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VA Operations During COVID-19

VA Operations During COVID-19 With Director of VA Regional Office

Recorded on April 23, 2020

Video Transcript:

Robert Chisholm: Good afternoon, this is Robert Chisholm from Chisholm Chisolm and Kilpatrick, welcome. We’re pleased to present another update on what’s happening at the VA regional offices. With us today is EJ McQuaid from the Providence Regional Office, he’s the director of the Providence Regional Office, as well as the Acting Director of the Hartford Regional Office. Also present is Rachel Thurmond, if I’ve got the name correct, and Rachel is the Service Center Manager here in Providence. Present at CCK is Brad Hennings and Christine Clemens. Without further ado, we have a lot of things to cover today and we wanted to thank you all for being here today. EJ if you could sort of outline in general terms, what’s happening now at the Regional Offices, are they open? How are you all working? If you could update us on that.

EJ McQuaid: Sure. And Robert, thanks for the opportunity and the team of CCK. For folks, what we’re going to do is I was really talk regional office operations. Rachel was going to talk C&P exams, and then Mark was going to talk mail. We’ve chunked it out a little bit, really based on subject matter expertise and of course, a lot of all being in all categories. I’ll start us off and then hand it over to Rachel. Regional offices are still closed for walk-in traffic. When I say closed, they are open for business, want to be very very clear there, every regional office for VBA remains open, but for walk-in traffic, we are not seeing walk-in traffic in our public contact, or in VR&E which is where traditionally we see most of our walk-in traffic. This also includes out based facilities, any facility aboard usually a military installation is where most of our out based facilities are aboard, but that would also include here in Providence we see walk-in traffic at the Medical Center, Providence VA Medical Center, same for the Hartford RO where I’m the Acting Director. They have an office at the West Haven Medical Center, where they see walk-in traffic, and those offices remain closed to the public. There’s multiple other initiatives to fill in those gaps. For VR&E, tele-counseling is fully operational, and I will just share with you, we are seeing outstanding results there. COVID-19 has forced some very positive changes for VBA, as difficult as it’s been for everybody and, of course, my best wishes to everyone’s families that’s listening today, or in the future, but certainly for things like VR&E tele counseling services have proven to be very effective. I did want to share that, but regional offices remain closed for walk-in traffic, but open for business, where we are still providing all the business line functions. In terms of what is scheduled for board hearings at the regional offices, many of these hearings have been postponed. We have not had in either Providence or Hartford many hearings that were scheduled, most that we did have just been postponed, but I know BVA is working diligently for other hearing alternatives whether voice or video to supplement. But I really did not have a comprehensive update regarding board hearings, but for any hearing that we had scheduled that couldn’t be replaced via a teleconference, it has been postponed. I think that is where VBA is working to get those schedules reassessed, and certainly with VSOs and attorneys, as well. Have we seen an increase in terms of claims for benefits? Certainly, business has not slowed. We have not seen a drop-off in claim, and in terms of updates that we’re providing, as folks are essentially having more time on their hands. We are seeing a more increase for benefits entitlements, certainly in VR&E as this has taken a huge toll on the economy and many folks are out of work right now, or have been furloughed, or laid off, or their businesses have just been so drastically impacted. VR&E services we have seen an uptick there in both, Hartford and Providence, in terms of application for VR&E services. Again, a great alternative for qualifying veterans. Loan guarantee, and certainly a GI bill for education-type processing. A lot of activity there, we are not a regional processing center for either education, or loan guarantee, but I can tell you that both have seen for refinancing purposes, as well as for GI Bill and all the impacts on the university are very very busy right now and still processing claims there. I don’t really have great updates on education, there’s so much happening right now regarding what’s going to be happening with fall semesters, and even those graduating college, and what’s going to be happening there. It changes from university to university, and college to college, but a lot of activity there.

On the RO side, I want to say VBA right now, much like all federal agencies, and cabinet-level departments, is starting to have that discussion about what does the way forward look like, how do we start seeing walk-in traffic on veterans that need to come in person while respecting social distancing, and the safety of our workforce, as well as veterans. A lot still to be flushed out, but I would say that conversation is happening. Certainly, for all claims processing actions, we are still in a maximum telework posture, and there’s no set date as to when we would come out of that. What I can share with you, though is that in parts of the country, that are not considered COVID-19 hotspots, I think you can almost consider all the Northeast a COVID-19 hotspot, but for parts of the country that don’t fall into that criteria you may see them start seeing walk-in traffic on the sooner side for public contact or VR&E. But in areas like the Northeast, New Orleans, Detroit, Seattle, I think you’re still looking at several weeks at the earliest, so I did want to share that. We’re still processing claims, we’re still providing all the services, we’re still here, but in terms of seeing veteran traffic in person at the regional offices, I feel like we’re still several weeks away from that, for hotspot-type areas. With that I want to turn over to Rachel for C&P exams and then we can circle back for any questions that folks have about regional office operations.

Rachel Thurmond: I’m going to be looking off to the left here to make sure I cover all of the questions that you guys had submitted. In regards to C&P exams, VHA is currently not doing any C&P exams, and neither are the contractors and a full as telehealth sort of exams, or at least we have not seen any of those as of yet. What we’re trying to do is right off of the evidence of record, and putting a reemphasis back on ACE exams. You’d ask a couple of questions regarding the ACE exams, and there have been some restrictions lifted off of the ACE exams, some minor ones which have all been updated in the manual reference. If you need that manual reference on what qualifies for ACE, and what doesn’t, I can certainly provide that to you guys.

That’s the biggest thing right now, the exams are the biggest impact that we have seen in the claims processing aspect with all of this COVID-19, I know thousands of exams have been impacted. Anything that can be partially rated, based on the evidence of record, or an ACE exam, or getting a medical opinion, we’re rating it partially in order to get as many benefits out that we can. For things that require an in-person examination, those are being flashed within our systems with a special code, and they are just suspending and VBMS and WQ until we are able to get those exams. Those are going to be delayed until we have some solutions regarding either telehealth or ways forward for the in-person exams. I suspect just like with the public contact, we have areas that are more hot spotted than others, where exams may be impacted, I wouldn’t be surprised if there is more of a phased approach on opening up in-person exam options. No veterans are going to be penalized, everything is just hanging out there again with a focus on the evidence of record and ACE. The contractors are able to get DBQ information over the phone, so if they need some information from the veteran, they can do that. That’s kind of been all we’ve seen as far as telehealth, it’s more like this information is incomplete based on what we have, and they’ll call and get some of that information over the phone, to get the information completed when possible. Questions on any of that? As far as the exam process goes, or anything more specific?

Christine Clemens: Yes, Rachel, I have a question actually. This is something with the public, I think DBQ it used to be on these website having been removed recently. If a veteran, let’s say, had been previously scheduled for an examination that due to COVID was canceled, so they know that VA needs those exams to process, or adjudicate their claim. If they had access previously to the DBQ, maybe they had downloaded it already, is that something that VA would accept, if they had their current treating provider complete?

Rachel: Yes, absolutely. We actually just received official guidance on that, two or three days ago which said we will be accepting any evidence that we received even though they’ve been taken down if they had access to them in private providers, we’re filling them out, we’ll take any sort of evidence.

Christine: Would that be essentially a way around, having to wait through the process of having one of these examinations, and going to the process of getting it rescheduled would either be to submit a DBQ, or a report from one of their treating providers, where they know that the examination is going to be essentially needed to complete their claim?

Rachel: Yes, absolutely. That was in the question we had, “What advice do you have” that would have been the advice.

Christine: Thank you.

Rachel: You’re welcome.

EJ: Before we go to mail, I was just going to chime in for a minute Robert. Rachel hit on it with exams being certainly the biggest challenge right now in the COVID-19 environment, but right on the heels of that too is also records requests. In Providence, we’re very proud to be one of the innovators of how do we improve that records request and leverage technology. But right now there are many appeals, I would say that are currently being delayed, or waiting for records. These are records that we would normally be obtaining through the Joint Records Research Center. We’re looking for creative solutions, VAs, or VBAs, compensation service business line, I know is working diligently as well to try to come up with solutions there, but of course, those entities, those records research centers have also really been impacted by COVID-19 and don’t have the manpower right now providing those services. Exams is certainly the biggest challenge right now, in regards to any sort of appeal, or disability compensation claim. And then right behind that, any sort of records request activity is also certainly a hurdle that we’re trying to overcome.

Robert: To the extent that we could help veterans get medical records, any other records, and submit them. That would help the process along, it seems.

EJ: Absolutely.

Christine: EJ, just for our viewers, when you talk about these records from the types of requests that are going there, these are typically things that would be, for example, corroborating stress, or events, things that happen in service, service records, are those the types of requests? Or are they kind of more comprehensive?

EJ: I would say that pretty much hits the nail on the head there, Christine. Is those type of stressor related, that verification-type things. Again, sometimes those are in the form of a DD214, other times they’re in another record type, you know type action, but really those are the major ones there.

Rachel: Even just our PIES requests for service verification, or STRs have not been able to be fulfilled very quickly at this point.

EJ: Every regional office is configured differently. I’ve worked at seven different regional offices, so I can speak to that. I’ll just talk about Hartford and Providence, that I currently have oversight of. Hartford is co-located with a medical center and Providence, we’re in a standalone, federal building with multiple other tenants, although, we aren’t the largest. The fact is, right now, all mail is going to our centralized scanner. Mark talked about some of the VSO mail and I’m sure folks that are listening to this may be hearing about that anecdotally are saying, “I have examples where VSO mail did not reach the VSO, went right into the scanner.” That is being worked out with the VSOs. I will tell you the biggest issue there is, more or less, checks for the VSOs. That also includes checks for our private attorneys. We have run into one, or two situations already where we are aware of private attorney checks, or payments that have been sent to the scanner. We are working with our headquarters and with the scanning vendor to get those verifications. There’s, approximately, three, or four centers that are being set up to make sure that any sort of check that was going to a VSO, or for a private attorney that somehow we get that payment, or get that return to the Regional Office for action. Before I turn it back to Rachel for what advice we have, just a couple of things. In terms of deadlines that have been extended, there’s none that really jump out to me, Robert, aside from exams. Obviously, any exam that has been postponed for veterans, which is really the more appropriate term than canceled, is that there are several processes in place so that that’s being tracked whether a contract provider, C&P unit, or VHA. Those exams will be rescheduled for either some type of an in-person, or a telehealth exam in the future, so that to me is the biggest deadline, in terms of extending. Claims that can be rated without an exam, we are working feverishly to make sure that we do that, but for any claim that does require an exam to include an appeal, those exams will be taking place at some point in the future. We already talked about some of the rules and procedures, DBQ is a great one there and the only thing I would just add for advice to claimants is, VBA is open. We are open for business, all of our business lines, so if there is a question, and a benefit that someone is considering applying for, there’s no reason why they should delay. Whether that’s compensation, education, loan guarantee, other, we are very much open for business. Rachel, any advice you want to share?

Rachel: Not so much advice other than just probably watch out for more changes coming, particularly with communication with veterans. I think we’re going to try to explore different technologies, appointments, and different ways that we can reach out during this time, and moving forward. That all is yet to be determined, but that’s what we’re working through in very early stages right now.

Rachel: Okay. As far as the appeals, as far as deadlines and that being extended, while deadlines haven’t been extended there was a policy letter 20-02 titled Novel Corona, COVID, claims, and appeals processing guide, so it does apply to claims and it does apply to appeals, as well. Which is effective as of March 1st which allows any claimant to request an extension to submit evidence for good cause, and the coronavirus is a good cause reason that has been extended. If you don’t have that letter, I would be happy to share that with you. The caveat on that is, it is required that there is a request for an extension on the part of the claimant to submit the evidence that we need. That’s the biggest thing that’s out there. As far as impact on informal conferences, there has really not been an impact on informal. We’re still doing those telephonically, and Skype when available. Same with, even formal hearing. We’ve been given guidance that we are now able to proceed with formal DRO hearings via Skype, so we’re doing that as well. As EJ and Mark explained, request for claims folder, like they said, the RMC is very minimally staffed, and it’s really pertaining to some of those higher priority groups that they are attempting to expedite request such as homeless, soon-to-be homeless, terminally ill. Those requests are a bit backlog right now. It’s still the same procedure, but they are going to take some time. I think that covers most of it on here. As far as filing the extension, that can be anything as simple, just a quick note, or even a telephone call to the call centers requesting an extension, and we would document that on an OE2O in the system.

Robert: Thank you very much. This has been really helpful. Brad do you have any follow-up questions at this point?

Brad: The one thing I wanted to ask about, and maybe I missed it when we discussed it earlier, was the postmark issue that they talked about in the Federal Register that VA is accepting.

Rachel: Yes. We are accepting the post office postmark as the date of claim at this point. I believe that’s going to continue. I think it said 60 days, don’t quote me on it, but I think was like 60 days until the COVID thing had expired.

Brad: If there is no postmark, it says that they will consider it to be received no later than February 29th?

Rachel: Correct.

Brad: Okay, thanks.

Rachel: Yes, but just so you know, faxes are really hard for us right now since we do not have people in the office. It’s hard for us to get that, because we have to grab the mail and then have it shipped out. I would recommend using the Postal Service as much as possible.

Robert: Okay. We fax a lot of things to the EIC, is that a different operation in terms of receiving faxes or anything?

Rachel: No. I meant faxes just straight to the Regional Office.

Robert: Okay, great. Okay. Listen, I’m going to sum up here. We really want to thank you all for joining us here today and spending some time updating us on what’s happening with the Regional Office. It’s good to see you all, and it’s good to see you all working, we really appreciate all the hard work the VA is doing, so thank you.