“In fiscal year (FY) 2018, the Veterans Benefits Administration (VBA) paid over $27 billion in annual benefits to more than 680,000 veterans receiving disability compensation at the 100 percent rate. The number of veterans receiving this level of disability compensation increased from about 260,000 in FY 2008, according to VBA’s FY 2008 and FY 2018 Annual Benefits Reports. VA’s disability compensation program, administered by VBA’s Compensation Service, pays veterans benefits for service -connected disabilities based on the degree of the disability. A service-connected disability is the result of a disease or injury that happened during or was made worse by active military service…”
“Based on the significant cost of disability compensation benefits and other services for P&T veterans and their dependents, and the increasing number of veterans receiving these benefits, the OIG sought to determine whether VBA decision makers cited adequate medical evidence in rating decisions used to establish P&T status for veterans with at least one disability rated as 100 percent disabling.”
What the Review Found
“The OIG reviewed a statistical sample of 100 veterans’ rating decisions, from an estimated population of over 24,800 veterans with at least one disability rated at 100 percent as of August20, 2018, and a P&T status decision issued from October 1, 2017, to September14, 2018, to determine whether VBA decision makers cited adequate medical evidence to support establishing P&T status. The OIG found that 61 percent of the rating decisionsdid not cite adequate evidence showing the disabilities were permanent and estimated that VBA staff established P&T status for about 15,100 veterans without this evidence. VBA’s rating decisions also lacked a clear explanation of the benefits associated with establishing P&T status. VBA staff are not likely to reevaluate P&T status decisions because the decisions are effectively considered permanent with no controls for future examinations that may show a change in the disability. Furthermore, when a P&T status rating decision does not cite adequate medical evidence, ineligible veterans and their dependents may improperly receive benefits or services…”
“The OIG estimated that VA improperly paid about $38 million in additional benefits related to P&T status between October 1, 2017, and December 31, 2019, to veterans under the age of 55…”
What the OIG Recommended
“The OIG recommended that the under secretary for benefits ensure the adjudication procedures manual is updated for consistency with all applicable laws, regulations, and policies for P&T status decisions; make certain that decision-making staff support P&T status decisions by describing the evidence used to make their conclusions; replace the title “Dependents’ Educational Assistance under 38 U.S.C. Chapter 35” and the standardized language used in rating decisions to clearly state that P&T status is being considered; and ensure appropriate training is provided to decision-making staff based on the updated procedures, and monitor the effectiveness of that training…”
Access the full 45-page report here.
Source: The Veterans Benefits Administration Inadequately Supported Permanent and Total Disability Decisions – September 10, 2020. VA OIG.
