#Middlebury #Claims #PACT #VeteransAffairs
VETERANS POST
By Freddy Groves
It seems that when there are new rules and regulations to be followed, the Department of Veterans Affairs often needs time to get caught up and understand new procedures. The Office of Inspector General for the VA investigated whether veterans were given the correct benefits after the PACT Act expanded eligibility for toxin exposure. The news isn’t good. What the OIG found was that service-connected claims were improperly handled before they were denied.
Processing staff made several errors as they handled the claims. They asked for medical opinions to see if there were service connections even though the PACT Act clearly designated certain illnesses as service connected. Staff asked for exams that weren’t warranted, which delayed the processing of claims. Staff also made their decisions after examinations resulted in inconsistent results.
OIG investigators found that two veterans were denied $56,700 in claims after their service connections were denied. The OIG discovered that there was $1.4 million in costs (for a six-month period) for exams and medical opinions that weren’t necessary and 870 potential benefits-related errors. It seems that staff didn’t understand that presumptives don’t need a medical opinion after it’s already been established that a veteran was in a certain location at a certain time.
Mistakenly denying conditions covered under the PACT Act wasn’t the only Act-related snarl. Under the PACT Act, survivors of service members who died in the line of duty or from service-related illness who’d had their expanded toxic exposure claims denied were allowed to refile and receive retroactive benefits. Survivors due benefits under Dependency and Indemnity Compensation didn’t receive the correct payments when they refiled.
The OIG investigated two groups of claims over a six-month period: those that were refiled and denied a second time and those that were refiled and approved. Processing staff didn’t have a clear understanding of how to do the math, it seems, resulting in $33 million of underpayments to survivors.
If you’re filing under the PACT Act, keep an eye on what’s going on – and ask a lot of questions.
© 2024 King Features Synd., Inc.
