Let’s start with an overview of VA C&P exams, as this work takes place behind the curtains inside the rarely explored Veterans Benefits Administration (VBA). C&P exams are a critical part of the VA’s healthcare process for veterans. In most instances, a veteran must file and win a disability compensation benefit claim against VA before receiving free VA medical care. (There are, of course, some exceptions to this VA rule, including for veterans who deployed to a war zone.)
VA’s existing claim process requires a veteran file several complex VA forms, submit detailed medical evidence, and then attend a lengthy C&P medical exam performed by a medical professional where VA seeks to determine first if a veteran’s medical condition exists and then the severity of the veteran’s condition. The C&P exam also generates a medical opinion stating if the condition is, or is not, related to a veteran’s military service. That opinion is given to a non-medical VA claim processor to decide if the veteran will receive VA care and benefits.
For example, if a veteran files a disability benefit claim for a knee condition, then a VA C&P exam will determine if a veteran has a knee condition, and if the knee injury is related to an injury suffered by the veteran while in the military. If the condition is related to an event which occurred during service, such as a parachute jump, then VA will provide the veteran with free medical care and pay the veteran monthly compensation benefits based on the severity of the condition. However, if VA finds the veteran’s injury is related to an automobile collision after military service, then VA will deny the veteran’s claim, and the veteran will not receive free VA care or compensation for the knee condition. In short, C&P exams are a critical component to protect veterans, the VA, and taxpayers.
VA’s obsolete and tissue-thin argument in favor of privatizing C&P focuses on improving speed and accuracy. In the past few years, VA has faced challenges in providing prompt and complete C&P exams, often due to a lack of funding and training. In simple terms, there weren’t enough VA doctors to perform C&P exams fast enough, so VA sought help from doctors outside of VA.
In 2014, due to VA’s inability to meet sharply rising demand for both VA care and benefits, veterans waited months, or longer, for C&P exams at a VA hospital or clinic. A VA delay in a C&P exam meant a veteran faced long waits in obtaining VA care or receiving benefits to pay the rent or feed a family. This prompted VA to deputize far too many C&P exams to the private sector to handle the surge. VA saw the situation as temporary and deliberately chose to outsource rather than hire more VA employees. Today, the situation has stabilized at VA, largely thanks to new hires, and timeliness has improved. However, VA still wants to avoid hiring government staff, preferring instead to pay private contractors.