Report: Thousand Of Veterans Had Claims Denied During Pandemic
A new report finds veterans have been improperly denied benefits because they couldn’t see a doctor during the pandemic.
Marc Session of Chula Vista was 34 years old when he entered Navy boot camp. He retired in 2017. And like many vets, he has lingering issues from his time in the service, especially with his back. He’s been wrestling with the Veterans Affairs benefits process since his retirement.
This year, during the pandemic, the real issue for the Navy vet has been getting in to see a doctor.
“I was initially scheduled (to be seen) in February, then it was rescheduled until September, then in October they said it would be scheduled in November,” Session said.
Even in a normal year, the VA claims process is long and exhausting, Session said.
“It’s very frustrating,” he said. “I want this whole situation to be over. Finally, not have to worry about any more exams...I just want to be done with it. Get it out of the way so I can move on.”
Beginning in April, the VA shut down all in-person appointments. Everything moved online, including doctor appointments. The backlog of exams ballooned to 1.5 million during the pandemic.
As far back as March, leadership at the VA was holding training for its staff in how to work remotely. A new report by the VA inspector general points to thousands of claims being improperly denied, even though VA leadership declared that no vet should have their claim denied because it wasn’t safe to see a doctor.
“They didn't get the memo, because there was so much happening,” Walker said.
Session’s private attorney, Casey Walker, once worked for the VA. He’s now with the VA Disability Law Group. Requiring people to work from home created challenges, he said.
“A lot of these employees worked from home for the first time, ever,” he said. “A lot of them were not too capable with their technology at home. They always worked at the regional office, their entire lives.”
The VA made the backlog worse, by telling outside mental health providers they could not fill out disability benefits questionnaires for patients remotely, when it came to filing VA benefit claims. At the same time, VA was telling its own doctors and contractors to only see patients using telehealth, he said.
“Almost in the same month, they said you must do all mental health exams by telehealth means,” Walker said. “Then I thought, what gives here?”
Most of these exams are done by doctors, contracted by the VA. The VA’s website shows nearly all of the country is open for in person exams to some degree, to chip away at the backlog of 1.5 million exams.
“I have noticed more examination reports coming in. So I know they are working on some of the exams that were pending throughout the pandemic. So that’s a start,” said Maura Clancy, an attorney who handles veteran benefits appeals for Chisholm Chisholm & Kilpatrick, a national law firm based in Rhode Island, which has clients in San Diego.
Instead of scheduling new visits, she says the VA could also lean more heavily on using existing medical records, what the VA calls Acceptable Clinical Evidence, or ACE, instead of waiting for another medical exam.
The VA told its inspector general it is looking at cases denied during the pandemic. But vet’s shouldn’t count on their cases being reopened automatically, Clancy said. Instead, vets should assume they will have to file an appeal by the deadline.
“It only helps to be able to point to what VA’s guidance was in the beginning of the pandemic, which was those denials weren’t supposed to happen," Clancy said. "And hopefully, they will take some corrective action.”
The VA has been trying to clear away its backlog of benefit claims for years. Designed to speed up the process, the Veterans Appeals Improvement and Modernization Act of 2017 went into effect fully last year. According to advocates who help guide veterans through the process, juggling a new system and a pandemic, probably created even more cracks in the system.