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Veterans' Disability Benefits: VA Should Improve Its Management of Individual Unemployability Benefits by Strengthening Criteria, Guidance, and Procedures

GAO-06-309 Published: May 30, 2006. Publicly Released: May 30, 2006.
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Highlights

As part of its Disability Compensation program, the Department of Veterans Affairs (VA) provides Individual Unemployability (IU) benefits to veterans of any age who are unemployable because of service-connected disabilities. Over the last decade, the number of IU beneficiaries and benefit costs have more than tripled. In 2005, about 220,000 veterans received an estimated $3.1 billion in IU benefits. In response to a congressional request, GAO assessed VA's management of IU benefits. This report (1) examines the added value of IU benefits for veterans of selected ages and disability ratings, (2) assesses the criteria, guidance, and procedures used for initial decision making, (3) assesses VA's ongoing eligibility enforcement procedures, and (4) compares VA's decision-making and enforcement procedures with those used by other disability programs.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs To help ensure that IU decisions are well-supported and IU benefits are provided only to veterans whose service-connected disabilities prevent them from obtaining or retaining substantially gainful employment, VA should clarify and strengthen its eligibility criteria, guidance, and procedures for determining unemployability. For example, VA could: clarify in its regulations and guidelines how vocational factors, such as education, skills, or prior work history, should be used to assess a claimant's eligibility; establish procedures for rating specialists to request VR&E to conduct vocational assessments of IU claimants as appropriate; and seek legislative authority to use earnings data from the National Directory of New Hires.
Closed – Implemented
The Department of Veterans Affairs (VA) has taken several steps to help improve management of its Individual Unemployability benefits. Changes implemented by the agency to strengthen eligibility criteria, guidance, and procedures have included providing instructions to its regional offices to help ensure key forms to collect eligibility information are received by veterans and their employers. For example, in 2006, VA clarified using the Form 21-8940 to document employment history. To promote nationwide consistency in the processing of Individual Unemployability claims, VA issued a training letter in Jan. 2007, and recently developed a new IU training letter that will be released to regional offices by October 2010. Topics covered in the letter include evidence development, medical examination requests, and the effective date of awards. In addition, the agency has sought and gained legislative authority, which became effective in December 2007, to use earning data from The Department of Health and Human Service's (HHS) National Directory of New Hires (NDNH) to verify income for determining veterans' eligibility for Individual Unemployability benefits. To utilize this data, VA reports that it has entered into a memorandum of understanding, referred to as the computer matching agreement, with HHS to use NDNH data. VA expects to complete the determination of technical requirements to use NDNH data as early as June 2011. VA also contracted with Economic Systems, Inc. to review criteria related to unemployability. Ultimately, in a report to Congress in 2009, the agency considered but rejected recommended changes to Individual Unemployability eligibility criteria related to age limitations and retirement.
Department of Veterans Affairs To improve the efficiency and effectiveness of VA's enforcement efforts to monitor ongoing eligibility, VA should update procedures and strengthen criteria for the enforcement of the IU earnings limit. For example, VA could: update and automate its enforcement process, including using more current earnings data and threshold amounts in its income verification match; clarify guidance on the review of IU beneficiary earnings following the match; and annually track and report on the results of matching process and related enforcement activities.
Closed – Implemented
The agency has taken several efforts to improve the efficiency and effectiveness of its enforcement of ongoing eligibility assessments for veterans receiving unemployability benefits, by updating procedures and criteria to enforce the individual unemployability (IU) earnings limit. On February 21, 2007, the Veterans Benefit Administration (VBA) released Training Letter 07-01 to the field instructing regional offices on procedures for the handling and management of Individual Unemployability (IU) claims. The letter also provides guidance on procedures for cases involving substantial and marginal employment. VBA management also approved a project initiation request to update and increase the poverty threshold for making IU evaluation up to $10,294. In addition, VBA's manual provides instructions to the regional offices on the location of the Census Bureau Internet address for the poverty threshold and how to use it for cases involving IU. In addition, VA completed a cost analysis for the use of IRS Income Verification Match for the current computer matching agreement, which is estimated to save $18.9 million. The savings includes all income-related claims. The agency also reported that it expects to complete its cost analysis for the matching agreement with the Social Security Administration in October 2008.
Department of Veterans Affairs To help modernize its IU decision-making process, VA should develop a strategy to ensure that IU claimants with work potential receive encouragement and assistance to return to work, while protecting benefits for those unable to work. For example, VA could encourage claimants to return to work by having vocational counselors from VR&E develop return-to-work plans and provide assistance to claimants with work potential.
Closed – Implemented
The Department of Veterans Affairs (VA) has developed an enclosure providing information on its Vocational Rehabilitation and Employment (VR&E) program that is included in the disability ratings information sent to veterans who are awarded a total disability rating based on Individual Unemployability regulations. The enclosure is intended to encourage interested veterans to contact the agency's VR&E program for return-to-work assistance. VA also contracted with Economic Systems, Inc. to review the relationship between Individual Unemployability and VR&E eligibility. Ultimately, in a report to Congress in 2009, the agency considered but rejected a policy recommendation made by Economic Systems, Inc. to incorporate a vocational rehabilitation assessment when determining eligibility for the Individual Unemployability benefit, because it would be too costly.

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Topics

Disability benefitsEligibility criteriaEligibility determinationsUnemployment compensation programsVeteransVeterans benefitsVeterans disability compensationIndividual unemployability benefitsDisabilitiesProgram beneficiaries