PACT Act Implementation: Modernizing VA Disability Claims Through Effective Technology

All right, we'll figure this out. Uh, in accordance with committee rules, I ask you on a mis-consent that representative Goodlander from New Hampshire, our newest member of the committee, be permitted to participate in today's subcommittee hearing. And without objection, it is so ordered. Um, good afternoon everyone, the subcommittee on technology modernization will now come to order, and the chair may declare recess at any time. I want to thank our witnesses for joining us as we continue our oversight of the technology used by VA in processing benefit claims. In February, we focused on the digital GI Bill's troubled implementation and examined how acquisition reform could set VA up for success by ensuring they have the right people doing the right jobs from the very beginning of the planning process. In April, the full committee held a hearing examining the administration's success in reducing the disability claims backlog. A large part of these efforts has involved an increase in the use of automation and technology. We're here today to explore to what extent these technologies fulfill their purpose, to quickly, efficiently, and correctly process compensation and pension claims, especially following the implementation of the PACT Act. Our focus today is not as much the software as it is how the VA manages that process. Just like the digital GI Bill, we see a massive disconnect between the VBA, the Veterans Benefit Administration, and the Office of Information and Technology. Because these two are siloed, the claims process remains outdated and complex. With that being said, the question we should always ask ourselves is whether the process is working for veterans. I had the privilege of having Secretary Collins in my district recently, just a few days ago, and he was reminding all the stakeholders we met with, that the one singular client of the VA is veterans. Last month during our field hearing in Grand Ledge, Michigan, I heard directly from veterans that it is not working in the way that we need it to work. And uh, ranking member Baszynski was there with me, appreciate you coming to my district and seeing a little firsthand of of the folks that I have the privilege of representing. Instead of a working system, the men and women who served faced an incredible burden getting the benefits they earned. forced to become their own private detectives, couriers, and administrators. They're expected to track down their own files, physically carry documents between private doctors and VA offices and manage a bureaucratic maze just to get VA to live up to their end of the deal. We know this with the oftentimes fragmented record keeping that veterans have, physical files, paper, and other things that become difficult to manage. It was the outdated paper based process that VA first began digitizing back in two thousand and nine that led to that led to today's Veterans Benefits Management System, or VBMS for short. Now back in two thousand and nine is when I got my first iPhone, so we've certainly come a long way since then. Today's hearing will evaluate VBMS's performance over the years and how the platform has evolved as it struggled to keep up with the influx of claims. Back in twenty twenty-two, Congress recognized that VBA's aging IT Yeah. Sure. Today we will hear from VA about their efforts and how this plan has guided the agency through more than a hundred and forty-seven modernization efforts at VBA. This proactive oversight framework was enacted to ensure VBA's IT modernization efforts were strategic and that VBA wasn't running around with a blank checkbook. Thankfully, this administration has been focused on ensuring that it is executed accordingly, And, as we come to the end of the plan in twenty twenty seven, we must ask the question, how has technology evolved and what will the future look like in how VA processes veterans' claims? We cannot and should not repeat the mistakes of past VA IT projects and give VA a blank check. Our job on the committee is to ensure VA is meeting the expectations of the law. In this case, The PACT Act. If a policy needs to be changed in order to align with modern technology, VA should be informing Congress of those recommendations so that we can get it right the first time. In that same vein, when technology advances so quickly, policy and the intent of Congress must act as guardrails to ensure that veterans' data is protected. On this subcommittee, we will continue to ensure VA is using the future of technology to enhance the veteran experience and not replace the human deciding factor. in the claims process. I want to be very clear with veterans who are watching and veteran stakeholders who are participating, we will make sure that technology does not replace human deciding factors in veterans' claims. Artificial intelligence and automation are terms constantly used in this space, often in interchangeable ways, but they are distinct and different features. I want to be clear, we will make sure that there are strong guardrails where no veteran claims

Thank you, Thank you, Mister Chairman, Mister Chairman, and good afternoon to everyone, and good afternoon to every one, thank you to our panelists for being here. thank you to our panelists for being here. Um, On August tenth, on August tenth, twenty twenty-two, twenty twenty-two, President Biden signed, President Biden's signed, ranking member, ranking member, honoring our PACT Act into law. The PACT Act, which was the largest expansion of veterans' benefits since the GI Bill was passed in nineteen forty-four, expanded eligibility to three point five million veterans. In passing this bill, Congress fulfilled its promise to veterans to honor their service and recognize toxic exposure as a cost of war. Part of the investment from the PACT Act was a commitment to modernize the IT offerings at VBA. particularly in the disability claims process, in the modernization of the Veteran Benefits Management System, or VBMS. VBMS itself is a unique system, one that touches veterans, VA employees, and veteran service officers to varying degrees. Each of these groups were promised an all-encompassing system to ease the disability claims process, a system with the better with better warm touch points for those involved and with quicker results, for veterans. And unfortunately, what we see today seems far removed from that all-encompassing goal. Just as we know one pee can ruin a good night's sleep, so too can one bad update ruin a well-intended but highly interdependent claims modernization system. My staff has have heard from numerous front-line employees that the system itself is clunky and de- heavily degraded. leading to significant downtime, hindering employee productivity, and slowing the process the processing of claims for veterans. Some employees noted losing up to one hour each day because of these lags and crashes. Despite these issues, claims examiners are still expected to reach their daily quotas by processing claims as excluded time is granted inconsistently, um, increasing the risk of error and burnout for employees. Further, I hear from employees that the so-called fixes that VA has pushed, like automation and pilots of artificial intelligence tools, often produce incorrect information, compounding issues and slowing production. Some claims examiners have told my staff that they would consider themselves more of an unpaid software tester than a claims examiner. Ultimately, AI should be used used as a tool, not to augment staff. And that tool should be assessed and improved regularly, based on feedback of those that use it every day. Unfortunately, employees' concerns in feedback are routinely ignored and dismissed. In twenty fifteen GAO found VBMS to be rife with system defections and that VA has no process to integrate upgrades and improvements based on user satisfaction. Almost ten years later, VA finally launched a tool to solicit feedback from its employees and the results echo much of what I have highlighted from front-line staff today. Much of my frustration in this subcommittee has been that while VA needs world-class technology to provide veterans the services and benefits they've earned, it cannot exist without ensuring the department has the people and the processes they need to make that goal a reality. With the daily challenges that claims raters face, Paired with the hostile environment that I believe comes from the secretary's leadership it has been established I'm alarmed but not surprised the VA has lost over eleven hundred veteran claims examiners just this fiscal year alone. As a whole, since January twenty twenty-five, VA is down nearly twenty-seven hundred examiners and a hundred and twenty hundred IT specialists. There is no world in which that does not impact at which veterans receive their disability claim or the effectiveness in VA's ability to implement a modern cloud-based IT system for VBA. And to get ahead of this talking point, the lack of personnel cannot be solved by letting the computer do the work. In many instances, AI and automation systems make things harder for claims processors. VA routinely punishes its employees for not meeting production standards yet fails to give them the reliable tools That is unacceptable and will only lead to a further exodus of employees. Now, we typically don't have VSOs join us in the subcommittee, so I'm extremely glad we have representatives from the foreign of, ex- excuse me, veterans of foreign wars and the paralyzed veterans of America here with us today. The veteran perspective is often lost, while oftentimes Chairman Barrett and I and my fellow subcommittee members are discussing IT systems and processes like supply chain modernization and EHRM. I genuinely hope that the VA witnesses on the first panel will stay and listen to the insights and experiences of the veterans and service officers on the second panel I look forward to today's discussion and I yield back.

Thank you, thank you, member Baczynski. And um I will now introduce our witnesses from the Department of Veteran Affairs. We have Mister Robert Orifisi. Did I say it correctly? I practiced, so hopefully I got it right. From the VA's Office of Information and Technology, acomp- accompanying him we have Mr. Derek Herbert, Acting Chief Production Officer at the Veterans Benefits Administration. From the GAO, the Government Accountability Office, we have Doctor Sterling Thomas, Chief Scientist on GAO's Science and Technology team. If you can all please stand. Uh, I will ask you to raise your right hands for the oath. You solemnly swear under penalty of perjury that the testimony you are about to provide is the truth the whole truth and nothing Thank you and let the record reflect that all witnesses have answered in the affirmative. Mister Arifasi, you are now recognized for five minutes to deliver your opening statement on behalf of VA.

Chairman Barrett, Ranking Member Budzinski, and distinguished members of the subcommittee. Thank you for the opportunity to appear before you today. I am joined by Mister Derek Herbert, Acting Chief Production Officer with the Veterans Benefits Administration. Congress passed the PACT Act to ensure that veterans exposed to toxic substances receive the benefits in the health care that they have earned. Recognizing the technology investment required, Congress mandated a five-year modernization plan. We submitted that plan in March, twenty twenty-three, and implementation is now in its fourth year and on track. Since twenty twenty-two, the PACT Act has driven historic surge in veterans seeking benefits, and more than three point five million PACT related claims have been received so far. Technology modernization has been critical to delivering faster, more accurate outcomes. As one measure of that progress, the rating backlog has stayed below seventy-five thousand since May six of this year, a decrease of more than seventy-three percent since January twenty twenty five. That is a result of better systems, smarter workflows, the dedication and the dedication of our workforce. Let me highlight a few areas of progress. First, we are modernizing the Veterans Benefits Management System, the core platform our claims processors use every day. One of our most impactful advances has been digitizing more than one point two billion veteran claim evidence documents. And our smart search technology now lets processors locate relevant information within the veteran's file in moments, saving hours of manual review and supporting more consistent, accurate decisions. And while we use artificial intelligence, to help our employees make faster and better decisions, I want to be clear on this point. Every disability claim is decided by a trained VA employee, not by AI or automation. These tools support human decision making. They do not replace it. For example, the toxic exposure risk activity memos, once completed entirely by hand, now use AI to partially populate the system with verified data linked to the source documents. That has cut the time to complete a memo by up to forty percent, allowing us to complete PACT-Act eligibility much faster. Second, we have improved how veterans experience the process. We have simplified our on-line forms and veterans now receive updates by email, mobile app notification, and text message with engagement rates above fifty percent. When we need more evidence, plain language requests help veterans understand exactly what to submit. And in twenty twenty five, we launched the Discover Your Benefits tool, a self-service resource that helps veterans, service members, and their families explore benefits across the federal government, especially around this time of separation. Third, we have strengthened our infrastructure while reducing costs. Our corporate database, the central repository for veterans' records, has been migrated to the cloud, improving security, resiliency, and our ability to scale. Through data-driven management of those resources, we have already avoided sixteen million dollars annually in cloud costs, with efforts underway to target another seven million dollars. And since twenty twenty-three, we have decommissioned sixteen legacy systems, including the forty-eight year old benefits delivery network, with fourteen more planned for retirement by twenty thirty-two. In conclusion, this modernization has already delivered real results. Faster claims, stronger reliability, better decision support for our workforce, and a more seamless experience for veterans and their families. We remain committed to completing this transformation. Mister Chairman, thank you for your continued support of programs that serve the nation's veterans. My colleague and I look forward to your questions.

Thank you, Mister Riffesey. The written statement of Mister Riffesey will be entered into the hearing record. Doctor Thomas, you are now recognized for five minutes over your opening statement on behalf of GAO.

Chairman Barrett, Ranking Member Businski, and members of the subcommittee. Thank you for inviting me to today's hearing on technology innovation for the Department of Veterans Affairs Disability Compensation program. This program provides billions of dollars in disability compensation to millions of veterans and their families. VA must be able to make timely and accurate decisions about the amount of compensation a veteran receives as a matter of fairness to veterans and assure the program is achieving its intended results. As you know, GAO is the nonpartisan watchdog for Congress, and we've been watching VA's disability compensation program closely for decades. We have four VA areas in our high risk list, VA management of disability compensation claims, IT modernization, acquisition management, and healthcare, all areas of concern to this committee. New technology, including but not limited to AI, is a big part of this modernization, as well as a growing focus for GAO. We started a science and technology unit in two th two thousand and nineteen which includes a team of data scientists. We also have a unit devoted to information technology and cyber security, and last year my colleague Karen Carol Harris from that team testified before you, uh on VA's use of artificial intelligence. My message today is threefold. First, as VA pursues new technology to process disability compensation claims faster, it must avoid the types of shortfalls we've observed in the past, with technology and with managing this program. Second, as VA increasingly uses AI, We have concerns about this usage outpacing governance. And third, VA needs a workforce with the appropriate skills to apply AI and other innovations. Regarding my first point, GAO has a large body of work on VA's challenges in managing the disability and compensation program and implementing new technology. I wanna be clear, VA has responded to some of these challenges and made real improvements. However, our prior work has shown that these efforts, VA did not consistently achieve its goals for improvement. A main reason for these shortfalls was VA not fully using leading management practices such as establishing goals using quality data and monitoring performance these practices are also needed to achieve VA's goals for using AI my second point VA like other federal federal agencies is rapidly increasing its use of generative AI and plans to use AI to help process disability compensation claims. It also reports that an AI tool called the payment redirect fraud model can help identify requests to change a veteran's direct deposit that are likely to be fraudulent. I'm optimistic about some of these uses, but VA must be thoughtful about the deployment and oversight. For example, VA must pay close attention to the data, how it can support and improve disability programs, and how we can avoid causing harm to our veterans. AI poses a particular threat A particular challenge because it follows statistical patterns from large data sets. But veterans have experiences and needs that different from the d- differ from those patterns often dramatically. As VA develops the system, we uh as VA develops the systems, we need to ensure it uses data sets that represent them. If we don't, AI can lead to harms like denying compensation to deserving veterans. GAO's AI framework of key practices can guide VA's approach. Broadly, AI is still in early stages of development and implementation, and rapid deployment without deliberate focus on governance has already led to unintended consequences. Before pouring data science on the problem, we need solid, reliable ground truth data and a human in the loop to ensure data reliability and application of the technology. GAO has an AI accountability framework which lays out these and other principles and key practices. My third and final point is that harnessing innovation also requires a federal workforce that has the right skills. But VA and other agencies continue to face barriers in hiring, managing, and retaining staff with advanced technical skills. This is another area where GAO has made recommendations, and we have explored innovative big picture solutions like establishing a digital services academy. Technology, including AI and other data science tools, offers VA opportunities to save taxpayer money and to continue to honor the obligation we have to our veterans. GAO believes that sound management and governance, reliable data, and a skilled workforce are critical for the federal government to realize these opportunities. Uh, Chairman Barrett, Ranking Member Businski, and the members of the subcommittee, thank you, and I look forward, I'm happy to respond to any questions.

Thank you, Doctor Thomas. The uh written statement of Doctor Thomas will be entered into the record and we'll now proceed to questions. And I will start by recognizing myself for five minutes, and then we'll go through the uh members that have um are here today. Um the first question I have uh, Mister Riffesey, if you could just um for the benefit of myself and and others, can you give me some examples of the difference between AI and automation and how they are distinct from one another while perhaps trying to achieve the outcome we're going for.

Yes, so thank you for that question. So when we talk about automation, We're talking about uh very explicit tasks that are rules-based, that could follow a very explainable set of logic to accomplish that task, like ordering um a mail from one point and having that delivered into the system, or pre-populating a form with data that's set from a basis of rules. When we look at AI, we're looking at various models. We're looking at some models which look at predictions and patterns, to really make recommendations forward from data sets that are available. And then we have generative AI, which is really using that to generate a response, uh, or some piece of action from that. And so those are three cat- three different categories in their distinction.

Um, is AI being used in a, uh, chat function with veterans as they're going about interfacing with the VA in different ways right now? Are there, um, you see a lot of these on customer service platforms and things like that. Is the VA using that technology to communicate with veterans right now?

I do not believe we're using AI in to communicate when chats to veterans at this point in time.

Okay. Um, assuming that may be an interest of the VA at some point, are we able to get assurances that there would be a a disclaimer of sorts or a notice to veterans that this is being done using an AI feature?

Yeah, that's a great question, and I will commit to taking that back with our AI governance to make sure that that is a disclaimer.

Okay. Thank you. Um, I wanted to nes- next ask you about a um, a situation that came up in my district speaking with a um one of the county VSOs in in my district. They had a veteran that came to them who had filed a claim with fourteen unique um uh situations within it or fourteen separate conditions. And uh he was using the quick submit system that the VA has. Um, now he didn't have one of those uh Adobe subscriptions to fill out the PDF and everything else so he used an on-line tool that he downloaded for free and it offset some of the formatting by enough to throw off the system uh it flagged it as being incomplete and it sent it to a VA employee for review which is ideally what should happen is that a human takes over to look at it but then the employee entered only the very first condition into system, not the remaining thirteen other conditions that were claimed. Um, and obviously that set him back significantly and it became very difficult to overcome that. Um, where within the VBA's metrics or error reporting or accuracy logs would those, you know, thirteen failed submissions, where would that be counted and where would it be, um, accounted for?

Uh, thank you for that question. I'll defer to my colleague, Mr. Herbert.

Okay.

Thank you, sir. The um so for quick submit my um my understanding of that specific issue, right, is that the the automation worked as intended. The the pattern recognition on the front-end of the of the actual five two six failed the initial review which then defaulted over into human review. The the compounding problem with that specific issue is that it's a combination of automation doing what it was intended to do, diverting to a human for involvement, but then compounded by the employee making the mistake of not capturing all of the different contentions, fourteen instead of just the one. Regarding the uh the error reporting, I I'm I'm happy to take that back where that specifically would be counted.

'Kay. Okay. Um, yeah, that would be helpful as we kind of work through that. Um, I am curious you know, I'm sure this situation isn't unique to one veteran in one county in my congressional district you know based on the hundreds of thousands of instances that this will be spread across the country what are we doing to I guess anticipate the ways in which this might not work cuz it's designed a certain way but if veterans are using tools available to them because they don't have a expensive PDF subscription service how are we anticipating what that failure would be and how can we correct it?

Yeah, that's a great question, and we're currently looking at uh how PDF overflows work when it exceeds

Mm-hmm.

the field size to make sure that the system could make sure it is showing that information to the correct point so that is the feature work that's under development right now to correct that error.

Is there a look at like, you know, a lot of Americans file their taxes using tax software, TurboTax, other things like that, you're not in there filling out the IRS PDF form, you're filling out a series of questions that are guided and then that on the back-end fills

Yeah, that's a great question. And we are we have several forms already on VA dot gov that work in a guided interview fashion, where they are walk through the process. But uh for quick submit in particular, that is a place where it's intended to be more a bulk upload. A lot of VSOs and our partners use that to pre-complete the form and submit them in in more of a bulk fashion. And so that model is not necessarily being I don't believe it's being utilized in the quick submit but for VA dot gov we are certainly looking at that.

Okay. Thank you. Ranking member Basinski, you're recognized for five minutes.

Thank you, Mr. Chairman. Um, Mr. Riffisi, um, how often would you say that the that VBMS has system-wide or regional outages?

Thank you for that question.

And could you speak up just a little closer to the mike?

Sorry.

Sorry, thank you.

Yes, thank you. Thank you for that question.

Thank you.

Uh how often does it have that uh regional outages?

Yes.

I would say probably once a month, but not usually very prolonged outages. Um the team's very responsive and be able to to quickly turn around anything. And so, you know, I would say around once a month.

Okay. And just to that um point you made, uh you do you know how long typically the outage is?

I do not have that information off the top of my head, so I'd be happy to take that back for the record.

Okay. And then for individual level crashes, how often does that happen?

Thank you for that question. When we look at tickets and not individual crashes, but people submit tickets when there's anything that they're encountering with the tool that they don't understand or they believe it's an issue and it takes us around eight days on average to turn around those individual help desk tickets that are filed.

Eight days. Okay. Um, one question I'd have is you know, would this be something that we could have more of a conversation on, how the VA is tracking these types of outages and and then how long the outages are, just both l- from a regional but also an individual position, like how often that takes place.

I'd be happy to work with members of your staff to put together a briefing on the incident and incident response for VBMS.

Okay. Okay, that'd be great. Um, and we've heard from staff that, um, they are losing, what we've been hearing is up to an hour a day with these crashes and lags. which often impairs their ability obviously to reach their mandated quotas. When employees experience issues with VBMS or ADS, whether it's a degraded feature or errors in the draft, drafted case contentions, where does VA direct them in order to get resolution on these issues?

Uh, that's a good question. So, most of these tickets we direct our front-line staff to submit uh incidents in our service management module, which is ServiceNow. and then those tickets get routed to the appropriate staff, whether that is VBA or OIT uh staff to resolve those tickets.

Mm-hmm, okay. And and Doctor Thomas, just to follow up, in light of of these issues and concerns from front-line employees using ADS, um do you believe that VA's method for receiving and addressing feedback and functionality concerns is appropriate or do you have any recommendations?

Um so we haven't looked specifically at that program, but our recommendations, you know, kind of follow along the same ones I talked about earlier as, you know, developing standard management practices to identify, you know, how quickly things are resolved, how quickly you're communicating, identifying your core issues, um, as well as, you know, dealing with underlying technology challenges. You know, these good management practices are really the fundamental component to making these technology programs work.

Okay.

Thank you. Um, Mister Herbert, I understand the demand to review and decide on claims in a timely manner is important. Um however it is concerning to see VA routinely punish its employees for not meeting production standards though the department has failed to give them reliable tools with which to do their jobs how is it determined if employees receive excluded time and adjustments to their quotas in cases of these crashes?

Thank you for the question, Raking member, this is really uh really the the purview of our office of field operations, but what I can absolutely tell you is that the automation capabilities that we're deploying are not intended to replace employees. And I also wanna be very clear that in disability compensation, automation is not making decisions on claims. What we really strive to do is look at those really high volume, highly administrative tasks, focus our resources and really basic automation on those capabilities, so that we are really supporting and augmenting the productivity of our employees. We th- i- it is the - the shared concern of all of us where we do not wanna put anything that is not usable in front of an employee.

Yeah. Cuz obviously they might - they're wanting to meet their quota, but if the system crashes, how do they account for that in relation to their quota and not get penalized for it, I think is the - the bigger concern. Um, just to follow up, from what I've heard from employees is that this time is not granted consistently in cases of regional or individual level outages. How is VA working to standardize this?

I would say oftentimes that the the the outages may not manifest themselves the same way across the entire enterprise of fifty-six regional offices. So we we absolutely do need to work with the Office of Information and Technology on as outages occur rapidly identifying to what extent and who exactly is impacted so that we can have an accurate logging of who truly is impacted and off-line enables our veterans.

So it's on a case-by-case basis.

Yes, ma'am.

Okay, I yield back.

Thank you, thank you, Member Buszynski. I just uh missed a call from the uh Battle Creek VA appointment line, so if you're watching today, I'll call you after this hearing is over. Um, but uh with that, Mister Littrell, your recognizer,

You better hope that works.

please. Yes. Yes.

Thank you, Mr. Chairman. Uh, thank you all for being here today.

So in the build-out of the IT system, or the modernization of the IT system where all of the veteran's data is moving through the system trying to get the benefits kind of under we're under control, but processed completely, Mister Herbert, Mister Tom, Doctor Thomas, you mentioned quality of data. And the way that I understand it, which is a great point. The way that I understand when a veteran's when a veteran's information enters into the system it has to go through a process where the uh the rating act uh The VSR has to go into the Department of Defense, find all the information about the veteran, push that thing along. If another benefit is added, it com- it starts completely over. I have no idea why the VA hasn't said all stop. If we are doing a modernization that's costing billions of dollars because we need clean refined data on a veteran, why can't that start in the Department of Defense? Why can't we ha- like I don't know who your counterpart is, sir, mister or if see in the in Department of War- Department of Defense, Department of War. And say, okay, hey look, there is no doubt that when you leave the service, you're gonna be a veteran. And we are having so much trouble inside the VA collecting all this information, this clean information to push this information through for veterans and their benefits. Can't you tee that up for us? Because of the struggle that we have with employees, Department of War doesn't have that problem. And we can ease the pressure on the VA if it's done on the front side, as the transfer happens onto into the VA space and say, okay, here we go. Why don't we do that?

That's a great question. I look forward to uh the confirmation of our CO. When listening to his nomination hearing, he had this as one of his top things, bringing over that record from DOW. and starting to really have that solid record to build from. I agree that this is something that's very important, starting with that data from DOW building up.

I mean, it's twenty twenty six. We figured this out. And we're trying to develop an uh language models that can that can do all this. We're spending billions and billions and billions of dollars on our side, and the Department of War is doing the same thing on their side. And I hear, trust me, I got it, hey, well, we don't communicate, we don't like to talk to each other. OK. But inevitably what happens on the back side is the veterans are the ones that are suffering. And it seems like as United States government we could kinda figure this thing out. I have said it once and I'll say it ten thousand times, I have no idea why you can't, before you leave active duty, sit down with somebody who has your entire record, all your medical, all your certificate, everything, and just drag that bad boy from one computer to another, call the VA, he's like, " Hey, Lieutenant Luttrell is inbound, do you have him?" "Yeah, I got him." And it's all of his rec- everything, every one and zero that corresponds to him is in the system and the benefit package is teed up ready to go if he needs it. But we keep kicking the proverbial can down the road every single year. Trying to figure out another lane to walk in, it seems like in the VA when the Department of War could easily hand this off to us that Just a, I mean I, there's veterans in the room. Just think about the onboarding that happens when you when you sign that line and swear in everything from start to finish and how they what they do and then when the when it's time to leave uh you know the the bullet train doesn't stop it's ready set go oh and by the way here's all your stuff and if you don't have it you gotta find it later and good luck with that because you're no longer a military asset you're a civilian again and we really don't have time to help you out and then that's that's punched that's kicked off to you guys and then the and then the VA has gotta go grinding through to try to find the information for the veterans so when it comes to the pact act you would think that the military would be great about writing down and documenting where we all were, everything that we had touched. And when the VA tries to find that, the Department of War is like, " Now we don't have it." And then you got the veteran in the middle saying " Yeah well I was there." So why can't we have this guy? I don't have a question for you, this is just, this is five minutes for me to rant, so I appreciate it. It just seems s- so easy. for the secretaries and the depth checks and all of you to say hey look, create a language model that communicates between the department of war and the VA, take the veterinary equation, do all the lift form, and when they're out, they're ready to go. I I I just really wish that would save I don't know how many billions of dollars, how many months, weeks and years of time from start to finish. Mr. Chairman, I yield back.

Thank you, Mister Luttrell. Uh, Ms. Goodlander, you're recognized for five minutes, welcome to the committee.

Thank you, I'm so glad to be here. Thank you to our witnesses for being here today. Congressman Luttrell, I couldn't agree with you more. I was looking at um the VBA's annual benefits report and I'm curious about this point Congressman Luttrell is making. So, am I right that this past year you've brought um around a half a million new recipients into the compensation program.

Thank you for the question, Mr. Herbert.

Yes, thank you for the question, Congresswoman. This year we have uh uh I'm not exactly sure the number of

Or in fiscal year twenty twenty five.

of new claimants, but this year but this year we have received already uh two point three million uh claims.

Yes.

I don't know to what extent those are uh new applicants.

Well, to the extent I'd be curious, and we'll follow up with some additional questions, but to just get a better understanding of your new compensation recipients, how many are coming directly out of active duty and could we cut down on some of the bureaucratic processes. I do wanna ask you about claim examiners and Dr. Thomas, I'm delighted that you're here. I wish we had a GAO witness in every hearing in Congress. Um, I wanna ask you about your fifteen outstanding recommendations for VA. which you mentioned in your written testimony. Can you walk us through what additional GAO recommendations have not yet been implemented? And can you highlight for us the ones you'd prioritize for this committee?

Yeah, so I I in my testimony I talked about the areas in our high risk list. Those are the ones that we identify as priorities. Um and then in addition, yeah, we have fifteen outstanding um uh um issues that have either been partially addressed or not addressed at all. Um it would take a long time to go through them. the foundational component to each one of these comes down to making sure you're identifying clear goals for your programs identify if you're particularly in the AI and automation space designing pilots that have specific uh conditions that meet those goals so that they actually do serve the s the purpose you're after,

Mm-hmm.

and define the limitations of how you use it. Um a lot of the technology modernization management issues we've identified come down to those basic things.

Thank you. Um, can I ask how many claims examiners or processors are currently employed for the who focus on um on compensation on disability compensation? How many are are currently employed by VA?

Thank you, Congresswoman, I don't exactly have the the exact number

Do you have a rough estimate?

at this at this moment. I I believe there are about uh thirty thousand or so employees in BBA.

And how many claims, wha- what's the role of a claims processor, would you say, just when it comes down to it? Mission critical, right? In delivering

Absolutely.

benefits to veterans.

Absolutely mission critical, really I think it's divided into two primary categories. One would be the acquisition, the development of all of the pieces of evidence needed to adjudicate a c- the claim, and then of course it would be the actual adjudication of the claim.

So this is not something that can be entirely outsourced.

By te- by technology?

Correct.

No, uh, no, in disability compensation, and to be clear, uh, technology is, it will never be intended to, uh, to automate a claim for disability compensation claims.

S- so, so how many processors, claims processors do you have on staff at the VA right now? Can you get us that answer?

Uh, I'll be happy to answer that.

Ha- ha- have you reduced the number of claims processors since last January?

I can certainly take back the

You don't know if you've l- if you've lost numbers?

Well, generally speaking, VA uh has reduced the number of employees, but what I would also say is that we are also currently hiring right now.

Mm-hmm.

So there there are open there there's open hiring activity happening across VA right now.

Understood. I I'd share Congresswoman Buszynski's concern that she raised at the outset of this hearing. We are losing experienced federal employees who have been career civil servants who have done this hard work, uh work that cannot be outsourced entirely to technology, we're losing that experience in the workforce, and it's leading us to have less accurate adjudication of claims. Um, so I wou- I w- we will look forward to receiving from you the numbers so that we have a clearer picture about what's happened to this absolutely critical portion of the VA workforce. Sound good?

Yes, Congresswoman, we'll take that back.

Okay. Thank you. I yield back.

Thank you. Uh, Miss Gelander yields back, and you'll be excited to know that we, I think in virtually every committee hearing we've had someone from GAO present at our uh at our hearings, so we we do take that seriously. Uh, we're gonna do a three minute um second round for for this panel. Uh, I'll recognize myself for three minutes. Um, Doctor Thomas, just to um kinda continue on some of the discussion you were having, um, obviously you've got a a level of expertise in this and one of the, one of the things that we're wrestling with is overlaying a very advanced technology, auto- you know, automation and artificial intelligence that is still kind of on the the leading edge of what it could become. It's not really fully refined yet. and yet it's being laid on top of legacy systems that are kind of based on on a paper intake type of uh system. Um, it says in my notes here, rapid automation models over rigid legacy databases. So maybe that explains it more in scientific terms. Why is it critical to establish an independent testing and performance management framework in that environment?

Well, just as you, I mean, thank you. That's a um great question. and it's something that is happening across a lot of agencies, but specifically within VA, you know, the challenge is just as you described, you're putting this advanced piece of technology, it's looking at all of that information that's paper-based, OCR to some level of quality, uh, OCR means it's pulled the actual text off the page,

That's where you're looking at the photo of the word and

maybe Yeah.

you're pulling that as like an image of the words on the page.

Yeah. Exactly. To try to get that understanding, cuz the large language models is one example of of AI is looking for that language, that's what it needs to make the determination of what is actually said in that document. If you don't have that high quality data, it's gonna be broken from the beginning. It's the same garbage in, garbage out you've heard from other types of automation tools. So it's critically important that you have a testing and tr- and and really piloting program, where you can first of all validate that the tool does what the vendor or developer says it actually does. it produces a result that you can rely on depend on, and actually makes the uh the adjudicator's job easier. That's the challenge of some of these tools is if they have to spend a lot of time actually correcting the mistakes of the AIs it actually making their job any better. And that's what you'd find out from a well-designed study.

Sure. Okay. Uh, thank you, Mister Riffisi, I got a couple of quick uh questions for you before I have to yield back. Uh, number one is the electronic health record upgrade at the VA going to allow that import of information more directly from the Department of War over to the VA automatically? Will that help with this claims process? And then I know you were serving as co-chair of the team that wrote the blueprint for this five-year IT um modernization. Was there any um anything put in there around the ingestion of records and materials? Um, I'm hearing that that may have been absent and that's something that I think speaks to some of the issues we're having with getting these records set in such a way that would um expedite that process. Thank you.

Yes. So thank you for those questions. In terms of the the HR uh rollout, we are looking at APIs between the benefit systems and the HRM Oracle rollout, and so that will uh do to uh facilitate that data exchange and make it easier than it currently is to to pull some of that data. We also have a lot of work that's ongoing with DOW that is automating a lot of the record pools with STR and other files so that is also advancing uh in terms of your other question if you're talking about the the the bill of goods for kind of the case the documents behind the case that is part of the the planned data was one of the uh pillars of the seven one B M modernization plan we have progressed with uh getting a lot of the data that was needed from DOW to make the toxic exposure determinations that was previously absent from the records that we were getting from them. And so a lot of our progress in that space has been focused and centered around the data that was needed to make those decisions around toxic exposure.

Okay. Thank you. Look forward to uh following up on on that. I appreciate it. Um, Ranking Member Buszynski, recognize for three minutes.

Thank you, Mr. Chairman. Um, Mr. Orofisi, um, can I ask you a follow-up question? You had mentioned that um employees, it takes about an average of

Uh thank you for that question. And so there's a process for being able to escalate these tickets when they Mm-hmm. Mm-hmm.

I would say, and thank you for the question. And thank you for the question. I would just say generally the process would be the same. I would just say generally the process would be the same. We have several different types of feedback mechanisms We have several different types of feedback mechanisms to capture to capture when employees run into issues. when employees run into issues that would be a situation where That would be a situation where that employee would escalate that employee would escalate and then they would be able to through the different channels at the regional office that they've run into an issue, and then we could take appropriate action based on the details of the claim.

Yeah, I guess the the concern I would just voice is that it's very dependent on the leadership that they're escalating it to while there's an eight day um you know, uh system issue that needs to be addressed, so it's just something that it'd be great to work on closing that eight day window. Um, Mister Herbert, my next um question actually just for you is earlier you mentioned the VA plans to always have a person making

Thank you for the question. My my focus specifically is disability compensation. So uh if I wasn't clear previously, to be clear now, it is uh for disability compensation claims, automation would not be making decisions.

Okay.

I'll yield back.

Thank you. Uh, ranking member Brzezinski yields. Mister Littrell.

Thank you, Mister Chairman. Is it the older generation veterans, their kind of that, is that the Are we having more success inside the VA with benefits with the the younger generation, my generation and forward, and the older generation's having the problems, or is it still a challenge for up until today?

Uh thank you for that question. Uh I will defer to Mister Herbert uh for that information.

Yes sir, thank you, thank you for the the question. I I'm not sure that there is a general demographic pattern. I think really the the one thing that is true that affects a claim regardless of demographics is, are all of the different record sets available as rapidly as possible to process the claim? So whether you are a w as an well as an example,

What does that mean?

if you were a post-World War Two Korea veteran, and your file, your military personnel file was destroyed in the f- the fire at the National Archives in nineteen seventy three, there would be a supply chain dependency on acquiring the record.

But those are very small numbers.

Well, well it is now, but

They were up for our remaining kind of our, I like to say, my four fi- our forefathers and mothers, but c- up until now.

That that's absolutely true. Another example might be private medical records. So, depending on the provider, We we oftentimes have different levels of res-

Is the private medical record the one that's slowing the process down more than the this active duty service record?

I think it's a combination. So where we're at with service records, we recently just piloted with IT the ability to connect to the uh Department of War system of record to automatically pull military personnel files. We automatically trigger service treatment record requests also from the Department of War. We receive about two thirds of SDRs within one day. So there are still there's still a lot to do on the Department of War uh side. However, we are seeing pretty significant progress. I would say that private medical records, we receive about eight thousand of those requests a day. So there is absolutely a dependency on the faster that we can get those private medical records, the faster we can move the claim out of the evidence gathering cycle, and get that in front of a claims processor to make a decision.

Those aren't just community care providers, that's just a medical record period across whomever they may be seeing?

That's correct, sir.

Which means they need to hand walk that from their provider over to the VA?

Well, ideally we're ideally we're not hand walking, we we we really don't want to put it that administrative work.

You'd be interested what I hear in my district, sir, but I I'll agree with you, go ahead.

Y- yes, sir, uh uh really where we need to get to and where automation holds promise is as that request comes in and as the veteran authorizes us to go out and get those records for him or her, we are able to automatically trigger that initial response. The challenge comes into play where private providers, there's a variable amount of time that some providers respond very well, some providers don't. And so we cannot advance the claim unless we've done our due diligence to acquire those records.

And you have the records. Alright. Thank you, Mr. Chairman.

Thank you, Mr. Latrelle, I'm a Skidelander for three minutes.

Thank you, Mister Herbert, I just wanted to come back to the choke points and the delays that you're seeing. Can you walk us through the most common paperwork gaps or the most the most common uh delays that you're y- you're seeing in the system when it comes to, cuz it you've just helped me understand your argument about automation and the role it can really play. Have you chronicled these anywhere? Where where are the main choke points?

Thank you, Congresswoman. Y- uh yes, I'm not sure that it is uh chronicle but the but the the da- the data absolutely suggest and identify that. Eighty percent of our claims right now are in the evidence gathering phase, so we have about six hundred thousand claims that are pending. Eighty percent of those are in evidence gathering. That evidence consists of a variety of different records. That could be military records from the National Archives, it could be military records from Department of War,

Mm-hmm.

depending on period of service, it's private medical records, it's any number of those

So twenty percent of your pending claims are currently before examiners who are adjudicating.

They are either in pr- uh pre-evidence gathering, so the initial development, so we'll receive twenty thousand pieces of mail today, that would be before evidence gathering, ten thousand of that would be claims.

Mm-hmm.

That's before evidence gathering, and then you have eighty percent in evidence, and then you have the remainder that would be at some stage uh leading up to adjudication and award.

A- and of the six hundred pending claims, do you have a count on how how many of these are moving through a process that's almost entirely digital? What percentage of the claims have some um physical hard copy element to them.

I don't know that number off-hand, but we absolutely can identify the number of claims we're receiving, whether it's through VA dot gov or through Quick Submit or um or the the files, or the, excuse me, the claims that come in through paper. I don't have that in front of me, but I can certainly get that for you.

Well, we'd love to work with you on this. Um Congressman Luttrell and I both serve on the Armed Services Committee, so anything that we can do to help cut the red tape and make this a more workable system. We wanna work with you to do that.

I'd welcome the opportunity to uh to work closely.

Thank you. Yield back.

Thank you. Um representative of business, you're uh goodlander yields um so thank you for our panelists on uh panel one, appreciate you participating, look forward to hearing back on the outstanding uh remaining questions that are out there and I'd like to um bring up our second panel um For uh For the second half, thank you.

The opening actually.

Here we go.

Can you submit that now?

We're not gonna put them like that. Sorry. No that's okay, we're uh right here. We're gonna put them like this. Just put them right there. Quick shift change.

Yeah, yeah.

All right. Thank you um thank you for our folks on our uh second panel and thank you for members who are able to um participate in the second panel. Um uh introducing members on our second panel today we have Mr. Caleb Max, President and CEO of the National Artificial Intelligence Association. Mr. Jeremy. Yenneway, did I say it? Did I get it?

It's uh Via Nova, sir.

Say it again.

Via Nova.

Via Nova.

Yep.

Okay, Via Nova. Uh, Associate Legislative Director for uh Paralyzed Veterans of America. And finally, we have Mister Greg Ordo, Deputy Director for National Veteran Services for Veterans of Foreign Wars. Uh, so as the witnesses please stand and raise your right hands. Do solemnly swear under penalty of perjury that the testimony you are about to provide is the truth the whole truth and nothing but the truth. Thank you and let the recorder reflect of the witnesses of answering the affirmative. And thank you all again for attending today. Mister Max, you're now recognized for five minutes to deliver your opening statement on behalf of NAIA.

Good afternoon. Chairman Barrett, Representative Basinski, and distinguished members of the subcommittee. Thank you for this opportunity to testify today. My name is Caleb Max and I am President and CEO of the National NAIA, the premier association representing hundreds of companies dedicated to driving responsible AI innovation and adoption across industries, including the federal government. Before the invention of the automated teller machine, or ATM, every bank customer had to wait in line for a human teller regardless of how simple their transaction was. A customer depositing twenty dollars waited behind customers with much more complex transactions that took far longer to come to process. ATMs changed that. Simple rules-based transactions were automated. Tellers are free to handle what actually required human judgment. And I don't think anyone would argue that ATMs replaced tellers in a meaningful or harmful way. They made the whole system faster, more accurate, and more accessible. The approach that makes this work is called neurosymbolic AI, a combination of rules-based logic that the federal government has used since the nineteen seventies and modern AI capable of reading, interpreting, and routing complex information. If an automated system cannot approve of claim uh based on available evidence, if it can approve a claim based on available evidence, it does. If it cannot, it flags the the claim for human review with the evidence already organized and the relevant gaps identified, the human always maintains the loop. The human always has the final word. This is the model that the VA needs, not AI replacing people, but AI handling what does not require human touch so the VA employees can do do, what they do best, which is supporting our American heroes. I want to address a concern directly that I know is in this room, and has been mentioned already, that AI will replace the humans that approve veteran claims. It will not, and it should not. Augmentation of work with technology is not a threat to the workforce, it is a force multiplier for it. And for veterans waiting months for a decision that determines their access to care and compensation that difference is everything, which is why statute matters. Today, AI governance, a veteran of fair benefits, at the VA moves lives mostly in contract language. That approach has three flaws. First, safeguards vary from contract to contract. Second, they expire when the contract does. And thirdly, Congress has no systemic visibility into whether the AI governance and standards are working. OMB guidance sets a baseline, but memoranda can be rev revised or withdrawn. Congress should elevate these safeguards into permanent department-wide law applied to every AI system that touches a veteran claim. From the standpoint of the AI industry, clear statutory requirements are not a burden. They are a road map. When companies know the rules on development, deployment, transparency, benchmarking, traceability, as defined by the customer, in this case the VA and the VBMS, they build to that standard and deliver measurably better results. Without defined standards, every vendor interprets the requirements differently and bias creeps in whether intentional or not. So at a minimum, every AI c- claims related AI system should be benchmarked on accuracy against claims with known outcomes, failure rates with automatic escalation to human review, biased veteran biased across veteran populations and workflow traceability of every AI generated summary to its source source documents. Before I close, I will mention that the Albany VA Medical Center is actively s- exploring a pilot concept of a solution which coordinates a veteran's healthcare journey from prior authorizations, scheduling, medical records exchange, medical claims, and provider payments. Their pilot concept offers lessons directly applicable to improving VBMS. The Albany VA Medical Center solution includes neural symbolic AI component, which processes prior authorizations. I bring this up because there is a structural problem that no amount of good tech solutions can overcome on its own. And I would be doing this subcommittee a disservice if I'd not name it plainly. New AI tools often die on the table of implementation because of perceived risk of the implementation often outweigh the benefits for contracting and program offices. Congress has the authority to change those incentives through procurement reform budget flexibility for proven AI transitions, and safe harbor provisions for good faith AI pilots, just like the one in Albany. In closing, Julius Caesar once observed that experience is the teacher of all things. The more VA employees and veterans interact with well-designed AI tools, the more trust is built. The goal is not to mandate adoption, is to create enough successful experiences with artificial intelligence that resistance becomes the exception rather than the rule. Veterans have earned the right to a benefit system that operates at the speed and accuracy that modern technology makes possible. NAIA and its member companies stand ready to partner with the Veteran Affairs Committee and the Veteran Affairs Agency on an if AI strategy with clear milestones accountability measures, and a road map that treats AI not as an experiment, but as the operational background of a modern benefit system. So thank you and I look forward to your questions.

Ended it on the dot. Thank you. Appreciate your testimony. Mister Villanueva, uh, you're recognized for five minutes, uh, for your opening remark. Oh, and uh, Mister Max's uh opening statement will be entered into the record as well. Thank you.

Chairman Barrett, Ranking Member Buszynski, and members of the subcommittee. I appreciate the opportunity to appear before you today on behalf paralyzed veterans of America to discuss VA's ongoing efforts to modernize their benefits IT systems post-Pact Act. Throughout the country, PVA employs seventy-four National Service Officers, or NSOs, and seventy-three offices who work tirelessly to help secure benefits to our nation's veterans free of charge. Due to the complex nature of our members' conditions, our NSOs are some of the nation's experts in VA benefits, especially when it comes to special monthly compensation and other ancillary benefits. Using VA systems, NSOs can submit claims on behalf of the veteran, input evidence, track the claims process, review files, track VA payments, and other tasks. This is a capability that non-accredited agents do not have. Chief amongst these systems is the Veterans Benefits Management System, or VBMS. While NSOs have mostly read-only access to this system, it has significantly improved how a veteran's claim is handled and how questions can be answered. However, some of the modernization and consolidation efforts have not led to the drastic improvements promised and, it can be argued, some changes have set the claims process back. While I could list several function that veteran service organizations have repeatedly asked to be improved, for the sake of brevity, I'll mention a couple. First, PVA recommends that VA create a process to quickly and easily remove dependents from a veteran's claim after death or a divorce. While significant improvements have been made to add dependents onto a veteran's ward it isn't still an overly lengthy and burdensome process to remove a dependent and will almost always create an overpayment that the veteran will have to pay back. This is no way to treat a grieving veteran or survivor. In the same vein, we ask that a new process be added to stop payments to veterans who choose to go back onto active duty. Again, This current process is not automated, and there is no specific form for them to fill out. It often leads to the creation of a debt to the veteran, and any veteran who has chosen to return to duty to serve our country deserves better. But our principal focus today is to draw Congress's attention to how VA is using automation in the claims process. While PVA supports using new technologies to enhance the capabilities of VA and improve the experience of veterans, we are wary of the overuse of automation and the problems that it can create. When VA started automation efforts on DAC claims in May of twenty twenty, they made assurances that it would not automate the decision-making process, and that end-to-end automation was not going to take place. However, a VA OIG report from April twenty twenty six revealed that not only has there been end-to-end automation, but that the quality review for these claims was less rigorous than the steps traditionally processed claims undergo. The same VA OIG reported report noted that out of eight thousand one hundred automated decisions at least eight thousand or to put it another way, nearly ninety-nine percent of them contained deficiencies, either legal or procedural. Making the problem even more egregious. The two percent granted the benefit erroneously. And these were for survivor benefits. Now, a service officer will have to field calls from surviving family members to explain to them why they are now losing this benefit and may possibly be in debt. This is unacceptable. Entitled or not, a veteran's grieving loved ones deserve so much better. In conclusion, Mister Chairman, while PVA is supportive of efforts to use new technology as a tool to help smooth out the claims process, It should be remembered that AI and automation are just that, tools. And while a chainsaw is more effective than an axe, if not used properly, it can also be more destructive. Thank you, once again, for the opportunity to present our views on VA's disability claims process. We look forward to continuing our work with you to ensure that VA systems help and not hinder a veteran's path to their earned benefits. And I would be happy to answer any questions you may have.

Thank you, Mister Villanueva, and uh your written statement will be entered into the record. And I look forward to working with you as we sculpt policy to achieve what you're talking about. I know uh my office is working on drafting policy now and we'd be happy to engage other members of the committee on that as well. Uh, Mister Orto, you are now recognized for five minutes over your opening statement on behalf of VFW.

Thank you, sir. Uh, Chairman Barrett, Ranking Member Budzinski, and distinguished members of the subcommittee, On behalf of the veterans of foreign wars of the United States, thank you for the opportunity to testify today regarding the modernization of the Department of Veterans Affairs. The VFW recognizes that VA has made meaningful progress over the past decade in reducing backlogs and transitioning from paper-based systems to digital processing. However, modernization must go beyond simply converting paper records into electronic files. service members, veterans, their families, and their accredited representatives still face significant challenges caused by the fragmented systems that do not fully communicate with one another. While the Veterans Benefits Management System, or VBMS, was a major advancement when first implemented, it currently operates more as a depos uh a depository or r- repository than a truly integrated case management system. The system is sixteen years old, and it's time to take a serious look at VBMS for an overhaul. VA employees who navigate VBMS on a daily basis somehow make it work for them and the veterans that they serve. However, both accredited representatives and VA employees often are forced to navigate multiple disconnected platforms for all claims, including appeals, caregiver support claims, and claims in general. This fragmentation creates unnecessary delays, duplicate work, inconsistent visibility into c- into claims activity, and increased risk for avoidable errors and missed evidence. It is an ecosystem of disconnected programs that cause frustration for both veterans and those working in that system. It works, but so did my Chevy Vega back in the day. It got me from work to home. It was smoking. The radio cut in and out. and I hope the engine didn't blow every time I turned it on. The VFW does believe that service members and veterans deserve a modernized system that provides real-time visibility, integrated communications tools, and seamless coordination across all VA benefit lines and the appeals processes. Modernization should improve transparency and usability, not only for VA employees but also for veterans, and their advocates who use that system every day. The VFW also recognizes the growing role that automation and artificial intelligence may play in improving administrative efficiency and reducing repetitive workload issues. However, we strongly emphasize that automation and AI must remain a tool that assists VA employees, not replace them. Veterans' claims involve complex medical evidence. legal standards, and deeply personal circumstances that require human judgment and compassion. For that reason, all AI-assisted products should be reviewed by a qualified VA employee before any decision is made. Additionally, robust quality assurance and continuous oversight are essential to ensure these systems remain accurate and compliant with laws and policies that apply. Without proper safeguards, automated efforts could spread rapidly across thousands of claims and erode veterans' trust in the system. As Congress and VA continue to modernize efforts under the PACT Act and related initiatives, the VFW urges policymakers to remain focused not only on speed and efficiency, but also on integration, transparency, workforce support, and the overall veteran experience. Veterans deserve systems that are reliable and accurate. Chairman Barrett, Ranking Member Budzinski, this concludes my remarks and I am prepared to answer any questions you or the members of the subcommittee have. Thank you.

Thank you, Mister Rorto, and uh your testimony will be entered into the hearing record. Uh, we're now gonna move on to questions and I'll recognize myself for five minutes. Uh, Mister uh Vino Eva, your testimony um really emphasized the really uh significant hurdles that veterans encounter while navigating the VA claims process. And I know uh your organization spends a great deal of time helping veterans to navigate that uh we know that the Social Security Administration leverages a qualified health information network to automatically put millions of medical records in real time uh to pull them in in real time and fast track them for consideration for uh social security determinations. and the VA is already the single most active participant in that network today. If the VBA were to adopt this identical proven automated model to eliminate the manual record uh collection process, how much would this lighten the veterans' burden to get their claims approved in your estimation, would you say?

Uh, thank you, Mr. Chairman. That is a great question. Um, you know, I know that for many NSOs when they're you know, explaining this to the veterans and and having them try to bring in outside medical records in it is a hindrance not just for um getting the claim done, but psychologically to the veteran, right, who has to now try to think like is there some medical records that I forgot, how many offices, how many different doctors, how many different hospitals have I had to go through, you know, and now that we're going into, you know, uh we're now in twenty twenty six, where almost all medical offices are out there using some forms of electric uh electronic medical records to be able to use that and tap into that would be uh a

uh-huh

great significance um not just for like the VSOs but for the veterans themselves

sure um would you say that's the single biggest um barrier for claims is the accumulation of the records at this point in the organizing of those

it could be it could be um You know, I don't think that there's any single, you know, um portion of the process to to point out, but I would say this. Uh, like I said, when it comes to the the psyche of the veteran, having them, you know, go from the NSO, go back to get those medical records, and then actually come back, that is probably one of the hardest things for an NSO to control, because it is completely out of their realm. Once a veteran goes home and they have a hurdle or they hit something, and already in the back of their mind,

Mm.

they're kind of second guessing whether or not they should be putting in this game.

Yeah.

and they don't wanna go through the hurdles especially for the first time uh VA uh you know applicants you have to understand like getting them back into the office to finalize that claim and by automating that I'm I think it would be a a world uh of to help them to come back in to finish that claim and to put in there for their benefits.

Okay, thank you, and for you or Mister Orto uh just um asking your opinion on this, how much of the accumulation of records is from the Department of War versus outside civilian doctors that may have been an intervening you know practitioner from the time you left the military till when you filed your claim um which is the bigger issue that you encounter?

Thank you. Uh yes so the uh the the accumulating the private medical records is a significant challenge for veterans, especially those who are rural veterans who are trying to now establish a claim and uh as my colleague said um then trying to get them back into the to see the nso is an issue so getting those private medical records uh department of the war seems to be doing pretty good for the benefit delivered discharge as far as pushing those records in

uh ok so it's more on the fragmented nature and and to your point i think mister villanueva about every medical practice nowadays has an electronic health record system but they're all very different and they don't all speak to each other and they don't all consolidate well together uh mister max do you think there is an opening there to have an automation or ai model that could kinda synthesize these things in a way that would make them readable um for that accumulation of of records in a way that is then digestible for for processing

i would think so i mean i will say whenever it comes to health records and we deal with this a lot outside of you know better affairs cross-AI is HIPAA laws and healthcare records.

Mm-hmm.

Um, the data, the heartbeat of AI is is the data, and a lot of our companies, because of so much uh regulation in that in that area, for good reason for the most part, um, makes that sort of talking to each other of the system is very complicated, um, and a lot of approvals necessary.

Even though the veteran would be obviously giving consent for their medical record to be, you know, transmitted this way.

Yeah, it would go to like wh- who's the, you know, wha- what system is gonna go into that database and actually extract it? Is that tied to a veteran? Do they have an account there? Do they have permissions? Have we identified that individual?

Okay.

Um, it gets a little tough on the back-end. It is possible. It's certainly the tools exist, but HIPAA laws and others do make it a little tough.

Okay. Thank you. Uh, ranking member Basinski.

Thank you, Mr. Chairman. Um, Mr. Orto, um, thank you for joining us here today, um, and thank you for continuing to stand against any cuts to veteran benefits. Um your testimony discusses the initial excitement around VBMS and having an all-encompassing system but as we're learning that in reality isn't really what it's turned out exactly to be um I am curious how often are you navigating outside of VBMS to get pertinent information for a claim and then my second question for you would be in addition to that what are what systems would you appreciate seeing incorporated into the platform?

Thank you, that's excellent. I really do appreciate that because um we are seeing where we're having to navigate out of the VBMS system in order to gather evidence or to find out what's going on with the claim um one of we were talking about Quick Submit just a little while ago and Quick Submit is one venue that veterans have to uh submit the claim well sometimes it gets hung up there and so we're looking for the claim the veteran told us they submitted a claim or we submitted the claim through uh quick submit. And then we're not seeing it go all the way through. Well, the help desk there uh says that uh okay well at one point they can no longer help us talk to your regional office the VA regional office the re VA regional office doesn't have that information so we're having to go back into quick submit to try to find uh do some forensic evidence finding. to find out what's going on with the claim. So that's one part. The other one is appeals. So if you wanna do if you wanna look at a board of veterans' appeals, it's not in VBMS. You have to go into the remnants of vehicles or um case flow in order to get into and see what's going on into the uh claim system. What about the uh the program of conferences of assistance for family caregivers? Um the the caregiver program, if they wanna do an appeal There's nothing in VBMS for that. So these are folks who have now been denied the caregiver program.

Mm-hmm.

So we're doing the forensics, okay, can you give me some information about that? Maybe we can go into the VA's CAPRI system to try to find, uh, and that's case by case, to try to find information so that we can build an appeal or see if that's, uh, viable to do. So we are going out of the VBMS system to gather this information.

Would you have any advice for us on, you know, how you think we could make it better, though?

No. Yes, thank you. I I do. I think that, um, there needs to be a a conductor of the orchestra. So there's all of these systems that we have, um, and they're taking it peace and what we're seeing is they're taking it piecemeal. We think that, kind of like EHRM, somebody needs to lead the way and oversee the operation in order to integrate it correctively uh correctly um so that we can now see uh like corporate DB is a system that's outside of BBMS but corporate DB is something that um causes changes to a person's um last name so we'll get I'll do a BDD claim,

Mm-hmm.

benefit deliverance discharge claim, for somebody put it in as their name and then corporate DB VA system somehow changes it because it's a different name that they have. Well, this person's been using that same name for thirty years. Why now in the VA system is it being changed?

Mm-hmm.

And then trying to get that changed is an issue.

Yeah.

Um, and then once it does get cha- I had just recently, I had a a female get it changed. We were able to do it. And then when the decision was made, the the name was changed again for them.

Mm-hmm. Okay.

It causes a lot of frustration, especially from females.

Yeah.

who are coming from um domestic abuse situations.

Sure, I can imagine. I've got one more minute, I'm gonna try to sneak in another question, I do wanna say it's so wonderful to have our VSOs here, uh Mister Ordo and Mister Villanueva, that you're both here, appreciate that, I think you add a unique perspective as we spend so much time talking about these IT programs, but to to hear from you on how veterans interface with it is really helpful. Um Mister Ordo and Mister Villanueva, VA's Office of Inspector General recently released a

Uh, thank you, Rad- Madam, uh, ranking member. That's that's a great question. I think one way to to conceptualize this and how some of our members or just veterans just in general would look at at uh uh slip ups like that um when it comes to you know people's personal information is that the average veteran that is out there doesn't really look at it as a VHA slash VBA they just look at VA

Mm.

and when you lose credibility on one part you're gonna get it and it's gonna affect the other right so any of these you know losses of trust from the VA has a ripple effect that goes throughout all of our members, whether or not there it's has m- keeping them from going to seek help or whether or not it's them just not wanting to seek their benefits because they lost that trust.

Thank you. I'm out of time. I'll I'll yield back.

Thank you and and totally agree with you. If a veteran has a um violation of trust in one part of the VA, they're gonna blame the entire uh agency of course, and and I think that's natural to expect that they would. Um, Miss Goodliner for five minutes.

Thank you, thank you all for being here today, and for your really helpful testimony. Mister Orito, I wanna start with you, and this has come up in the conversation, but one of the things that surprises me the most about the Veterans Benefit Management System, it's really one of the great misnomers in government, cuz you really would think that this was a user-centered portal where you could go and manage benefits, but talk to me a little bit about how in the course since two thousand nine this system has developed up um not around a user cent not around a veteran-centric model um tell us about how that has impacted the work of your important organization.

Or well it's it's become so it's not a five five alarm fire for us, but it is something that is a constant issue for us to work within what is supposed to be the veterans benefit management system. So you're supposed to see everything, or supposedly. And we're working outside of those systems. So it's a sense, it's a source of frustration for us and the veterans,

Mm-hmm.

because the veterans then, they see the remnants of what is in VBMS through VA dot gov, which is poorly laid out in itself. Uh, so the frustration that the veterans have because they don't know what evidence is going into VBMS, or what evidence may not be in VVMS, uh it is a source of frustration for us.

So when you say that you mean you don't even know what VA you don't have a veteran through one of your VSOs does not have visibility into what actually has been inputted into the system on their behalf.

Yes, so uh the vet- talking about the veterans themselves, and they're the ones that uh uh ask us, so what evident what medical evidence are they seeing in there? Is there something additional? like when the Department of War sends fragmented files over to them, well, the veteran doesn't see any of that information, so they don't know what's going on with that. So all they're they have VA dot gov.

Mm-hmm.

VA dot gov is disjointed as it is. Um, they so there are things that they can't see, so they ask us so that we can look into it for us. Exams, something as important as exams. They don't know what exams are going to be had until um, an examiner uh sends them a letter or calls them on the phone and says, we need to schedule you for exams, but they don't know if that's complete once they do those three or four exams. So is that done?

You're shootin' blind throughout the entire process,

Yeah, exactly. That's right. Yes, correct.

which is totally preventable and should not be happening to our veterans.

Correct.

Um, Mister Villanueva, thank you for your testimony and thank you in particular for highlighting this April twenty twenty six Office of the Inspector General report. It's extremely concerning. To your, to the point uh about the conversation earlier on automation, it really does, this raises questions about how many end-to-end automated systems exist within VA right now, um, and whether, when a claim is being adjudicated, a veteran knows or a family member knows, um, that this automation was used in the adjudication process. So is it your view that Congress should require by statute, um, we need more visibility into how automation is being used end-to-end and when it's impacting what is your recommendation to us to get better visibility?

Well that that is a great uh question, ma'am. And there's there's a few ways of course, oversight, oversight, oversight. I'll I I think automated claims, especially at the very beginning of this, have to have more oversight than just the regular claims process. Um because of just just what we you know highlighted in our in our written testimony, we do think that there are ways to use AI and automation um I've as a matter of fact there's a couple ways that we've been you know batting around about uh working on the remans churn and how AI and automation might might actually be able to help that, but you know in in these cases where you're actually talking about like the decision-making process. Um, yeah, no, like, we do not believe that automation, you know, or AI functions should even be giving recommendations on what, uh, an RVSR or VSR, you know, some of the the people who are doing these claims because as we talked about, or you guys talked about earlier on in this hearing, um, with a lot of the, you know, loss of experienced workers, you have unexperienced people taking that and they will use the recommendation given to them by the automation and take that as that's what I'm supposed to be doing instead of using you know their experience to say like,

Mm-hmm.

no this is this was actually wrong and then garbage in, garbage out. And when you have garbage claims coming out,

Yep.

that's gonna cost the government a lot of taxpayer funds.

Well thank you, I yield back.

Thank you um, it's good later, yields back. Um, thank you to our uh second panel. Appreciate you participating today and we look forward to following up with you as well as we work toward you know improving these outcomes for veterans. Uh, we're now gonna move on to uh closing statements and want to yield to uh ranking member Basinski for her close.

Thank you, Mister Chairman, um I appreciate today's hearing to discuss VBMS's modernization and how we can support veterans getting timely accurate and complete benefits. I wholeheartedly believe that VA's employees must be better engaged in assessments workflows, policies and the tools that that are there to support them. Unfortunately, I do not see this being the case in this current program, but I hope to see VA's continue VA continue to course correct here. Um, I believe we must acknowledge the immense efforts undertaken by by VBA employees, especially as the department has already lost over twenty-seven hundred claims examiners since January of twenty twenty five. As Secretary Collins, um, under for um, excuse me, former Under Secretary for Health recently noted, VA's employees are one of its most precious resources. They deserve a commitment of support from the secretary and this body for the work they perform day in and day out. Thank you and I yield back.

Thank you, Ranking Member Businski, and I want to thank um all of our uh witnesses for appearing today and thank you all of everyone who uh joined us. For this hearing and thank you to members who were participating today as well, I really appreciate that. I think we learned a a few things in uh testimony today, one resounding that was clear is that technology is quickly evolving and it's vital that VA joins the twenty-first century. Uh my wife used to work for the uh state of Michigan uh and worked in one of these kind of complicated systems that was updated and patched together and she said one of the benefits of like one of the ways that you would become a high performing employee is if you could figure out the work arounds to the system because it wasn't flowing in the way that it was supposed to so they would often share comparison comparisons of how you got the system to do what you needed it to do by working around the process that was embedded within it and we hear about that within the VA with systems like VBMS that are compartmentalized in different ways are kind of based off the paperwork process and are not driven by the technological capability that we have today. And as we look forward into the future of what we need to do, that's what I think we need to bear in mind, is how is the end user gonna use this? How is the veteran gonna benefit from it? Uh, too often in government we look at what we are doing in the form of outputs, not outcomes. And I think we need to shift our focus away from strict output-based metrics, how many did we process, what was this, you know, system done, and things like that. What is the outcome? And to the point I made in my opening remarks, the outcomes are the veterans that we are seeking to serve through the department. So instead of looking at metrics driven driven by this piece of that process and and the outputs, what are the outcomes? How many lives were changed? How many veterans received benefits that they hadn't had before? how many are receiving health care that they didn't have before, how many are having their lives improved by the benefits that they've earned that we've committed to them as a solemn process from our country in recognition of the service that they've done so um obviously we've got a lot of work ahead of us. Uh, AI comes with a lot of overtones and connotations associated with it that comes with some skepticism that we need to work our way through to make sure that it is done in a ethical and appropriate way to protect veterans both on the uh privacy of their health records but also on the certainty of their claim that it's done in the appropriate way. So I appreciate each of you for being here today to help us work through that. Um, section seven O one B of the PACT Act set the stage for incorporating new technology, and we need to make sure that we are holding to that. We're coming to an end of this modernization plan that was set in place by the passage of the PACT Act. It only goes through next fiscal year, and it's up to us to ensure that the future VBA IT evolves at the speed of technology while protecting the interests of veterans. Um, so that's our job on this committee is to make sure that the ever-evolving landscape and to sure ensure that VA is executing accordingly. Uh, look forward to working with each of our stakeholders and each of our committee members to make sure that we get that right. So, thank you so much for being here today. And with that, we're adjourned.