Topics: Veterans Affairs

MAKING AMERICA'S HEROES WAIT: Critics, IG say VA benefits claims books being cooked

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Politics,News,Watchdog,Mark Flatten,VA Disabilities,Veterans Affairs,Veterans

Second of a five-part series

Accuracy reports have been manipulated by the Department of Veterans Affairs to make it appear employees make fewer mistakes on claims for disability payments than they actually do, The Washington Examiner has found.

Audits of individual case files by the agency's inspector general consistently show error rates on disability claims much higher than those claimed in official reports.

The IG also found the agency's accuracy gauge is easily manipulated by VA officials seeking to improve their apparent performance.

The pressure to process benefits claims cases as quickly as possible creates an incentive to "cook the books," according to veterans advocates and the VA's own internal investigators.

"VA is notorious for flat-out cooking the books," said Paul Sullivan, a former VA official who is now a board member of the group Veterans for Common Sense. "The error rate is under-reported and it's intentional. VA is trying to hide VA's blunders and mistakes."

Sullivan is also director of veterans outreach at the law firm Bergmann & Moore, which represents veterans with VA claims.

Mistakes can doom veterans to years of appeals as they fight to correct improper denials that prevent them from receiving monthly stipends federal laws entitles them to due to service-connected health conditions.

VA Secretary Eric Shinseki vowed in 2009 that all disability rating claims would be processed within 125 days with 98 percent accuracy by 2015. Currently more than 70 percent of the cases have lingered past the deadline. The agency claims an average accuracy rate of 86.3 percent.

Making America’s Heroes Wait
A Washington Examiner Watchdog investigative series on the Department of Veterans Affairs’ broken promises to U.S. military veterans.
Yesterday: Vets trapped in endless VA bureaucracy
Today:: Critics, IG say VA cooks claims books
Coming tomorrow: Vets face lies, damn lies and VA statistics
Coming Thursday: Claims backlog not our fault, VA officials say
Coming Friday: Claims backlog grows despite parade of VA ‘solutions’
Read the entire series at this link

The accuracy figure comes from VA's Systematic Technical Accuracy Review (STAR) system implemented in 1999 to track and reduce errors. Rating decisions from each of the regional offices are randomly selected by STAR reviewers and analyzed to determine if they were processed correctly.

But a 2009 report by the IG found multiple ways VA officials were gaming the system by ensuring certain types of cases were not being counted in STAR.

Requested files were not sent to STAR reviewers or were transferred to other regional offices. Mistakes in those cases were not factored into the official numbers.

The practices allowed regional offices to "inappropriately withhold a claim from the STAR reviewers if they suspect the claim to have errors," the IG concluded.

Mistakes also were made by STAR reviewers, and were not corrected when they were identified, the IG found.

The bottom line was that the actual error rate was about 23 percent, 10 points higher than claimed in STAR. That translates to another 88,000 veterans whose claims were mishandled in one year.

"There's clearly enough evidence in the benefits inspections reviews to say there's a problem with accuracy," Linda Halliday, assistant VA inspector general for audits and evaluations, told The Washington Examiner.

Pressure to fast-track cases often leads to mistakes, Halliday said. The pressure also can lead to "gaming" STAR data as raters and their bosses try to make their productivity numbers look good, she said.

The IG has not yet followed up to ensure the problems it identified in STAR have been fixed. VA officials told the Government Accountability Office in 2010 they had taken steps to address the shortcomings identified by the IG, including cases withheld from STAR examiners or transferred to other offices.

Sullivan and other veterans' advocates also say the tactics identified in the 2009 IG report are still being used.

VA officials refused multiple interview requests for this story.

Since the 2009 audit, the disparities between what is reported in STAR and what the IGs find in examinations of individual regional office has gotten worse.

In 2009, the IG began auditing cases dealing with certain high-risk conditions, including traumatic brain injury and illnesses linked to the Vietnam-era herbicide Agent Orange.

A May 2011 report summarizing results from 16 regional offices projected an error rate of 23 percent. By May 2012, when 50 offices had been reviewed, the error rate had reached 30 percent. By contrast, VA claimed an error rate of less than 14 percent.

"I don't think there is any question that this is a cultural challenge," said Sen. Richard Burr, R-N.C., the ranking Republican on the Senate Veterans' Affairs Committee. "The system they have designed has no penalty, no downside for inaccuracy."

Mark Flatten is a member of The Washington Examiner's Watchdog reporting team. He can be reached at mflatten@washingtonexaminer.com.

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