The Department of Veterans Affairs (VA) Office of Inspector General (OIG) released a Report on May 8, 2024, entitled “Delays Occurred in Some Veterans’ Benefits Claims while Awaiting Decision,” in which compensation benefit claims were not reviewed or processed in a timely manner.

From May of 2022 to July of 2022, the OIG Review found the Veterans Benefits Administration (VBA) had completed 433,000 disability compensation claims, a majority of these claims were completed in 125 days or less.

However, the OIG Review found on August 1, 2022, a total of 10,541 disability compensation claims and healthcare benefits were 365 days or older at the National Work Queue (NWQ) Division.

These claims were awaiting a decision but were overlooked and NOT distributed to VA’s Regional Offices for decisions.

In 2016, the VBA began centralizing management and distribution of benefit claims through the NWQ Division. This Division prioritized and distributed claims across VBA’s Regional Offices that process claims.

The overlooked disability claims were submitted by Navy veterans in 2021 and were for leukemia, multiple myeloma and other diseases related to Agent Orange and other herbicide exposure. These claims required a review by teams with specialized training.

Over 99% of the overlooked claims required routing to specialized teams that processed special mission herbicide claims. The VBA’s Office of Field Operations (OFO) leaders limited staffing for these teams to control quality for those complex claims and balanced workloads, and the OFO leaders generally expected the delays.

However, according to the OIG Report, by the OFO Leaders restricting the number of claims that could be distributed by the NWQ to these specialized teams, directly contributed to significant delays in the claims.

Compounding the situation, some of the NWQ division tools’ ranking rules were not functioning as intended. This contributed to the delays for some of the VBA’s oldest claims. Also, the NWQ scored some claims incorrectly, which affected whether they were distributed to the regional offices for further action.

For example, some claims were erroneously given a lower priority to some groups of claims related to herbicide exposure.

Cited in the OIG Report was a 566-day-old claim, describing how a Navy veteran’s request for benefits related to bladder cancer and diabetes—conditions linked to herbicide exposure—had not been distributed for a decision because it “was not ranked highly enough to be distributed.”

These specialized teams were primarily responsible for Blue Water Navy claims; Blue Water Navy – Nehmer claims; Fiscal Year 2021 National Defense Authorization Act – Nehmer claims; and other herbicide-related claims which were also being routed to these teams.

The Inspector General only initiated the review after learning about significant delays from Navy veterans, who had not received decisions on their claims for over 365 days. Nearly all the delayed claims involved medical conditions related to the recent passage of the Blue Water Navy Veterans Act of 2019.

Passage of the Blue Water Navy Veterans Act in 2019 extended VA benefits for the first time to veterans who served off the Vietnam coast or in the Korean Demilitarized Zone.

As with all OIG Reports, the Finding focused on Recommendations. The VA claimed that adjustments have been made to the NWQ distribution tool to prioritize older claims and claims related to herbicide exposure.

The OIG auditors advised the VA to monitor the NWQ more closely. The VA staff informed the OIG auditors that now teams spot-check claims to determine if they are advancing in a timely manner.

My Opinion: Hopefully, the delays have been addressed in regards to rendering a decision on the 10,541 claims filed by the Navy veterans.

But the plight of these Navy veterans is not over. Although many veterans have been waiting over a year for a decision to be rendered, some of these veterans will receive a “disapproved” on their submitted disability claims.

They have the right to appeal the VA decision and file an appeal. There is a significant backlog of disability claims for veterans who are determined to file their claims, and these Navy veterans may have another long wait for a VBA determination.

My simple solution is for the VBA to monitor these 10,541 delayed claims caused by the obvious VBA’s error to determine how many claims were disapproved. The Navy veteran has one year to appeal the disapproval.

If the “disapproved” Navy veteran does not file an appeal, then the matter is settled. However, if the “disapproved” Navy veteran files an appeal, then the veteran’s claim should be prioritized before other disability claims.

The VBA has a hard job and mistakes are often made. For example, recently a court order was granted requiring the VBA to conduct a second review of over 60,000 disability claims that were improperly disapproved, who were not connected with the 10,541 Navy veterans’ claims.

The totally sad part of the situation involving the delay is: these are Vietnam War Navy veterans, who average over 70 years-old and finally received congressional authorization to have their disability claims approved by the Blue Water Navy Veterans Act in 2019.

How many veterans passed away from their illnesses from exposure to herbicides, like Agent Orange, without receiving any of their earned benefits? And then, to wait another year because their disability claim was overlooked is heart-breaking. The VBA must work and do better.

BioSketch: John Plahovinsak is a retired 32-year Army veteran who served from 1967 to 1999. He is the Disabled American Veteran (DAV) Department of Ohio Hospital Chairman and Adjutant of Chapter #63 (Clermont County). He can be reached at: plahovinsak@msn.com.

Page THREE of THREE Pages