VA Shorted Benefits to Some Vets with Lou Gehrig's Disease, IG Finds

Michael Missal, who took over as inspector general for the VA in April 2016, addresses during a field hearing of the Senate Homeland Security and Governmental Affairs Committee in Tomah, Wis., Tuesday, May 31, 2016. (Steve Rundio/La Crosse Tribune via AP)
Michael Missal, who took over as inspector general for the VA in April 2016, addresses during a field hearing of the Senate Homeland Security and Governmental Affairs Committee in Tomah, Wis., Tuesday, May 31, 2016. (Steve Rundio/La Crosse Tribune via AP)

The Department of Veterans Affairs has been cutting benefits to some of its patients with the incurable neurological condition known as Lou Gehrig's disease, and overpaying others, in a program riddled with mistakes, according to a review by the VA's Office of Inspector General.

The review by VA Inspector General Michael Missal, released Tuesday and first reported by The Washington Post, found that veterans with amyotrophic lateral sclerosis (ALS) are at "high risk" for improper payments.

Staff at the Veterans Benefits Administration (VBA) made 71 errors in 45 of the 100 cases of ALS among veterans that were examined by the IG's office from April through September 2017, the report said.

"Based on this sample, the team projected that 430 of the 960 total ALS veterans cases in the system completed during that six-month examination had erroneous decisions," the report said.

That comes out to a roughly 45 percent error rate.

"For those 430 cases, improper payments were made to about 230 veterans through September 2017, resulting in underpayments of approximately $750,000 and overpayments of approximately $649,000," the report said.

If the error rate continued over five years, the VBA "would make $7.5 million in underpayments and $6.5 million in overpayments for a total of $14 million in improper payments," the IG's office said in the report.

ALS typically causes death within three to five years of the onset of symptoms, according to numerous scientific studies. The condition has become known as Lou Gehrig's disease after the New York Yankees hall-of-famer who died of ALS in 1941.

For undetermined reasons, veterans have been more susceptible to ALS than the civilian population. In 2008, the VA declared that ALS is a "presumptively compensable illness" for all veterans with 90 days or more of continuous service.

Then-VA Secretary Dr. James Peake said at the time, "Veterans are developing ALS in rates higher than the general population, and it was appropriate to take action."

In 2012, the VA increased the minimum disability evaluation for veterans with service-connected ALS to 100 percent.

To avoid future errors, the IG's office recommended that the VBA come up with a plan "to improve the decisions and additional reviews of claims involving service-connected ALS and monitor these claims to ensure staff demonstrate proficiency."

The recommendation was accepted by the VA.

-- Richard Sisk can be reached at richard.sisk@military.com.

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