DOD, VA need more data on how their toxic exposure tracking app is used, watchdog says

The Department of Defense and the Department of Veterans Affairs jointly launched a system in 2019 to enhance toxic exposure-related services for military personnel and veterans, but they are not fully tracking staff usage of the tool to ensure that performance expectations are being met, the Government Accountability Office said in a report released on Thursday. 

The individual longitudinal exposure record, or ILER, is a web application that aggregates information from DOD and VA records on active duty personnel and veterans who were exposed to burn pits and other toxic chemicals. 

VA’s Veterans Health Administration and Veterans Benefits Administration, in addition to the DOD, make the system available to employees to help expedite the processing of claims related to toxic exposure and provide a centralized system for related healthcare information.

GAO’s review found that VBA’s use of the tool substantially increased following enactment of the PACT Act in August 2022, which expanded access to benefits for veterans whose toxic exposure-related conditions were not previously covered by the department. VA officials announced earlier this week that 1 million claims had been granted under the law.

DOD and VA oversight of the ILER, however, has not kept pace with the growing use of the system to process veterans' disability claims. GAO said the agencies previously tracked use of the ILER through a joint Deployment Health Work Group but noted that, as of fiscal year 2024, the group is no longer doing so. 

“By monitoring such information through goals and performance measures, DOD and VA would know how ILER is being used for clinical care, processing claims and research,” the watchdog said. “This, in turn, would better position the agencies to determine if actions — such as additional outreach to staff — are needed to increase awareness about ILER and ensure it is fully used for all of its intended purposes.”

GAO interviews with DOD and VA staff using the ILER found that personnel appreciated the system’s capacity to centralize needed information and the ability to log into it from multiple internal networks. 

Employees told the watchdog, however, that the system did not often include exposure information prior to the September 11 terrorist attacks, which “can result in inefficiencies in processing and awarding disability benefits to veterans because they have to spend extra time documenting the lack of information.”

DOD and VA do collect feedback on users’ experiences with the system, the report said, and the agencies are already undertaking an effort to “automate the addition of ILER summaries” into their benefits management system to include more pre-September 11 information. That initiative is expected to be completed by “late 2024,” GAO said. 

The watchdog made four recommendations — two to VA and two to DOD — to “develop goals with performance measures on ILER use by staff type and purpose” and to “use such data to inform staff outreach and other efforts supporting ILER's use.”

Both agencies concurred with GAO’s recommendations.