VOV (Voice of Veteran) Surveys

VOV (Voice of Veteran) Surveys

VBA_Comp & Pen_Enrollment questionnaire_

VOV (Voice of Veteran) Surveys

OMB: 2900-0782

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Voice of the Veteran Enrollment Satisfaction 4/30/2013

Compensation & Pension

Compensation sample population definition: Individuals who have received a decision in the past 30 days (includes those who were found eligible on a new or subsequent claim and those who have been denied and are not appealing the decision) [DO NOT INCLUDE]


Pension sample population definition: Individuals who have received a decision in the past 30 days (includes those who were eligible on a new claim, and those who were denied and are not appealing the decision) [DO NOT INCLUDE]


[DO NOT DISPLAY/IDENTIFY SECTION HEADERS. DISPLAY SINGLE QUESTION PER PAGE.]


[RESPONSE CODES APPEAR IN BRACKETS AT THE END OF EACH RESPONSE FOR SINGLE RESPONSES AND IN THE PROGRAMMING INSTRUCTIONS FOR MULTIPLE RESPONSES.]

Benefit Information


  1. How did you FIRST learn about VA benefit programs? (Mark only one) If you are unsure, please indicate the first way you remember learning about VA benefit programs. [RADIO BUTTONS. SINGLE RESPONSE.]

    1. VA website [1]

    2. VetSuccess.gov [2]

    3. eBenefits.va.gov [3]

    4. Mail (from VA) [4]

    5. VA phone number (800-827-1000) [5]

    6. Transition Assistance Program/Disabled Transition Assistance Program briefings [6]

    7. Veterans Service Organizations, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc.

(Specify) ______________ [TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.] [7]

    1. VA medical center [8]

    2. VA Vet center [9]

    3. In person at a Regional Office [10]

    4. Social media websites (e.g., Facebook, Twitter, etc.) [11]

    5. Visit from a VA employee [12]

    6. Other Veterans [13]

    7. Internet (excluding VA and social media sites) [14]

    8. Friends or family [15]

    9. Other publications (e.g., Army Times, local newspaper, etc.) [16]

    10. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.] [97]

    11. Don’t know or not sure [99]


  1. What method(s) do you MOST FREQUENTLY use to obtain general information about VA’s benefits or services? (Mark all that apply) [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Phone

    2. Mail

    3. E-mail

    4. In person at a Regional Office

    5. Veterans Service Organizations, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc. (Specify) _________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    6. Disabled Veterans’ Outreach Program

    7. VA website

    8. VetSuccess.gov

    9. eBenefits.va.gov

    10. Social media websites (e.g., Facebook, Twitter, etc.)

    11. Other websites (excluding VA or social media sites)

    12. VA medical center

    13. VA Vet center

    14. Friends or family

    15. Other publications (e.g., Army Times, local newspaper, etc.)

    16. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    17. Don’t know or not sure [MUTUALLY EXCLUSIVE RESPONSE.]

    18. None of the above [MUTUALLY EXCLUSIVE RESPONSE.]


  1. How frequently would you like to receive communications (e.g., e-mails, letters, newsletters, etc.) about VA benefits or services? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Weekly [1]

    2. Monthly [2]

    3. Quarterly (every 3 months) [3]

    4. Semi-annually (twice per year) [4]

    5. Annually (once per year) [5]

    6. Never [6]

    7. Don’t know or not sure [99]


  1. How would you like to receive information from VA about applying for VA benefits or services? (Mark all that apply) [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Phone

    2. Mail

    3. E-mail

    4. VA website

    5. Social media websites (e.g., Facebook, Twitter, etc.)

    6. In person at a Regional Office

    7. Veterans Service Organizations, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc. (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    8. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    9. Don’t know or not sure [MUTUALLY EXCLUSIVE RESPONSE.]



The following question asks you to rate various aspects of your experience with Compensation and/or Pension using a scale of 1 to 10, where 1 is Unacceptable, 10 is Outstanding, and 5 is Average. [SHOW ON SAME PAGE AS THE QUESTION THAT FOLLOWS]


  1. When thinking about your most frequently used methods of communication please rate your experience in obtaining information about your benefit application on the following items: (Mark only one per row) [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND ATTRIBUTES/RESPONSES IN ROWS (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, ALTERNATE SHADES IN ROWS. SINGLE RESPONSE PER ROW. RANDOMIZE ALL ATTRIBUTES EXCEPT THE LAST ONE.]

    1. Ease of accessing information [ALLOW N/A RESPONSE][1-10, N/A=99]

    2. Availability of information [ALLOW N/A RESPONSE] [1-10, N/A=99]

    3. Clarity of information [ALLOW N/A RESPONSE] [1-10, N/A=99]

    4. Usefulness of information [ALLOW N/A RESPONSE] [1-10, N/A=99]

    5. Frequency of information provided by VA [ALLOW N/A RESPONSE] [1-10, N/A=99]

    6. Overall rating of information [1-10]



Contact with VA


  1. During the past 6 months, did you contact anyone from VA about the benefit application process? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Yes [1]

    2. No [0]


(Ask Q7-Q12 if Q6 is yes, otherwise go to Q13)


  1. Which of the following best describes the reason for your most recent contact? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Resolve a problem [1]

    2. Ask a question [2]

    3. Request a change to your records/provide information [3]


  1. Can you briefly describe the nature of your most recent contact? (Mark all that apply) [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Change your address or direct deposit information

    2. Report the death of an individual who received VA benefits

    3. Report that you did not receive your VA check or direct deposit

    4. Report a problem with a VA customer service representative

    5. Ask a general question

    6. Obtain information about submitting/re-opening a claim

    7. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]


  1. Thinking about your most recent contact, how did you contact VA? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Phone [1]

    2. Fax [8]

    3. eBenefits.va.gov [10]

    4. Website [6]

    5. E-mail [7]

    6. Mail [9]

    7. In person [3]


  1. Was your most recent issue resolved? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Yes [1]

    2. No [0]


(Ask Q11 if Q10 is No, otherwise go to Q12


  1. Why wasn’t your most recent issue resolved? [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Did not receive all of the information required

    2. Received incorrect information

    3. Was referred to the incorrect office/person

    4. Waiting for follow-up from VA

    5. Other (Specify) ____________________ [TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    6. Don't know or not sure



  1. Thinking of your most recent contact with the VA, how would you rate your overall customer service experience with the VA or VA representatives using a scale of 1 to 10 where 1 is Unacceptable, 10 is Outstanding, and 5 is Average. [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND SINGLE ROW (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, SINGLE RESPONSE PER ROW.][1-10]




Benefit Eligibility and Application Process


  1. Thinking about your most recent application, did someone from VA (e.g., call center representative, office staff, etc.) provide you with information about the benefit application process? [RADIO BUTTONS. SINGLE RESPONSE]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]


  1. Thinking about your most recent benefit application, what method did you use to apply for your benefit? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE]

    1. Veterans Online Application [1]

    2. Mail [2]

    3. In person at a Regional Office [3]

    4. In person at a Veterans Service Organization, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc. [4]

    5. Other (Specify) ___________________ [TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.] [97]

    6. Don’t know or not sure [99]


  1. After you submitted your application, did you receive a letter from VA notifying you that your claim was received? [RADIO BUTTONS. SINGLE REPONSE.]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]


(Ask Q16-21 if Q15 is Yes, otherwise go to Q22)


  1. Thinking about the letter, was it clear and easy to understand? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Not at all clear [1]

    2. Somewhat clear [2]

    3. Completely clear [3]

    4. Don’t know or not sure [99]

    5. I did not read the letter [96]


  1. Did you contact VA to obtain clarification about any of the letters you received? [RADIO BUTTONS. SINGLE REPONSE.]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]


  1. Did you provide VA with the documentation that was requested in the letter(s)? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Yes [1]

    2. No [0]

    3. Nothing was requested [96]

    4. Don’t know or not sure [99]


(Ask Q19-Q20 if Q18 is yes, otherwise go to Q21)

  1. How did you submit the documentation to VA that was requested in the letter? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Mail [1]

    2. In person at a Regional Office [2]

    3. Online [4]

    4. Through a Veterans Service Organization, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc. [3]

    5. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.] [97]

    6. Don’t know or not sure [99]


  1. What is your preferred method to submit the documentation to VA that was requested in the letter(s)? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Mail [1]

    2. In person at a Regional Office [2]

    3. Online (ebenefits/ Veterans Online Application) [3]

    4. Through a Veterans Service Organization, e.g., Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America, etc. [4]

    5. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.] [97]

    6. Don’t know or not sure [99]


  1. Did you receive a subsequent letter requesting information in support of your claim from VA? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]


  1. During the application process, did you have to provide the same information more than once? (Mark only one) [RADIO BUTTONS. SINGLE REPONSE.]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]



(Ask Q23 if Q22 is Yes, otherwise go to Q24)

  1. What information did you have to provide more than once? (Mark all that apply) [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Discharge papers (DD214)

    2. Service treatment records

    3. Private medical records

    4. Other (Specify) ___________________[TEXT BOX. FORCE TEXT IF RESPONSE IS SELECTED. 50 CHARACTER MAX.]

    5. Don’t know or not sure



The following question asks you to rate various aspects of your experience with your benefit application using a scale of 1 to 10, where 1 is Unacceptable, 10 is Outstanding, and 5 is Average. [SHOW ON SAME PAGE AS THE QUESTION THAT FOLLOWS]


  1. Please rate your experience with the benefit application process on the following items: (Mark only one per row) [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND ATTRIBUTES/RESPONSES IN ROWS (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, ALTERNATE SHADES IN ROWS. SINGLE RESPONSE PER ROW. RANDOMIZE ALL ATTRIBUTES EXCEPT THE LAST ONE.]

    1. Ease of completing the application [ALLOW N/A RESPONSE][1-10, N/A=99]

    2. Timeliness of eligibility/entitlement notification [ALLOW N/A RESPONSE] [1-10, N/A=99]

    3. Flexibility of application methods [ALLOW N/A RESPONSE] [1-10, N/A=99]

    4. Overall rating of application process [1-10]


(Paper Only Instruction: Ask Q25-Q27 if previously found ineligible for VA benefit payments, otherwise go to Q28)

  1. If you were previously found ineligible for VA benefit payments, did you understand why you were found ineligible? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]

    4. Not applicable,never been found ineligible (Online Only Response) [96]


(Online Instruction: Ask Q26-Q27 if Q25 is yes, otherwise go to Q28)


  1. Were you provided information about how to appeal your decision? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE]

    1. Yes [1]

    2. No [0]

    3. Don’t know or not sure [99]


  1. Using a scale of 1 to 10, where 1 is Unacceptable, 10 is Outstanding, and 5 is Average, please rate the clarity of the information you were provided about appealing your decision. [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND SINGLE ROW (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, SINGLE RESPONSE PER ROW.][1-10]




Benefit Entitlement


The following question asks you to rate various aspects of your experience with your benefit payment using a scale of 1 to 10, where 1 is Unacceptable, 10 is Outstanding, and 5 is Average. [SHOW ON SAME PAGE AS THE QUESTION THAT FOLLOWS]


  1. Please rate your benefit payment on the following items: (Mark only one per row) [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND ATTRIBUTES/RESPONSES IN ROWS (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, ALTERNATE SHADES IN ROWS. SINGLE RESPONSE PER ROW. RANDOMIZE ALL ATTRIBUTES EXCEPT THE LAST ONE.]

    1. Amount of benefit payment [ALLOW N/A RESPONSE][1-10, N/A=99]

    2. Timeliness of receiving initial benefit payment [ALLOW N/A RESPONSE] [1-10, N/A=99]

    3. Overall rating of your benefit payment [1-10]



Overall Application Experience


  1. Thinking about ALL aspects of your experience applying for your compensation or pension benefit, 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) [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND SINGLE ROW (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, SINGLE RESPONSE PER ROW.] [1-10]



Overall Experience with VA


  1. 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) [SHOW RESPONSES IN GRID WITH 10-POINT SCALE IN COLUMNS AND SINGLE ROW (SEE JDPA CONVENTIONS DOCUMENT PG. 1 FOR SPECIFIC DETAILS OF LAYOUT). EVENLY SPACED RADIO BUTTONS/COLUMNS, SINGLE RESPONSE PER ROW.] [1-10]



  1. How likely are you to inform other Veterans or beneficiaries about your experience VA benefits or services? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Definitely will not [1]

    2. Probably will not [2]

    3. Probably will [3]

    4. Definitely will [4]


  1. Do you have any other comments or concerns about your experience? (Open Capture) [OPEN-END. TEXT BOX. 1000 CHARACTERS MAX. ALLOW NO COMMENT, MUTUALLY EXCLUSIVE CHECK BOX. CODE NO COMMENT AS 0 IF UNCHECKED AND 1 IF CHECKED]

____________________________________________________


Additional Questions


As a reminder, your responses will be kept completely confidential and will not affect any current or future benefits you may receive. [SHOW ON SAME PAGE AS THE QUESTION THAT FOLLOWS.]



  1. How are you currently using or intending to use your benefit payment? (Mark all that apply) [CHECK BOXES. MULTIPLE RESPONSE. CODE EACH RESPONSE AS 0 IF UNCHECKED OR 1 IF CHECKED]

    1. Rent/mortgage payment

    2. Paying bills

    3. Paying down debt

    4. Education expenses

    5. Establishing savings

    6. Other (Specify) ___________________ [TEXT BOX, FORCE TEXT IF RESPONSE IS SELECTED, 50 CHARACTER MAX.]

    7. Prefer not to state [MUTUALLY EXCLUSIVE RESPONSE]

    8. Don’t know or not sure [MUTUALLY EXCLUSIVE RESPONSE]


As a reminder, your responses will be kept completely confidential and your e-mail address will not be sent to VA with any responses on this survey. [SHOW ON THE SAME PAGE AS THE QUESTION THAT FOLLOWS.]


  1. Would you like to provide an e-mail address so VA can contact you with general information about VA benefits and services? (Mark only one) [RADIO BUTTONS. SINGLE RESPONSE.]

    1. Yes [1]

    2. No [0]

    3. I do not have an e-mail address [96]

    4. Prefer not to answer [98]


(Ask Q35 if Yes in Q34)

  1. Please enter your preferred e-mail address where you would like to be contacted: (Open Capture)

    1. E-mail: [TEXT BOX. 100 CHARACTER MAX.]


JDPA: V1C, V1P

OMB Control Number: 2900-0782 10

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File TitleWe are conducting a survey on behalf of the Veteran’s Benefits Administration to understand Veterans’ experience with the [INSER
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File Modified2013-05-08
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