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VA handling of sex trauma claims uneven, GAO report finds

Despite an overall improvement in how the Department of Veterans Affairs handles disability claims involving military sexual trauma, decisions to deny or approve such cases remain uneven across the agency’s health care system, according to a government watchdog report released Monday.

National approval rates for claims based on military sexual trauma, or MST, have significantly increased during the past four years, the report by the Government Accountability Office said.

The GAO found wide variations, however, in approval rates among regional offices, ranging from 14 percent to 88 percent for fiscal year 2013. Half the offices had approval rates near the average, between 40 to 60 percent, but the rest were either higher or lower.

Veterans filed more than 29,000 claims for disabilities related to MST for fiscal years 2008 through 2013, the GAO report said.

The VA has been rocked recently by revelations of veterans facing extraordinarily long waiting times for appointments, even as officials and staff in the system tried to cover up the delays, found by an inspector general’s report to have been caused in part by bonuses tied to performance. VA Secretary Eric Shinseki was ousted in the wake of the scandal, and Congress has introduced legislation intended to mitigate wait times.

The GAO report on sexual trauma noted that variation in approval rates “does not necessarily signify inconsistency.” But investigators found that some VA offices described ongoing difficulty in applying uniform standards, with “several instances of widely varying interpretations.”

“Some VHA medical examiners GAO spoke with required more evidence than others to establish that an MST incident occurred,” the report said. “[Veterans Benefits Administration] and [Veterans Health Administration] staff in almost every office GAO contacted said that further training would be useful, feedback that is consistent with good practices previously identified by GAO and others for reinforcing training.”

The GAO interviewed personnel from five of the VBA’s 57 regional offices: Nashville, Milwaukee, Pittsburgh, San Diego and Portland, Oregon.

Sexual abuse during military service is a problem that’s garnered greater attention the past couple of years as more victims have come forward demanding change.

The Defense Department estimates that about 26,000 servicemembers experienced unwanted sexual contact during fiscal year 2012, a 27 percent increase from 2010. In 2012, one in five women and one in 100 men told VA medical staff they’d experienced military sexual trauma.

Veterans with service-connected disabilities, including MST, are entitled to disability compensation benefits, according to federal law. But many veterans have had difficulty producing evidence of sexual trauma acceptable to the VA.

The VA revised its handling of MST claims as the result of a court ruling in 2002. The revision allows evidence outside a veteran’s service record to be used to corroborate claims of military sexual trauma. That could include civilian law enforcement records and rape crises centers, as well as statements from friends and family members.

Despite those changes, the VA’s own quality assurance reviews found “high error rates” for MST claims in subsequent years, the GAO report said.

In response, the VBA began assigning specially trained mediators for MST claims in 2011, and the VHA began providing optional training to medical examiners involved in the cases in 2012.

Last year, the VBA announced it would review denied claims for post-traumatic stress disorder for 2,667 veterans who had been processed before the new training regimen, the GAO report said. Veterans, however, are required to resubmit claims.

The GAO recommended that the VBA begin a more systematic collection of data in order to analyze approval rates for specific regional offices.

olson.wyatt@stripes.com

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