Five years have passed since Scott Davis testified before Congress about mismanagement at the U.S. Department of Veterans Affairs (VA), a condition that resulted in almost a million backlogged applications and a sometimes deadly state of limbo for veterans waiting to get health care. On 13 May 2019, Davis penned a widely read opinion piece for the Washington Examiner in which he stated that despite a whirlwind of media attention in years past, the problem had hardly been resolved.

Despite President Donald Trump’s blasting the administration of his predecessor for the problem, Davis wrote, “The Trump administration has decided to execute a plan to purge 200,000 applications for VA healthcare caused by known administrative errors within VA’s enrollment process and enrollment system — problems that had already been documented by the Office of the Inspector General in 2015 and 2017.”

“I tried in a very non-partisan way to say, two years after you made a big deal about this, this is happening on your watch,” Davis told us by phone. Davis is a former public affairs officer for VA Member Services, which deals with enrollment. Although he currently works in a different department, Davis is still employed by the VA.

The VA has taken issue with Davis’ use of the word “purge” in reference to applications, with spokeswoman Susan Carter telling us by email that it’s a “loaded term” and calling Davis’ opinion piece “misleading.” However, the VA confirmed that 208,272 veterans’ applications for health care had been moved from “pending” status to “closed” status between January and February (she did not specify the year). Once an application has been closed, the veteran must reapply for health care benefits.

Davis maintained taking issue with his terminology was just wordplay, and that no functional difference existed between “closing” and “purging” an application from the veteran’s perspective. “Offering the person the opportunity to reapply is not offering them anything,” Davis told us. “Intake is a very basic function of any government organization. If you can’t do that, that’s a problem. And that’s a problem that people in my opinion, from the president on down, should be concerned with, because this is the nation’s largest health care system.”

If a veteran applies to receive VA benefits but the application is incomplete, the person has a year to submit necessary additional information. During that time, the application is placed in “pending” status. After a year, in accordance with federal law, the application is placed in “closed” status by the VA, and the veteran is notified by letter how to reapply. The VA states it notified all veterans with incomplete applications via letter “that they are in pending status and that they have 365 days to complete their applications.”

Between January and May 2019, a total of 21,881 applications have been moved to “pending” status, according to Carter’s email. Davis sent us a copy of the VA’s Fiscal Year 2019 briefing book showing more than 317,000 applications currently in “pending” status. That same book shows over 270,000 applications in “closed” status.

Davis told us that known issues exist with the VA’s notification process dating back to a 2014 scandal that prompted Veterans Affairs Secretary Eric Shinseki to resign. As a presidential candidate, Donald Trump had been critical of the scandal. The VA Office of Inspector General determined in 2015 that “extensive, persistent problems with veterans’ health care enrollment records maintained by the [Health Eligibility Center or HEC]” existed.

Whistleblower Allegations

The 2015 report confirmed whistleblower allegations that the VA had 867,000 “pending” applications, and that of that backlog more than 307,000 were records associated with deceased veterans. But auditors were unable to determine how many of those were people who died while awaiting health care because of sloppy record-keeping by the VA. (The issue was widely misreported, and Trump asserted that all 307,000 cases were veterans who died awaiting care while their applications were pending.)

In 2017, auditors reported that the VA lacked an adequate, uniform system for enrolling veterans at the point of contact, VA health-care facilities. We asked the VA whether a national enrollment policy was enacted in response to that report, and spokeswoman Susan Carter told us a policy was “still under development.”

Carter also said that the VA makes thousands of attempts to reach veterans in “pending” status. The VA “regularly reaches out to Veterans both by mail and by phone. In this fiscal year alone, VA has made over 200,000 call attempts to Veterans with pending applications, and over 300,000 attempts to newly enrolled Veterans. On average over 27,000 calls are placed each month to Veterans with a pending [Veterans Health Administration] application to assist them with completing anything that is missing in order to reach an enrollment determination. VA makes six attempts with each Veteran over the course of one year.”

We asked how many of those attempts yielded verifiable contacts with veterans but have not yet received an answer to that question.

Letters by Mail

Davis questioned whether veterans ever received the letters or calls. He provided us an internal memo dated 30 November 2016 in which Health Eligibility Center (HEC) officials cautioned that tens of thousands of addresses had been flagged as potentially bad, while acknowledging that “although a letter was never returned by the postal service, we cannot say that the Veteran received it.”

“How many times do we all miss one letter in the mail? In 2019, that’s how they’re communicating? It’s ridiculous,” Davis said. “To say, ‘We sent a letter to people’ in 2019 — I know people in government don’t know how the internet works, but people under 60 aren’t running to the mailbox every day.”

The quality of VA health care for veterans, and the agency’s mismanagement of processes that help them get it, have for years been a focal point of public concern, but the controversy rose to the surface again in April 2019 amid news reports that four veterans had committed suicide at VA facilities in the span of one month. On that issue, the Atlanta Journal-Constitution wrote:

Veteran suicide is an acute crisis wrapped in a national crisis. Between 2005 and 2016, suicide rates in the general population climbed 21%. For veterans, already taking their lives at twice the U.S. rate, it climbed 26%. More than 6,000 veterans are dying by their own hands each year – nearly 20 a day. The latest deaths renew questions about whether the VA, criticized and investigated for failing to provide timely or sufficient help to veterans, is doing enough to solve the problem. That is despite making suicide prevention a high priority in recent years.

We asked the VA how many veterans committed suicide while their applications were in “pending” status between January 2012 and May 2019 but received no response to that question.