Veteran says VA contractor examinations not thorough enough
By WESLEY BROWN | The Augusta (Ga.) Chronicle | Published: August 18, 2014
Ollie Washington’s injured left knee was never tested for soreness, twisted for tenderness or measured for flexibility in December 2010 when he first had a follow-up disability evaluation in Augusta for the Department of Veterans Affairs.
The doctor, contracted by the VA through a group called QTC Medical Services, told the disabled Army veteran to bend the joint while seated on an exam table and walk down a hallway. She noted in her report, which the VA used to retain Washington at 10 percent disability, that there were “no signs of instability, abnormal movement or deformity,” and that his “gait and posture were normal,” despite three decades of noticeable stiffness, swelling and fatigue.
Most of the 200 veterans who attended Rep. John Barrow’s VA town-hall meeting last month, including Washington, complained that the QTC exam center routinely rates local veterans poorly for disability.
QTC completed 23,272 evaluations last year in the Atlanta region, which includes much of Augusta’s claims, according to VA data. Of the 14,816 veterans awarded disability in Richmond, Columbia and Aiken counties, the most common rating was 10 percent compensation, the lowest available. It was awarded to 2,435 veterans.
Records show more than half of the veterans granted disability in the Augusta area in 2013 received a compensation rating of 40 percent or less.
“It’s a total waste of time,” Washington, 63, said of QTC exams. “They’re notorious for turning down veterans.”
The VA first contracted with QTC in 1998 to conduct exams under a pilot program. Since then, the group has provided more than 3 million physical exams and 2 million diagnostic tests, while its contract with the VA has increased from $61 million in 2005 to more than $144 million today for medical service “exceeding performance standards,” according to company and VA reports.
According to the Veterans Benefits Administration, each contractor must have a quality review department inspect each exam before it’s sent to a regional VBA office. That office can either accept the evaluation or, if it finds a discrepancy or incomplete information, return the exam to the contractor to be corrected at no additional cost.
“QTC does not determine the claimant’s eligibility for benefits; QTC employees manage the examination workflow and deliver high quality examinations to its customers,” spokeswoman Tabatha Thompson said last month in an e-mail in response to local complaints. “Physicians and health care professionals, all of whom are independent contractors in the QTC network, perform the medical examinations. The government agencies that contract with QTC determine eligibility and handle appeals.”
VA worksheets and handbooks, however, show determining disability is not that simple. The VBA looks at evidence from military service documents, private health records and disability exams to connect veterans’ injuries to their armed forces careers.
Washington, who served in the Army from 1973 to 1981 as a communications officer during peacetime operations, was immediately approved for 10 percent disability, or about $129 a month, when he left the military. He has re-filed three times in the past decade for a rating he feels more accurately reflects his pain.
“Over the years, I’ve fought through the pain, but now it’s getting progressively worse and throwing off my back posture,” said Washington, who injured his knee at Fort Campbell, Ky., during a field exercise.
In 2000, when he started the process to get a higher disability rating, the VA initially recommended alternative medications and different knee braces to help alleviate the pain during daily activities. But Washington said the one that provides the most support has metal hinges and at times can make it difficult to walk and stand for prolonged periods.
Washington said he is scheduled to have arthroscopic surgery Sept. 11 to tighten his meniscus and remove bone fragments in his knee, but he worries that without increased compensation to pay for a pool membership, the problem could worsen.
“I would like to receive compensation that’s more than the bare minimum,” he said. “I have researched 20 and 30 percent ratings, and I feel I fit the criteria of each.”
QTC has been scrutinized for providing incomplete examinations. In 2005, 32 percent of VA disability raters surveyed in an inspector general review said 20 percent or more of QTC medical examinations should have been returned because they were not sufficient for rating purposes. In all, 49 percent evaluated the quality of examinations by QTC physicians as good or very good; 16 percent evaluated them as poor or very poor.
Washington said he’d like to see an in-house process at the Charlie Norwood VA Medical Center in Augusta that can review local files and, as a result, more accurately and efficiently diagnose veterans. He said he had his most recent QTC exam in May but that it has taken two months for the VA to request medical records from his private physician.
“The orthopedic specialists at the (Augusta) VA have been seeing me for years and every time I have gone in, X-rays, MRIs and doctors agree a greater problem exists,” he said. “When I’m sent to a QTC general practitioner with no specialty experience in orthopedics, I see a representative for 15 minutes and a decision that can forever alter my life is made. It makes no sense to me.”