VBA Did Not Identify All Vietnam Veterans Who Could Qualify for Retroactive Benefits

Report Information

Issue Date
Report Number
23-01266-78
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Report Topic
Claims and Appeals
Major Management Challenges
Benefits for Veterans
Stewardship of Taxpayer Dollars
Recommendations
3
Questioned Costs
$1,008,400,000
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary

The OIG conducted this review to determine to what extent VBA identified veterans potentially eligible for prior disability claim readjudication and retroactive benefits under the National Defense Authorization Act (NDAA) and identified two missed populations. Of the approximately 86,894 veterans in the first dataset with NDAA diseases in their VHA medical records, about 36,125 were entitled to approximately $836.8 million in unpaid benefits. A VA senior management advisor stated VHA records were not involved in readjudication determinations because VBA did not have ready access to VHA diagnosis data. For the second dataset identified through Camp Lejeune service records, the OIG reviewed claims for 226 veterans and estimated 102 were entitled to about $7.5 million in benefits. VA concurred with two of the OIG’s three recommendations to improve methodologies for identifying eligible veterans and to send outreach letters, improve claims processors’ identification of claims possibly warranting readjudication, and update procedures to include veterans’ medical records.

Nehmer v. US Department of Veterans Affairs was a 1986 class-action lawsuit in which Vietnam veterans and their survivors alleged VA had improperly denied their compensation claims for service-connected disabilities caused by herbicide exposure during military service. In 1991, VA was required to readjudicate claims filed by Vietnam veterans. When regulations add new presumptive diseases of service connection, VA must search its records to find eligible claimants and award benefits, without requiring action by the claimant. The 2021 NDAA added three diseases (bladder cancer, hypothyroidism, and parkinsonism) that carry presumptive service connection due to herbicide exposure during the Vietnam War. In 2021, VBA stated VA would review claims for Nehmer eligibility from approximately 70,000 veterans and survivors in its implementation of the NDAA, and additional veterans might be identified through other document reviews. This review highlights deficiencies in fully identifying affected veterans.
 

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Benefits Administration (VBA)

Ensure Veterans Benefits Administration staff use improved methodologies similar to the Office of Inspector General’s review to identify eligible veterans, readjudicate claims, and send outreach letters to potential Nehmer class members who could qualify for retroactive benefits under the National Defense Authorization Act.

No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 2/3/2025

Ensure claims processors at screening sites understand the need to identify any claims that may warrant readjudication by meeting the Nehmer consent decree and subsequent court orders.

No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 10/21/2024

Update the standard operating procedures to have staff consider whether veterans’ medical records show a diagnosis of the now-covered herbicide-related diseases at the time of any prior disability benefits claim before January 1, 2021, regardless of whether a current claim is for a disease recognized by the National Defense Authorization Act.

Total Monetary Impact of All Recommendations
Open: $ 1,008,400,000.00
Closed: $ 0.00