U.S. Department of Veterans Affairs
In 2023, Friends From The City and partners teamed up with the Department of Veterans Affairs to streamline, simplify, and enhance the VA’s debt repayment process. Previously, Veterans would either reach out to VA’s debt management help desk or submit a Financial Status Report (FSR, VA Form 5655) by mail to establish a repayment plan or request a waiver. Although the FSR transitioned to a digital format in 2020, the new online option lacked user-testing and effective communication to Veterans.
Our agile, cross-functional Debt Resolution team collaborated with the VA to define, design, develop, and deploy new features for the digital Enhanced Financial Status (eFSR) form. We adopted an iterative, research-driven approach to improve the Veteran experience, with a focus on accessibility and usability. The eFSR enhancements paved the way for the development of the Streamlined Waiver, a Presidential Initiative, providing Veterans with an accelerated path to immediate medical copay debt relief.
Historically, Veterans managed their VA debt by submitting a Financial Status Report (FSR) as the first step. VA debt sources varied from GI Bill overpayments to unpaid medical copays. However, many Veterans found the FSR form confusing, and the approval process was complicated. For instance, Veterans needed to complete, print, and return the FSR to the VA by mail. Subsequently, they had to draft and submit a separate eligibility document to request a waiver, compromise, or repayment plan approval. Throughout the process, Veterans couldn’t track their applications. Instead, they had to wait for a decision by mail. If the submitted FSR contained errors or incomplete information, the process had to begin again. Many Veterans abandoned the process midway, resulting in benefits garnishments, penalty fees, and unnecessary charge-offs. Understandably, this cycle negatively impacted Veterans and diminished their trust in the VA.
Our goal was to enhance the debt management process and, ultimately, restore Veteran's trust. We analyzed previous research, including usability studies, and identified significant opportunities for immediate improvement.
Subsequently, we performed a heuristic evaluation, uncovering 66 surface-level design and coding issues with the FSR form. These challenges varied from accessibility concerns to design inconsistencies, such as confusing list loop patterns and other development issues.
Based on our findings, we submitted 14 pull requests to immediately address a variety of issues. These included addressing color contrast, spacing and heading inconsistencies, and removing nested field sets.
We then shifted towards an empathetic approach, considering factors such as personal attitudes towards finance and debt, levels of financial hardship, and varying degrees of financial literacy among Veterans.
However, a significant issue we identified was the previous lack of Veteran engagement in prior studies. To address this, we introduced collaborative co-design sessions with Veterans to gain a deeper understanding of their personal experiences with the debt management process. Although co-design sessions are a newer concept within the VA, they received positive feedback from Veteran participants and observing stakeholders.
"I attended one session, and it had a profound impact on how I empathize with Veterans with visual difficulties. Knowing they can't just simply make it easier on themselves. There are so many pain points. It had me thinking the rest of the day. I'm glad we're doing this because it does seem like it falls between the cracks when you're developing. Makes a difference for so many. Makes the overall UX experience better. It was really interesting."
The feedback collected from the co-design sessions proved invaluable. It played a pivotal role in the development of an end-to-end eFSR clickable prototype, which served as a critical tool in our following usability study.
We framed the usability study around the following questions:
We recruited participants from a wide demographic of backgrounds and abilities to ensure that our data reflected the diverse population of Veterans. Following the study, we made several improvement recommendations.
From a usability standpoint, we enhanced the FSR form by removing nested field sets and adding contextual help text to clarify commonly misunderstood terminology, among other refinements. We standardized the FSR using the VA Web Design System. Lastly, we created multiple persona-based user flows for the Streamlined Waiver, and we conducted a usability test to improve the streamlined waiver user experience.
"I think it's very easy to use, like way easy to navigate, and I don't have any issues filling out the form. But I like the definition of each term, like what you need to fill out."
By July and August of 2023, we successfully launched the new eFSR and Streamlined Waiver for 100% of Veterans.
As a result:
Additionally, we uncovered significant human-level issues such as homelessness, technology limitations, and mental health challenges among Veterans. This data prompted the team to adopt more trauma-informed design and research practices, leading to the creation of an emergency protocol for Veterans experiencing crises during user engagements.
We are still collaborating, innovating, and refining our solutions to ensure that Veterans can easily access the debt relief they deserve. Friends From The City remains steadfast in providing ongoing support to the Veterans Administration's effort to deliver more human-centered products and services.
