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#VAFail: VA claims staff quitting in droves. what does that mean for health care?

Stethoscope and Medical Files Close up with VA Fail Text

By Concerned Veterans for America

We talk a lot about the Department of Veterans Affairs failing veterans on the health care side of VA, but there are also failures on the benefits side. 

The VA was already overwhelmed with a backlog of disability benefits claims before last year when the PACT Act, extending new presumptive benefits to millions of veterans struggling with toxic exposure-linked illnesses, was signed into law. This issue was made worse in part because the VA chose to begin processing all new PACT claims from the beginning of 2023 instead of phasing in the new disability presumption guidelines over three years.  

Those veterans need access to benefits and care, but the VA is struggling to keep up and deliver. 


VA staff disincentivized from doing good work 

The VA has a quota set up for disability claims processors to ensure they are getting through the backlog of claims in their queues. Processors earn “points” for completed tasks such as going through service records, gathering paperwork, verifying information, etc. They’re required to earn a certain number of points per pay period, and when they don’t meet those numbers, supervisors will evaluate the processors’ performance. 

Quotas aren’t bad in and of themselves. Obviously, the VA needs metrics that ensure processors are getting through the claims and performing their jobs well. 

But in this case, the quotas are causing processors to do their jobs poorly, rushing through claims evaluations lest they don’t meet their points threshold. 

“If I review all this, then I won’t make my points, and I will be terminated,” a former VA claims processor recently told NBC News. She explained that it was “easier and quicker to look for the first thing that would discredit a claim and close it out, rather than find ways to approve it.”

In other words, VA performance incentives have rewarded surface-level processing of claims, rather than accurately evaluating them. 

As a result, many veterans are unnecessarily sent to the back of the claims line because processors aren’t rewarded for evaluating discrepancies further that they may not be disqualifying for an application on closer inspection. 

Claims backlogs were already an issue before the PACT Act, but its expedited rollout is making these existing problems worse. 


More claims than the VA can handle 

According to NBC News, since the PACT Act was signed into law in 2022, more than 900,000 related claims have been filed. That is a 37% increase in compensation claims from the year before.  

But even before that wave of claims, the VA was already drowning. 

As of September 30, 2023, there were 1 million disability compensation and pension claims pending and nearly 300,000 backlogged claims that had been unresolved for more than 125 days.  

VA staff can’t handle what they usually have in the queue, never mind the increases due to PACT Act coverage. And as NBC News notes, eventually the surge in claims will slow down, but the VA expects claims as a whole to increase “as more than 1 million service members are supposed to depart the military by 2024.” 

The ever-growing number of claims is driving claims processors to resign or retire in droves: 

  • 420 in 2020 
  • 500 in 2021 
  • 600 in 2022 
  • 500 in 2023 as of August 31 

And while the VA has launched a hiring spree to meet the demands and replace those leaving, one anonymous current employee called the VA a “turnstile for employees”. They doubled down on the point saying “especially now with this point system…it’s crushing people.” 

Another employee told a story of a new team member that only made it a few hours before cracking. “He went to lunch, and he never came back,” she told NBC News. 

If this is the toll on the claims staff on the benefits side, what will the chaos be like in health care delivery? 


Can VA meet health care demands? 

While compensation benefit demands are going up, health care needs for those suffering the results of toxic exposure will increase too. 

Exposure to Agent Orange, radiation, burn pits, and other toxins leads to all kinds of unique health problems that the VA may not be equipped to fully handle.  

The department already has problems seeing veterans in a timely manner. Adding to their caseload without a way to relieve some of the pressure threatens to make the problems worse if business as usual continues. 

Luckily, the VA has community care to ensure veterans get the care they need; the department just has to use it. 

Veterans left waiting too long or traveling too far to a VA appointment have access to community care through the VA MISSION Act. But since the law’s passage, the VA has stood in the way of veterans getting into community care, choosing to lock veterans into the VA’s own system. 

As the demands continue to rise for care, veterans and the VA would be best served by more options in how veterans receive their care. 

Veterans health should always come first. 


Learn more about how choice would help veterans get the care they need.