WASHINGTON — An internal Department of Veterans Affairs memo obtained by KARE 11 shines new light on the number of veterans who may have been wrongly denied benefits for missing appointments the VA itself had already cancelled due to the COVID-19 crisis.
At first, the VA claimed KARE 11 had identified an isolated example of the problem, but the memo indicates thousands of veterans may have been impacted.
“VBA (Veterans Benefits Administration) has identified approximately 20,000 denied claims with one or more cancelled examinations, potentially indicating premature or improper denial” states the June 19th memorandum addressed to all Veterans Benefits Administration (VBA) Regional Offices.
The effort to identify improper benefits denials was launched by the federal agency after members of Congress began demanding action in the wake of a KARE 11 investigation.
Harry’s Bad Denial
“That’s a total lie!” said an angry and frustrated Harry Payne after receiving a benefits denial letter in May from the VA claiming he failed to show up for a required exam.
Payne, of Kempner, Texas, is one of thousands of veterans who had disability claims pending with the Department of Veterans Affairs when the COVID-19 pandemic struck the nation in force in March.
He had been scheduled for an in-person Compensation and Pension (C&P) exam with a VA medical contractor in late April.
However, before his scheduled appointment, a prior KARE 11 investigation exposed how veterans were being told to report to exams – even to exams in New York City – as the coronavirus crisis worsened. Veterans said they should not be forced to choose between the risk of exposure to the coronavirus and having their benefits claims denied or drastically reduced.
On April 3rd, VA ordered that in-person benefits exams be cancelled due to health risks during the coronavirus crisis.
Veterans were promised on the VA website that, “We won’t deny a claim solely for failure to report for an exam at this time.”
But that’s exactly what happened to Harry Payne.
“The VA sent me a letter saying my claim was denied,” Payne said when he reached out to KARE 11 Investigates asking for help. “And then you read the reason why, and I get even madder because it’s a flat out lie!”
Records show he was scheduled for a C&P exam on April 21st by VA contractor QTC.
However, after VA put a stop to in-person exams on April 3rd, Payne says he received a phone call from QTC informing him his appointment was cancelled.
He thought his claim was just on hold until it was safe to do the exam. He was wrong.
The Veterans Benefits Administration (VBA) sent him a letter informing him his PTSD claim had been denied.
The letter conceded he has PTSD caused by his service, but stated he was denied because, “We received notification from QTC Medical Services, Inc. that you declined to participate in the examination process for your claim.”
“I in no way refused to cooperate,” exclaimed Payne. He was concerned the denial would force him to go through a lengthy appeals process.
Once KARE 11 began asking questions, both VBA and QTC made things right for Mr. Payne.
At the time, KARE 11 was told Payne’s case was “an anomaly,” an “isolated case,” and the VA staff involved with issuing his benefits denial were “being retrained.”
It was not an anomaly.
A Thumb in the Eye
Veterans from across the country began reaching out to KARE 11 with similar denials for not showing up to exams that VA itself cancelled.
Members of both bodies of Congress expressed dismay over the wrongful denials KARE 11 exposed.
“We should not allow a single veteran’s claim to fall through the cracks during this pandemic,” said Congresswoman Elaine Luria, (D-VA) Chair of the House Veterans' Affairs Subcommittee on Disability Assistance during the Congressional forum.
“Now you tell me, that don’t even make sense!” exclaimed U.S. Senator Joe Manchin of West Virginia. “That’s when we say C’mon!”
“We’ll get this corrected,” Manchin told KARE 11 during a May interview, “I really believe we will.”
Veterans advocates tied the obvious errors to the VA’s decision to abruptly end a decades-old practice of giving veterans service representatives 48 hours to review benefits decisions for accuracy before they become final and are sent to veterans.
The VA’s decision to do away with the 48-hour review came despite a direct appeal by veterans groups to President Trump to block it.
Before that change was made, the nation’s largest veteran service organizations (VSOs) and members of Congress in a bipartisan letter argued that ending the 48-hour review would result in delays, create confusion, and undermine a veteran’s right to competent representation when applying for VA benefits.
“The 48 review is extremely important,” said Ron Quade, the Director of Claims and Field Operations for the Minnesota Dept. of Veterans Affairs (MDVA).
MDVA is the local state agency that helps Minnesota veterans navigate the complex VA claims process.
“On a regular basis we find even simple errors that we can help the VA with,” Quade explained.
Within weeks of the VA ending the 48-hour review period, KARE 11 began hearing from veterans around the country claiming they’d been unfairly denied benefits.
A few days after his interview with KARE 11, Manchin and a group of Democratic Senators introduced legislation to restore the 48-hour review process. Under the legislation, VSOs, as well as attorneys and claims agents, would be permitted to review benefits decisions before they are final.
That legislation is still pending.
Internal Review
The VA itself launched a review of all benefits claims denied during the COVID pandemic based on a veteran allegedly missing their exam.
“This is a priority for VBA,” said spokesperson Randal Noller in mid-June, “and we are working to get it done as quickly as possible.”
Days later, the internal VA memo was sent to the Regional VBA offices outlining the approximately 20,000 claims VBA had identified as being potentially denied improperly.
Those claims are all now being reexamined.
Impacted veterans are receiving the following notification letters:
The Veterans Benefits Administration (VBA) has undertaken a review of all claims decided since March 1, 2020 in which an examination was cancelled or not completed as a result of complications from the COVID-19 pandemic. Because your recent claim falls into this category, we will be conducting a review of our decision. You will be notified of any additional information we may require of you and will receive a new decision upon completion of our review.
The VA has not provided a timetable for when their review will be completed.
If you’re one of the veterans impacted by VA scheduling benefits exams during the COVID-19 crisis, contact the team working on this investigation at: investigations@kare11.com