Hun­dreds of mil­lions in bo­gus claims at VA

Whistle­blower claims ig­nored

The Washington Times Weekly - - Politics - BY STEPHEN DI­NAN

The VA’s rush to cut a huge back­log of claims from dis­abled vet­er­ans has forced it to cut cor­ners else­where, and yet the depart­ment is still botch­ing about one out of ev­ery 10 claims de­ci­sions, top of­fi­cials and whistle­blow­ers tes­ti­fied to Congress on Mon­day, sig­nal­ing that the prob­lems go far be­yond the hospi­tal wait times that have plagued it.

The very pro­gram the Obama ad­min­is­tra­tion started years ago to cut the back­log has re­sulted in bad de­ci­sions that have forced many vet­er­ans into a lengthy ap­peals process and cre­ated back­logs in other claims such as de­pen­dents’ ben­e­fits, mem­bers of the House Com­mit­tee on Vet­er­ans’ Af­fairs con­cluded.

Whistle­blow­ers, mean­while, de­scribed im­por­tant claims documents set to be shred­ded, a cul­ture of ig­no­rance and re­tal­i­a­tion among man­agers and pres­sure to quickly get through the back­log, which meant some vet­er­ans likely got shut out of ben­e­fits, while oth­ers may have scammed the sys­tem. All the while, ap­peals have shot up.

“These are vet­er­ans. I mean, some­body would be asleep at the wheel not to re­al­ize these things were go­ing up,” said Ron­ald Robin­son, a se­nior vet­er­ans ser­vice rep­re­sen­ta­tive and one of three whistle­blow­ers to tes­tify.

The rev­e­la­tions come even as Vet­er­ans Af­fairs’ deals with the fall­out from its se­cret wait lists and ac­cu­sa­tions of botched treat­ment for vet­er­ans seek­ing med­i­cal care. Taken to­gether, they show a depart­ment grap­pling with its mis­sion at a time when its caseload is sky­rock­et­ing af­ter more than a decade of the war on ter­ror.

As with the health care scan­dal, the VA has cooked the books on wait times for disability ben­e­fits, and some of­fices stand ac­cused of shred­ding mail or leav­ing it to pile up in bins, po­ten­tially ob­struct­ing some valid claims, the VA’s in­spec­tor gen­eral found.

The IG also said it’s seen in­stances in which the VA was mak­ing mul­ti­ple pay­ments to the same vet­eran be­cause his or her records were du­pli­cated in the sys­tem — yet man­agers, who were made aware of the prob­lem, didn’t con­sider it a pri­or­ity to cor­rect it.

“Im­proved fi­nan­cial stew­ard­ship is needed,” Linda A. Hal­l­i­day, the VA’s as­sis­tant in­spec­tor gen­eral for au­dits and eval­u­a­tions, said in tes­ti­mony pre­pared for Mon­day’s hear­ing.

Al­li­son A. Hickey, VA un­der­sec­re­tary at the Vet­er­ans Ben­e­fits Ad­min­is­tra­tion (VBA), said de­lays in vet­er­ans get­ting their pay­ments “has never been ac­cept­able” and said the depart­ment has been try­ing for four years to get a han­dle on the sit­u­a­tion.

Un­der for­mer Sec­re­tary Eric K. Shin­seki, who re­signed ear­lier this year amid the grow­ing scan­dal over health care, the VA set a goal of elim­i­nat­ing the back­log of disability cases and pro­cess­ing all claims within 125 days, at a 98 per­cent ac­cu­racy rate, by next year.

Ms. Hickey said they have suc­ceeded in cut­ting the back­log and re­duc­ing the aver­age pro­cess­ing time and said they’ve man­aged to main­tain qual­ity in their de­ci­sions.

“We have in­creased our claim­based ac­cu­racy from 86 per­cent in 2011 to 90.3 per­cent to­day,” she said in her pre­pared tes­ti­mony.

But the rate varies dra­mat­i­cally among the VA’s re­gional of­fices, with some show­ing ac­cu­racy rates of 96.8 per­cent, while oth­ers fell be­low 80 per­cent when mea­sured by a claims-based method.

The VA has in­tro­duced a new is­sue-based ac­cu­racy rate, which scores some­what higher — but au­di­tors ques­tioned that mea­sure, say­ing the VA ig­nores com­monly ac­cepted sta­tis­ti­cal meth­ods in mak­ing the cal­cu­la­tions.

“VBA is pro­duc­ing im­pre­cise es­ti­mates of ac­cu­racy that, while not com­pletely re­li­able, are be­ing used by pro­gram man­agers to guide im­prove­ment ef­forts,” Daniel Ber­toni, di­rec­tor of ed­u­ca­tion, work­force and in­come se­cu­rity is­sues at the Govern­ment Ac­count­abil­ity Of­fice, tes­ti­fied.

“VBA also missed an op­por­tu­nity to win the pub­lic’s trust when it in­tro­duced a new ac­cu­racy mea­sure with­out full ex­pla­na­tion of its mean­ing and lim­i­ta­tions. At the same time, VBA is ex­pend­ing more re­sources than needed to pro­duce its ac­cu­racy es­ti­mates — re­sources that could be bet­ter used to achieve more pre­cise es­ti­mates or drill down on er­ror trends to guide im­prove­ment ef­forts,” he said.

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