PACT Act Implementation: Modernizing VA Disability Claims Through Effective Technology
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House Veterans' Affairs Subcommittee on Technology Modernization U.S. House of Representatives
Follow its sittingsTom Barrett
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. And I want to be clear, we will make sure that there are strong guardrails where no veteran claim is fully decided by AI or automation. There must be quality assurance policies to ensure that the use of AI and automation always have a human deciding in that process.
Thank you all again for being here today. I look forward to your testimony and with that, I yield to Ranking Member Budzinski for her opening statement.
Nikki Budzinski
Thank you, Mr. Chairman, and good afternoon to everyone. Thank you to our panelists for being here. On August 10th, 2022, President Biden signed Ranking Member Takano's Honoring our PACT Act into law. The PACT Act, which was the largest expansion of veterans' benefits since the GI Bill was passed in 1944, expanded eligibility to 3.5 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 and the modernization of the Veterans Benefits Management System, or VBMS. VBMS itself is a unique system, one that touches veterans, VA employees, and veterans' service officers to varying degrees. Each of these groups were promised an all-encompassing system to ease the disability claims process, a system with better warm touchpoints 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 pea can ruin a good night's sleep, so too can one bad update ruin a well-intentioned but highly interdependent claims modernization system.
My staff have heard from numerous frontline employees that the system itself is clunky and heavily degraded, leading to significant downtime, hindering employee productivity, and slowing 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, increasing the risk of error and burnout for employees.
is 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 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 and feedback are routinely ignored and dismissed.
In 2015, 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 10 years later, VA finally launched a tool to solicit feedback from its employees, and the results echo much of what I have highlighted from frontline staff today. Much of my frustration in the subcommittee has been that while VA needs world-class technology to provide veterans the services and benefits they have 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 a hostile environment that I believe comes from the Secretary's leadership that has been established, I am alarmed but not surprised that VA has lost over 1,100 veteran claims examiners just this fiscal year alone. As a whole, since January 2025, VA is down nearly 2,700 examiners and 120 hundred IT specialists.
There is no world in which that does not impact the speed 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 with which to do their jobs. That is unacceptable and will only lead to a further exodus of employees.
Now, we typically don't have VSOs join us in this subcommittee, so I'm extremely glad we have representatives from the Foreign of, 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.
Tom Barrett
Thank you, Ranking Member Budzinski, and I will now introduce our witnesses from the Department of Veteran Affairs. We have Mr. Robert Orifici. Did I say it correctly? I practiced, so hopefully I got it right. From the VA's Office of Information and Technology.
Accompanying him, we have Mr. Derek Herbert, Acting Chief Production Officer at the Veterans Benefits Administration. And from the GAO, the Government Accountability Office, we have Dr. Sterling Thomas, Chief Scientist on GAO's Science and Technology team. If you can all please stand, I will ask you to raise your right hands for the oath. Do you 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 record reflect that all witnesses have answered in the affirmative.
Mr. Orifici, you are now recognized for five minutes to deliver your opening statement on behalf of VA.
Robert Orifici
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 Mr. 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 and healthcare that they have earned. Recognizing the technology investment required, Congress mandated a five-year modernization plan.
We submitted that plan in March 2023, and implementation is now in its fourth year and on track. Since 2022, the PACT Act has driven historic surge in veterans seeking benefits, and more than 3.5 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 75,000 since May 6th of this year, a decrease of more than 73% since January 2025. That is the result of better systems, smarter workflows, 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 advancements has been digitizing more than 1.2 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 40%, allowing us to complete PACT Act eligibility much faster. Second, we have improved how veterans experience the process. We have simplified our online forms, and veterans now receive updates by email, mobile app notification, and text message, with engagement rates above 50%.
When we need more evidence, plain-language requests help veterans understand exactly what to submit. And in 2025, 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 the 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 $16 million annually in cloud costs, with efforts underway to target another $7 million.
And since 2023, we have decommissioned 16 legacy systems, including the 48-year-old Benefits Delivery Network, with 14 more planned for retirement by 2032. 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. Mr. Chairman, thank you for your continued support of programs that serve the nation's veterans. My colleague and I look forward to your questions.
Tom Barrett
Thank you, Mr. Orifici. The written statement of Mr. Orifici will be entered into the hearing record. Dr. Thomas, you are now recognized for five minutes to deliver your opening statement on behalf of GAO.
Sterling Thomas
Chairman Barrett, Ranking Member Budzinski, 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 ensure 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 start a science and technology unit in 2019, which includes a team of data scientists. We also have a unit devoted to information technology and cybersecurity, and last year my colleague Carol Harris from that team testified before you 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 want to be clear, VA has responded to some of these challenges and made real improvements. However, our prior work has shown that despite 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 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 datasets. But veterans have experiences and needs that differ from those patterns, often dramatically.
As VA develops the systems, we need to ensure it uses datasets 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 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. Chairman Barrett, Ranking Member Bozinski, and the members of the subcommittee, thank you, and I look forward and am happy to respond to any questions.
Tom Barrett
Thank you, Dr. Thomas. The written statement of Dr. 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 members that have are here today. The first question I have, Mr. Rufisi, if you could just for the benefit of myself 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?
Robert Orifici
Yes, so thank you for that question. So when we talk about automation, we're talking about very explicit tasks that are rules-based, that could follow a very explainable set of logic to complete that task, like ordering a mail from one point and having that delivered into the system, or pre-populating a form with data that's set from a base 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 or some piece of action from that.
And so those are three different categories and their distinctions.
Tom Barrett
Is AI being used in a chat function with veterans as they're going about interfacing with the VA in different ways right now? Are there 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 to communicate in chats to veterans at this point in time.
Speaker 14
Okay. Assuming that may be an interest of the VA at some point, are we able to get assurances that there would be a disclaimer of sorts or a notice to veterans that this is being done using an AI feature?
Tom Barrett
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. I wanted to next ask you about a situation that came up in my district, speaking with a one of the county VSOs in my district. They had a veteran that came to them who had filed a claim with 14 unique situations within it or 14 separate conditions. And he was using the Quick Submit system that the VA has.
Now, he didn't have one of those Adobe subscriptions to fill out the PDF and everything else, so he used an online tool that he downloaded for free, and it offset some of the formatting by enough to throw off the system. 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 the system, not the remaining 13 other conditions that were claimed. And obviously that set him back significantly, and it became very difficult to overcome that. Where within the VBA's metrics or error reporting or accuracy logs would those, you know, 13 failed submissions, where would that be counted and where would it be accounted for?
Okay.
Derek Herbert
Thank you, sir. The, so for Quick Submit, my, my understanding of that specific issue, right, is that the automation worked as intended. The pattern recognition on the front end of the, of the actual 526 failed the initial review, which then defaulted over into human review. 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, 14 instead of just the one. Regarding the, the error reporting, I'm, I'm happy to take that back where that specifically would be counted.
Tom Barrett
Okay. Yeah, that would be helpful as we kind of work through that. 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? Because 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?
That's a great question and we're currently looking at how PDF overflows work when it exceeds the field size to make sure that the system could make sure it is showing that information to the correct point. So that is a 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 out the IRS form that is submitted after you review it for accuracy and everything else. Is there a look at moving toward a design of that type so that you're not having that kind of error take place?
Robert Orifici
Yeah, that's a great question and we are, we have several forms already on VA.gov that work in a guided interview fashion where they are walked through the process. But 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 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.gov we are certainly looking at that.
Nikki Budzinski
Okay. Thank you. Ranking Member Budzinski, you're recognized for five minutes.
Thank you, Mr. Chairman. Mr. Rafisi, how often would you say that the, that VBMS has system-wide or regional outages?
Thank you for that question.
Robert Orifici
Yes. Thank you for that question. How often does it have that regional outages? Yes. I would say probably once a month, but not usually very prolonged outages.
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.
Speaker 11
Okay. And just to that point you made, do you know how long typically the outage is?
Robert Orifici
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?
Nikki Budzinski
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. 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 then how long the outages are, just both from a regional but also an individual position, like how often that takes place?
Speaker 24
I'd be happy to work with members of your staff to put together a briefing on incident response for VBMS.
Nikki Budzinski
Okay, that'd be great. And we've heard from staff that 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 drafted case contentions, where does VA direct them in order to get resolution on these issues?
Robert Orifici
That's a good question. So most of these tickets we direct our frontline staff to submit 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 staff to resolve those tickets.
Nikki Budzinski
Okay. And Dr. Thomas, just to follow up, in light of these issues and concerns from frontline employees using ADS, do you believe that VA's method for receiving and addressing feedback and functionality concerns is appropriate or do you have any recommendations?
Sterling Thomas
So we haven't looked specifically at that program, but our recommendations kind of follow along the same ones I talked about earlier is developing standard management practices to identify how quickly things are resolved, how quickly you're communicating and identifying core issues, as well as dealing with underlying technology challenges. These good management practices are really the fundamental component to making these technology programs work.
Nikki Budzinski
Okay. Thank you. Mr. Herbert, I understand the demand to review and decide on claims in a timely manner is important. 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?
Derek Herbert
Thank you for the question, Ranking Member. This is really 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 want to 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 basic automation on those capabilities so that we are really supporting and augmenting the productivity of our employees.
It is the shared concern of all of us where we do not want to put anything that is not usable in front of an employee.
Nikki Budzinski
Yeah, because obviously they might be 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 bigger concern. 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 approach and best support its employees facing degraded interfaces and the downtime?
Derek Herbert
I would say oftentimes that the outages may not manifest themselves the same way across the entire enterprise of 56 regional offices. So 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 offline, unable to serve veterans.
So it's on a case-by-case basis?
Yes, ma'am.
Okay. I yield back.
Tom Barrett
Thank you, Ranking Member Budzinski. I just missed a call from the Battle Creek VA appointment line, so if you're watching today, I'll call you after this hearing is over.
Better hope that works.
Yes. Yes.
Morgan Luttrell
Thank you, Mr. Chairman. 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 control but processed completely, Mr. Herbert, Dr. 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 information enters into the system and has to go through a process where 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 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 have, like I don't know who your counterpart is, sir, Mr. Orifici, in the Department of Defense, Department of War, and say, okay, hey look, there is no doubt that when you leave the service, you're going to 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 the struggle that we have with employees, the 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 into the VA space and say, okay, here we go. Why don't we do that?
Robert Orifici
That's a great question. I look forward to the confirmation of our CIO, 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.
Speaker 17
I mean, it's 2026. We've figured this out. And we're trying to develop language models 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. Okay. But inevitably what happens on the backside is the veterans are the ones that are suffering. And it seems like as United States government, we can kind of figure this thing out. I have said it once and I'll say it 10,000 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 certification, everything, and just drag that bad boy from one computer to the next, call the VA, it's like, hey, Lieutenant Luttrell is inbound to you, do you have him?
Yeah, I got him and all of his record, 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, I mean, there's veterans in the room. Just think about the onboarding that happens when you sign that line and swear in, everything from start to finish and how they, what they do for you. And then when it's time to leave, 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 got to 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 kicked off to you guys. And then the VA has got to go grinding through to try to find the information for the veteran. 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, no, 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... I don't have a question for you, this is just five minutes for me to rant, so I appreciate it. It just seems so easy for the secretaries, the depsecs, and all of you to say, "Hey, look, create a language model that communicates between the Department of War and the VA, take the veteran out of the equation, do all the lift for them, and when they're out, they're ready to go." 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.
Marie Perez
Thank you, Mr. Luttrell. Ms. Gluesenkamp Perez, 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 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 around a half a million new recipients into the compensation program?
I think that the question was for Mr. Herbert.
Derek Herbert
Yes, thank you for the question, Congresswoman. This year we have... I'm not exactly sure the number... Or in fiscal year 2025. ...of new claimants, but this year we have received already 2.3 million claims. I don't know to what extent those are new applications.
Marie Perez
Well, to the extent, I'd be curious and we'll follow up with some additional questions for the record, 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 want to 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. I want to ask you about your 15 outstanding recommendations for VBA, 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?
Sterling Thomas
Yeah, so in my testimony I talked about the areas on our high-risk list. Those are the ones that we identify as priorities. And then additional, yeah, we have 15 outstanding issues that have either been partially addressed or not addressed at all. It would take a long time to go through them, but the foundational component to each one of these comes back down to making sure you're identifying clear goals for your programs, particularly in the AI and automation space, designing pilots that have specific conditions that meet those goals so that they actually do serve the purpose you're after, and define the limitations of how you use it. A lot of the technology modernization management issues we've identified come down to those basic things.
Marie Perez
Thank you. Could I ask how many claims examiners or processors are currently employed who focus on compensation, on disability compensation? How many are currently employed by VA?
Do you have a rough estimate?
Speaker 21
At this moment, I believe there are about 30,000 or so employees in VBA.
Speaker 20
And how many claims... what's the role of a claims processor? What would you say, just when it comes down to it, mission critical, right, in delivering benefits to veterans?
Derek Herbert
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 the claim, and then of course it would be the actual adjudication of the claim.
By technology?
Correct.
Derek Herbert
No. In disability compensation, and to be clear, technology will never be intended to automate a claim for disability compensation claims.
Marie Perez
So how many processors, claims processors, do you have on staff at the VA right now? Can you get us that answer?
I'll be happy to.
Derek Herbert
I can certainly take back the... You don't know if you've lost in numbers? Well, generally speaking, VA has reduced the number of employees. But what I would also say is that we are also currently hiring right now. So there are open... there's open hiring activity happening across VA right now.
Marie Perez
Understood. I share Congresswoman Budzinski's concern that she raised at the outset of this hearing, that we are losing experienced federal employees who have been career civil servants, who have done this hard work, 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. So 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.
Tom Barrett
Thank you. Ms. Gluesenkamp Perez yields back. And you'll be exciting to know that we, I think in virtually every committee hearing, we've had someone from GAO present at our hearings. So we do take that seriously. We're going to do a three-minute second round for this panel.
I'll recognize myself for three minutes. Dr. Thomas, just to kind of continue on some of the discussion you were having, obviously you've got a level of expertise in this. And one of the things that we're wrestling with is overlaying a very advanced technology, automation and artificial intelligence, that is still kind of on 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 a paper intake type of system.
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?
Sterling Thomas
Well, just as you... thank you, that's a great question. And it's something that is happening across a lot of agencies, but specifically within VA. 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. OCR means it's pulled the actual text off the page.
Tom Barrett
That's where you're looking at the photo of the word and you're pulling that as like an image of the words on the page.
Sterling Thomas
Exactly. To try to get that understanding, because the large language models, as one example 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 going to 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 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 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 AI is it actually making their job any better. And that's what you'd find out from a well-designed study.
Tom Barrett
Sure. Okay. Thank you. Mr. Orafici I got a couple of quick questions for you before I have to yield back. 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 modernization. Was there any anything put in there around the ingestion of records and materials. 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 expedite that process. Thank you.
Robert Orifici
So thank you for those questions. In terms of the EHR rollout we are looking at APIs between the benefit systems and the EHRM Oracle rollout and so that will facilitate that data exchange and make it easier than it currently is to pull some of that data. We also have a lot of work that's ongoing with DOD that is automating a lot of the record pulls with STR and other files so that is also advancing. In terms of your other question if you're talking about the the bill of goods for kind of the case the documents behind the case. That is part of the the plan data was one of the pillars of the 7.1 billion modernization plan.
We have progressed with getting a lot of the data that was needed from DOD 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 that data that was needed to make those decisions around toxic exposure.
Tom Barrett
Okay. Thank you. Look forward to following up on on that I appreciate it. Ranking Member Budzinski recognized for three minutes.
Nikki Budzinski
Thank you Mr. Chairman. Mr. Orafici can I ask you a follow-up question. You had mentioned that employees it takes about an average of eight days for an IT ticket to close. It's my understanding that employees are submitting tickets when they are constantly getting kicked out of the system or when ADS is populating incorrect information. So eight days is too long.
What advice would you have though for a VBA employee expected to what are they expected to do in cases like this.
Robert Orifici
Thank you for that question. And so there's a process for being able to escalate these tickets when they produce a work stoppage and an inability to work a claim and get that through. And so I recommend they work with their their team leads there to make sure that ticket is being escalated and that will get attention to that ticket for closure faster. And in terms of ADS escalation I would turn to my colleague Mr. Herbert.
Derek Herbert
I would say and thank you for the question. I would just say generally the process would be the same. We have several different types of feedback mechanisms to capture when employees run into issues. That would be a situation where that employee would escalate 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.
Nikki Budzinski
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 you know 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. Mr. Herbert my next question actually just for you is earlier you mentioned that VA plans to always have a person making decisions yet just a month ago VA decided to fully automate DIC burial and other end-of-life benefits. Why has VA chosen to disregard the automation and modernization framework we laid out in the PACT Act.
Derek Herbert
Thank you for the question. My focus specifically is disability compensation. So, if I wasn't clear previously, to be clear now, it is for disability compensation claims automation would not be making decisions.
Speaker 17
Thank you, Mr. Chairman. Is it the older generation veterans, they're kind of that, is that the, are we having more success inside the VA with benefits with 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?
Robert Orifici
Yeah, thank you for that question. I'll defer to Mr. Herbert for that information.
Derek Herbert
Yes, sir. Thank you, thank you for the question. I'm not sure that there is a general demographic pattern. I think really the, the one thing that is true that affects claims 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...
What does that mean?
Derek Herbert
Well, as an example, if you were a post-World War II Korea veteran and your file, your military personnel file was destroyed in the fire at the National Archives in 1973, there would be a supply chain dependency on acquiring the record.
Speaker 17
But those are very small numbers. For our remaining, kind of I like to say my forefathers and mothers, but up until now.
Derek Herbert
That's absolutely true. Another example might be private medical records. So depending on the provider, we, we often times have different levels of responsiveness.
Speaker 17
Is the private medical record the one that's slowing the process down more than the, the active duty service record?
Derek Herbert
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 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 STRs within one day. So there are still, there's still a lot to do on the Department of War side.
However, we are seeing pretty significant progress. I would say that private medical records, we receive about 8,000 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.
Morgan Luttrell
Those aren't just community care providers, that's just a medical record period across whomever they may be seeing.
That's correct, sir.
Morgan Luttrell
Which to me is they need to hand-walk that from their provider over to the VA.
Derek Herbert
Well, ideally we're, ideally we're not hand-walking. We, we really don't want to put that administrative...
Speaker 31
You'd be interested what I hear in my district, sir, but I'll agree with you, go ahead.
Derek Herbert
Yes, sir. 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. All right. Thank you, Mr. Chairman.
Marie Perez
Thank you, Mr. 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 delays that you're, you're seeing in the system when it comes to, because 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?
Derek Herbert
Thank you, Congresswoman. Yes. I'm not sure that it is chronicled, but, but the data absolutely suggest and identify that 80% of our claims right now are in the evidence gathering phase.
So we have about 600,000 claims that are pending. 80% 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, depending on period of service, it's private medical records, it's any number of those pieces of information that we need. There's no question that evidence gathering is the place where resources need to be leveraged and where we're leveraging automation to help accelerate that process.
Marie Perez
So 20% of your pending claims are currently before examiners who are adjudicating?
Derek Herbert
They are either in pre-evidence gathering, so the initial development, so we'll receive 20,000 pieces of mail today, that would be before evidence gathering, 10,000 of that would be claims. That's before evidence gathering, and then you have 80% in evidence, and then you have the remainder that would be at some stage leading up to adjudication and award.
Marie Perez
And of the 600 pending claims, do you have a count on how many of these are moving through a process that's almost entirely digital? What percentage of the claims have some physical hard copy element to them?
Derek Herbert
I don't know that number offhand, but we absolutely can identify the number of claims we're receiving whether it's through VA.gov or through QuickSubmit or the files, or, 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.
Marie Perez
Well, we'd love to work with you on this. 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 want to work with you to do that.
Tom Barrett
Thank you. Representative Goodenlander yields. So thank you for our panelists on panel one, appreciate you participating, look forward to hearing back on the outstanding remaining questions that are out there, and I'd like to bring up our second panel for the second half. There we go. Thank you.
All right. Thank you for our folks on our second panel and thank you for members who are able to participate in this second panel. Introducing members on our second panel today, we have Mr. Caleb Max, President and CEO of the National Artificial Intelligence Association, Mr. Jeremy Villanueva, did I say it?
Did I get it?
It's Villanueva, sir.
Say it again.
Villanueva.
Villanueva.
Tom Barrett
Okay. Villanueva. Associate Legislative Director for Paralyzed Veterans of America. And finally, we have Mr. Greg Orto, Deputy Director for National Veterans Services for Veterans of Foreign Wars. So as the witnesses, please stand and raise your right hands.
Do you 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 record reflect that the witnesses have answered in the affirmative. And thank you all again for attending today. Mr. Max, you're now recognized for five minutes to deliver your opening statement on behalf of NAIA.
Caleb Max
Good afternoon. Chairman Barrett, Ranking Member Budzinski, 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 Artificial Intelligence Association. 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 process. ATMs changed that. Simple rules-based transactions were automated, tellers are freed 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 neuro-symbolic AI, a combination of rules-based logic that the federal government has used since the 1970s and modern AI capable of reading, interpreting, and routing complex information. If an automated system cannot approve a claim based on available evidence, if it can approve a claim based on available evidence, it does. If it cannot, it flags 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 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's 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 of veteran affair benefits at the VA 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 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 roadmap.
When companies know the rules on development, deployment, transparency, benchmark, 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 claims-related AI system should be benchmarked on accuracy against claims with known outcomes, failure rates with automatic escalation to human review, bias across veteran populations, and workflow traceability of every AI-generated summary to its source documents.
Speaker 39
Before I close, I will mention that the Albany VA Medical Center is actively 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 neuro-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 the subcommittee a disservice if I did not name it plainly.
New AI tools often die on the table of implementation because of perceived risk of 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.
It 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. And AI and its member companies stand ready to partner with the Veteran Affairs Committee and the Veteran Affairs Agency on an AI strategy with clear milestones, accountability measures, and a roadmap 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.
Speaker 34
Landed it on the dot. Thank you. Appreciate your testimony. Mr. Villanueva, you're recognized for five minutes for your opening remark. Oh, and Mr. Max's opening statement will be entered into the record as well.
Thank you.
Jeremy Villanueva
Chairman Barrett, Ranking Member Budzinski, and members of the subcommittee. I appreciate the opportunity to appear before you today on behalf of Paralyzed Veterans of America to discuss VA's ongoing efforts to modernize their benefits IT systems post-PACT Act. Throughout the country, PVA employs 74 national service officers, or NSOs, in 73 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 agencies 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 functions 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 award, it is 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 it can create. When VA started automation efforts on DAC claims in May of 2020, 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 2024 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 report noted that out of 8,100 automated decisions, at least 8,000, or to put it another way, nearly 99% of them contained deficiencies, either legal or procedural.
Making the problem even more egregious, the 2% 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, Mr. 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.
Tom Barrett
Thank you, Mr. Villanueva, and your written statement will be entered into the record, and look forward to working with you as we sculpt policy to achieve what you're talking about. I know my office is working on drafting policy now, and we'd be happy to engage other members of the committee on that as well. Mr. Orto, you are now recognized for five minutes to deliver your opening statement on behalf of VFW.
Greg Orto
Thank you, sir. 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 depository or repository than a truly integrated case management system. The system is 16 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 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 hoped 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.
Tom Barrett
Thank you, Mr. Orto, and your testimony will be entered into the hearing record. We're now going to move on to questions and I'll recognize myself for five minutes. Mr. Villanueva, your testimony really emphasized the really significant hurdles that veterans encounter while navigating the VA claims process. And I know your organization spends a great deal of time helping veterans to navigate that. We know that the Social Security Administration leverages a qualified health information network to automatically put millions of medical records in real time, to pull them in in real time and fast-track them for consideration for 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 collection process, how much would this lighten the veteran's burden to get their claims approved in your estimation, would you say?
Jeremy Villanueva
Thank you Mr. Chairman, that is a great question. I know that for many NSOs when they're explaining this to the veterans and having them try to bring in outside medical records in, it is a hindrance not just for 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. And now that we're going into, we are now in 2026 where almost all medical offices that are out there are using some forms of electronic medical records, to be able to use that and tap into that would be a great significance, not just for the VSOs but for the veterans themselves.
Tom Barrett
Sure. Would you say that's the single biggest barrier for claims is the accumulation of the records at this point in the organizing of those?
Jeremy Villanueva
It could be. It could be. I don't think that there's any single portion of the process to point out but I would say this, like I said when it comes to the psyche of the veteran, having them 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, they're kind of second guessing whether or not they should be putting in this claim. And they don't want to go through the hurdles especially for the first time VA applicants.
You have to understand like getting them back into the office to finalize that claim. And by automating that, I think it would be a world of to help them to come back in to finish that claim and to put in there for their benefit.
Tom Barrett
Okay. Thank you. And for you or Mr. Orto, just 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 practitioner from the time you left the military till when you file your claim? Which is the bigger issue that you encounter?
Greg Orto
Thank you. Yes, so 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 as my colleague said, then trying to get them back in to see the NSO is an issue. So getting those private medical records, Department of the War seems to be doing pretty good for the benefit delivery discharge as far as pushing those records in.
Tom Barrett
Okay. So it's more on the fragmented nature and to your point I think Mr. 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. Mr. Max, do you think there is an opening there to have an automation or AI model that could kind of synthesize these things in a way that would make them readable for that accumulation of records in a way that is then digestible for processing?
Speaker 38
I would think so. I mean I will say whenever it comes to health records and we deal with this a lot outside of Veteran Affairs across AI is HIPAA laws and healthcare records. The heartbeat of AI is the data and a lot of our companies because of so much regulation in that area for good reason for the most part, makes that sort of talking to each other of the systems very complicated and a lot of approvals necessary.
Tom Barrett
Even though the veteran would be obviously giving consent for their medical record to be transmitted this way?
Speaker 38
Yeah it would go to like who's the, what system is going to go into that database and actually extract it, is that tied to veteran, do they have an account there, do they have permissions, have we identified that individual?
It gets a little tough on the back end. It is possible, certainly the tools exist, but HIPAA laws and others do make it a little tough.
Nikki Budzinski
Thank you, Mr. Chairman. Mr. Ordo, thank you for joining us here today and thank you for continuing to stand against any cuts to veteran benefits. 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. 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 sys what systems would you appreciate seeing incorporated into the platform?
Greg Orto
I really do appreciate that because 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. Thank you, that's excellent. One of we were talking about QuickSubmit just a little while ago and QuickSubmit is one venue that veterans have to submit the claim. Well, sometimes it gets hung up there. And so we're looking for the claim, the veteran told us that they submitted a claim, or we submitted the claim through QuickSubmit, and then we're not seeing it go all the way through.
Well, the help desk there says that okay, well, at one point they can no longer help us, talk to your regional office, the VA regional office. The VA regional office doesn't have that information, so we're having to go back into QuickSubmit to try to find 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 want to do if you want to look at a Board of Veterans' Appeals, it's not in VBMS.
You have to go into the remnants of VACOLS or Caseflow in order to get into and see what's going on into the claim system. What about the the Program of Comprehensive Assistance for Family Caregivers? The caregiver program, if they want to do an appeal, there's nothing in VBMS for that. So these are folks who have now been denied the caregiver program. 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 and that's case by case to try to find information so that we can build an appeal or see if that's viable to do. So we are going out of the VBMS system to gather this information.
Nikki Budzinski
Would you have any advice for us on, you know, how you think we could make it better though?
Greg Orto
Yes, thank you. I do. I think that there needs to be a conductor of the orchestra. So there's all of these systems that we have and they're taking it piece 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 correctly correctly so that we can now see like Corporate DB is a system that's outside of VBMS.
But Corporate DB is something that causes changes to a person's last name. So we'll get I'll do a BDD, Benefits Delivery at 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 30 years. Why now in the VA system is it being changed? And then trying to get that changed is an issue.
And then once it does get changed, I had just recently, I had a female get it changed, we were able to do it, and then when the decision was made, the name was changed again for them. It causes a lot of frustration, especially from females who are coming from domestic abuse situations.
Nikki Budzinski
Sure, I can imagine. I've got one more minute, I'm going to try to sneak in another question. I do want to say it's so wonderful to have our VSOs here, Mr. Orto and Mr. 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 hear from you on how veterans interface with it is really helpful. Mr. Orto and Mr. Villanueva, VA's Office of Inspector General recently released a report where it voiced data privacy and patient safety concerns with VHA's use of generative AI.
How do these concerns and risks track over into the VBA space? What have you heard from your membership regarding the use of AI and automation in the disability claims process?
Jeremy Villanueva
Thank you Madam Ranking Member, that's a great question. I think one way to conceptualize this and how some of our members or just veterans in general would look at slip-ups like that when it comes to people's personal information is that the average veteran that is out there doesn't really look at it as a VHA/VBA, they just look at VA. And when you lose credibility in one part, you're going to get it and it's going to affect the other, right? So any of these losses of trust from the VA has a ripple effect that goes throughout all of our members whether or not it's 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.
Tom Barrett
Thank you and totally agree with you, if a veteran has a violation of trust in one part of the VA, they're going to blame the entire agency of course, and I think that's natural to expect that they would. Ms. Gluesenkamp Perez for five minutes.
Marie Perez
Thank you. Thank you all for being here today and for your really helpful testimony. Mr. Orto, I want to 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 is really one of the great misnomers in government because you really would think that this was a user-centered portal where you could go and manage the benefits. But talk to me a little bit about how in the course since 2009 this system has developed not around a user-centered, not around a veteran-centric model. Tell us about how that has impacted the work of your important organization.
Greg Orto
Well it's become so, it's not a 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, supposedly, and we're working outside of those systems. So it's a source of frustration for us and the veterans because the veterans then they see the remnants of what is in VBMS through VA.gov, which is poorly laid out in itself. So the frustrations that the veterans have because they don't know what evidence is going into VBMS or what evidence may not be in VBMS, it is a source of frustration for us.
Marie Perez
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.
Greg Orto
Yes, so talking about the veterans themselves and they're the ones that ask us, so 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 they have VA.gov, and VA.gov is disjointed as it is. 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 an examiner sends them a letter or calls them on the phone 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?
Yes, correct.
Marie Perez
Which is totally preventable and should not be happening to our veterans. Mr. Villanueva, thank you for your testimony and thank you in particular for highlighting this April 2026 Office of the Inspector General report. It's extremely concerning. To the point 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 and whether when a claim is being adjudicated, a veteran knows or a family member knows that this automation was used in the adjudication process. So is it your view that Congress should require by statute, 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?
Jeremy Villanueva
Well, that is a great question, ma'am, and there's a few ways, of course, oversight, oversight, oversight. I think automated claims, especially at the very beginning of this, have to have more oversight than just the regular claims process because of just what we highlighted in our written testimony. We do think that there are ways to use AI and automation. As a matter of fact, there's a couple ways that we've been batting around about working on the remand churn and how AI and automation might actually be able to help that. But in these cases where you're actually talking about like the decision-making process, yeah, no, like we do not believe that automation or AI functions should even be giving recommendations on what an RVSR or VSR, you know, some of the people who are doing these claims, because as we talked about or you guys talked about earlier on in this hearing, with a lot of the 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 their experience to say like, no, this was actually wrong.
And then garbage in, garbage out. And when you have garbage claims coming out, it's going to cost the government a lot of taxpayer funds.
Tom Barrett
Thank you, Ms. Gluesenkamp Perez yields back. Thank you to our second panel, appreciate you participating today and we look forward to following up with you as well as we work toward improving these outcomes for veterans. We're now going to move on to closing statements and I want to yield to Ranking Member Budzinski for a close.
Nikki Budzinski
Thank you, Mr. Chairman.
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 of workflows, policies, and the tools 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. I believe we must acknowledge the immense efforts undertaken by VBA employees, especially as the department has already lost over 2,700 claims examiners since January of 2025. As Secretary Collins, 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.
Tom Barrett
Thank you, Ranking Member Budzinski, and I want to thank all of our witnesses for appearing today, and thank you all of everyone who joined us for this hearing, and thank you to members who are participating today as well. I really appreciate that. I think we learned a few things in testimony today. One resounding that was clear is technology is quickly evolving, and it's vital that VA joins the 21st century. My wife used to work for the state of Michigan 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 workarounds to the system because it wasn't flowing in the way that it was supposed to.
So they would often share 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 going to use this? How is the veteran going to benefit from it? 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 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 by this piece of that process 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 healthcare 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 obviously we've got a lot of work ahead of us. 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 an ethical and appropriate way to protect veterans both on the 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. Section 701B 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 of VBA IT evolves at the speed of technology while protecting the interests of veterans. So that's our job on this committee is to make sure that the ever-evolving landscape and to ensure that VA is executing accordingly. 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.