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IG: St. Louis veterans benefits office botches one-third of disability claims

ST. LOUIS, Mo. — A federal investigation shows the St. Louis veterans’ benefits office mismanages one-third of the disability claims it processes, both overpaying and underpaying qualified veterans.

There are 12,373 compensation claims awaiting processing at more than 50 regional benefit offices, including one in downtown St. Louis with 815 employees, according to the report released Thursday by the Office of the Inspector General. The office handles pension and education benefits, employment assistance and counseling for veterans. The average benefits claim has been pending for 171 days, about two months above the Veterans Benefits Administration target.

The acting director of the St. Louis regional office, S. Nick Nickens, agreed with the investigators’ recommendations to improve performance by focusing on benefits claims. Calls to the office were not returned Thursday.

The investigation looked at more complicated benefits claims, so the overall performance of the St. Louis office might be better, according to the report. Most of the inaccurate disability claims were caused by office staff delaying the scheduling of medical exams for an average of nine months. Staff attributed the delays to workload demands. The St. Louis VA health care system, which includes the Cochran and Jefferson Barracks hospitals and various clinics, has the fifth-longest wait time for new specialty appointments out of 141 health systems in the country, according to a separate audit released earlier this year.

The investigation details some of the botched claims:

  • The date of a veteran’s medical exam was used to determine the beginning of benefit payments instead of the onset of migraine headaches five months earlier, resulting in an underpayment of $1,053.
  • A veteran was assigned a 10 percent disability for a traumatic brain injury despite symptoms that qualified for a 40 percent disability, a difference that could result in an additional $341 in monthly benefits.
  • A veteran was incorrectly granted military-related credit for blindness that was actually attributed to heart disease, resulting in an overpayment of $108,262.
  • A veteran with multiple sclerosis was underpaid $34,009 because all of the veteran’s disabilities were not included in the evaluation.
  • A veteran was underpaid $7,580 because psychiatric disability was not added to a spinal condition in the evaluation.
  • A veteran was not awarded a housing grant of $67,555 that he was entitled to for disabilities related to diabetes and peripheral neuropathy.

Dr. Jose Mathews, who filed a whistleblower complaint last year, has told federal investigators he uncovered multiple problems in the pension and evaluation system at the St. Louis VA.

According to the latest report, investigators “remain concerned” about the potential for improper payments, and will follow-up with additional inspections.
 

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