Outsource Disability Exams
VA Doctors Alarmed with Plan to Outsource Disability Exams

A new initiative to reduce the burgeoning backlog of VA disability cases is raising eyebrows at VA hospitals and clinics. Last month, the Department of Veterans Affairs announced it plans to outsource more disability exams to private contractors.  The hope is that these exams, which are essential to the awarding of benefits for veterans with service-related injuries or illnesses, will be completed more promptly. Contractors could perform as much as 60 percent of the exams as the VA tries to dig out of a log jam of disability cases, which the Military Times estimates at 70,000 nationwide. The VA had pledged to reduce the backlog to zero by the beginning of this year, but clearly it is falling short of that goal.
VA doctors, however, are pushing back on this initiative. They say the quality of exams will suffer, creating more clashes between vets and the VA. The Baltimore Sun reports that “the union that represents most of the VA employees who conduct medical exams filed a grievance after learning of the outsourcing plan. The union contends that contractors could put profits ahead of veterans' needs, leading to less scrupulous exams. Contractors are ‘rewarded for quick-and-dirty,’ said Marilyn Park, a lobbyist for the American Federation of Government Employees. VA staff, she said, would ‘miss less’ and ‘give a more thorough exam, a more specialized exam.’” The cost of outsourcing the exams is another area of concern. By some estimates this new initiative could cost taxpayers more than one billion dollars a year. 
The VA, however, defends its decision, by pointing out this “move could make it easier for veterans in remote areas to be seen, and speed up payouts.”  Furthermore, the VA has been prodded by Congress to use more outsourcing as a way to whittle down wait times at VA hospitals and clinics.  “A panel of senators charged with helping the department cut the backlog of disability claims endorsed the idea, writing in a report last year that more extensive use of private doctors ‘ensures that disability exams continue to be completed in a timely manner, especially in locations where the VA may have higher demand for care and lack the facilities or resources to provide these exams quickly,’” the Sun reports. Outsourcing more exams would also free up doctors to focus more on treating vet patients, according to one VA official.
But the Sun goes on to report that a union official for the VA employees “said the VA's own doctors have a deep understanding of the connections between military service and disabilities. Without that specialized knowledge, he said, doctors could make mistakes, ultimately slowing down the process of applying for benefits. ‘I think it's just going to lead to much more frustration,’ he said.”
Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska
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