A Report Finds Thousands Of Veterans Had VA Claims Improperly Denied During The Pandemic
A VA Inspector General's report has found that the agency improperly denied benefits to thousands of veterans who couldn't see a doctor during the pandemic.
Marc Session of Chula Vista, California was 34 years old when he entered Navy boot camp. He retired in 2017 after 20 years of service, and like many vets, he has lingering issues from his time in the service, especially with his back. He's been wrestling with the Department of Veterans Affairs benefits process since his retirement.
Since the pandemic began last year, his biggest challenge has been getting in to see a doctor.
"I initially was scheduled in February, then it was rescheduled until September, then September to October, then in October I finally got scheduled for November," Session said.
Even in a normal year, the VA claims process is long and exhausting, Session said. But it's been worse during the pandemic, and now, he said, he just wants to be done with it.
"It's very frustrating," he said. "I want this whole situation to be over. Finally, not have to worry about any more exams or having to contact my attorney or anything like that."
A new report by the VA Inspector General concluded that the agency improperly denied thousands of claims during the pandemic. The backlog of exams ballooned to 1.5 million in July 2020, about three months after the VA shut down all in-person appointments and attempted to move them online.
Even though VA leadership declared that no veterans should have their claims denied because it wasn't safe to see a doctor, the Inspector General found that agency employees rejected more than 12,000 claims.
"They didn't get the memo, because there was so much happening," said Session's private attorney, Casey Walker, who once worked for the VA.
In part, he blamed the problems on VA staff working from their homes.
"A lot of these employees worked from home for the first time ever," Walker said. "Many of them were not too capable with their technology at home. They always worked at the regional office their entire lives."
The VA made the backlog worse by issuing confusing guidance about mental health disability claims. It told outside mental health providers not to fill out disability benefits questionnaires for patients remotely, Walker said. Meanwhile, it instructed its own doctors and contractors to see patients only using telehealth.
"Almost in the same month, they said you must do all mental health exams by telehealth means," Walker said. "Then I thought, what gives here?"
The VA's website now shows nearly all of the country is open for in-person exams to some degree, allowing the agency to chip away at the backlog of exams.
"I have noticed more examination reports coming in. So I know that they are working on the exams that were pending throughout the pandemic. So that's a start," said Maura Clancy, an attorney who handles veteran benefits appeals for Chisholm Chisholm & Kilpatrick, a national law firm based in Rhode Island.
The VA told its Inspector General that the agency is looking at cases denied since the pandemic began. But Clancy said vets shouldn't count on their cases being reopened automatically. Instead, she advises them to assume they'll have to file appeals.
"It only helps the case, I think, to be able to point to what VA's guidance was in the beginning of the pandemic, which was those denials weren't supposed to happen," Clancy said. "And hopefully, they will take some corrective action."
Instead of scheduling new exams for every veteran with a denied claim, Clancy hopes the VA will lean more heavily on existing medical records - what the VA calls Acceptable Clinical Evidence.
The VA has been trying to clear its backlog of benefit claims for years. Designed to speed up the process, the Veterans Appeals Improvement and Modernization Act went into effect fully in 2019. The new system gives veterans more options for appeals after claims are denied.
But according to advocates who help guide veterans through filing disability claims, rolling out the new system just as the pandemic hit probably created even more cracks in the claims process.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.