WASHINGTON – House Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs (DAMA) Chair Elaine Luria (VA-02) today led an oversight hearing on VA’s contract exam process, specifically emphasizing its impact on rural veterans, including her constituents on the Eastern Shore of Virginia.

The hearing focused on VA’s ability to fix gaps in processes related to contracted compensation-and-pension (C&P) disability exams for veterans. These exams are critical to the success of a veteran’s claim, being a deciding factor in a disability claim and allowing physicians to determine the scope of a disability.

Among other issues, Congresswoman Luria cited the locations of such C&P exams, some of which have been reported by veterans to be held in places like nail salons. Another example highlighted a veteran with mobility issues who had difficulty reaching an appointment because the contract examiner did not have an access ramp.

Congresswoman Luria also called attention to the fact that her Eastern Shore constituents in Accomack and Northampton counties must travel long distances for these critical exams. She questioned Ken Wiseman, Virginia State Adjutant for the Veterans of Foreign Wars, about ways to improve this issue.

Mr. Wiseman came prepared with recommendations, including possibilities involving telehealth and physicians who can work part-time in rural areas. Congresswoman Luria vowed to research those recommendations.

“VA’s oversight of contract vendors is key to making sure each veteran receives excellent and convenient care, and exam results enable quick adjudication by VA raters,” Congresswoman Luria said. “It’s clear we still have some work to do, but I am hopeful that in the future VA will continue to improve the contract exam program to guarantee better results for veterans and their families.”

Congresswoman Luria’s full opening statement can be seen HERE, and her remarks are transcribed below:

I’d like to start today’s hearing by asking any veteran in the room to raise their hand.

I know that my colleagues join me in thanking you for your service. We share the sense of dedication to ensure that we never forget the sacrifice that our women and men in uniform have made in service to our country.

The path to service-connection starts with a claim for benefits and most often requires a VA examination—commonly known as a compensation-and-pension (C&P) exam.  These exams are critical to the success of a veteran’s claim.  They often provide the missing link to service or give a medical assessment of the severity of a disability.  This information can be a deciding factor whether a claim for service-connection is granted or disability evaluation is increased.  Because disability exams play a key part in enabling veteran access to benefits, we are under a continuing obligation to make sure they are completed correctly and in a timely fashion.

In recent years, we’ve seen a spike in the number of C&P exams outsourced to contract examiners.  The work that contract examiners perform continues to increase–in fact, GAO highlights that the number of contracted examinations has quadrupled since 2012.   Currently, contractors carry out 64% of exams, up from 61% in May of this year, and 53% in May of 2018. While I welcome the increased capacity that contracted examiners offer to veterans in rural areas — including veterans who live in my home state of Virginia — quick expansion often comes with growing pains.

Today we’re following up on last November’s hearing on disability contract exams to ensure VA is making progress on GAO’s recommendations.  At the last hearing, VA assured Congress it would improve its quality review process, correct flaws in their software and IT programs, and ensure contract examiners completed VA trainings.  This is an opportunity for VA to tell us about the progress they’ve made over the last 10 months and what work still needs to be done.

Since VA’s recent improvements, Veterans report a general decrease in the amount of wait times for C&P exams but are concerned that cultural training is not appropriately provided to contract examiners.

Veterans also report that locations of contract examinations are not consistently vetted. One example provided in written testimony by the National Association of County Veteran Service Officers, highlights a veteran’s experience where their C&P exam was conducted inside of a nail salon. Another example cited to my staff highlighted that a veteran with mobility issues had difficulty reaching their appointment because the contract did not have a handicapped access ramp.

My staff has also heard reports that contract examiners are not consistently providing travel reimbursements to veterans. This, too, was supported by a recent survey conducted by the Disabled American Veterans who outlined that as many as 40% of their service offices had reported that veterans were not receiving travel reimbursements for the contracted medical exams.

Numerous veteran service organizations, groups, and veterans report that expansion to access for benefits is a priority. Our veterans who live in highly populated areas have easier access to VA services than our veterans who live in rural communities and in remote locations including tribal lands.

I understand the new contract awarded in November 2018 redistricted the geographical regions amongst vendors in an attempt to increase veteran access to examiners and evenly distribute rural veterans amongst the contract vendors.  I look forward to hearing about the successes and challenges with this initiative.  It should be clear to everyone that we simply cannot let distance be the barrier to a quality and timely C&P exam.

VA has made large strides in reducing wait times and improving access to VA benefits. I applaud the VA for their efforts thus far, but more work to improve access must be done in the realm of the contract examination process.

I look forward to hearing the testimony from the VA, GAO, and Veteran Service Originations today.

I welcome your ideas and ask for your continued open and solution-driven communication.