The following crimes against the VA, veterans, and U.S. taxpayers, reveal lessons, which, if we take the teaching, can lead to preventing such craven acts and thereby help vets, and save some taxpayer cash in the process.
First, and close to home for me, is news of veterans filing fraudulent travel vouchers at the Charles George VA Medical Center in Asheville, North Carolina (where I used to work):
One Defendant Was Allegedly Reimbursed over $18,000 in Fraudulent Travel Vouchers
ASHEVILLE, N.C. – U.S. Attorney Jill Westmoreland Rose announced today that in the month of June the U.S. Attorney’s Office in Asheville has filed federal charges against 16 individuals that defrauded the U.S. Department of Veterans Affairs (the VA) by submitting fraudulent travel vouchers for reimbursement.
Kim Lampkins, Special Agent in Charge of the Mid-Atlantic Field Office, Washington, D.C., of the U.S. Department of Veterans Affairs, Office of Inspector General (VA-OIG), joins U.S. Attorney Rose in making today’s announcement. …
The charging documents allege that the defendants submitted fraudulent travel vouchers that overstated the distance they traveled for medical appointments or to receive medical treatment. The VA reimbursed the defendants for their travel expenses based on mileage information on the fraudulent vouchers. A total of 16 individuals have been charged separately in connection with travel voucher fraud. [Click here for the full press release from the U.S. Attorney’s Office in Asheville]
Lesson #1: Improve the way VA confirms a veteran’s home address. I hear from many veterans that travel fraud is common. It seems like it should be easy to confirm a veteran’s true address, but maybe it’s more complicated than I assume. If anyone knows, please comment below (“Leave a Reply”).
Lesson #2: If you look the other way, you are part of the problem. Many veterans (and others) espouse the view that it is not honorable to ‘narc’ or ‘squeal’ on another veteran who gives the VA a false address in order to reap more travel money. There are certainly situations where being a ‘snitch’ is unwise, or even dishonorable. I’m sure you can think of several.
But is this one?
What honor is there in tacitly approving theft? Is that what you fought to defend?
There is not a big money tree at 810 Vermont Avenue. The VA receives funding from you, your family and friends, your neighbors, and your fellow veterans in the form of taxes. Stealing from VA is stealing from you, your family and friends, your neighbors, and all U.S. citizens.
If you know a veteran who is stealing money from the taxpayers, and hurting the reputation of disabled veterans everywhere, report the crime to the VAOIG via the Hotline, or directly to the Office of Investigations in your area.
PORTLAND, Ore. – A former employee of the Deschutes County District Attorney’s Office and the Oregon Department of Justice appeared in federal court this week and admitted to stealing more than $55,000 from the Department of Veterans Affairs, U.S. Department of Agriculture, and U.S. Department of Health and Human Services.
Bruce A. Endicott, 34, pled guilty to theft of government funds before U.S. District Court Judge Robert E. Jones on Tuesday, and admitted he committed the theft over a course of more than three years. According to court records, Endicott began receiving service-connected disability benefits through the Department of Veterans Affairs (VA) in 2005.
In June 2012, Endicott filed an additional claim with the VA for Individual Unemployability benefits, claiming he was unemployed and unable to be employed due to his service-connected disabilities that included physical and mental impairments.
Endicott also submitted a statement to the VA in February 2013, that stated he had not worked within the past 12 months. In fact, Endicott was currently working at the Oregon Department of Justice under a second Social Security number that he had not disclosed to the VA.
Based on Endicott’s false statements and concealments, the VA awarded him additional benefits… [Read the full Press Release from the U.S. Attorney’s Office, District of Oregon]
Lesson #3: Toughen up review of IU claims. Conscientious C&P psychologists and psychiatrists will tell you that they must conduct many exams for very questionable, even frivolous, individual unemployability (IU) claims. The classic case is a vet who worked for 40 years, often performing his or her job with skill, expertise, and diligence, but shortly after retirement he or she files an IU claim.
On rare occasions such veterans have indeed become so disabled that they cannot work, but the vast majority of such claims seem to arise from a (faulty) belief among some service officers, fellow vets, or family members that the veteran filing the claim “should” receive 100% service-connected benefits, and that an IU claim is the easiest path to achieving this goal. “He risked his life for his country–he deserves his 100%!” is an oft-heard remark.
Conscientious VBA staffers, and VHA C&P examiners, if they receive enough time to do so, are often able to conduct a reasonable assessment of a veteran’s ability to seek and maintain gainful employment, although publicity-conscious VA management places severe restrictions on the resources needed for such reviews.
For example, VBA staff and VHA examiners may not use the Internet to obtain information about a claimant, and requesting tax records from the IRS, which would quickly reveal if an employee has actually been working (in most cases), is not routine procedure at the claims stage.
And VHA managers will quickly accuse a C&P examiner who requests such tax information as being “not Veteran-Centric”, shorthand for “anti-Veteran” in VA bureaucratese.
An even more serious problem arises when VA employees feel pressed to achieve greater productivity, with quality concerns given short shrift. (See: Six Exams Per Day.)
For C&P examiners under the produce or perish gun, the path of least resistance is to not question a veteran’s report that he or she is utterly incapable of meaningful employment, and to write a medical opinion saying so.
Veteran Charged With Mail Fraud and Structuring Financial Transactions
A criminal information was filed charging a veteran with mail fraud and structuring financial transactions. An OIG and IRS CID investigation revealed that the defendant fraudulently took payments from 16 veterans by promising them that they would receive VA compensation benefits at a 100 percent rating.
The veterans believed the payments to the defendant were to be used to pay an attorney to research and file claims with VA. The defendant subsequently stole over $400,000 from the veterans and never filed a single claim on their behalf. [emphasis added]
Lesson #4: Make sure that you work only with an accredited claims agent or attorney, or with a veterans service officer employed by your State (County Veterans Service Officer) or by an approved veterans service organization.
I don’t know if the criminal in this case was a veterans service officer or accredited claims agent, but I doubt it. Requesting help from an accredited or approved representative does not absolutely guarantee accountability, but it is much less risky than sending money to a self-proclaimed advocate.
In addition, keep in mind that a veteran rarely needs to pay in advance to have an accredited or approved representative help him or her with a disability benefits claim.
(Hiring an expert witness to conduct an IME or to review records is another matter, but in those situations it is advisable to involve your, veterans service officer, accredited claims agent, or veterans law attorney in the process of retaining an expert.)
A veteran was found guilty at trial of health care fraud. An OIG and FBI investigation revealed that from March 1995 to June 2013, the defendant misrepresented his vision loss to VA and as a result was granted a 100 percent service connection for vision loss, special monthly compensation, and other program benefits to which he was not entitled. The defendant was observed walking without assistance, driving with a valid driver’s license, and even receiving a speeding ticket. In addition to approximately $700,000 in monthly VA compensation benefits, the defendant also received a $10,000 VA grant to purchase an automobile, which was intended for another person to drive the defendant, and an $11,000 VA grant towards the installation of an in-ground swimming pool at his residence. In addition, the defendant received over $75,000 in VA health care benefits to which he was not entitled, to include CHAMPVA, dental services, beneficiary travel pay, blind rehab training, and prosthetics equipment and devices. The loss to VA is approximately $800,000.
Lesson #5: VA must establish a rigorous, peer-to-peer Quality Improvement program. I wonder if the vet in this case had a C&P exam, and if so, how the examiner confirmed his alleged blindness? And did another optometrist or ophthalmologist ever review the exam report? Unlikely, since neither VHA nor VBA has a peer-to-peer Quality Improvement program. That’s right. Neither VHA nor VBA reviews C&P exam reports for quality. Some VA spokespersons will claim they do, but the truth is VA reviews C&P exam reports for ‘ratability’ only, which constitutes perhaps 4% of the quality equation. [For more details on this point, see: Did VA Provide a Complete, Honest Answer to Senator Wicker’s Questions About PTSD C&P Exam Quality?]
Veteran and Sister Plead Guilty To Committing Fraud Against VA
The sister of a veteran pled guilty to delivery of a false writing and the veteran pled guilty to wire fraud. An OIG investigation revealed that both defendants filed forged documents with VA that lead to the issuance of VBA compensation benefits to the veteran and VHA Caregiver Support Program payments to the sister. The veteran claimed to be totally disabled due to a traumatic brain injury (TBI) and other injuries sustained in Iraq and that he was unable to perform tasks of daily living. As a result, VA appointed the veteran’s sister to be the full-time caregiver. In actuality, the veteran did not suffer from a TBI and lived a lifestyle that required no assistance. The sister facilitated the ongoing fraud by continually making statements to VA that she was the full-time caregiver. The loss to VA is approximately $82,000.
Lesson #6 (Bonus! ;o): Require all C&P psychologists and psychiatrists, whether employed by VA or contractors, to conduct evidence-based evaluations consistent with professional practice standards.
If I was a betting man, I would wager good coin that the veteran in this case never received a neuropsychological evaluation that included symptom validity tests (SVTs) and performance validity tests (PVTs). Although such tests, particularly in a forensic context such as a C&P exam, are the standard of practice in neuropsychology and clinical psychology, and highly recommended in forensic psychiatry, the VA refuses to recognize their importance or to require evidence-based, professional neuropsychological assessment for TBI claims.
This negligence dishonors the many veterans who suffer every day from actual brain trauma and its long-lasting deleterious effects.
1. If you want to understand the sick system that rewards pandering to veterans (how many vets want that?), and punishes ethical practice, read this incisive, scathing indictment of current VHA management practices:
Russo, A. C. (2014). Assessing veteran symptom validity. Psychological Injury and Law, 7(2), 178-190. doi:10.1007/s12207-014-9190-2
2. You can subscribe to the VAOIG Monthly Highlights via email or via RSS [what is RSS?].
3(a). Bush, S. S., Heilbronner, R. L., & Ruff, R. M. (2014). Psychological assessment of symptom and performance validity, response bias, and malingering: Official position of the Association for Scientific Advancement in Psychological Injury and Law. Psychological Injury and Law, 7(3), 197–205. doi:10.1007/s12207-014-9198-7
3(b). Bush, S. S., Ruff, R. M., Troster, A. I., Barth, J. T., Koffler, S. P., Pliskin, N. H., Reynolds, C. R., Silver, C. H. (2005). Symptom validity assessment: Practice issues and medical necessity. Archives of Clinical Neuropsychology, 20(4), 419–426. doi:10.1016/j.acn.2005.02.002
3(c). Heilbronner, R., Sweet, J., Morgan, J., Larrabee, G., Millis, S., & Conference Participants. (2009). American Academy of Clinical Neuropsychology consensus conference statement on the neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 23(7), 1093–1129. doi:10.1080/13854040903155063
4. American Academy of Psychiatry and the Law (2008). AAPL practice guideline for the forensic evaluation of psychiatric disability. Journal of the American Academy of Psychiatry and the Law, 36(4), S3–S50.
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