Reports of Mediocre Disability Exams by VA Contractors Prompts Senator's Demand for Answers

A prominent Democratic senator is demanding the Department of Veterans Affairs review the quality of its privatized disability benefits exams after receiving what she described as "disturbing reports of inadequate and unprofessional treatment" of veterans.

In a letter to VA Secretary Denis McDonough, Sen. Elizabeth Warren, D-Mass., pushed for answers by May 14 to an array of questions about VA compensation and pension exams done by private contractors in light of "multiple complaints" she said she received about the quality of exams both in her home state and across the country.

"For example, constituents have reported to my office that contractor examiners failed to review service treatment records of veterans prior to their appointments, and shredded medical questionnaires instead of adding them to medical files as evidence because" VA policy doesn't allow examiners to add anything to veterans' medical records, she wrote in the letter obtained by Military.com ahead of its public release. "They have indicated that contractors directed veterans to meet them for exams outside of medical facilities, including co-working offices, broom closets and hotel rooms."

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Asked for comment on the letter, a VA spokesperson told Military.com the department appreciated Warren's outreach and will respond to her directly. The department also stressed that it is processing benefits claims at a record rate and that more veterans are receiving VA benefits than ever before.

"VA's mission is to provide every veteran with the benefits that they have earned for their service to our nation, and we will never settle for anything less," VA Press Secretary Terrence Hayes said in an emailed statement. "Whenever a veteran applies for benefits, our goal is to provide them with the best experience possible -- and do everything in our power to get to 'yes.'"

Compensation and pension, or C&P, exams are a key step for veterans filing disability benefits claims to help determine whether their disability is service-connected and what disability rating they will get.

Congress first allowed the VA to use contractors, rather than VA physicians, for C&P exams in a limited capacity in 1996, and the scope of the privatization has significantly expanded in recent years. Nowadays, about 90% of all VA disability exams are done by contractors.

While the goal of allowing contractors to do the exams was to alleviate the VA's workload and the disability claims backlog, government watchdogs have flagged numerous issues with the privatized exams over the years.

A 2019 VA inspector general report found that department staff was hampered in its ability to oversee exam contractors because of limitations with the Veterans Benefits Administration's electronic exam management systems, a lack of reliable data and inadequate staffing. Another inspector general report in 2022 found that deficiencies in the contracts left veterans at risk for incorrect claims decisions.

A 2021 Government Accountability Office report also found that the VBA had trouble processing benefits claims for traumatic brain injuries, military sexual trauma and Gulf War illness in part because of problems with exams done by contractors. VBA claims processors returned exam reports for veterans with those three conditions to examiners for correction or clarification at about twice the rate of exam reports overall, according to the GAO.

In her letter, Warren pointed to the watchdog reports as well as the concerns she said were voiced to her by constituents as she demanded to know the eligibility requirements for contractors, how the quality of service is measured, the average wait times for contracted exams, and how appeals after contracted exams compare to appeals after exams by VA doctors, among other questions.

In addition to the odd locations of exams and cavalier attitudes of examiners, Warren said constituents have told her the contracted exams take 30 to 45 days or longer to complete, compared to about 10 days for exams conducted by VA doctors. Veterans have also told her they've had to travel to multiple locations over the several days to complete the contracted exams, she wrote.

"Additionally, my office has heard numerous heartbreaking reports from veterans who described the financial hardship and emotional pain and stress that they endured when they experienced a denial or a slow-moving appeal in cases where their exam was inadequate," she wrote. "These veterans would have been spared such hardship if the contracted exam was conducted correctly the first time."

Editor's note: This story has been updated with comment from a VA spokesperson.

Related: VA's Widespread Mishandling of Disability Claims Could Have Caused Delays and Denials for Veterans