The Department of Veterans Affairs did not properly process nearly half of posttraumatic stress disorder claims related to military sexual trauma in fiscal year 2017, according to a report from the VA Office of Inspector General.
The Veterans Benefit Administration denied about 5,500, or 46 percent, of the approximately 12,000 claims it processed last year for PTSD related to military sexual trauma, according to the report. However, the OIG estimated the Veterans Benefit Administration incorrectly processed about 1,300, or 49 percent, of the 2,700 military sexual assault-related claims denied from April 2017 to September 2017.
The OIG found various types of errors in processing. For example, in 28 percent of incorrectly processed cases, reviewers found staff did not request a medical exam and opinion, although sufficient evidence existed to make such requests, according to the agency. Additionally, reviewers found evidence-gathering issues in 13 percent of incorrectly processed cases, and in 10 percent of cases, veterans service representatives used "contradictory or otherwise insufficient medical opinions" to decide veterans' claims.
The OIG said the improper processing and denial of military sexual trauma- related claims is attributable to multiple factors, including "the lack of reviewer specialization, lack of an additional level of review, discontinued special focused reviews and inadequate training."
Based on its findings, the OIG made six recommendations to the VA, such as reviewing all denied military sexual trauma-related claims since the beginning of last year, reviewing and taking corrective action on incorrectly processed claims, and directing military sexual trauma-related claims to a specialized group of claims processors. The OIG also called for the VA to improve oversight and training on the processing of military sexual trauma-related claims.
The VA told Becker's it appreciates the OIG's oversight and concurs or concurs in principle with its recommendations, "which the department will begin implementing right away."
"We know this is an area where the department can improve. That's why VA has required all of its claims processors to take MST [military sexual trauma] training and pledged to review each and every denied MST-related claim decided between Oct. 1, 2016, and June 30, 2018," the VA said.
"If mistakes were made, we will fix them in order to ensure affected veterans are getting all of the support, benefits and services they have earned."
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