Putting communications back in Veteran's hands

Menaka and Daniela testing a preference panel prototype with a Veteran

This is the fourth and final entry in a series of blog posts describing our experience working with the U.S. Department of Veterans Affairs (VA). We are a student team in a Harvard Kennedy School field class working to understand and improve VA communications with Veterans.

Brad started graduate school shortly after leaving the Army. Before leaving the service, he applied for disability benefits for hand and knee injuries incurred during active duty. During the transition from military service to life as a Veteran and student, compensation from the VA would be his family’s only source of income.

Weeks passed. School deadlines were approaching. And still, no word from the VA. “The lag, more than anything, creates a sense of frustration and hopelessness,” he told us. 

Brad was our first interviewee as part of our semester-long project with the VA, in which we were tasked with exploring how communications could be used to improve Veteran satisfaction with the disability claim process. He set the stage for comments we would hear again and again. 

From Brad and others, we heard frustration about the length and lack of clarity of the claims process. We heard doubt that the VA’s processes could be simplified and made easier to understand. And we heard the full diversity of Veteran needs and preferences. 

We listened to these stories and concerns. And then set about creating some solutions.

What we built

The first thing we built to address the comments we kept hearing from Veterans is a mobile application for tracking the status of a disability claim. The purpose of this app is to give people like Brad real-time, easily accessible information about their claims progress. This app, which shows the stage a claim is at, allows Veterans to replace their daily walk to the mailbox to check for updates with a simple push of a button on their phones. Alerts would notify them when a claim has moved forward or action needs to be taken, reducing the frustration and lack of control that Veterans told us they feel during the current process. 

Select screens from our VA Claims Tracker prototype

Next, we built a preference panel webpage for va.gov which allows Veterans to control which communications they receive from the VA, and how they receive it. Brad, who was regularly on the move during his transition, told us that he was worried about critical information from the VA always being “one address behind.” Our preference panel allows him to opt-in to primarily digital communications, while still allowing other Veterans to receive mail or text messages. 

Our preference panel prototype, which leverages the current design of VA. gov

We also put together a database of insights for the VA from our research and brainstorming. The collection of interviews, quotes, and ideas of solutions that our team came up with can inform a range of communications-related projects the VA undertakes in the coming months and years. 

What we learned

We learned that how the VA communicates (or doesn’t, in some instances) with Veterans can make a huge difference to their satisfaction with the disability claims process. We also learned that small things really matter, like the positioning of alerts on a proposed claims app, or whether the preference panel uses toggle buttons or check marks. 

We learned that change at the VA is hard, but not impossible. From the redesigned and simplified va.gov website, to the VEText initiative which sends Veterans text reminders of upcoming medical appointments, we were inspired by the VA’s use of technology and design to improve the Veteran experience. We learned that Veteran’s voices and experiences are the most powerful drivers of these changes.  

Most importantly, we learned that our work and ideas could really make a difference. Just last week, we showed the above two prototypes to Brad. “I wish this is how it worked,” he told us. “I hope to be able to log into va.gov in the future and see this.” 

Thank You

Thank you to Clarice Chan, Zach Goldfine, and Charles Worthington from the VA for partnering with us on this important project, and all the people across the VA who gave us their time and advice as we developed these solutions. Thanks also to Dirk Adams from Harvard Advanced Leadership Institute for his contributions to this project.

Most importantly, thank you to the Veterans and active service members who shared with us their opinions, experiences, and preferences. We hope our solutions go a little way to making your experiences with the VA better going forward.

Communication, As Defined by Veterans

Good communication is hard to define, and hard to do—especially for large organizations like the U.S. Department of Veterans Affairs (VA). Part of the problem is that there is no single right answer.

If you ask Nate, an Afghanistan Veteran who filed his disability claim (to receive compensation for injuries or health problems incurred or aggravated as a result of service) through a VA website known as eBenefits before leaving the Marine Corps, good communication is short and immediate. Rarely without his iPhone in his hands, Nate is used to receiving real-time notifications about his online grocery delivery from Amazon and his gate and boarding time from the Delta Airlines app. The communications he receives from the VA are, in comparison, dense and slow.

If you ask Amanda, a Gulf War Veteran and single mother who relies significantly on the income from her claim, she will tell you that good communication is comprehensive and easily accessible. She likes the idea of a centralized VA website, like the one she uses for online banking, that helps her understand the VA claims process and her status in it. 

If you ask Simon, a Vietnam Veteran who depends on his wife and large network of Veteran friends for advice and assistance in navigating the VA, he will tell you that good communication is personalized and easy to understand. While he doesn’t mind the occasional text (especially if it’s to remind him of an upcoming appointment), he prefers important information to reach him via letter and phone call.

We know this, because we asked. We are a student team in a Harvard Kennedy School field class working with the VA to understand and improve VA communications with Veterans.

For the past few weeks, we have been getting to know people like Nate, Amanda and Simon to answer the question driving our work with the VA, namely: how do we use communications (and notifications) to improve Veterans’ satisfaction with the disability claims process?

To answer this question, we leveraged our personal and professional network to speak to Veterans. We spoke to classmates, recently retired faculty, and ten Veterans from across Montana (one of us is from the state). We used these initial conversations to fine tune our interview questions and familiarize ourselves with the claims process. 

We then reached out to Veterans through official VA channels and Veteran Service Organizations (VSOs)—non-profit organizations created to help Veterans and their families. The Earl W Harvey Chapter and the William Hurley Chapter of the Disabled American Veterans organization gave us an especially warm welcome. In total, we reached over 40 Veterans, 19 through in-person interviews and an additional 10 by telephone, over 5 weeks.

The HKS team at a Disabled American Veterans meeting.

Our final approach focused on the vibrant online community. Reddit, Facebook Groups, and VA forums provided a valuable window into the common challenges and concerns that Veterans experience when filing a claim. Commenters in these discussion groups were supportive of fellow Veterans, but didn’t always have accurate information about the claims process.

From this research emerged three types of Veterans—what designers call “personas”—each with distinct needs and preferences when it comes to communications from the VA. Yes, you guessed it—Nate, Amanda, and Simon. 

These three Veteran personas are strikingly distinct. But they share some frustrations—complaints about spam from the VA, lack of personalization, and complexity of content. Using these personas and data from our interviews, we developed the following high-level insights into disability claims communications: 

Insights about communications content

• Veterans do not feel in control during the claims process.

• Veterans are more likely to have a positive experience with the VA when the VA provides clear and reliable expectations.

• There is inadequate notification about the movement of a disability claim through the claims process.

• Clear justification for a Veteran’s disability rating was often not given to a Veteran.

Insights about communications delivery

• Veterans are overwhelmed by promotional content, not by updates to claims status.

• The letter is not “dead” and text is not the (only) answer.

• Many Veterans (in our interviews almost all) receive information on the progress of their disability claims from non-VA sources, such as VSOs.

•  Notification infrastructure and resources exist that Veterans are simply unaware of.

However important these insights are, it’s important to note that our interviews with Veterans were intense and personal conversations. We heard their service experiences, physical and psychological wounds, hardships of waiting for a disability claim decision that determines family income and quality of life, frustrations with inaccessible processes, and relief when those processes work well. We are thankful to those who let us into their world and told us their stories. 

Our conversations with Veterans gave us rich data, quotes, and insights that we can’t wait to put into action as we enter the next phase of our project: brainstorming, prototyping, and testing solutions to improve VA communications with Veterans. 

Isaac Yoder, Daniela Jozic, Dirk Adams, Menaka Narayana, & Raina Davis

Harvard students partner with VA to improve Veteran communications

Veteran. It’s a short word to represent the diversity of people that have served our country. In the U.S. there are over 20 million veterans hailing from all fifty states and ranging from early twenties to over 100 years of age. Some are peak physical condition, others have a range of ailments and service-related disabilities. And just like the general population, Veterans span the entire range of communications needs, preferences, and technology savviness.

It’s the job of the U.S. Department of Veterans Affairs (VA) to serve these Veterans and their families, which includes communicating clearly and effectively with them about benefits, health care, and much more. But the Vietnam War veteran from North Dakota may prefer information through the mail, and the twenty-seven-year-old living in Los Angeles may associate the word “mail” with her smartphone Gmail app.

The VA is the largest healthcare provider in the United States, and the second largest government branch after the Department of Defense. Serving over nine million Veterans annually, the VA is asking the question: How can we improve communications with Veterans?

That is where we come in! We are a team of Harvard students in a field class at Harvard Kennedy School called Tech and Innovation in Government taught by Nick Sinai, the former U.S. Deputy Chief Technology Officer. More about us:  

Isaac Yoder is a Master in Public Policy candidate at the Harvard Kennedy School, with focus on social insurance and social safety net policy. Prior to Harvard, Isaac worked with Economic Security Planning on financial analysis, Social Security strategy, and personal finance software tools MaxifiPlanner, MaximizeMySocialSecurity, and AnalyzeMyDivorceSettlement. 

Daniela Jozic is a Master in Public Administration student at the Harvard Kennedy School, where she is a Program on Education Policy and Governance Entrepreneurship Fellow and co-leader of the Behavioral Insights Student Group. Prior to Harvard, Daniela managed education policy and advocacy initiatives across Australian state government and UNESCO, and supported public sector client engagements at the Boston Consulting Group. Daniela also holds a Bachelor of Business and Masters in Political Economy.

Dirk Adams founded, owned, and operated the Montana-based Lazy SR Ranch, a large-scale, certified-sustainable livestock ranch. Mr. Adams also spent 30 years in senior executive positions in the mortgage and banking industry with some of the largest savings and loans in the U.S. after beginning his career as a trial attorney. Dirk is a member of the Harvard Advanced Leadership Institute. 

Menaka Narayanan is a senior at Harvard College studying Computer Science with a secondary in Global Health and Health Policy. In addition to serving as a Teaching Fellow for CS50, she was a research fellow at Harvard SEAS working on the interpretability of Machine Learning algorithms. Her last internship was as a software engineer at LinkedIn, and she is an incoming Forward Deployed Engineer at Palantir Technologies. 

Raina Davis is a Master in Public Policy 2020 candidate at Harvard Kennedy School and a Belfer International and Global Affairs Student Fellow. Prior to attending HKS, she worked as a research coordinator at Columbia University in the Office of Global Centers and Global Development, where her research focused on education, democratization, and geopolitics in the Arab world.

We are excited to be working with Charles Worthington (VA Chief Technology Officer), Zachary Goldfine (Presidential Innovation Fellow), and Clarice Chan (Presidential Innovation Fellow) on this project—and are look forward to engaging across the VA on this important issue.

Focusing on Disability Compensation

The VA has many interactions with Veterans and their families. To narrow the scope of our project, we are starting with Veteran communications in the Disability Compensation Program. 

The Disability Compensation Program encourages Veterans to submit evidence of disabling conditions that can be traced back to their military service. If the claim is approved, the Veteran receives monthly tax-free payments from the VA as compensation for the injury.

Here are VA Disability claims by the numbers:

●     1.3 million disability compensation claims projected for 2019;

●     77 days, on average, that a claim is pending;

●     107 days, on average, for a claim to be completed; and

●     59,000 claims pending more than 125 days.

Our team is initially focused on interviewing a diverse set of Veterans, both to gain a deeper understanding of the claims process and to get a sense of their communication expectations and needs from the VA. If you a Veteran and interested in helping us improve the communications that you receive from the VA, please get in touch with us at harvardbvct@gmail.com.

Isaac, Menaka, Raina, Dirk and Daniela (not pictured) brainstorm interview questions

We will also do background research to explore communications and customer service that delights rather than “does the job.” We will look to other government agencies and the private sector—particularly to analogous services in banking, insurance claims and healthcare—for best practices. 

 For example, companies like MetLife are actively exploring how they can keep customers informed and engaged as they await insurance claim decisions. They ended up building a mobile application that allows users to check their claim status at any time while also allowing them to upload files and complete tasks related to their claim. 

 Whether our recommendations take the form of an app or something else, our focus will be the same at MetLife’s: improving the user experience through better communications. We can’t wait to get started. 

 Keep checking back in on this website for periodic updates on our progress. 

Isaac Yoder, Daniela Jozic, Dirk Adams, Menaka Narayana, & Raina Davis