Noteboom The Law Firm

Lowered Burden of Proof Requirements Could Open VA to Fraud

May 6, 2010 - There are an enormous amount of troops returning from the wars in Iraq and Afghanistan. A dangerous percentage of these veterans are also suffering from post-traumatic stress disorder (PTSD) and need help. The Department of Veterans Affairs (VA) is already backlogged with a huge number of disability claims and these new veterans' claims will only worsen the issue.  

Congress has leaned on the VA to settle the outstanding disability claims as quickly as possible and to the advantage of the veteran. The VA's inefficient system for processing disability claims is a hindrance so in an attempt to fix the situation, the VA has planned changes. These changes, however, could end up making it easier to defraud the VA.

The VA is attempting to lower the burden of proof required to show a veteran is suffering from PTSD so disability claims will be processed quicker. With PTSD already a difficult condition to diagnose, it is almost a foregone conclusion fraud will ensue.  

Unfortunately, claims analysts will be forced to question soldiers' stories. This situation is likely unavoidable, however, as fraudulent claims could cost the VA millions of dollars if they are not caught. As of the end of fiscal year 2009, almost 390,000 veterans were collecting VA benefits due to PTSD.

VA Secretary Eric Shinseki proposed a change to the rules last summer; no longer would independent proof be required to document a veteran's traumatizing event. Under Shinseki's new proposed rule, the only thing required is "lay testimony" about an event as long as it: 

• Is related to the veteran's fear of hostile military or terrorist activity; and
• Is consistent with the places, types, and circumstances of the veteran's service.

 The VA is suffering from a real shortage of claims processors. This dramatically slows down the claims process and does not allow any time to scrutinize claims and detect fraud. By lowering the standards required to be diagnosed with PTSD not only will the VA suffer, those veterans actually suffering from PTSD will be hurt as well.