Letter to the Honorable Robert Wilkie, Secretary of Veterans Affairs - Congresswoman Elaine Luria Urges VA to Provide Timely, High-Quality C&P Exams

Letter

Dear Secretary Wilkie:
The Department of Veterans Affairs recently advised my staff of its intention to shutter
the compensation and pension (C&P) examination program at the Veterans Health
Administration (VHA) and shift to the use of private contractors. As a global pandemic has
caused a backlog of 350,000 C&P examinations and concerns of the Government Accountability
Office (GAO) are still unresolved, I am concerned about VA's ability to adequately oversee the
program. Considering VA's announcement, I need your commitment that VA will ensure all
contractors provide timely, high-quality C&P examinations to our disabled veterans.
During last year's Subcommittee hearing on contract C&P examinations, VA testified
that contract exams were intended to supplement the existing VHA C&P program, providing
local examinations to rural veterans and prompt appointments when VHA facilities had long wait
times. Now, VA says full migration of C&P examinations to contractors was always the plan.
VA privately advised my staff of the decision after it was made, without a press release or
communication to the affected veterans, advocates, or labor representatives. Such a
consequential decision should have been communicated directly to the Chair and Ranking
Member of this Subcommittee and should not have moved forward during the turbulence of the
pandemic.
The timing and circumstances of the decision to fully migrate to contract examiners could
create hardships. The COVID-19 pandemic caused a backlog of 350,000 C&P examinations that
has lingered since in-person examinations resumed, without appreciable improvement. Despite
this, VA is actively eliminating VHA C&P examiner jobs. Without an alternate plan to reduce
this backlog, VBA has tied one hand behind its back as it forges ahead on its decision. I am also
concerned that eliminating the VHA C&P program will endanger federal jobs while millions of
Americans struggle with unemployment. As VA retires the VHA C&P program, it should
carefully consider other opportunities within VA for affected employees. Last year's Subcommittee hearing examined VBA's quality review process for vendors
in its contract examination program based on a GAO report from October 8, 2018. In that report,
GAO provided four recommendations to improve oversight over contract vendors, focusing on
quality, timeliness, and training. More than two years later, VBA has not fully implemented
these recommendations it agreed were necessary for proper oversight. For instance, VBA's
Exam Management System still cannot synchronize with contractor systems to properly invoice
or calculate examination timeframes. VBA also has not yet implemented its training
management system, which allows for better data collection on the effectiveness of training.
VBA's failure to implement these recommendations raises concerns about its ability to oversee
contractors as they increase their workload from 60% of C&P examinations to nearly 100%.
VBA needs a plan and timeline for implementation of GAO's recommendations as it migrates all
C&P examinations to contractors. Further delays endanger the program's success, especially as it
undergoes rapid expansion.
For many veterans, thorough and accurate C&P examinations are crucial to securing
service-connected benefits. VA's quiet decision to carry out a major reorganization of its C&P
program without a plan to make key improvements, reduce backlog, or retain employees is
unlikely to deliver the high-quality results we expect. Considering these challenges, I would like
commitments and answers to the following questions:
1. Please provide a plan and timeline for complete implementation of the
recommendations in GAO's October 2018 report, VA Disability Exams: Improved
Performance Analysis and Training Oversight Needed for Contracted Exams.
2. What steps, if any, have been taken to notify VA C&P examination providers of their
opportunities to continue to work at VA in the event their jobs are under
consideration for elimination and what are those opportunities?
3. How many C&P examination staff positions does VA expect to eliminate in the
migration to contract examinations, including any frontline scheduling staff?
4. Please provide a list of the C&P examinations that will continue to be performed by
VHA staff and whether VA has considered the value of having VHA examiners
conduct specialty examinations for Gulf War Illness and other toxic exposures,
Military Sexual Trauma, and Traumatic Brain Injury?
Please respond to this letter by no later than Monday, November 16, 2020. If you have
any questions, please contact Julie Turner, Staff Director of the Disability Assistance and
Memorial Affairs (DAMA) Subcommittee at Julie.Turner@mail.house.gov. Thank you for your assistance
with this request.

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