Sometime in the last several years a dying veteran filed a claim with the Department of Veterans Affairs to treat liver disease brought on by heavy drinking to cope with service in the military. 

The vet had a statement from a health care provider linking the alcohol use to post-traumatic stress disorder and a failing liver.

But a claims official neglected to cite that evidence, and the VA denied the claim to treat the terminally ill patient.

The VA’s office of inspector general cited this as one example among thousands it estimates the department has mishandled. 

A study released Wednesday took a survey of the VA’s caseload in 2020 and 2021 and estimated claims processors made significant mistakes in 68% of the claims veterans filed during that time.

Claims processors gather the medical evidence that tells medical examiners what to check. In almost 40% of the cases, the report said they did not submit any relevant evidence to back up veterans’ disability claims.

In other cases, the processors did not use correct terms, or included only part of the evidence.

During an interview with researchers for the report, a VA examiner said the processors use vague, confusing language and that some requests “seem to be copied and pasted without being reviewed.”

The report blames the failures on inadequate equipment, training and oversight and says these failures could waste money, delay claims and prevent accurate medical opinions. 

The VA team noted that processors have an electronic filing system that allows them to submit claims without evidence. It recommends changing the system so those claims wouldn’t be able to go forward.

The report also cites faulty training, saying that 88% of processors who made mistakes had all the training required, but that the training didn’t explain key pieces of information, like what evidence a medical examiner would need to make a decision.

One claims processor told investigators: “No one has ever trained us what the medical opinion should actually say.” 

Another VA worker said claims processors do not really understand how to file the claims.

The VA then doesn’t adequately check its own work to spot errors, the report concluded.

Joshua Jacobs, the VA’s senior advisor for policy, agreed with the report and responded with a memo promising to add training and improve oversight and the computer filing system in the next several months.

The VA faces an additional challenge the study did not capture. The study ended in September – weeks before the VA announced that it expected a surge in claims to increase its backlog of work.

By December the backlog jumped 27% nationwide and 21% in Virginia. 

In response, the VA said it was hiring 2,000 new workers to process claims.

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