In rush to cut benefits backlog, VA made errors

WASHINGTON (AP) -- In a rush to cut a huge backlog of claims for disability benefits, the Department of Veterans Affairs is making payments to tens of thousands of veterans without adequate medical evidence that they deserve the benefits, the department's inspector general's office said Monday.

Without improvements, the VA could make unsupported payments to veterans totaling about $371 million over the next five years for claims of 100-percent disability alone, said Linda Halliday, an assistant inspector general.

The IG's office also found widespread problems at VA regional offices in Philadelphia and Baltimore, including mail bins full of disability claims and associated evidence that had not been electronically scanned for three years.

Spot inspections revealed that the VA also made errors in 1 in 4 claims involving traumatic brain injury, Halliday told the House Veterans Affairs Committee at a hearing Monday night.

"Improved financial stewardship at the agency is needed," Halliday said. "More attention is critical to minimize the financial risk of making inaccurate benefit payments."

Special initiatives designed to remove older claims and speed processing of new claims are worthwhile, Halliday said, but in some cases they "have had an adverse impact on other workload areas" such as managing appeals filed by veterans and reducing overpayments to veterans.

The VA used the hearing to claim "tremendous progress" in reducing a disability claims backlog that reached about 611,000 in March 2013. The backlog is now about 275,000 -- a 55 percent decrease from the peak, said Allison Hickey, undersecretary for benefits at the VA.

Last year, the Veterans Benefits Administration completed a record 1.2 million disability rating claims, Hickey said, and the agency is on track to complete more than 1.3 million rating claims this year and pay a total of $67 billion in benefits -- about half the VA's budget. More than 90 percent of the claims are being processed electronically, she said.

The VA has long struggled to cope with disability claims. The backlog had intensified in recent years as more solders returned from Iraq and Afghanistan, and as the VA made it easier for Vietnam-era veterans to get disability compensation stemming from exposure to Agent Orange.

The VA has set a goal to process all claims within 125 days at 98 percent accuracy in 2015, but so far has fallen far short. The agency now processes most claims within 154 days at a 90-percent accuracy rate, compared with an accuracy rate of 86 percent three years ago, Hickey said. At one point, veterans were forced to wait an average nine to 10 months for their disability claims to be processed.

"It has never been acceptable to VA ... that our veterans are experiencing long delays in receiving the benefits they have earned and deserve," Hickey said. She said the department has spent the past four years redesigning and streamlining the way it delivers benefits and services.

Halliday, however, said her investigators have found numerous problems in handling VA benefits, including faulty claims processing that "increases the risk of improper payments to veterans and their families."

Inspectors surveying Philadelphia's VA benefits center in June found mail bins brimming with claims and associated evidence dating to 2011 that had not been electronically scanned, she said.

Inspectors also found evidence that staffers at the Philadelphia regional office were manipulating dates to make old claims appear newer. The findings are similar to problems that have plagued VA health centers nationwide. Investigators have found long waits for appointments at VA hospitals and clinics, and falsified records to cover up the delays.

In Baltimore, investigators discovered that an employee had inappropriately stored thousands of documents, including some that contained Social Security data, in his office "for an extensive period of time." About 8,000 documents, including 80 claims folders, unprocessed mail and Social Security information of dead or incarcerated veterans, were stored in the employee's office, Halliday said.

Kristen Ruell, an employee at the VA's Pension Management Center in Philadelphia, told the committee that mail routinely "sat in boxes untouched for years" at the pension office. Once, after becoming concerned that unopened mail was being shredded, Ruell opened the boxes and took photos. Instead of addressing the problem, she said, VA supervisors enacted a policy prohibiting taking photos.

After VA officials in Washington issued a directive last year ordering that a backlog of claims older than 125 days be reduced, the Philadelphia office "took this to mean that they could change the dates of every claim older than six weeks," Ruell said. While pension center managers later told the IG's office that the mislabeling was based on a misunderstanding of the directive, Ruell said, "these behaviors are intentional."

The incorrect dates "are used to minimize the average days pending of a claim to make the regional office's numbers look better," she said. For instance, claims that should have been dated 2009 were dated 2014, "therefore making the claim appear 'new,' " she said.

"The VA's problems are a result of morally bankrupt managers that through time and (government service) grade have moved up into powerful positions where they have the power to and continue to ruin people's lives," Ruell said.

Lawmakers in both parties have complained about the Obama administration's handling of the benefits backlog and some have called for an independent commission to address it.

___

Follow Matthew Daly on Twitter: https://twitter.com/MatthewDalyWDC

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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