Veterans may submit compensation claims to VA for disabilities associated with active service.1 When they disagree with a claim decision, veterans may appeal using VA’s decision review process. On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act of 2017 (also known as the Appeals Modernization Act or AMA).2 The AMA is meant to streamline and improve the processing of VA decisions on veterans’ appeals.3 The AMA became effective on February 19, 2019.4 The AMA required the VA Secretary to submit an initial comprehensive plan to Congress for the processing of appeals decisions on pending legacy claims and implementing a new appeals system that processes requests for higher-level reviews, supplemental claims, or direct appeals to the Board of Veterans’ Appeals (hereafter referred to as the board) in a timely manner.5 The plan was also required to include how the new appeals system would be monitored, identifying tracking goals and metrics. Furthermore, the plan was required to include a description of any necessary modifications to the information technology systems that the Veterans Benefits Administration (VBA) and the board use to carry out the new appeals system. The technology system VA adopted to support the new appeals system is called Caseflow. Caseflow acts as the single system for reviews of decisions, including appeals to the board. Caseflow also receives and processes requests for reviews under the AMA, capturing data on veterans’ appeals and satisfying VA’s reporting and tracking requirements. The VA Office of Inspector General (OIG) conducted this audit to assess the Office of Information and Technology’s (OIT) program management of Caseflow, ensuring functionality is being developed to improve processing and tracking of appeals and meet the AMA’s requirements.
What the Audit Found The OIG found VA’s lack of an enterprise-wide governance structure over Caseflow resulted in inefficiencies in reporting and functionality. The audit team determined that Caseflow’s AMA reporting and general functionality issues affected the system’s efficiency and ability to streamline appeals processing. Additionally, the team found that OIT lacked an overall development roadmap and restricted the board’s direct access to developers. This lack of clear direction made it difficult to implement requirements during development. These problems occurred, in part, because VA did not assemble an enterprise-wide governance structure as planned in its AMA-mandated initial plan to Congress. This governance structure would have provided strategic guidance and steered the operations for all parties involved, including the contractor. Without it, there was a lack of oversight during Caseflow development, and decisions were made without the meaningful input from all stakeholders. Furthermore, many additional functions were not implemented due to lack of funding, which makes governance even more important. Caseflow functionality was also affected by the contractor’s development process. The process involved lengthy timelines—for example, it took 18 months to develop the case distribution function—and did not always include developers in meetings intended to communicate users’ needs. Beyond lengthy development timelines, the board’s innovation strategist explained that some users have given up on changes because when the change was finally released, it was not what the users wanted, or some other functionality was broken because of the change. The contractor’s process of determining how to prioritize functionality concerns was also problematic, as it relied on the volume of help desk tickets to determine priority rather than addressing the underlying issues. The OIG found this process was inefficient and unreliable because, even in instances where many help desk tickets were submitted for one problem, underlying functionality concerns were not always addressed. Finally, the audit team discovered that contractor staffing was inconsistent with the requirements of the Caseflow contract. The team confirmed with the contracting officer’s representative that the contractor has not maintained the number of staff assigned to the system’s development as required by the contract.
As a result of the program management concerns listed above, some VA offices have questioned using Caseflow. For example, the chief for VBA’s Policy, Procedures & Development told the audit team some VBA program offices have decided to stop using Caseflow. Furthermore, according to Veterans Health Administration (VHA) legal administrative specialists, some VHA program offices have decided not to use it at all.
What the OIG Recommended The OIG recommended the assistant secretary for enterprise integration, in conjunction with the assistant secretary for information and technology and chief information officer, evaluate whether VA should establish an enterprise-wide governance structure for Caseflow development consistent with VA’s initial comprehensive plan to Congress.7 The OIG also made two recommendations to the assistant secretary for information and technology and chief information officer to develop a well-defined roadmap for the future development and implementation of Caseflow and enforce contract requirements through improved oversight, ensuring violations are addressed and remediated. VA Management Comments and OIG Response The deputy chief information officer for connectivity and collaboration services (deputy), performing the delegable duties of the assistant secretary for information and technology and chief information officer, concurred with recommendations 1 and 2 and provided action plans for each. The deputy concurred in principle with recommendation 3. Appendix B includes the full text of the deputy’s comments. The OIG will monitor implementation of OIT’s corrective actions and close the recommendations when sufficient evidence demonstrates progress in meeting the intent of the recommendations.
