Eric Shinseki, the head of the Department of Veterans Affairs (VA), will be grilled by senators today over the latest controversy sweeping the department, which has been accused of chronic delays in the diagnosis and treatment of sick veterans — and then attempting to cover up its mess.

Thursday’s hearing before the Senate Veterans Affairs Committee comes just a week after the American Legion, the largest veterans organization in the country, called for the resignations of Shinseki and other top staffers amid a growing scandal over Kafkaesque dysfunction at some VA health care centers. This includes claims of interminable waits for urgent tests, endless backlogs, and a series of preventable deaths.

'The cover-up allegedly involved staff literally shredding evidence of the waitlist for appointments.'

The scandal exploded after a six-month CNN investigation into delays at VA facilities revealed that at least 40 veterans had died while waiting for doctor appointments in the Phoenix VA Health Care system.

But the veterans had not only been denied timely care — they had also been placed on a “secret waiting list” designed to hide the fact that between 1,400 to 1,600 of them had been forced to wait months to see a doctor, CNN reported.

The cover-up allegedly involved staff literally “shredding” evidence of the wait list for appointments, which were not recorded within the VA computer system to avoid leaving a paper trail of the delays. When patients came in, their appointments were apparently printed out from computer screen grabs, but the actual records were never saved.

'These allegations, if true, are absolutely unacceptable.'

The scandal had a domino effect on VA hospitals and clinics across the country, as allegations of mismanagement and chaos also came in from Atlanta, Austin, San Antonio, and Fort Collins, Colorado. Last week, the House Veterans Affairs Committee voted to subpoena top VA officials for documents on the screw-up.

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The VA said it won’t comment on Shinseki’s senate appearance until after today's hearing, but defended his record at the helm of the department. It also pointed to a recent, independent survey that ranked VA customer satisfaction "among the best in the nation" and "equal to or better than ratings for private sector hospitals."

“Nobody is more committed to completing the work that lies ahead,” than Shinseki, a spokesman told VICE News.

“These allegations, if true, are absolutely unacceptable,” the spokesman added, referring to the Phoenix incident. “If the Inspector General’s investigation substantiates these claims, swift and appropriate action will be taken.”

But the problem might be a lot bigger than a handful of bad apples in the US government’s second largest department, critics of the VA said.

They say the real issue is not just with the Phoenix VA or other isolated incidents, but with the VA’s visceral problems with leadership, accountability, and oversight.

“There’s a growing sense that this really is going to be more of an institution-wide problem,” Nick McCormick, a legislative associate at Iraq and Afghanistan Veterans for America (IAVA), another vets group, told VICE News. “The culture within the VA is just not very reassuring.”

'What are we going to see in two, five, ten years from now when we’re going to have an even larger population of veterans?'

McCormick paid tribute to the many “terrific, top-notch employees of the VA” — the very insiders who are now turning whistleblowers on the department's inefficiencies — but added that responsibility ultimately falls at the top.

“At the end of the day the buck stops with the secretary. We don’t see the secretary really taking this stuff head on, beforehand, before things get out of control, and that is a concern to our membership,” McCormick said. “If the secretary determines that individuals under his watch can’t get the job done, he needs to do something about that. He needs to be out, leading the way on this; he needs to take the bull from the horn. We want a proactive secretary, not a reactive secretary.”

Veterans groups like IAVA stopped short of endorsing the Legion’s call for Shinseki’s resignation, but said that the department needs to get its act together. This is an increasingly urgent priority as thousands of veterans of the recent wars are set to enter the system in coming years.

“The VA is in this unique place right now, where the war in Iraq ended a few years ago, Afghanistan is getting ready to end, and we are going to see a new influx of veterans,” McCormick said. “We need to make sure that the VA has the capabilities and the presence to handle this new influx. If these sorts of issues are popping up right now, what are we going to see in two, five, ten years from now when we’re going to have an even larger population of veterans?”

Instead, the IAVA is pushing for legislation that would give Shinseki — or a possible successor — what McCormick describes as “enhanced capabilities of ridding the VA of these entrenched bureaucrats that have presided over these scandals, as a way to shuffle personnel that just aren’t getting the job done.”

That’s not so easy.

Changing the culture of red tape and bureaucracy of a department that employs nearly 280,000 people and runs over 1,700 health care sites across the US is going to take years.

“For an agency as large as the VA a lot of these changes aren’t going to happen overnight,” McCormick said.

But for veterans waiting for backlogged disability claims or doctor appointments — and for the families that support them — waiting for years is not exactly an option.

Waiting for the VA

Lindsay Dove knows something about waiting for the VA. Her husband, Kevin English, served three tours as a marine in Iraq before coming home to Arizona with excruciating headaches and neck pain after a Humvee accident. He ended up needing neurosurgery — but used his wife’s private insurance to get it because the VA was just taking too long.

English also filed a disability claim in early 2011 then waited, and waited, and waited. Fed up, his wife took her frustrations to YouTube.

“My baby was six weeks old,” Dove says in her video called The VA Does Not Care, speaking of the day when the claim was filed. “My child is almost two now. This is getting absolutely ridiculous."

The VA responded with its own YouTube video, and English eventually got a 100 percent disability recognition, almost two years after filing. “I had to make a YouTube video and all this stuff to get some attention,” Dove told VICE News.

But that was hardly the end of the problems. If backlogs for VA claims are notoriously troublesome, those for doctor visits actually present a serious health risk to veterans.

English, who needs to go to the VA at least a couple of times a month, has come to dread the very interaction.

“There are little frustrating things that happen every week, it’s just hard to go through. My husband doesn’t even deal with them anymore, he gets anxiety when he sees their caller ID pop up on his phone, he actually asks that they don’t call him, that they call me instead," Dove said. “If he’s having a really bad day, like a 10 in pain, he won’t even go to the VA, he’ll go straight to an urgent care and they just treat him, with whatever he needs. Every time he has gone to the VA ER, he knows that it’s worthless.”

'They’re throwing the ball back and forth and nothing is getting accomplished.'

Dove, who has two young children and was the sole provider for the family, had to quit her job to take care of her husband and advocate on his behalf with the VA’s bureaucracy. She is currently fighting to get him diagnosed with fibromyalgia, a syndrome common among veterans, which causes persisting and widespread pain through the body.

“He has not been diagnosed yet, but we are fairly confident that he has that,” Dove said. “That would explain a lot of the pain problems.”

Dove took her concerns to her husband’s primary care physician within the VA.

“A month and a half went by, so I talked to her again and she goes, ‘rheumatology is not taking any new patients,’” Dove recalled. "Period, end of story."

When pushed, the physician suggested English seek outside care, but in order for the VA to cover that cost, he would need the case reviewed by a VA rheumatologist first. The rheumatologist sent him back to the primary physician.

“They’re throwing the ball back and forth and nothing is getting accomplished,” said Dove, who has repeatedly taken her husband’s VA troubles to the office of her local senator — John McCain. “I don’t know who am I supposed to contact at this point.”

Dove's husband, Kevin English, produced a YouTube video on May 9 where he explains how VA health care works "NBA playoff style."

Sources within the VA speak of an entrenched system, burdened by both a “difficult internal structure and clientele,” with clients confined to “six-month waiting lists,” and employees plagued with “burnout, resentment, and frustration, which ends up causing riffs between veterans and the VA.”

“Morale is incredibly low with employees. Many seem dysthymic if not depressed, which gets projected onto their clients and transcends to treatment,” a former VA staffer, who asked his identity not be revealed, told VICE News. “Veterans often go to local congresspeople when they don't get what they want, and the VA freaks out when they get pressure from Congress. They respond to the fire, not the underlying issues, and get derailed.”

“Many veterans end up giving up entirely and discontinue their relationships with the VA,” he added.

The latest scandal is hardly the VA’s first — and hardly a surprise for veterans and their families dealing with the dysfunction on a day-to-day basis.

Dove and English, who deal with the Phoenix VA system at the heart of the controversy, had long known about the problems there.

“All of us knew, the veterans and the wives, we’ve all known that this was going on for a long time, but the fact that it’s gotten national attention is what has opened America’s eyes," Dove said. “It’s ridiculous, nothing is getting accomplished, it’s like they just don’t care."

But veterans and lawmakers alike are now demanding answers.

“We all need to continue to ask the hard questions,” Daniel Dellinger, the Legion’s national commander said at a Congress hearing in April. “What is VA doing to fix these problems?... How is VA holding their leaders accountable for these errors?”

Follow Alice Speri on Twitter: @alicesperi