Study: VA not doing enough to fix disparities in disability pay

Injured veterans could be shortchanged in their government disability pay depending on where they live because of wide disparities from state to state, an internal study concludes.

The 1 1/2-year investigation, conducted by the Institute for Defense Analysis, is the first to examine scientifically the reasons behind the Veterans Affairs' uneven handling of veterans claims for disability compensation. It was launched by the VA following reports in 2005 of wide differences in payments.

The 50-page report, made available to The Associated Press, found that average annual disability payments swung widely _ from $7,556 in Ohio to $12,395 in New Mexico. Nationwide, the average pay was $8,890.

Illinois, which was the lowest in the nation in 2004 at $6,961, was the seventh lowest at roughly $7,816.

"The process by which VA adjudicates claims has potential for producing persistent regional differences in rating results," said David Hunter, who compiled the study. "For certain claims, different raters could reasonably arrive at different results."

Since reports of disparities emerged in 2005, the VA has struggled to explain them. It has largely blamed problems on demographic factors beyond its control; for instance, whether a particular state had more Vietnam veterans, who on average receive higher payments, or whether a veteran had legal help when making a claim.

But the study released to the AP found that roughly one-third of the problems could be blamed on poor VA standards and inadequate training. As a result, disability raters in VA regional offices often had too much power and discretion to decide how much pay a veteran was entitled.

The report also faulted the VA for not collecting data on certain types of claims, such as how many post-traumatic stress disorder cases are rejected. As a result, it was impossible to determine whether part of the disparity might be due to a VA office inappropriately rejecting a high number of claims for PTSD, a signature injury of the Iraq war.

Some soldiers and veterans groups have charged that Army disability review boards, which are under the Pentagon's purview, unfairly reject PTSD claims to avoid paying disability pay. No data was available to determine whether that might be the case for the VA, the report said.

Among the findings:

_PTSD claims generate among the highest disability pay, averaging $20,000 each year to more than 200,000 veterans. While VA staff expected PTSD claims would be more subjective from state to state, their ratings were actually more stable compared with other injuries and illnesses, such as cardiovascular problems.

_Veterans who receive legal help or aid from advocacy groups receive on average $11,162, compared with $4,728 for those who go it alone. Currently about two-thirds of veterans get such advocacy help; the highest representation is in North Dakota (81.9 percent), while the lowest is in Maryland (44.8 percent).

_Vietnam veterans received annual awards of $11,670, compared with $7,410 for those who fought in other wars. The lowest pay was given to Gulf War veterans _ $6,506.

The report comes as the Bush administration races to improve its veterans care system following disclosures earlier this year of shoddy outpatient treatment at the Pentagon-run Walter Reed Army Medical Center.

On Tuesday, VA Secretary Jim Nicholson unexpectedly announced he would step down by Oct. 1 to return to the private sector, leaving the helm of the VA's vast network of 1,400 hospitals and clinics that provide supplementary care to 5.8 million veterans.

Both Congress and a presidential commission are considering sweeping measures that could shift more responsibility for rating a veterans' disability from the Pentagon to the VA _ a move that some veterans advocates say could further strain an already backlogged VA system.

In interviews, Patrick Dunne, VA's assistant secretary for policy, planning and preparedness, and Ronald Aument, the VA's deputy undersecretary for benefits, said they welcomed the findings and would take additional measures to improve training and oversight.

Beside hiring hundreds of additional staff, the VA is beginning to collect more data on the types of claims rejected, standardizing procedures from office to office and improving collaboration with its medical personnel to ensure claims processors have enough information to make a decision based on objective criteria, Aument said.

The agency also is doubling the size of its quality assurance program _ currently 15 people _ to review data and audit pay outcomes on a regular basis.

A separate review of the VA system for handling disability claims is also under way to determine how to cut through bureaucratic delays, confusing paperwork and long appeals processes as thousands of veterans return home from Iraq and Afghanistan.

"If we work on accuracy, consistency will in turn follow," Aument said.

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