuals selected by the Secretary to represent different
organizations recognized by the Secretary for the representation of veterans
under section 5902 of title 38, United States Code.
(c)
Duties
The
duties of the working group are as follows:
(1) To assess and
develop recommendations for the improvement of the employee work credit and
work management systems of the Veterans Benefits Administration.
(2) To develop a data
based methodology to be used in revising the employee work credit system of the
Department and a schedule by which revisions to such system should be
made.
(3) To assess and
develop recommendations for improvement of the resource allocation model of the
Veterans Benefits Administration.
(d)
Review and
incorporation of findings from prior study
In carrying out its
duties under subsection (c), the working group shall review the findings and
conclusions of the Secretary regarding previous studies of the employee work
credit and work management systems of the Veterans Benefits
Administration.
(e)
Reports
(1)
Interim
report
Not later than 180 days after the date of the
establishment of the working group, the working group shall submit to Congress
a report on the progress of the working group.
(2)
Final
report
Not later than one year after the date of the
establishment of the working group, the working group shall submit to Congress
the methodology and schedule developed under subsection (c)(2).
(f)
Implementation
of methodology and schedule
After submitting the report under
subsection (e), the Secretary shall take such actions as may be necessary to
apply the methodology developed under subsection (c)(2) and apply such
methodology according to the schedule developed under such subsection.
102.
Establishment
of task force on retention and training of Department of Veterans Affairs
claims processors and adjudicators
(a)
Establishment
The Secretary of Veterans Affairs shall
establish a task force to assess retention and training of claims processors
and adjudicators that are employed by the Department of Veterans Affairs and
other Federal agencies and departments.
(b)
Composition
The
task force shall be composed of the following:
(1) The Secretary of
Veterans Affairs.
(2) The Director of
the Office of Personnel Management.
(3) The Commissioner
of Social Security.
(4) An individual
selected by the Secretary of Veterans Affairs who represents an organization
recognized by the Secretary for the representation of veterans under section
5902 of title 38, United States Code.
(5) Such other
individuals selected by the Secretary who represent such other organizations
and institutions as the Secretary considers appropriate.
(c)
Duration
The
task force established under subsection (a) shall terminate not later than two
years after the date on which the task force is establish under such
subsection.
(d)
Duties
The
duties of the task force are as follows:
(1) To identify key
skills required by claims processors and adjudicators to perform the duties of
claims processors and adjudicators in the various claims processing and
adjudication positions throughout the Federal Government.
(2) To identify
reasons for employee attrition from claims processing positions.
(3) Not later than
one year after the date of the establishment of the task force, to develop a
Government-wide strategic and operational plan for promoting employment of
veterans in claims processing positions in the Federal Government.
(4) To coordinate
with educational institutions to develop training and programs of education for
members of the Armed Forces to prepare such members for employment in claims
processing and adjudication positions in the Federal Government.
(5) To identify and
coordinate offices of the Department of Defense and the Department of Veterans
Affairs located throughout the United States to provide information about, and
promotion of, available claims processing positions to members of the Armed
Forces transitioning to civilian life and to veterans with disabilities.
(6) To establish
performance measures to assess the plan developed under paragraph (3), to
assess the implementation of such plan, and revise such plan as the task force
considers appropriate.
(7) To establish
performance measures to evaluate the effectiveness of the task force.
(e)
Reports
(1)
Submittal of
plan
Not later than one year after the date of the establishment
of the task force, the Secretary of Veterans Affairs shall submit to Congress a
report on the plan developed by the task force under subsection (d)(3).
(2)
Assessment of
implementation
Not later than 120 days after the termination of
the task force, the Secretary shall submit to Congress a report that assesses
the implementation of the plan developed by the task force under subsection
(d)(3).
103.
Streamlining
non-Department of Veterans Affairs Federal records requests
(a)
In
general
Paragraph (2) of
section 5103A(c) of title 38, United States Code, is amended to read as
follows:
(2)
(A) Whenever the Secretary
attempts to obtain records from a Federal department or agency, other than the
Department, under this subsection, the Secretary shall make not fewer than two
attempts to obtain the records, unless the records are obtained or the response
to the first request makes evident that a second request for such records would
be futile.
(B) The notification requirements under
subsection (b)(2) of this section shall apply if the Secretary is unable to
obtain all of the records sought from a Federal department or agency other than
the
Department.
.
(b)
Subsequent
attainment of records
Such section is further amended by adding
at the end the following new paragraph:
(3) If, after adjudicating a claim for a
benefit under a law administered by the Secretary, the Secretary receives a
record relevant to such claim (or associates with the file for such claim a
record) that the Secretary requested from a Federal department or agency before
the adjudication, the record received (or associated) shall be deemed to have
been in the file for such claim as of the date of the original filing of the
claim for such
benefit.
.
(c)
Effective
date
The amendments made by this section shall take effect on the
date that is 180 days after the date of the enactment of this Act and shall
apply with respect to any claim that—
(1) is filed on or
after the date that is 180 days after the date of the enactment of this Act;
or
(2) was filed before
the date of the enactment of this Act and was not final as of such date.
104.
Recognition of
representatives of Indian tribes in the preparation, presentation, and
prosecution of claims under laws administered by the Secretary of Veterans
Affairs
Section 5902(a)(1) of
title 38, United States Code, is amended by inserting Indian tribes (as
defined in section 4 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b)) after Foreign Wars,.
105.
Pilot program
on participation of local and tribal governments in improving quality of claims
for disability compensation submitted to Department of Veterans
Affairs
(a)
Pilot program
required
The Secretary of Veterans Affairs shall carry out a
pilot program to assess the feasibility and advisability of entering into
memorandums of understanding with local governments and tribal
organizations—
(1) to improve the
quality of claims submitted to the Secretary for compensation under chapter 11
and pension under chapter 15 of title 38, United States Code; and
(2) to provide
assistance to veterans who may be eligible for such compensation or pension in
submitting such claims.
(b)
Minimum number
of participating tribal organizations
In carrying out the pilot
program required by subsection (a), the Secretary shall enter into memorandums
of understanding with at least—
(1) two tribal
organizations; and
(2) 10 State or local
governments.
(c)
Tribal
organization defined
In this section, the term tribal
organization has the meaning given that term in section 3765 of title
38, United States Code.
106.
Quarterly
reports on progress of Department of Veterans Affairs in eliminating backlog of
claims for compensation that have not been adjudicated
(a)
In
general
Not later than 90
days after the date of the enactment of this Act and not less frequently than
quarterly thereafter through calendar year 2015, the Secretary of Veterans
Affairs shall submit to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of Representatives a report on
the backlog of claims filed with the Department of Veterans Affairs for
compensation that have not been adjudicated by the Department.
(b)
Contents
Each
report submitted under subsection (a) shall include the following:
(1) For each month
through calendar year 2015, a projection of the following:
(A) The number of
claims completed.
(B) The number of
claims received.
(C) The number of
claims backlogged at the end of the month.
(D) The number of
claims pending at the end of the month.
(E) A description of
the status of the implementation of initiatives carried out by the Secretary to
address the backlog.
(2) For each quarter
through calendar year 2015, a projection of the average accuracy of disability
determinations for compensation claims that require a disability rating (or
disability decision).
(3) For each month
during the most recently completed quarter, the following:
(A) The number of
claims completed.
(B) The number of
claims received.
(C) The number of
claims backlogged at the end of the month.
(D) The number of
claims pending at the end of the month.
(E) A description of
the status of the implementation of initiatives carried out by the Secretary to
address the backlog.
(4) For the most
recently completed quarter, an assessment of the accuracy of disability
determinations for compensation claims that require a disability rating (or
disability decision).
(c)
Availability to
public
The Secretary shall make each report submitted under
subsection (a) available to the public.
(d)
Definitions
In
this section:
(1)
Backlogged
The
term backlogged, with respect to a claim for compensation received
by the Secretary, means a claim that has been pending for more than 125
days.
(2)
Pending
The
term pending, with respect to a claim for compensation received by
the Secretary, means a claim that has not been adjudicated by the
Secretary.
II
Board of
Veterans' Appeals and Court of Appeals for Veterans Claims
201.
Modification
of filing period for notice of disagreement to initiate appellate review of
decisions of Department of Veterans Affairs
(a)
Filing of
notice of disagreement by claimants
(1)
In
general
Paragraph (1) of section 7105(b) of title 38, United
States Code, is amended—
(A) by striking
one year and inserting 180 days in the first
sentence; and
(B) by striking
one-year and inserting 180-day in the third
sentence.
(2)
Electronic
filing
Such paragraph is further amended by inserting or
transmitted by electronic means after postmarked.
(3)
Good cause
exception for untimely filing of notices of disagreement
Such
section 7105(b) is amended by adding at the end the following new
paragraph:
(3)
(A) A notice of
disagreement not filed within the time prescribed by paragraph (1) shall be
treated by the Secretary as timely filed if—
(i) the Secretary determines that the
claimant, legal guardian, or other accredited representative, attorney, or
authorized agent filing the notice had good cause for the lack of filing within
such time; and
(ii) the notice of disagreement is filed
not later than 186 days after the period prescribed by paragraph (1).
(B) For purposes of this paragraph, good
cause shall include the following:
(i) Circumstances relating to any
physical, mental, educational, or linguistic limitation of the claimant, legal
guardian, representative, attorney, or authorized agent concerned (including
lack of facility with the English language).
(ii) Circumstances relating to significant
delay in the delivery of the initial decision or of the notice of disagreement
because of natural disaster or factors relating to geographic location.
(iii) A change in financial circumstances,
including the payment of medical expenses or other changes in income or net
worth that are considered in determining eligibility for benefits and services
on an annualized basis for purposes of needs-based benefits under chapters 13,
15, and 17 of this
title.
.
(b)
Application by
Department for review on appeal
Section 7106 of such title is
amended in the first sentence by striking one-year period described in
section 7105 and inserting period described in section
7105(b)(1).
(c)
Effective
date
The amendments made by this section shall apply with respect
to claims for compensation and benefits under laws administered by the
Secretary of Veterans Affairs filed with the Secretary after the date of the
enactment of this Act.
202.
Determination
of manner of appearance for hearings before Board of Veterans' Appeals
(a)
In
general
Section 7107 of title 38, United States Code, is
amended—
(1) by redesignating
subsection (f) as subsection (g);
(2) in subsection
(a)(1), by striking in subsection (f) and inserting in
subsection (g); and
(3) by striking
subsections (d) and (e) and inserting the following new subsections:
(d)
(1) Except as provided in
paragraph (2), a hearing before the Board shall be conducted through picture
and voice transmission, by electronic or other means, in such a manner that the
appellant is not present in the same location as the members of the Board
during the hearing.
(2)
(A) A hearing before the
Board shall be conducted in person upon the request of an appellant.
(B) In the absence of a request under
subparagraph (A), a hearing before the Board may also be conducted in person as
the Board considers appropriate.
(e)
(1) In a case in which a
hearing before the Board is to be held as described in subsection (d)(1), the
Secretary shall provide suitable facilities and equipment to the Board or other
components of the Department to enable an appellant located at an appropriate
facility within the area served by a regional office to participate as so
described.
(2) Any hearing conducted as described in
subsection (d)(1) shall be conducted in the same manner as, and shall be
considered the equivalent of, a personal hearing.
(f)
(1) In a case in which a
hearing before the Board is to be held as described in subsection (d)(2), the
appellant may request that the hearing be held at the principal location of the
Board or at a facility of the Department located within the area served by a
regional office of the Department.
(2) A hearing to be held within an area
served by a regional office of the Department shall (except as provided in
paragraph (3)) be scheduled to be held in accordance with the place of the case
on the docket under subsection (a) relative to other cases on the docket for
which hearings are scheduled to be held within that area.
(3) A hearing to be held within an area
served by a regional office of the Department may, for cause shown, be advanced
on motion for an earlier hearing. Any such motion shall set forth succinctly
the grounds upon which the motion is based. Such a motion may be granted
only—
(A) if the case involves interpretation of
law of general application affecting other claims;
(B) if the appellant is seriously ill or
is under severe financial hardship; or
(C) for other sufficient cause
shown.
.
(b)
Effective
date
The amendments made by subsection (a) shall apply with
respect to cases received by the Board of Veterans' Appeals pursuant to notices
of disagreement submitted on or after the date of the enactment of this
Act.
203.
Disclosure of
certain medical records in appellate proceedings in certain
courts
Section 7332(b)(2) of
title 38, United States Code, is amended—
(1) by redesignating subparagraphs (E) through
(G) as subparagraphs (F) through (H), respectively; and
(2) by inserting after subparagraph (D) the
following new subparagraph (E):
(E) To
the Supreme Court of the United States, the United States Court of Appeals for
the Federal Circuit, or the United States Court of Appeals for Veterans Claims,
and all parties of record, in a case that is appealed to such court and such
records are included in the record on appeal. Upon disclosure of such records,
the court concerned shall impose appropriate safeguards against unauthorized
disclosure that are consistent with the provisions of section 7268 of this
title.
.
III
Other
matters
301.
Extension of
authority for operations of Manila Department of Veterans Affairs Regional
Office
Section 315(b) of title
38, United States Code, is amended by striking December 31, 2013
and inserting December 31, 2014.
302.
Extended
period for scheduling of medical exams for veterans receiving temporary
disability ratings for severe mental disorder
Section 1156(a)(3) of title 38, United
States Code, is amended by striking six months and inserting
540 days.
303.
Extension of
marriage delimiting date for surviving spouses of Persian Gulf War veterans to
qualify for death pension
Section 1541(f)(1)(E) of title 38, United
States Code, is amended by striking January 1, 2011 and
inserting the date that is 10 years and one day after the date on which
the Persian Gulf War was terminated, as prescribed by Presidential proclamation
or by law.
304.
Making
effective date provision consistent with provision for benefits eligibility of
a veteran's child based upon termination of remarriage by
annulment
Section 5110(l) of
title 38, United States Code, is amended by striking , or of an award or
increase of benefits based on recognition of a child upon termination of the
child's marriage by death or divorce,.
305.
Extension of
temporary authority for performance of medical disabilities examinations by
contract physicians
(a)
In
general
Section 704(c) of the
Veterans Benefits Act of 2003 (Public Law 108–183; 38 U.S.C. 5101 note) is
amended by striking December 31, 2013 and inserting
December 31, 2014.
(b)
Report on
disability medical examinations furnished by Department of Veterans
Affairs
(1)
In
general
Not later than 180 days after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report on the furnishing of general medical and
specialty medical examinations by the Department of Veterans Affairs for
purposes of adjudicating claims for benefits under laws administered by the
Secretary.
(2)
Contents
The
report submitted under paragraph (1) shall include the following:
(A) The number of
general medical examinations furnished by the Department during the period of
fiscal years 2009 through 2012 for purposes of adjudicating claims for benefits
under laws administered by the Secretary.
(B) The number of
general medical examinations furnished by the Department during the period of
fiscal years 2009 through 2012 for purposes of adjudicating a claim in which a
comprehensive joint examination was conducted, but for which no disability
relating to a joint, bone, or muscle had been asserted as an issue in the
claim.
(C) The number of
specialty medical examinations furnished by the Department during the period of
fiscal years 2009 through 2012 for purposes of adjudicating a claim.
(D) The number of
specialty medical examinations furnished by the Department during the period of
fiscal years 2009 through 2012 for purposes of adjudicating a claim in which
one or more joint examinations were conducted.
(E) A summary
(including citations of) any medical and scientific studies which provide a
scientific basis for determining that three repetitions is adequate to
determine the effect of repetitive use on functional impairments.
(F) The names of all
examination reports, including general medical examinations and Disability
Benefits Questionnaires, used for evaluation of compensation and pension
disability claims which require measurement of repeated ranges of motion
testing and the number of examinations requiring such measurements which were
conducted in fiscal year 2012.
(G) The average
amount of time taken by an individual conducting a medical examination to
perform the three repetitions.
(H) A discussion of
whether there are more efficient and effective scientifically reliable methods
of testing for functional loss on repetitive use of an extremity other than the
three time repetition currently used by the Department.
(I) Recommendations
as to the continuation of the practice of measuring functional impairment by
using three repetitions during the examination as a criteria for evaluating the
effect of repetitive motion on functional impairment with supporting
rationale.
(c)
Report on
progress of Acceptable Clinical Evidence initiative
(1)
In
general
Not later than 180 days after the date of the enactment
of this Act, the Secretary shall submit to the Committee on Veterans' Affairs
of the Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the progress of the Acceptable Clinical Evidence
initiative of the Department of Veterans Affairs in reducing the necessity for
in-person disability examinations and other efforts to comply with the
provisions of section 5125 of title 38, United States Code.
(2)
Contents
The
report required by paragraph (1) shall include the following:
(A) The number of
claims eligible for the Acceptable Clinical Evidence initiative during the
period beginning on the date of the initiation of the initiative and ending on
the date of the enactment of this Act, disaggregated by fiscal year.
(B) The total number
of claims eligible for the Acceptable Clinical Evidence initiative that
required a medical examiner of the Department to supplement the evidence with
information obtained during a telephone interview with a claimant.
(C) Information on
any other initiatives or efforts of the Department to further encourage the use
of private medical evidence and reliance upon reports of a medical examination
administered by a private physician if the report is sufficiently complete to
be adequate for the purposes of adjudicating a claim.