Deputy Assistant IGs Discuss Two Burn Pit Reports
In this episode, host Fred Baker talks with Leigh Ann Searight and Brent Arronte, deputy IGs with the Office of Audits and Evaluations, about two burn pit reports published in July. Plus highlights of the OIG's recent oversight work.
Related Reports:
Airborne Hazards and Open Burn Pit Registry Exam Process Needs Improvement
Since 1990, some 3.5 million veterans have served in areas that potentially exposed them to airborne hazards and open burn pit toxins, which have been associated with health problems. In 2013, Congress ordered VA to establish a registry to research the potential health impacts of exposures. The VA Office of Inspector General (OIG) reviewed the management of registry exams, including whether VA medical facilities conducted them within the 90-day prescribed period. The Veterans Health Administration (VHA) began collecting and recording data in the registry in May 2014 through an online questionnaire and free in-person exams. The OIG found many veterans did not complete the 140-item questionnaire, which is not clear and veteran-centric. Veterans also did not always realize they were responsible for scheduling their own exams. Improvements in the registry exam process would help ensure more eligible and interested veterans receive them. VHA plans to establish a call center to assume some of the scheduling and coordination responsibilities by October 2022. This is well-timed given the number of veterans indicating they would like an exam has further increased since August 2021, when VA established a presumptive “service connection” for respiratory conditions due to exposure to particulate matter, such as asthma, sinusitis, and rhinitis. Whether the call center will mitigate the issues identified by the OIG cannot yet be determined, and its rollout does not negate the need for corrective actions. The OIG made seven recommendations to the under secretary for health that include revising the questionnaire to be more veteran-centric, identifying whether veterans with unscheduled exams are still interested in one, and implementing processes and metrics to ensure exams are completed. Further, the OIG recommended developing guidance to ensure responsible parties review and discuss performance data and the enhancement of registry information systems.
Veterans Prematurely Denied Compensation for Conditions That Could Be Associated with Burn Pit Exposure
VA recognizes exposure to smoke from the large burn pits used by the US military to dispose of waste from its bases in Iraq, Afghanistan, and Djibouti as a potential cause of disabilities. Veterans Benefits Administration (VBA) staff processed more than 21,100 burn pit-related claims from June 2007 through September 2021. Given the potential impact on many eligible veterans, the VA Office of Inspector General (OIG) conducted this review to determine whether VBA staff followed regulations and procedures when addressing conditions that could be associated with burn pit exposure. VBA treats burn pit-related claims like most other disability compensation claims, though it also considers exposure to environmental hazards based on a veteran’s service location. VBA provides medical examiners a burn pit fact sheet to help ensure any opinion is fully informed based on all known objective facts. The review team examined three distinct samples of claimed conditions potentially related to burn pit exposure completed from May 1, 2020, to May 1, 2021, and found VBA could improve its processing and oversight. Though VBA staff nearly always made the correct decision in granting compensation for conditions identified as burn pit-related, the OIG found most denials were premature. The OIG made seven recommendations to VBA management, including correcting four errors involving improperly granted conditions, and reviewing denied cases, correcting errors they identify, and certifying that corrections were made. VBA should also update its adjudication procedures manual to provide separate and specific guidance for handling claims based on burn pit exposure and modify its examination request application to add specialty language from the burn pit fact sheet into medical opinion requests. Finally, VBA should update training materials and ensure they are consistent with the adjudication procedures manual guidance.
Airborne Hazards and Open Burn Pit Registry Exam Process Needs Improvement
Since 1990, some 3.5 million veterans have served in areas that potentially exposed them to airborne hazards and open burn pit toxins, which have been associated with health problems. In 2013, Congress ordered VA to establish a registry to research the potential health impacts of exposures. The VA Office of Inspector General (OIG) reviewed the management of registry exams, including whether VA medical facilities conducted them within the 90-day prescribed period. The Veterans Health Administration (VHA) began collecting and recording data in the registry in May 2014 through an online questionnaire and free in-person exams. The OIG found many veterans did not complete the 140-item questionnaire, which is not clear and veteran-centric. Veterans also did not always realize they were responsible for scheduling their own exams. Improvements in the registry exam process would help ensure more eligible and interested veterans receive them. VHA plans to establish a call center to assume some of the scheduling and coordination responsibilities by October 2022. This is well-timed given the number of veterans indicating they would like an exam has further increased since August 2021, when VA established a presumptive “service connection” for respiratory conditions due to exposure to particulate matter, such as asthma, sinusitis, and rhinitis. Whether the call center will mitigate the issues identified by the OIG cannot yet be determined, and its rollout does not negate the need for corrective actions. The OIG made seven recommendations to the under secretary for health that include revising the questionnaire to be more veteran-centric, identifying whether veterans with unscheduled exams are still interested in one, and implementing processes and metrics to ensure exams are completed. Further, the OIG recommended developing guidance to ensure responsible parties review and discuss performance data and the enhancement of registry information systems.
Veterans Prematurely Denied Compensation for Conditions That Could Be Associated with Burn Pit Exposure
VA recognizes exposure to smoke from the large burn pits used by the US military to dispose of waste from its bases in Iraq, Afghanistan, and Djibouti as a potential cause of disabilities. Veterans Benefits Administration (VBA) staff processed more than 21,100 burn pit-related claims from June 2007 through September 2021. Given the potential impact on many eligible veterans, the VA Office of Inspector General (OIG) conducted this review to determine whether VBA staff followed regulations and procedures when addressing conditions that could be associated with burn pit exposure. VBA treats burn pit-related claims like most other disability compensation claims, though it also considers exposure to environmental hazards based on a veteran’s service location. VBA provides medical examiners a burn pit fact sheet to help ensure any opinion is fully informed based on all known objective facts. The review team examined three distinct samples of claimed conditions potentially related to burn pit exposure completed from May 1, 2020, to May 1, 2021, and found VBA could improve its processing and oversight. Though VBA staff nearly always made the correct decision in granting compensation for conditions identified as burn pit-related, the OIG found most denials were premature. The OIG made seven recommendations to VBA management, including correcting four errors involving improperly granted conditions, and reviewing denied cases, correcting errors they identify, and certifying that corrections were made. VBA should also update its adjudication procedures manual to provide separate and specific guidance for handling claims based on burn pit exposure and modify its examination request application to add specialty language from the burn pit fact sheet into medical opinion requests. Finally, VBA should update training materials and ensure they are consistent with the adjudication procedures manual guidance.
