A new report by the Veterans Affairs Inspector General found that almost half of the sexual assault post-traumatic stress disorder claims denied during a four-month period in 2017 were incorrectly processed, potentially denying benefits to more than 1,000 veterans.
The report said in almost 30 percent of the cases, evidence was sufficient to request a follow-up medical exam, but none was requested.
Other cases were denied after staff failed to request private treatment records from veterans or did not make a required phone call. Ten percent of the denied claims were done so based on contradictory or insufficient medical opinions.
The Inspector General cited a lack of specialization in the Veterans Benefits Administration, who review claims, as well as the lack of additional reviews for complex cases and inadequate training.
In the report, the Inspector General cited 2013 data from the RAND corporation that found most sexual assault victims do not seek medical care immediately. This might affects a veteran’s military medical history, which the agency uses to award benefits.
To combat this, benefits staff is supposed to look for markers in the service record which might indicate a sexual assault, such as changes in performance, increased use of leave, or pregnancy and sexually transmitted disease tests around the time of the incident.
In the 2017 fiscal year, the VBA processed approximately 12,000 sexual trauma-related claims and denied 5,500. Investigators looked at a sample of 169 of them and found 82 were improperly denied. Extrapolated for the year, that figures out to almost 2,700 mishandled denials that year.
The Inspector General made six recommendations to the VA, including that the agency review all denied military sexual assault claims from October 2016 to September 2017. It also recommended a specialized group of processors be assigned sexual trauma cases.
In its response, the VA said it was developing a plan to review all denied sexual assault claims from October 1, 2016 through June 30, 2018, as well as claims denied so far in fiscal year 2019.
The Inspector General’s office said it would monitor and follow-up with the agency.
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