Compensation Servicing Survey

VA_Surv6_CompSvc_5.25.16_v6 5/25/16 10:02 AM Page 1

Compensation
Servicing Satisfaction
MARKING INSTRUCTIONS
Please fill the response oval completely
and print clearly.

USE BLACK OR BLUE INK
(NO RED) to complete the survey.

CORRECT:

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INCORRECT:

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OMB Control No. 2900-0782

Throughout the questionnaire, you may be asked to skip certain questions that may not apply to you.

Benefit Information
1.

How did you FIRST learn about VA compensation benefit programs? (MARK ONLY ONE)
IF YOU ARE UNSURE, PLEASE INDICATE THE FIRST WAY YOU REMEMBER LEARNING ABOUT VA COMPENSATION BENEFIT PROGRAMS.
Online (e.g., eBenefits.va.gov, VA website, etc.)
Mail (from VA)
Other Veterans
In person with a VA representative (e.g., VA medical center,
Friends or family
VA Vet center, Regional Office, etc.)
Other (Please specify): ______________________________________
Transition Assistance Program/Disabled Transition
Don’t know or not sure
Assistance Program briefings
Veterans Service Organizations (e.g., Amer. Legion, DAV,
VFW, PVA, MOPH, etc.)

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What method(s) do you MOST FREQUENTLY use to obtain general information about VA compensation benefits or services?

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(MARK ALL THAT APPLY)

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Online (e.g., eBenefits.va.gov, VA website, etc.)
Phone
Mail
E-mail
In person with a VA representative (e.g., VA medical
center, VA Vet center, Regional Office, etc.)
Veterans Service Organizations (e.g., Amer. Legion,
DAV, VFW, PVA, MOPH, etc.)

Other Veterans
Friends or family
Other (Please specify): ____________________________________
Don’t know or not sure
None of the above

How frequently would you like to receive communications (e.g., e-mails, letters, newsletters, etc.) about VA compensation benefits
or services? (MARK ONLY ONE)

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Weekly
Monthly

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Quarterly (every 3 months)
Semi-annually (twice per year)

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Annually (once per year)
Never

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Don’t know or not sure

How would you like to receive information from VA about compensation benefits or services? (MARK ALL THAT APPLY)
Phone
Social media websites (e.g., Facebook, Twitter, etc.)
Other (Please specify): ________________
Mail
E-mail
VA website

In person at a Regional Office

Veterans Service Organizations (e.g., Amer. Legion,

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Don’t know or not sure

DAV, VFW, PVA, MOPH, etc.)

© 2016 J.D. Power and Associates. All Rights Reserved.

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VA_Surv6_CompSvc_5.25.16_v6 5/25/16 10:02 AM Page 2

Benefit Information (Continued)
5.

The following question asks you to rate various aspects of your experience with Compensation using a scale of 1 to 10,
where 1 is Unacceptable, 10 is Outstanding, and 5 is Average.
When thinking about your most frequently used methods of communication, please rate your experience in obtaining information
about your benefit on the following items:
(MARK ONLY ONE PER ROW)
Unacceptable
Average
Outstanding
1

a.

Ease of accessing information

b.

Availability of information

c.

Clarity of information

d.

Usefulness of information

e.

Frequency of information provided by VA

f.

Overall rating of information

2

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£
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¢
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5

∞
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10

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N/A

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NA

NA

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NA

Benefit Entitlement
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15.
16.

Have you submitted a claim for an increase in your compensation benefit in the past 6 months? (MARK ONLY ONE)
Yes
No (SKIP TO Q15)
Don’t know or not sure (SKIP TO Q15)
How did you submit your claim? (MARK ONLY ONE)
eBenefits.va.gov
In person at a Veterans Service Organization (e.g.,
Other (Please specify):
Mail
Amer. Legion, DAV, VFW, PVA, MOPH, etc.)
_____________________________
In person at a Regional Office
Don’t know or not sure
After you submitted your claim, did you receive a notification/confirmation from VA notifying you that your claim was received?

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(MARK ONLY ONE)

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Yes
No (SKIP TO Q12)
Don’t know or not sure (SKIP TO Q12)
Thinking about the notification/confirmation from VA, was it clear and easy to understand? (MARK ONLY ONE)
Not at all clear
Somewhat clear
Completely clear (SKIP TO Q11)
Don’t know or not sure (SKIP TO Q11)
I did not read the letter (SKIP TO Q11)
What did you find unclear/didn't understand in the notification/confirmation? (Please specify): ___________________________
___________________________________________________________________________________________________________

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Did you contact VA to obtain clarification about the notification/confirmation? (MARK ONLY ONE)
Yes
No
Don’t know or not sure
Did VA require you to provide additional medical evidence beyond the information you provided with your original claim?

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(MARK ONLY ONE)

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Yes
No (SKIP TO Q15)
Don’t know or not sure (SKIP TO Q15)
After you submitted your claim, did VA schedule a medical examination for you to be re-evaluated? (MARK ONLY ONE)
Yes
No (SKIP TO Q15)
Don’t know or not sure (SKIP TO Q15)
Not applicable (SKIP TO Q15)
Did the exam address your claimed condition(s)? (MARK ONLY ONE)
Yes
No
Don’t know or not sure
Have there been any interruptions to your benefit payments in the past 6 months? (MARK ONLY ONE)
Yes
No (SKIP TO Q17)
Don’t know or not sure (SKIP TO Q17)
Did you receive a letter notifying you as to the reason why your benefit payment was interrupted and/or terminated?
(MARK ONLY ONE)

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Yes

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No

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Don’t know or not sure

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Benefit Entitlement (Continued)
17.

The following question asks you to rate various aspects of your VA experience, using a scale of 1 to 10 where 1 is Unacceptable,
10 is Outstanding, and 5 is Average.
Please rate your compensation benefit on the following items:
(MARK ONLY ONE PER ROW)
Unacceptable
Average
Outstanding
1

a.

Combined disability evaluation rating percentage (e.g., 10% disabled)

b.

Timeliness of receiving benefit

c.

Clarity of your disability rating

d.

Overall rating of your benefit payment

¡
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2

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3

£
£
£
£

4

¢
¢
¢
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5

∞
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•
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10

N/A

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NA

NA

NA

Overall
Experience
with Benefit Program
(
)
MARK ONLY ONE PER ROW

18.

Thinking about ALL aspects of your experience with your compensation benefits, please rate VA overall, using a scale of 1
to 10 where 1 is Unacceptable, 10 is Outstanding, and 5 is Average. (MARK ONLY ONE)
Unacceptable
Average
Outstanding
1

2

3

4

5

6

7

8

9

10

¡ ™ £ ¢ ∞ § ¶ • ª ‚
Overall Experience with VA
19.

Taking into consideration all of the non-medical benefits (e.g., education, compensation, pension, home loan guaranty,
vocational rehabilitation and employment, insurance, etc.) you have applied for or currently receive, please rate your
experience with VA overall, using a scale of 1 to 10 where 1 is Unacceptable, 10 is Outstanding, and 5 is Average.
(MARK ONLY ONE)

Unacceptable
1

2

Average
3

4

5

Outstanding
6

7

8

9

10

¡ ™ £ ¢ ∞ § ¶ • ª‚
20.

Now think about your experiences with all the services provided by the Department of Veterans Affairs (which include
healthcare, benefits programs, or memorial services). Please tell us how you feel about the following statements.
(MARK ONLY ONE PER STATEMENT)

a.
b.
c.
d.
21.

Strongly
Disagree

Disagree

Neutral

Agree

Strongly
Agree

¡
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£
£
£
£

¢
¢
¢
¢

∞
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∞

I got the service I needed
It was easy to get the service I needed
I felt like a valued customer
I trust VA to fulfill our country’s commitment to Veterans

Do you have any other comments or concerns about your experience?
__________________________________________________________________________________________________________

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© 2016 J.D. Power and Associates. All Rights Reserved. 6

THANK YOU FOR TAKING THE TIME TO PARTICIPATE IN THIS IMPORTANT STUDY.
Please return to: J.D. Power and Associates Survey Processing Center
P.O. Box 510030 • Livonia, MI 48151-9907
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234332/0216/6

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