St. Louis VA Regional Office Disability Program A Mess

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St. Louis VA Regional Office

Benjamin KrauseAgency watchdog VA OIG just released its report discussing findings on the ground concerning disability compensation at the St. Louis VA Regional Office. Problems existed all over but temporary 100% grants were the most problematic.

VA OIG admitted that it was not confident that the regional office would successfully tackle the problems and has already scheduled a follow up inspection.

The highlights of the mess are as followed:

  • 34% of disability claims were not accurately processed
  • 63% of temporary 100 percent ratings were incorrectly processed
  • 12% of traumatic brain injury claims were incorrectly processed
  • 23% of claims were intentionally delayed

Here is the VA OIG summary:

We evaluated the St. Louis VARO to see how well it accomplishes its mission. We found VARO staff did not accurately process 31 (34 percent) of 90 disability claims reviewed. We sampled claims we considered at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Claims processing that lacks compliance with VBA procedures can result in the risk of paying inaccurate and unnecessary financial benefits. Nineteen of 30 temporary 100 percent disability evaluations we reviewed were inaccurate, generally because VARO staff delayed ordering medical reexaminations on average for 9 months after receiving reminder notifications. VARO staff incorrectly processed 4 of 30 traumatic brain injury (TBI) claims. Staff also incorrectly processed 8 of 30 claims related to special monthly compensation (SMC) and ancillary benefits. Generally, the errors in TBI and SMC and ancillary benefits processing were due to lack of oversight to ensure these complex claims were completed and reviewed by designated staff. VARO managers ensured Systematic Analyses of Operations were complete and timely. However, staff delayed completion of 7 of the 30 rating reduction claims we reviewed because management placed a higher priority on other work. We recommended the VARO Director implement the plans needed to ensure timely and appropriate action on reminder notifications for medical reexaminations, appropriate action on the 559 temporary 100 percent disability evaluations remaining from our inspection universe, staff assigned to a specialized team process TBI and SMC claims, clarify local policy by clearly defining which SMC claims require processing by a specialized team, staff comply with local policy requiring Decision Review Officers to conduct second-signature reviews of SMC claims, and prioritization of benefits reduction actions in order to minimize improper payments to veterans. The VARO Director concurred with all recommendations and the planned corrective actions are generally responsive. However, we remain concerned that potential delays in addressing issues related to temporary 100 percent disability evaluations and benefit reductions will result in continued improper payments. We will follow up on all actions.

Read the full report: https://www.va.gov/oig/pubs/VAOIG-14-01497-188.pdf

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13 Comments

  1. There are logical and common explanations for competency by VA staff. There are also other types of reasons, such as, by example of actual VA policy, whether written or verbal, to encourage veterans to use marijuana to help alleviate symptoms, ranging from PTSD to any sort of medical problem you can think of. The VA has heavily pressured me to use marijuana on a self-medicating basis, which is a violation of federal law, whether you like marijuana use in your personal life or not. The VA tells veterans on a daily basis to smoke pot. They want us stoned and passive and not getting real medical care or any benefit that we earned. Add to this the obvious fact that most VA employees, from the lowest employee to the highest levels to include the VA Secretary quite reasonably possible, are all smoking pot on a regular basis. If you can put your personal opinions of pot aside and understand that, as stated in the DSM-3 (the diagnostic and statistical manual for mental disorders as used by the AMA and APA) marijuana causes mental disorders. Updated manuals have different references to marijuana only because of social pressure to falsely say that it is not harmful. First, their is cannibis abuse, which means you use it to a point that you have gotten into some form of major social or behavior problem that was severe to cause harm to your personal life or to others. Then there is cannibis tolerance, and cannibis addiction, though the addiction part is not clearly asserted in the DSM-3. What we have in the end is a plague of drug abuse by VA staff who dodge their responsibilities to veterans while enriching themselves, all because they are basically loaded all the time. There is a strong push nationally and at not just the individual state level, but also at the federal level, to legalize marijuana use and sales. So-called authorities and medical experts, and our fearless political leaders, for the most part, jointly insist that “marijuana is no worse than alcohol”. Even if that is true, and it is not true, alcohol is a horrendous destroyer of lives, especially for veterans, and it is most certainly heavily abused by VA employees as well. What should be said is that pot is as bad or worse than booze, especially when veterans or anyone is self-medicating, or using for recreational reasons: to get high. Add to this problem that meth and heroin use is pandemic across the US, especially among college age persons which was never the case until about 3 or 4 years ago. When I was college age a college student was considered the biggest criminal low-life scumbag dangerous moron in the world if they used heroin, but now it is popular and most college students use it and every other drug you can think of on a regular basis, as is true for veterans and VA workers, and everyone across America. Sure, there are millions of people who do not abuse drugs and alcohol, but there is a plague right now of abuse that has destroyed the VA and many other institutions and America itself for this very reason. Solution: mandatory drug testing for VA employees, and mandatory arrest for coaching a vet to use pot or any drug that is still illegal in any form, amount or for any purpose according to federal law. If you are smoking pot, drinking alocohol more than once or twice a month and more than one drink/one ounce of alcohol at a time, you have a drinking problem and are playing with fire, no matter what anyone says to the contrary. If you use any street drug, including pot, you are playing Russian Roulette with your entire life as all of this stuff, alcohol included, will and does cause apathy, poor judgment, impairment of every sort of functioning there is, etc. Any VA employee who fails a drug test must be fired, flat out. We need people at the VA who are NOT loaded, never get loaded, and are deeply serious about their job, not idiots who think they do just fine when they are stoned a few times a week including on the job which they all damn well sure are. Stop smoking pot, stop drinking, don’t abuse prescription drugs, and damn well do not use heroin, meth, coke or anything else; even watch it on the coffee, because, believe it or not, caffeine dependence and tolerance and withdrawal are all common mental disorders that are listed in the DSM-3 and later updates of the manual. Snap out of it yourself and tell your loved ones and people you care about the same thing if they are into drugs, including pot and alcohol, or the VA is going to bury you, literally, which they most likely will F up like they F up everything else. This is the time for sober and clear minds.

  2. Seriously, I wish they would audit all the RO’s. Because after my 17 years of dealing with the VA I have no trust in any VA EMPLOYEES whether they fuck me or not. I’ve lost total confidence that will never come back or be fixed but these are my benefits and all I have to help me survive…so I try my best to use it minimal and only for service connected dealings. Now as far as the drugs and marijuana or booze is concerned for most older VETERANS this was a culture the military forced on us. I remember having to go to the EM CLUB fir thirsty Thursday lunch and Fridays because if I didn’t I had to stay at work and cover everyone else’s duties while they were getting buzzed. Needless to say I joined in and never looked back until my last duty station and realized how messed up the military had affected off work time. Some people need the drugs and alcohol to make it through the day others use it for fun. But to tell everyone to be sober is just too damned arrogant and wrong considering humans have been getting high since day 1!

  3. I say fire the ones who did wrong. Harsh punishment will make a point. No severance pay, no retirement, nothing. Pack your personal items and you are no longer needed here and you will never work in a VA facility again. I think I would straighten up if my fellow co-workers were fired on the spot. I would want to keep my job and that would help. I also like the random pee test, fail and get fired, pass and you get to keep your job. If we keep slapping these people on the wrist, they get used to it after a while and it is no big deal to them. Slap me and let me get back to screwing over people. If it was “what? I’m fired? how am I going to pay my bills and keep food on the table.” Answer, I don’t know and don’t care. If you would have done your job correctly you would not be asking those questions. Bye.

  4. This is typical, and similar OIG evaluations show the same problems in nearly every VARO.

    The point about the temporary 100% ratings is that these are emphasized at every audit because — more often than not — these are probably some of the VERY FEW errors that end up going in favor of the veterans. Of course the OIG wants to make it seem that veterans are actually getting the benefit of the doubt. The fact is that the majority of us aren’t.

    I had back surgery last year for an SC condition, and I am still waiting on my temporary 100% claim to be adjudicated. I understand that I am supposed to have an evaluation to establish the claim, then another to tell me I’m okay to go back to work. Neither of these has ever been scheduled. This was done through a non-VA referral, and I have kept meticulous notes — including notes from my surgeon and a rehab center physician. I’m still concerned, though, that I will again suffer for the VA’s negligence because they didn’t schedule me for a C&P exam in the month or so following my surgery.

    This is a really simple case with only a couple of criteria to meet. It has to have resulted from a service-connected cause (Check — I was referred from my local orthospine clinic), and it has to be 100% disabling (Check — I have documentation for the surgeon, the head MD at a rehab facility, and a VA physical therapist that I was unable to work). Despite this, I have now waited more than 10 months for this claim to be processed.

    I recently pointed out to the OIG and my congressman that the VA had even attempted to change the date of my claim by five months. They fixed this, but they did not admit any wrongdoing. Someone should get fired — and possibly go to federal prison — when they do something as outrageous as blatantly falisifying documents, but even my congressman claims his hands are tied in trying to hold anyone accountable.

    I’m fed up and disgusted, but the VA is the only game in town. It’s too fucking bad that people are coming into this country illegally and being put up in $1000/night resorts while the people who served the country can’t shake our earned benefits loose from a corrupt and immoral federal agency.

    • I do hope you get this resolved faster. I too have gone this route but had back surgery before going to the VA. All these years, 23, the VA has gone off my initial records to give me a 40% rating. The private doctors reports I submitted and the military sturgeon’s report are the solid evidence in my case. When medical guidelines change after 19 1/2 years being disabled, I had a C & P exam where the examiner stated my range of motion was a little worse since my first exam? Well that must have been in 1992 he was referring too. This was 2011. He said the VA has changed the range of motion tests. You are no longer disabled under those standards. (Although I am worse now) He said, “You are cured”! WTF?
      Now in present time, I have been receiving approximately $740 to live on from the VA. I am totally disabled. The have only given a range of motion test and stated I am cured. They didn’t do a new MRI or any other test. I took 2 morphine plus other pain killers before that test! (At that time I had been on 3 morphine tablets, 3 times a day. Not until 2013, I was changed to two tablets a day based on a physician assistant, my temporary primary doctor, reviewed my records and decided the VA standards have change any anybody with my condition only need to morphine a day! Even though he wouldn’t give me an exam or order a new MRI or since he didn’t have time, refer me back to pain management!! Even after a year receiving a new PCP and denied 3 morphine or even an appointment with pain management!! Then in the meantime waiting for an appointment sending me through physical therapy for 5 or 6 weeks and a chiropractor for 13 times in 6 or 7 weeks! Then I said no more. I hurt so much I could hardly get out of bed or walk. Depressed and in pain, I’m still waiting.

  5. .I watch and listen to the news, to what our elected officials deem important,and I grin to myself(without amusement). The very fact that the vet(past,present,or future)offered,is offering,or will offer to possibly pay the ultimate price. So that the present day elected officials are able to take a 5 week vacation(that they have worked so hard for)shows how honorable these elected officials are(if doing nothing and expecting something is the perk) They are facing a situation that requires action and common sense(I wonder where it went). Blood,sweat,and tears were paid for the office and ideals they are elected to uphold,now in a time of great turmoil concerning the UNITED STATES VETERANS status they are going on a 5 WEEK vacation because they are all honorable,honorable elected officials. The CONSTITUTION of the UNITED STATES doesn’t need to be changed,just the honorable,honorable individuals, we the people,have mistakenly elected. HONORABLE,HONORABLE,HONORABLE don’t you agree !!!!!!!! I would love to see this go viral

    iI

    • See what go viral? Your comment is void of anything related to Krause’s article or the VA for that matter.

  6. I am certain mine have been tampered with..delayed entry Sept 9, 1992 .I served Active Duty Army Oct 1992- Oct1996 ..recalled back to Army Reserve duty(muster) April 2000……ALL.documentation from each military reserve physical and Ft Benning MACH for med board dated 02/2001 to 07/2008… in 2009 I was Physical Disability Separation with orders stating 20% combined rating…DA18 indicated 6 injuries as combat related…and still the adjudicators…*dog and pony* with it…my clothing allowance claim was tampered with as well…I was told by the GA VSO counselor that my Reserve duty time didnt account for time served…I had LODs(line of duty) for each…the Med board given through the Army at Ft Benning MACH…indicated ALL injuries that occurred on active duty and what aggravated and exacerbated it…and still…no relief…Ive written Congressmen…Secy Shinseki…and yet NOTHING…

  7. I am sadly one of the veterans who also worked at the St. Louis VA the St. Louis VA Regional Office mistreated with things like, oh, scheduling an exam with a provider of whom I worked and having my claim there. I taught the STL VBA suicide prevention, was very honest about some of the incredibly sad deaths, and asked not to come back to teach them. Needless to say, but I will here, my claim was not decided in the favor of showing my applied for disabilities–as adjunct to already service connected problems. Now, I have another claim after spending 43 days in the hospital with clear and documented medical records and was scheduled a 4th exam since I was originally granted 80%.

    Mistreated by the very system and the very medical center where I worked was over whelming. I wish someone, like the Senate Veterans Committee or the VA IG, would respond or even care about what I experienced and just a few of the tragedies my fellow veterans experienced.

    • Why do you object to being examined by a doctor you know? Seems like a good thing, unless you alienated him/her. Basically you complain that the VA didn’t like what you said during your suicide prevention class and ended your involvement. and disagree with its decision on your claim for secondary service connection. You have not made any specific allegations, and I am not sure why you said what you said. I am not saying you don’t have any legitimate complaints or that the VARO didn’t do wrong. I am just not sold based on what you wrote.

      • “Why do you object to being examined by a doctor you know? ” Are you kidding? Thats improper practice, thats a henious ethical power imbalance.

        Dr./Patient professionalism is central to proper care and evaluation. In fact its illegal in many states to be treated by a medical provider you fraternize with.
        Bias is not always good, even if its good it may not be what you need but what you want.

  8. I have to say that the VA is waiting for you to die. Your claim will die with you, your survivors, are screwed, and they will not receive the entitled benefits they are entitled to. I have been runaround for 45 years after evacuation out of Vietnam with a disease that will kill me and the VA is fully aware of it. I spent a month in the hospital, with all organs and systems permanently damaged, and they put me on a waiting list. Bullshit. They are waiting for me and you to die abd I dare anyone at the VA to dispute this.
    22 vets everyday see the truth and can not handle it. Dying is easier than accepting the fact that the VA is saying F**k You to the vets. The VA is responsible for these suicides, and almost promote it with their acupuncture pushing Hindu doctors, that are talking down on American vets. They come from India with their caveman medicine, barely speaking English, dictating by God what is and what will be. Well Fu*k them too. Bunch of freeloading fuc*s, sucking the life out of the American government, and acting like we did something wrong. Well, we did when we allowed their nasty asses in our country.
    If you are expecting the VA to help you, you will die waiting. You will be put through the system, slowly working your way up to what you may or may not deserve. The VA ignored the facts of a permanent P3 profile, permanent damage to my body’s organs and systems from the exposure, continuing health decline while on active duty, the diseases and conditions that continued to develope, the non-deployability, and defied all authority and law governing service connection. They are waiting you and me out. We will die from the diseases or because of wait times. You lose either way. don’t GO ARMY.

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