U.S. Senator Elizabeth Warren, D-Mass. (Photo: Gage Skidmore)
U.S. Senator Elizabeth Warren (D-Mass.) is urging the VA to conduct a thorough review of the quality of its privatized disability benefits examinations. This call comes in response to what she characterizes as troubling accounts of insufficient and unprofessional treatment of Veterans.
In a letter addressed to VA Secretary Denis McDonough, Warren has pressed for a response by May 14, seeking clarification on a range of issues concerning VA compensation and pension, C&P, exams administered by private contractors. Citing “numerous complaints” received from both her constituency and nationwide sources, Warren states instances where contractor examiners purportedly neglected to review Veterans’ service treatment records prior to appointments.
Additionally, she points to alleged instances of medical questionnaires being shredded instead of being included in Veterans’ medical files, reportedly due to VA policy constraints prohibiting examiners from augmenting medical records. In her communication, Warren also reveals reports of Veterans being directed to unconventional exam locations, such as broom closets, co-working offices, and hotel rooms, raising concerns about the professionalism and appropriateness of the examination environment.
The VA acknowledged Warren’s outreach and commits to providing a direct response. The department pointed out that more Veterans than ever before are receiving VA benefits and that it is processing claims at a record rate.
“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,” said VA Press Secretary Terrence Hayes. “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.'”
C&P exams are an essential step in the disability benefits claims process; they help determine whether a disability is service-connected, which in turn helps determine disability ratings. The outsourcing of these examinations to private contractors, a practice authorized by Congress in 1996 to alleviate the VA’s workload, has expanded significantly in recent years, with approximately 90% of all VA disability exams now conducted by contractors. While intended to streamline operations and reduce claims backlogs, the privatization of exams has been fraught with challenges, as stated by government watchdog reports.
Reports from the VA inspector general and the Government Accountability Office, GAO, have identified systemic issues with the oversight and quality assurance of contractor-conducted exams, raising concerns about the accuracy and reliability of claims decisions. Warren’s letter draws attention to these reports and echoes the frustrations voiced by Veterans and constituents regarding prolonged wait times, logistical challenges, and the emotional toll of denied or delayed claims due to inadequate examinations.
Author: Rikki Almanza
Rikki is a Web Content Coordinator for the American Legion, Department of California. With a deep-rooted connection to the military, a spouse who is a Navy veteran, a father who served in the Air Force for 25 years, and a grandfather who proudly served, Rikki is committed to using her skills and knowledge to provide valuable assistance and resources to servicemembers and veterans.
I am a veteran with a formal complaint with the VA OIG, OptumServe and the Texas Medical Licensing Board for Psychologists. I read your recent article regarding, Senator Elizabeth Warren’s congressional inquiry to the Department of Veteran Affairs.
I was curious if you would be interested in covering my recent experience with OptumServe. For a brief background, OptumServe is currently performing an internal investigation of a complaint on fraudulent C&P examination reports submitted to the VBA. More specifically, a concurrent investigation is underway with the State of Texas Medical Licensing Board (Texas Behavioral Health Executive Council, Austin TX) regarding a specific C&P examiner for allegations of code of conduct violations for engaging in fraud and deceit in her services with OptumServe.
I have substantial documented evidence including a 1-1/2 hour audio recording of the C&P examiner discussion and the fraudulent report that was submitted to the VBA for denial of disability benefits.
I sent a message to Senator Warren’s caseworker team to engage them on this topic, as well. Please let me know if you would have the bandwidth to cover this powerful and serious matter. I would be happy to share my story and documented evidence.
Veteran
Veteran examinations are a fraud. They give false claims about the veteran and the VA uses these documents against the veteran instead of the VA looking at the entire file of the veteran. I have 5 appeals due to this mess and 2 duty to assist errors because the VA caught 2 issues that I brought up in a higher review showing the fact that QTC and LHI didnt do their job. Have had over 15 exams and out of that 4 made since the rest lasted less than 15 minutes. How do you exam a veteran and discuss the issues with them in that amount of time. I spend hours with my VA doctor. The Secretary of the VA doesnt do anything. The Disabled American Veterans dont do anything. The VA Hot line doesnt do anything. The VAOIJ doesnt do anything. THE VA DOESNT CARE THEY JUST ARGUE WITH YOU AND SAY SORRY TOO BUSY WITH OTHER VETERANS AND LIFE GOES ON AS ABNORMAL.
The VA is suppose to release copies of your medical exams by these companies within a normal period of time. I submitted request after request and they just stall over the issues. Veterans have a right to review these documents. I FILE APPEALS BASED ON THE FACT THEY DIDNT GIVE ME THE DOCUMENTATION THAT I NEEDED TO DEFEND A PROPER APPEAL. Janesville WI intake center is a joke, they out to call it the discard center because thats what they do is discard your records. Veteran look at your decisions and look for the documents that you submitted and you will find out they didnt even look at them. The exams by QTC and LHI determine your claim. WHAT A VA MESS>
I have information too but they dont listen. Just keep appealing and ask for the records from the examinations and then you might be able to prove the facts but the VA wont give you the records which you have a right to get. They dont use doctors they use LPN and NP to review your records which they never do before sending the report to the VA. Im going to keep on fighting.
I just completed about 6 months of tests for numerous medical problems which was requested by my Veterans Service Officer. My first visit was in a trailer parked in a grocery store parking lot. There was no Doctor present and the Physicians assistant just listened to my complaints ans said that I needed x-rays. I had to travel over 100 miles for 3 of my other appointments. Since I can no longer drive, I had to rely on other people. On my first appointment it seemed like I was interfering with the technician’s coffee break. The other visits were better, but at no time did .I see a doctor. I was previously rated at 70% disability which my primary said that I should be at 100%. I was given 80 %. The following letter was sent to VA:
COMPLAINT ABOUT OPTUM SERVE
In early August, I visited my Veterans Service Officer attempting to file for total disability. I have bad knees, lower leg and back pain. Also, at 83 years of age I am unable to work.
On August 12 I received a letter setting August 18, 2023 at 8 AM as my appointed date and time. The address turned out to be a large grocery store. I was instructed to look for an orange trailer in the parking lot. I arrived at the small trailer on time, expecting to see other veterans, but I was the only one,
I was examined by Zakaya James, a physicians assistant, who was the only medical person there. She examined me and said I had to have x-rays. I asked about the x-ray machine sitting beside me. I was told there was no x-ray tech there.
A couple of days later I received a call from Optum Serve trying to set up an appointment for x-rays in Sacramento. She stated that it was the closest place that they had a contract with. That would be about 4.5 hours for a 20 minute appointment. I no longer drive as I am in a wheelchair, and have to rely on Dial-A-Ride or someone else to transport me.
On August 29, I contacted Optum Serve and talked to Evelyn and after explaining my situation again, I was told that they were working on getting an x-ray location in the area.
If the VA has a contract with this business they should demand Optum Serve have more medical personnel on duty and find local medical facilities for x-rays or other examinations. It seems to me that they are taking advantage of the VA.
On September 29, I contacted OptumServe and talked to Robin, and again explained my situation. I again was told that they were still looking for a facility to get a contract with a facility to provide service for my x-rays. I then asked to speak to a supervisor. After several minutes Adriana told me the same thing-that they were still looking for a facility. I suggested Adventist Health in Clearlake and Sutter Lakeside in Lakeport. She said she would check those hospitals. I will continue calling them at least twice a week to try to solve this situation.
Two hours after my contact, I was called by Kasmin, one of the supervisors, to tell me that they are working on finding a site in Lakeport or Clearlake. I don’t understand the call back, but maybe I finally let them know that I was not giving up!
I have tried so hard with veterans affairs, I been getting screwed on same claim for almost 4 years, and when I catch them they puts it off on another department. I’m ashamed because I worked for veterans affairs, and watch them screw me over and over they make decisions and never use any evidence that veteran submits. My story is overwhelming and I’m stressed out. I have contacted everyone all the way DC we as veterans get treated bad. I would I tried talk to my governor got run around. Then pushed off to another department. Can I tal to some one. I’m tired this is very hurting.
I know the feeling. Just keep fighting and look at my reply above. It takes time. Last appeal took me over 7 years and they gave me 10% but during that 7 years my case got worse. APPEAL APPEAL APPEAL.. Im now at 70%.