The American Legion disputed the veracity of numbers promoted by the Obama administration touting its success in judging benefit claim applications from veterans suffering from post-traumatic stress disorder, military sexual trauma and other complex disabilities.
The Department of Veterans Affairs’ (VA) weekly Monday Morning Workload reports, published as part of its Transparency Program, inflates its department’s accuracy in adjudicating complex veteran benefit claims, according to the veteran organization the American Legion’s deputy director of benefits Zachary Hearn’s Dec. 4 testimony before the House Veterans Affairs subcommittee on disability and memorial affairs.
VA’s numbers “are not consistent” with and stand “in stark contract” to the American Legion’s own reports, according to Hearn’s testimony.
“Unfortunately, during these visits, it became clear through discussion with senior VARO staff that experienced staff is at a premium. Much of the staff has less than five years experience and may not have either the experience or knowledge base to accurately adjudicate complex claims,” Hearn stated in his written testimony, referring to the American Legion’s quality review visits to VA regional offices (VARO).
“Furthermore, VA’s accuracy statistics from the Monday Morning reports are not consistent with the review of recently adjudicated claims as conducted by the American Legion ROAR teams. When visiting VAROs over the past year, ROAR staff reviewed 260 claims adjudicated by the VAROs. Of those 260 claims, 55 percent were identified as having errors, particularly regarding the development of the claim,” Hearn said.
“This statistic is in stark contrast to the approximate 90 percent accuracy rating in claims’ adjudication indicated by VA’s Monday Morning workload reports,” Hearn noted.
“The American Legion believes VA should provide better information regarding VA disability claims in a public venue. Veterans and their families should have the opportunity to know the accuracy of adjudications,” Hearn said.
“Developing a plan to improve accuracy is essential because it has a definite and measureable impact on the lives of veterans. It is sometimes difficult to put the importance of accuracy in perspective, and to realize the scope of the impact of accuracy on these claims, consider the following statistics. As previously noted, the February 2013 CRS report indicated 386,386 service members diagnosed with PTSD, TBI, and/or amputations. If each veteran diagnosed with these conditions sought service connection, even utilizing VA’s favorable 90 percent adjudication accuracy rating, 38,638 veterans would either not be receiving service connected disability compensation or would be underrated for these conditions,” Hearn said.
“If the accuracy of these claims were closer to the accuracy levels documented by The American Legion in the past 12 months during ROAR visits, over 212,000 veterans — roughly the size of Reno, Nevada — would either not be receiving service connected disability compensation or would be underrated for these conditions. For those veterans, VA’s accuracy rate might as well be zero.”
“Veterans suffering from PTSD, TBI, amputations, or MST are often the most vulnerable veterans. Mobility, employment, and treatment are just some of the many issues that these veterans may face. With denial of these benefits, the opportunity for VA health care may not exist. Furthermore, denial of these benefits could exclude veterans from additional benefits they are entitled to, such as federal hiring preference and elimination of the VA funding fee for VA mortgages,” Hearn testified.
VA declined to comment to TheDC on the statistical discrepancy.
