VA doubling back to resolve TBI claims denials

Veterans Affairs officials aren't saying how 24,000 veterans were diagnosed with traumatic brain injury by VA physicians considered unqualified to make such a determination, but on Wednesday, told Congress the department is working to resolve related disability claims problems.

Some veterans diagnosed with TBI from 2007 to 2015 were denied disability benefits because they were examined by a VA health provider considered to be unqualified under VA policy.

After a media investigation by KARE 11 in Minneapolis found that as many as 300 veterans at the Minneapolis VA Medical Center were denied benefits as a result, the department announced it would review all cases involving veterans with improper exams.

In June, VA announced it would send letters to more than 24,000 affected veterans offering new exams.

Dave McLenachen, deputy undersecretary for disability assistance at the Veterans Benefits Administration, told a House Veterans' Affairs panel Wednesday he was unable to "find a reason” why the exams were conducted in violation of VA policy at a number of VA facilities.

“I don’t know if it was a lack of capacity, whether that was an issue at the particular time, or to the extent whether there were enough of those specific specialists available at the time. I don't know the answer to that question," McLenachen said.

The KARE 11 investigation found that at the Minneapolis VA only one of the 21 medical professionals who conducted initial TBI exams was a qualified specialist, defined as a psychologist, psychiatrist, neurosurgeon or neurologist.

Rep. Dina Titus, D-Nev., questioned whether sending a letter to an affected veteran was a sufficient response and she urged VA officials to conduct more outreach.
"Don't we need a public information campaign or work with the veterans service organization to ensure this is adequate?" Titus asked.

McLenachen said VA officials decided to send letters rather than simply reschedule exams because some veterans may have received a higher disability rating for TBI from their initial exam than they would have gotten from a specialist.

According to McLenachen, more than 14,000 affected veterans already are receiving disability compensation for service-connected TBI, "many at higher rates of evaluation."

"It could be misleading to go out and tell them we are going to schedule an exam without their choice, might have a significant impact on their benefits," he said.
More than 327,000 troops were diagnosed with a brain injury from 2000 to 2015. Roughly 80 percent of those diagnoses were for mild TBI, or concussion.

Roughly 170,000 veterans with TBI have filed disability compensation claims and 75,000 have been approved.

Lawmakers said Wednesday they are concerned over the disparities, which can't entirely be explained by the VA's failure to use specialists to diagnose veterans.

"Committee staff has been trying to get to the bottom of what happened and who is responsible, but even after four separate briefings, the answers are not clear," chairman Rep. Ralph Abraham, R-La., said. "The only issue that is clear to me is that the Veterans Benefits Administration and Veterans Health Administration created a royal mess by not communicating with each other ... and that senior VA employees once again failed to hold subordinates accountable."


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Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at [login to see] .