VA Scams and Backlogs: Vets, Do This To Protect Your Benefits
Taxpayers are spending an estimated $193 billion this year to help fund the Department of Veterans Affairs (VA), which provides monthly disability payments to more than 6.9 million disabled veterans. These benefits are crucial for many veterans who fell ill or were injured while serving their country.
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While most disability claims are legitimate, some are not. According to the Washington Post, the estimated total loss from fraudulent benefits claims is in the tens of millions of dollars.
To get their story, the Post reviewed 25 years of VA disability claims, highlighting certain ones. Notably, the number of fraudulent or exaggerated claims is a small fraction compared to legitimate ones.
Keeping that in mind, here's how some veterans have gamed the system, according to the Post's investigation.
Fraudulent Claims in the VA
As per the Post, millions of fraudulent or potentially questionable claims for VA benefits have flooded the system over the years. This is largely due to the VA's (apparently) lax controls and outdated system.
The Post found that many benefits claims are for treatable or relatively minor afflictions that only rarely hinder employability. This includes jock itch, hair loss and toenail fungus. The numbers of vets receiving benefits for these types of conditions are:
Eczema: 556,000
Hemorrhoids: 332,000
Benign skin growths: 110,000
Acne: 81,000
Varicose veins: 74,000
While individual payouts aren't very high, they've added up to billions of dollars per year.
Top Scams or Issues in the System
Again, keeping in mind that most claims are legitimate, here are a few ways (and reasons why) people are able to "game" the system, as per the Post.
Working Full-Time While Receiving Benefits
The VA's disability program was designed to aid veterans unable to work (or unable to work full-time) due to their time in active duty. But the Post determined many disabled vets under 65 still work full-time and receive benefits.
This is largely because of the lowered standard of proof.
Since 2001, lawmakers have lowered the standards demanding proof for disability claims. In 2022, the Pact Act made it even easier to claim benefits without requiring substantial evidence. Many claims (such as for cancer or other serious illness) are legitimate, but there's been an increase in claims for treatable or less serious conditions (like respiratory illness or irritable bowel syndrome).
No Conclusive Way To Prove Severity
As per the Post, there's not a clear, conclusive way to determine if the veteran making a claim is telling the full truth about the severity of their symptoms. This is particularly the case of conditions like depression, back pain and migraines.
The VA is required to give veterans the benefit of the doubt when it comes to their claims. If there's a 50/50 chance the claim is valid, they must approve the claim, which some people take advantage of.
Authorities Are Aware of Those "Gaming" the System
Documents and interviews with officials indicate the authorities have been aware that some vets are "gaming" the program, but that they haven't done much about it.
This may be partly due to the honor system.
In 2021, in connection to a court filing in which an Army vet defrauded the VA of over $200,000, Justice Department prosecutors noted that the VA "operates on an honor system with its veterans." The issue is that some common conditions, like sleep apnea, are difficult (or impossible) to accurately verify or measure.
Persistent Backlog
Back in September, the VA reportedly was processing almost 635,000 claims. Around 134,000 of these had been sitting in the system for four or more months. The backlog makes it difficult for even legitimate claims to get through. It also makes it harder to verify claims.
If their claim is denied, veterans can try again with regional VA offices, the U.S. Court of Appeals for Veterans Claims and the Board of Veterans' Appeals. Making an appeal often comes with free legal representation.
The Post also claims the VA hasn't done much to deter those who'd game the system. This may be due, in part, to the inspector general's office being overwhelmed with reports or fraud and abuse at the VA. The office received over 30,000 tips and complaints just last year.
Outdated Disability Rating System
The VA has a disability rating system — from zero to 100% — it uses for veterans based on their injury or illness' severity. The system was established in 1945.
A higher rating means greater compensation. Just last year, 1.5 million vets had a 100% rating. This is double the 2019 figure and almost nine times greater than the 2001 figure. Those with a 100% disability rating receive extra perks in some states, like property tax deductions and free hunting or fishing permits.
Ways Veterans Can Protect Their Benefits
While scams and fraud make up only a small fraction of the bigger picture, vets who do receive benefits should still protect themselves on the individual level. As per the VA, here's how you as a vet can protect your benefits:
Apply directly to the VA for benefits or through an accredited rep.
If you're missing payments or amounts seem incorrect, contact the VA at 1-800-827-1000.
Validate any legal representative or agent via the VA's OGC Accreditation Search Tool.
If you've been contacted by a suspected scammer, File a complaint with the Federal Trade Commission.
Review all docs before signing anything.
Update your technology, especially your internet browser, mobile software and computer's OS.
Learn more about scams and ways to protect yourself at benefits.va.gov/BENEFITS/fraud-prevention.asp.
This article was provided by MoneyLion.com for informational purposes only and should not be construed as financial, legal or tax advice.
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