GAO finds fault with VA’s system for dealing with claims for ailments linked to Agent Orange
Stars and Stripes September 2, 2022
WASHINGTON — The Department of Veterans Affairs may have denied benefits to thousands of Vietnam veterans suffering from Agent Orange-related conditions because claims processors failed to understand what evidence could be used to validate the claims, the Government Accountability Office said.
In a report released Thursday, the GAO looked into claims submitted in the 2003-2021 fiscal years by veterans suffering from nerve damage, skin cysts and blistering which they believed were due to exposure to Agent Orange, a defoliant widely used by U.S. Forces in Vietnam to remove jungle cover protecting Communist troops.
Under VA regulations, the conditions must have appeared within a year of Vietnam service for the VA to presume a connection between the ailment and exposure to Agent Orange and other herbicides.
The GAO found that of the 130,000 veterans submitting claims for those conditions during the 18-year period, only 11,000 were granted benefits.
Elizabeth Curda, GAO’s director of education, workforce and income security issues, said the agency did not determine whether the VA made the right decisions on individual claims.
“Claims may have been rightly denied because, for example, a veteran did not have [or lacked evidence of having] the claimed conditions or lacked evidence of a connection to their service,” Curda told Stars and Stripes in an email.
“However, given confusion about the guidance for processing these claims, there may be instances of wrongful denials.”
The report said, however, that GAO interviews with claims processors suggest that “they evaluate claims for these conditions inconsistently based on inaccurate interpretations of VA's claims processing procedures.”
According to the report, claims processors from three different regional benefits offices did not understand what kind of evidence could be used to verify claims that the conditions appeared within the one-year window.
Two of the claims processors didn’t realize that they could use a VA medical opinion that linked a veteran’s condition to herbicide exposure even if the claimant didn’t obtain medical documentation decades ago, the report said.
Claims processors also said they couldn’t use “lay evidence,” such as personal statements from the veteran or family members, to determine whether the conditions surfaced within a year of Vietnam service — even though VA regulations permit this.
Since the U.S. combat role in Vietnam ended 50 years ago, many veterans don’t have documentation on when their conditions emerged. Others delayed seeking medical care because they didn’t realize the seriousness of their conditions, the report noted.
“VA's guidance does not clearly address these issues,” the GAO said. “Without clear guidance, claims processors may incorrectly apply the one-year manifestation period requirement when veterans have evidence suggesting a direct connection to service and, in turn, could inappropriately deny benefits to some Vietnam veterans.”
The GAO recommended that the benefits undersecretary should clarify guidance in its claims process manual regarding the three conditions. The VA said it concurred and would determine “how best to add clarity for the one-year manifestation period” for herbicide-related disabilities.”