Sexual trauma claims by veterans wrongly denied by VA, investigation finds

Donovan Slack | USA TODAY

WASHINGTON – The Department of Veterans Affairs improperly denied hundreds of military sexual trauma claims in recent years, leaving potentially thousands of veterans suffering from post-traumatic stress disorder without benefits, a VA inspector general investigation found.

Last year alone, the investigation found the agency mishandled as many as 1,300 sexual trauma claims. Some 12,000 veterans file for sexual trauma-related PTSD benefits each year.

The inspector general found the VA failed to order required medical exams in more than half the cases, didn’t obtain necessary records to back up the claims in hundreds of cases or denied claims despite contradictory evidence.

The agency neglected to provide adequate training to employees vetting the claims. It stopped conducting quality audits of the sexual trauma claims process in 2015. And the following year, it shunted the claims into a national queue where staff without any specialized knowledge processed them.

The VA has specialized processing for other types of claims, including those related to traumatic brain injuries or from prisoners of war.

The inspector general recommended the agency review denied claims, reintroduce specialized vetting and audits, and provide better training for claims processors.

In response to the findings, Paul Lawrence, the VA’s top benefits official, said the agency will comply with the recommendations.

Such pledges were met with caution Tuesday among veteran advocates and assault survivors like Ruth Moore. She was raped twice by a supervisor in the Navy and endured repeated denials of her claims by the VA over 23 years.

"This is why women commit suicide, this is why women are homeless, this is why women don’t get help," said Moore, who went on to found Internity, a nonprofit in Maine dedicated to helping survivors of military sexual assault.

Service Women's Action Network said the improper denials amount to an "unconscionable heaping of additional pain and suffering on those who have service-connected trauma."

The VA put special rules in place in 2011 for vetting claims from victims of sexual assault during military service. They eased guidelines for the types of evidence needed to support the claims and required processors to take extra steps, including getting veterans’ complete personnel files and looking for signs of an assault, such as deteriorating performance.

Processors are supposed to advise veterans to seek statements from family members, clergy or colleagues they may have confided in at the time of the assault. And if there is contradictory evidence, the claim “should be resolved in favor of the veteran,” the IG report says.

Yet in one case examined by investigators last year, a veteran had reported being assaulted to a VA medical center and received related treatment from a private medical provider, but VA staff processing the claim denied it without even ordering a medical exam.

“Had (they) obtained a medical examination, a clinician might have provided a positive opinion regarding the veteran’s claim, which in turn could have resulted in the approval of the claim."

In another case, a male veteran indicated he received psychiatric treatment from several private providers, but VA claims staff never got the records and denied the claim saying “there was no credible supporting evidence of the event.”

VA staff told investigators that they stopped doing audits of sexual trauma claims processing in 2015 and “reallocated resources towards other areas” because the error rates declined.

The agency also hasn’t updated training materials for processors since 2014, and investigators found they are outdated, incomplete and inaccurate.

“Furthermore, the training was one-time only, and there was no requirement for annual refresher training,” they concluded.

The drop-off in focus on such claims at the VA coincided with a national uproar over a massive backlog in benefits claims at the agency. The backlog, which reached as many as 600,000 claims in 2013, had been reduced to 80,000 by the end of last year.