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Agent Orange benefit screening process scrutinized in Congress

WASHINGTON -- The House Committee on Veterans' Affairs is looking into whether a contractor thoroughly reviewed the files of Vietnam veterans who might deserve benefits for illnesses linked to exposure to Agent Orange.

A contractor that prescreens veteran files for evidence of those illnesses often spent just minutes reviewing each file, internal company documents show.

The contractor, QTC Medical Services, reviewed files for 160,000 veterans. The company was paid approximately $300 for every file reviewed under 2 inches thick and $350 for files more than 2 inches thick.

An unsealed lawsuit and contract documents obtained by McClatchy shed light on the contractor's prescreening process.

The suit alleges that QTC -- a Lockheed Martin company -- did not give its employees the necessary training to spot evidence of illnesses linked to Agent Orange and pressured employees to work at a pace that made it impossible to thoroughly review the file.

"This lawsuit raises a number of serious questions," said Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs, in a statement to McClatchy. "Every veteran's VA claim deserves a thorough and objective review. Our investigation will continue until we are satisfied that's the case in this situation."

QTC Medical Services and Lockheed Martin, citing ongoing litigation, declined to comment.

Agent Orange benefits are a moving target for the Department of Veterans Affairs. An ongoing class-action lawsuit -- Nehmer v. Department of Veterans Affairs -- requires the VA to review old veteran claims when new illnesses are linked to Agent Orange exposure.

That gives veterans who were previously denied benefits an updated review.

QTC reviewed 65,000 files for ischemic heart disease, Parkinson's disease and hairy cell leukemia potentially linked to herbicide exposure in Vietnam, as well as 95,000 files for peripheral neuropathy. Only the files flagged by QTC as potentially eligible were sent back to the VA for a final decision.

The National Veterans Legal Services Program, who filed the class-action suit, told McClatchy that since 2010, it has identified more than 1,600 cases in which the VA failed to recognize and pay the required retroactive Agent Orange compensation, resulting in an additional $42 million being paid to veterans and their survivors.

Barton Stichman, NVLSP's joint executive director, said the program is paying close attention to the allegations against QTC to see if prescreening is where veterans are falling through the cracks.

"If the contract or QTC did not ensure a process that was compliant with the Nehmer Court Orders, then the cases that were not flagged by QTC would have to be reviewed again." Stichman said.

The lawsuit against QTC, brought by former claims file analyst David Vatan, was dismissed on grounds that Vatan did not know the terms of the contract, so whatever evidence he presented about how QTC performed the reviews, he could not prove the company misrepresented its work. Vatan and his attorneys have appealed.

McClatchy obtained the full contract with QTC through a Freedom of Information Act request.

QTC's contract stipulates the company must train its employees before they review files for Agent Orange-related conditions based on a guide provided by the VA. Vatan's lawsuit alleges he and other analysts were not formally trained and were never given the VA's training guide.

Instead, analysts were given a "reference manual" from QTC that omits much of the background information on relevant medical conditions included in the VA's guide, as well as details about what supporting evidence for benefit eligibility might look like in a veteran's file.

The contract also states that QTC must review each veteran's entire file.

But QTC's reference guide permits analysts to abbreviate the process, using summaries of prior benefit decisions printed on colored sheets of paper.

QTC's senior vice president of operations, Dr. Margie Shahani, testified to Congress in 2008 that it would take a qualified analyst 60 to 90 minutes to review each claim file, an equivalent of seven or eight files per day.

Internal documents show QTC's analysts worked much faster under a competitive performance rating system. Some analysts averaged nearly 30 claims per day and those who reviewed fewer than 12 to 15 were reprimanded for poor performance.

In the response to Vatan's complaint, Lockheed Martin's lawyers argued the contract did not spell out how much time they should spend on each file. "There is nothing inherently wrong with QTC encouraging people to work quickly," the motion reads.

When one of his colleagues reported reviewing 50 files in a day, Vatan complained to a Lockheed Martin ethics officer. Vatan pointed out that 50 files a day would leave the analyst just 12 minutes per file if he or she worked two hours of overtime and took no breaks. "It takes 10-12 minutes for an experienced (analyst) to process one file in the computer system alone," Vatan said. "How was the review conducted?'

Both the Department of Justice and the VA Office of the Inspector General investigated the allegations in the lawsuit, but neither chose to intervene and neither would comment on their investigation.

In fiscal year 2015, QTC's various contracts with the Department of Veterans Affairs exceeded $175 million.

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