The Advisory Committee on Disability Compensation is a "statutory" federal advisory committee, which means it is specifically authorized by a United States statute: 38 U.S.C. § 546.
The Committee's purpose, defined in the statute, is to advise the Secretary of Veterans Affairs regarding the maintenance and periodic readjustment of the schedule for rating disabilities [VASRD]; and to:
Note: VASRD = VA Schedule for Rating Disabilities, which is located at 38 C.F.R. chap. 1, pt. 4.
Meeting Minutes for the Advisory Committee on Disability Compensation - links to PDF copies of all meeting minutes since May 2020.
More C&P exam news from the Advisory Committee on Disability Compensation ...
The Department of Veterans Affairs recently posted the Committee's July 14–15, 2020 meeting minutes.
The Committee received a presentation from Earl Hutchinson, Director, Medical Disability Exam Quality & Program Management Office, Compensation Service, Veterans Benefits Administration (VBA) about the removal of Disability Benefits Questionnaires (DBQs) from the VA website.
Here are excerpts from Mr. Hutchinson's presentation (from the minutes) with » my comments:
"The availability of DBQs created an industry characterized by abusive business practices that harmed Veterans. After Veterans had paid for these exams, they were often unusable by VA and delayed the claims process."
» From what I've heard this has certainly occurred, although VBA did not present any statistics in this regard, so it is not clear what percentage of DBQs from third-party firms were unusable and caused delays. That number would be helpful to know.
"The requirements of the Paperwork Reduction Act made it impossible for VBA to synchronize internal DBQs with external, or public, ones."
» This has been a problem for a while. Apparently, the OPM review process for all federal forms—new or revised—is onerous.
"Medical records from a Veteran’s treating physician were more influential to the outcome of a claim than a DBQ completed by a business established for the purpose of profiting off of claimants for VA benefits."
» This pejorative characterization is probably true for most such organizations, but not necessarily all of them. In other words, we should not assume that every organization that charges a fee to assist veterans prepare their disability claim exhibits unsavory or illegal business practices.
At the May 2020 meeting of the federal Advisory Committee on Disability Compensation, members responded to a letter received for the Public Comments portion of the meeting.1
Ann G. Knowles, Director of Sampson County Veterans Services (North Carolina) wrote the Committee to express her opposition to VA’s recent decision to remove DBQs from its public-facing website.
Here is an extended quote from the May 2020 Advisory Committee on Disability Compensation minutes:
Acting Chairman Pamperin read the VA response email from Machelle Harrell, an analyst in [the VBA] Compensation Service.
Ms. Harrell cited three reasons why VA decided to discontinue making DBQs available for public use:
(1) the VASRD [Veteran Affairs Schedule for Rating Disabilities] update had left many of the DBQs outdated, and updating them required a formal process that could take more than a year;
(2) VA had increased its capacity to conduct compensation and pension (C&P) exams; and
(3) VA was safeguarding against fraud.
She [v] added that discontinuing public-use DBQs had no impact on the rating process or a Veteran’s ability to support medical evidence in support of his/her claim.
Mr. Hazell felt VA’s justifications for removal were rather thin. The time required to update the VASRD negated any lag time for updating the DBQs, and VA had never provided satisfactory evidence that fraud was a significant problem.
Acting Chairman Pamperin agreed that VA did not provide much detail to support its position.
Mr. Lorraine thought the Committee should respond to Ms. Knowles’ email and that VA should provide DBQs on its public website, citing the need for transparency in the current environment. [emphasis & line breaks added to facilitate online reading]
VA Inspector General's Report
The Department of Veterans Affairs removed the Disability Benefits Questionnaires (DBQs) from the VA website after this VA Office of Inspector General (VAOIG) report was published:
Off. Inspector Gen., Dep't Veterans Aff., Rep. No. 19-07119-80, Telehealth Public-Use Questionnaires Were Used Improperly to Determine Disability Benefits (Feb. 18, 2020).
The VAOIG summarized their findings as follows.
This review was prompted by veterans’ benefits claims transmitted from VBA’s Medical Disability Exam Quality and Program Management Office as part of an effort by VA to identify potentially fraudulent claims in response to prior OIG report recommendations.
Moreover, VA regional office staff had related allegations to the OIG hotline.
At issue were healthcare providers who did not practice in the state, territory, or country where the veterans reside allegedly being paid to complete the public-use questionnaires and document conditions meriting disability benefits without ever seeing the veteran in person.
These questionnaires were being completed via “telehealth”—health care provided remotely through telecommunications technologies. The use of private provider telehealth examinations for rating purposes is prohibited.
Committee Questions VA's Prohibition Against Private Practitioner Telemental Exams
- The Committee questioned why VA-contracted examiners in the private sector have been encouraged to conduct telehealth C&P exams, whereas VA forbids the use of telehealth technology by veteran-requested examiners.
Members of the Advisory Committee on Disability Benefits discussed VBA's policy to encourage VA-employed and VA-contracted examiners to utilize telemental exam capabilities, but to forbid non-VA psychologists and psychiatrists from using the same technology.
Veterans have a right to submit IME (independent medical exam) or IPE (independent psychological exam) findings to support their claim.
Veterans are thus at a disadvantage because in many instances if they (or their attorneys) wish to retain an independent expert, the veteran might have to travel hundreds or thousands of miles and incur significant expenses for travel, lodging, and food costs, as well as lost time from work.
Here is what Advisory Committee members had to say about this unjust VA policy:
Mr. Wunderlich cited an Office of Inspector General (OIG) report that only 81 claims from April 2017 to September 2018 were deemed potentially fraudulent, and of those, only three were referred to OIG.
Furthermore, he argued that VA’s response did not really address Ms. Knowles’ concerns.
Mr. Hazell noted that the OIG report also mentioned the improper use of telehealth by private providers, but added that neither U.S. Code (U.S.C.) nor regulation prohibited [use of telehealth by private providers].
[Mr. Hazell] added that it was odd that VA was discouraging telehealth by private providers while expanding the ability of VHA and contract examiners to perform telehealth exams. Acting Chairman Pamperin agreed.
Dr. Sprague noted that his local Veterans Integrated Service Network had shut down all C&P exams during the COVID-19 pandemic except those that could be conducted by telehealth.
Acting Chairman Pamperin acknowledged VA’s right to make these kinds of policy decisions, but said that there was an obvious disconnect between this decision and what was actually going on, and suggested that the Committee include this topic in its biennial report.
Mr. Hazell offered to spearhead the write-up. Acting Chairman Pamperin pointed out that the topic seemed to have hit a sensitive note with several members, and encouraged Mr. Hazell to coordinate with them. Mr. Hazell said he was willing to do so.
[emphasis & line breaks added to facilitate online reading]
Advisory Committee on Disability Compensation: Meeting Minutes
The Advisory Committee on Disability Compensation (ACDC) posts meeting minutes on its home page. However, they post only the most recent minutes. Previous meeting minutes are available below. (I did not think about collecting these minutes until 2020, so I do not have minutes before May 2020.)
- ACDC September 2020 meeting minutes
- ACDC July 2020 meeting minutes
- Advisory Committee on Disability Compensation (ACDC) May 2020 meeting minutes
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