VA Disability Exams: Actions Needed to Improve Program Management

Thank you for the opportunity to discuss our recent review of the Department of Veterans Affairs (VA) planning and oversight efforts regarding its disability medical exam workloads. In 2018, VA issued contracts worth up to $6.8 billion over 10 years duration to private disability medical exam providers, according to Veterans Benefits Administration (VBA) officials. These exams help VBA evaluate claims from veterans seeking disability benefits for service-connected and other disabilities. In recent years, we have issued several reports on VBAs contract exam program as the program has expanded in size and scope. We reported in March 2021 that VA has increasingly relied on VBA contracted examiners to perform disability examsinstead of staff at Veterans Health Administration (VHA) medical centersand that various restrictions have been eliminated regarding the types of exams that contractors may perform, according to VBA officials.1 Accordingly, the number of exams performed by VBA contract examiners increased from roughly 180,000 in fiscal year 2012 to 1.1 million in fiscal year 2020. This total represented more than three-quarters of the 1.4 million exams performed in fiscal year 2020. GAO also reported in 2018 on issues with VBAs oversight of contract medical examiners, and VBA has not yet fully implemented the recommendations from our 2018 report.2 My statement today summarizes our findings related to (1) VBAs planning for allocating disability exam workloads among VBA contractors and VHA medical centers, and (2) how VBA assesses the quality of exam reports for certain complex claims.3 My testimony is based primarily on our March 2021 report.