VA Watchdog Finds Data Manipulation of Disability Claims at Arkansas Facility

Employees at the Veterans Affairs Department’s regional office in Little Rock, Ark., changed the dates of disability claims in dozens of cases, making it appear that the department was making more progress than it was on eliminating the long-standing backlog, according to a new inspector general report.

Staff at the Little Rock facility told the IG they were following guidance from the department’s Veterans Benefits Administration, which allowed them to adjust the dates of pending claims found in the backlog to the date of “discovery” rather than the date of receipt by the department for tracking purposes. An average of 20 months had elapsed between when the VA received the documentation in 43 cases requiring disability ratings, and the date that employees found the claim in the file. Among those cases, one claim was actually two decades old and had been changed to appear 14 days old.

The VBA terminated the departmentwide guidance, known in government jargon as Fast Letter 13-10, in January after first suspending it in June 2014. That guidance had superseded a prior directive instructing staff to use the earliest date stamp on the claim document for tracking. “Use the date a previously unadjudicated claim is discovered as the date of claim for system control purposes,” stated the now-defunct FL 13-10. “The earliest date stamp shown on the discovered document shall not be used as the date of claim for purposes of establishing the EP [end product], but it must be considered when determining the effective date if benefits are granted. This will ensure that the claimant is paid properly.”

As part of its investigation, the VA IG reviewed documentation related to 48 unadjudicated claims discovered from May 22, 2013, through June 20, 2014, at the Little Rock facility.

The IG said staff at the Little Rock VA regional office expressed concern over using the date of discovery rather than receipt for tracking unadjudicated claims, noting it was “not in the best interest of veterans” and could lead to even further delays in benefits decisions for veterans. To avoid such delays, facility staff created a spreadsheet with more detailed information on the unadjudicated claims to help ensure the oldest claims were processed first because “it was the right thing to do,” said the IG report.

The VA did not immediately respond to a request for comment about the report beyond the department’s formal response included in the audit. The VA agreed with the IG’s recommendation to adopt a universal policy on tracking disability claims. While the VBA agreed with the IG and rescinded FL 13-10, the IG worried that conflicting guidance on the issue remains.

VA often touts its progress in reducing the disability claims backlog, particularly now after last year’s eruption of the scandal involving patient wait times and data manipulation within the Veterans Health Administration prompted a large-scale reform effort. As of Feb. 21, the disability claims backlog was at 224,535 claims, down from 611,073 claims in March 2013. Claims in the backlog have been pending for more than 125 days. The growing number of claims filed by veterans who served in Iraq and Afghanistan has put pressure on a department already facing numerous challenges.

Last year, the IG found problems with data manipulation and unopened mail at VA facilities in Philadelphia and Baltimore, according to a July 15, 2014, Associated Press report. Lawmakers and the IG office have questioned the VA’s backlog numbers as well as the accuracy of claims processing and the amount of benefits payments to vets.

“This report underscores why I agree with VA Assistant Inspector General for Audits and Evaluations Linda Halliday’s assertion that VA’s backlog numbers are not to be trusted," said House Veterans' Affairs Committee Chairman Jeff Miller, R-Fla., in a statement on the Feb. 26 report. "Right now it’s incumbent upon VA leaders to ensure the claims of veterans affected by this scheme are correctly processed while moving swiftly to hold the responsible employees accountable. Although I believe Secretary McDonald is trying hard to correct VA’s course, the fact that incidents like this are still occurring highlights the scope of the challenges he is facing.”

An excerpt from an August 2014 email exchange between VA Deputy Secretary Sloan Gibson and Deputy IG Richard Griffin highlighted the tension between the VBA and its watchdog.

“Every week I get the summaries of IG reviews of regional offices where I see the same findings over and over,” Gibson wrote in part to Griffin in the Aug. 4 message. “Every time I follow up with Allison [Hickey, VA undersecretary for benefits], I get the same sense of fundamental disconnect between what they consider important and your teams [sic] audit. I would like to have an unemotional, open and candid discussion about these issues to see if we can’t reconcile these different views,” Gibson continued. “I do not believe that veterans are best served by the continued disconnect between VBA and our IG.”

About an hour later in response to Gibson’s email, Griffin wrote that he “looked forward to the meeting,” adding that the “VBA is in denial.”

(Image via Zonia / Shutterstock.com)