Does VA Care Improve Disabled Veterans' Health? More Research Needed, GAO Finds

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The U.S. Department of Veterans Affairs Medical Center in Portland, Oregon.
In this March 31, 2015, file photo, the U.S. Department of Veterans Affairs Medical Center is shown in Portland, Oregon. (AP Photo/Don Ryan)

The Department of Veterans Affairs keeps "limited" research on how its care helps veterans with service-connected conditions recover, a government watchdog said in a report released this month.

Rep. Jack Bergman, R-Michigan, a retired Marine Corps lieutenant general, asked the Government Accountability Office to study whether VA care and benefits are helping veterans with service-connected disabilities get better.

The subsequent GAO report found the results difficult to determine because the data wasn't easily available to compare and the majority of reevaluations of veterans' disability statuses did not change.

"Until VA develops and implements a plan to address challenges that have hindered analysis thus far and enhance collaboration between [the Veterans Benefits Administration (VBA) and Veterans Health Administration (VHA)] with regard to such analysis," GAO staff wrote in the report. "VA will not be positioned to understand the characteristics, needs, and health outcomes of veterans with service-connected conditions, which available research suggests may be different from other veterans."

GAO staff found that less than 4% of reevaluations performed in fiscal years 2013 through 2018 resulted in an increase or decrease to the veterans' overall disability ratings while about 95% of cases stayed the same.

"Importantly, tracking and analyzing trends and outcomes could shed light on an apparent contradiction: why the majority of recent reevaluations resulted in no change in veterans' combined ratings when the regulations state that reevaluations generally should not be conducted in these cases," staff added in the report.

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As a result of its study, among the GAO's recommendations were to create a plan to integrate the data necessary to see how VA care is improving the health of veterans with a service-connected disability and clarify its training for staff so service-related conditions excluded from reevaluation would be marked properly.

Proper training would keep "unnecessary reevaluations" from causing a burden on veterans, according to the report. A VA Inspector General report from 2018 found the addition of lesser-trained veterans service representatives to the reevaluation process caused an estimated 15,500 unwarranted exams.

The VA reported to Congress in 2018 that the VBA had completed 19,000 reevaluations out of its 364,000 disability compensation rating claims. Less than 5% of these reevaluations were backlogged, or waiting more than four months for completion.

The VA agreed with two of the recommendations, saying it would develop a plan by this summer to make the data easier to compare. However, it disagreed with the recommendation to clarify staff training on reevaluating veterans' ratings.

In a written response to the GAO report, VA staff said its 95% accuracy rating for claims confirms the VBA is giving its employees "the skills and knowledge to successfully process these claims."

"VBA agrees appropriately skilled and trained employees are necessary to complete all claims processing work, including review of [routine future examinations]," VA staff wrote. "If refresher training is warranted for individuals, local quality review team members can provide focused training locally."

-- Dorothy Mills-Gregg can be reached at dorothy.mills-gregg@military.com. Follow her on Twitter at @DMillsGregg.

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