Paul Harvey – Detestable VA Chronicles for Week Ending 07 Aug 2021

Bobblehead DollPaul Harvey is a hero of mine.  I miss his voice on the radio.  He exuded a calm demeanor, regardless of the terror, the trials, and the terribleness of the news reported and discussed.  I do not have Paul Harvey’s sense of calm.  When I heard about the beheading of a woman in America, in broad daylight, by an illegal immigrant who has been on a one-man crime spree from El Paso to Minneapolis since 2007, my cherub-like demeanor took a tremendous hit.

The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) reports on a couple from Kansas who are flat out despicable, faking blindness to increase disability payments from the VA and Social Security.  Frankly, I hate liars and thieves and agree to the restitution ordered, but I do not agree that the couple deserved probation.  Stealing benefits should come with more than simple probation and restitution.  Where is the community service in distinctive clothing and sandwich boards declaring they are thieves?VA 3

However, this couple represents a symptom, not the disease of the VA and Social Security specifically, and the Federal Government generally.  When leaders act reprehensibly, criminals will test the system to find weaknesses and attempt to benefit from leadership failures.  The disease of poor leadership has far-reaching consequences, and criminal activity is not unexpected.  Who is addressing the disease?  When will the citizens of America receive justice to see the healing of the illness that has captured the government?

Military Sexual Trauma

I-CareImperative to understanding, Military sexual trauma (MST) experienced while serving in the military affects both women and men with potentially severe and long-term consequences. Psychological trauma, such as MST, also increases the risk of physical health conditions such as cardiovascular disease, stroke, and diabetes.  The Veterans Health Administration (VHA) requires that each facility has a designated MST Coordinator with at least 20 percent of their time dedicated to protected administrative time.  For the record, “protected administrative time” is the time required to be spent on administrative duties, writing clinical notes, ordering supplies, scheduling appointments, administrative responsibilities, and so forth.

In 2018, the VA-OIG discovered just how detestable and deplorable the VBA’s processes and procedures were for military sexual trauma (MST).  Having been a victim of MST, this issue is of particular interest to me, and I continue to follow this issue closely.  I wish I had some encouraging news on this issue, but the VA-OIG found:

“… Processors did not always follow the updated policies and procedures. VBA leaders did not effectively implement the VA-OIG’s recommendations and did not ensure adequate governance over military sexual trauma claims processing. The VA-OIG concluded that VBA was not properly implementing the recommended changes.”VA 3

In 2016, when claims were being improperly and prematurely denied, the problems were considered a lack of training, a lack of policy, a lack of procedures, and comprehensive guidance was needed.  In 2018, additional training and guidance were needed, time, and leadership were recommended, even though claims were still improperly and prematurely denied.  In 2021, it is now blatantly obvious we have a systemic failure of leadership at the VBA to process claims in a manner that is conducive to good order and discipline!

On the same day, this investigation was released, the VHA investigation results for MST coordinators were released to the public.  I bet you can guess what was found, but let’s allow the VA-OIG the opportunity to detail the failures:

The VA-OIG conducted a national survey and interviews to evaluate MST Coordinators’ duties and perceived challenges.

            • 80% of the respondents reported having been assigned at least 20 percent or more of protected time.
            • 39% reported inadequate resources to fulfill MST Coordinator administrative responsibilities.
            • The VA-OIG found that insufficient protected administrative time, role demands, insufficient support staff, and inadequate funding and outreach materials challenged MST Coordinators’ ability to fulfill role responsibilities.
            • The VA-OIG found that MST Coordinators who reported more dedicated time than other MST Coordinators did not necessarily serve at facilities with higher numbers of patients in MST related care.”VA 3

Did you catch that final point?  Resources are not being adequately provided based upon patient load to locations where veterans need care.  Another symptom of leadership failure, being designed into the organization as a policy and working procedure, meaning this is designed incompetence!

Knowledge Check!Here’s the biggest rub, a veteran can be receiving care from the VA for MST at the VHA and still be denied MST on a VBA claim.  I have not heard it working in reverse where a claim is being paid, but the VHA refuses care, but given the failures of the VA as an organization, I would not be surprised to learn this was occurring.  How do I know that care can be provided for MST and not be allowed on a claim?  I am among a number of MST victims, all-male, who have been regularly denied VBA claims but are receiving care for the psychological harm.  Veterans talk to each other.  I have heard the stories of fellow veterans being attacked, assaulted, molested, drugged, raped by male and female attackers, and heard how the VBA had revictimized them.

What’s worse, MST leads to PTSD, and people are suffering PTSD from a number of traumatic events not receiving care or benefits because the VA refuses to acknowledge these problems.  Admitting a problem is the first step in addiction programs; well, it is also the first step in healing leadership failure, and the VA is suffering from dynamic leadership failure at every level!  Know a veteran whose story needs to be told, refer them to me; let’s get this information out.  I am sick to death of the VA getting away with murder.

Programs and Inspections

VA SealThis week, the final three emails from the VA-OIG reflected a VISN wide comprehensive healthcare inspection (CHIp) conducted virtually, a VAMC/VAHCS CHIp conducted in Spokane, Washington, and a program report on the failures in the Veteran-Directed Care Program.  The most interesting finding in the CHIps was how short the leadership teams had worked together, a month, and how many open positions for leaders there were, more than half.  Talk about glaring symptoms of leadership failure, were the leadership teams broken up from employee turnover?  If so, did the employees retire, or were they retired to avoid criminal convictions?  With all the investigations for fraud, as discussed on these pages frequently, I can only guess how leaders churn in a VAMC/VAHCS/VISN.

Believe it or not, the Veteran-Directed Care Program is full of faults, problems and is suffering from a lack of leadership as the program balloons.  Color me shocked!  Surely, somewhere in the VA, if only to screw with the gods of perversity and Murphy their prophet, there must be a functioning and well-led program, department, office, etc.Angry Wet Chicken

It is so absurdly depressing to catalog these failures of leadership week after week and never see any improvement.  We see increasing failures, we observe heightened criminal activity, there is undoubtedly raised awareness of needs and moral distress in abusing veterans, but where is the improvement towards achieving excellence?  Where is Congress in scrutinizing the legislative branches, officers, and leaders?

If a congressional representative can order the VA-OIG to investigate the MST Coordinators, which they did, where is Congressional action on the results?  Surely this is not too difficult a question to ask.  Better still, where is Congress?  I have now reached out to all the elected Federal officials in Arizona, Texas, and New Mexico.  Texas, because that is where I have been forced to receive care from.  New Mexico because I now live here.  Arizona because I was physically injured by VA employees there.  The amount of interest received has been less than zero!Angry Grizzly Bear

How can interest be less than zero, you ask.  Well, while I have not received any response to my original complaints, I have received a TON of marketing materials about how those congressional representatives “Care about veterans, the community, pets, animals, and America.”  Maybe, not always in that order, but absolutely with less sentiment than I have for the weeds growing on my sidewalk!  Thus, I ask again, with all sincerity, where is Congress in scrutinizing the government?  I demand to know the “Rest of the Story!”

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Department of Veterans Affairs Chronicles of Shame

I-CareAs a veteran who struggles with post-traumatic stress disorder (PTSD), stemming from military sexual trauma (MST), where a first-class petty officer jumped on my back and tried to rape me.  When I see the Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports on PTSD from MST, I pay close attention.  Since the Department of Veterans Affairs (VA) continues to deny my MST claim because MST does not happen to men, I get agitated when I see these VA-OIG reports repeating year-over-year with the same excuses and designed incompetence.  Designed incompetence is all about creating ready-made excuses for failing to perform correctly the role one has been hired or promoted to perform.  Consider the following:

“In 2018, the VA Office of Inspector General (OIG) reported that nearly half of disability benefit claims that were denied service connection for post-traumatic stress disorder (PTSD) and were related to military sexual trauma were not processed properly.”

That is the first sentence of the VA-OIG report released on 08 December 2020 declaring that the improvements suggested by the VA-OIG in 2018 had not occurred.  The following statistics come directly from the report issued.

      • 18,300 claims or approximately 16% were processed incorrectly in Fiscal Year 2019
      • 118,000 claims were submitted

Why were the claims processed incorrectly; because of designed incompetence by the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  From the report, we find the following five root causes, or excuses: emphasis mine.

    1. Most errors occurred because claims processors did not verify or ask veterans to provide the disorder’s cause, known as an in-service stressor.
    2. In other cases, claims processors did not request a medical examination, medical opinion, or clarification of inconsistencies in the examination as required.
    3. Claims processors made these errors because they did not fully understand PTSD stressor types and the stressor verification process.
    4. VBA’s Compensation Service did not mandate any national training for claims processors on these subjects except during the first year in the position.
    5. In addition, VBA’s procedures manual was not effectively organized to allow staff to locate this information and lacked specific guidance for some aspects of PTSD claim processing.

VA SealWhy are the causes of the problems considered designed incompetence, because they never change!  At the VBA, the processors all need constant training to remain current in their positions; but never receive the training.  The VBA never holds value-added training sufficient to train the employees on their jobs, but this remains the number one excuse to justify poor performance in VA-OIG inspections.  Failure to perform the job is also not a new excuse, where the VA-OIG reports are concerned.  Not understanding how to ask for help is also not new, and frankly astounds and mystifies observers that those hired remain employed when their performance clearly remains insufficient to the job expectations.  While it is unique to the VA to see a procedure manual, it is only natural and expected that the manual is poorly organized, poorly executed, hard to follow, difficult to find, and generally useless.  The VA is famous for this designed incompetence trick.

You say, “Big Deal;” everyone knows the VA is messed up, full of failures, and is generally known for poor performance.  Why this is a “Big Deal” stems primarily from the costs associated with poor performance.  An annual salary is paid for the processors, the adjudicator, and the entire chain of command, totaling in the hundreds of millions of dollars.  The veteran has to pay for lawyers and other services to appeal the original decisions, which take time.  The veteran has to pay for a third-party Nexus Letter to accompany the claim to declare the original claim was faulty.  All of this requires substantial time investments and other resources, all because the original work has to be duplicated.  How many times the claim is duplicated depends upon the processors’ abilities to do the job they were hired to perform.

Your car breaks down; the tow truck driver only secures your vehicle 84% before driving to the auto repair facility, is this satisfactory performance?  Your surgeon has an 84% success rate where his patients will live after surgery for tonsil removal, is this satisfactory performance?  You are in hospital; your nurse only gets your pain medication to you 84% of the time or is only 84% accurate in providing the right patient the proper medication; is this satisfactory performance?  Of course not, but for government employees, this level of performance is “award-winning.”

Military CrestsCongress mandates VBA claim error rates; there is supposed to be a quality assurance check to reduce the error rates.  Yet, with all the checks, the balances, and the quality assurance programs, the VBA continues to surpass the error rates and physically harms veterans due to their inefficiencies.  Yes; a failure rate of 16% is a “Big Deal!”

Want to know how bad the VA is managing your taxpayer monies; read the audit released 14 December 2020.  In that audit, you will find comments like the following:

      • The material weakness involving information technology security controls has been reported for more than 10 years.
      • VA did not substantially comply with federal financial management systems requirements and the United States Standard General Ledger at the transaction level, as required by the Federal Financial Management Improvement Act.
      • [The] VA’s complex, disjointed, and legacy financial management system architecture no longer supports stringent and demanding financial management and reporting requirements.
      • VA continued to be challenged [with] consistently enforcing established policies and procedures throughout its geographically dispersed portfolio of outdated applications and systems.

In light of the recent computer hacking issues the Federal Government is experiencing, knowing that the VA has dumped hundreds of millions of taxpayer dollars to patch and repair, and sometimes replace (sort of), legacy (old, expired, useless, insecure, unreliable, etc.) technology over the last 20-years, how is the VA able to keep getting away with these designed incompetence excuses?  Congress, when will you hold the administrator’s feet to the fire for making progress on these glaring issues?  Congress receives these VA-OIG reports and audits before they are made public, yet the elected representatives cannot take a moment to check this poor behavior.  Why not?

Police and Government Lines of CongruenceFor the first time in more than a decade of chronicling the VA-OIG reports, I am mentioning a monthly highlight (lowlight) condensed report.  This report is unique due to the insanity of criminal investigations mentioned, the results of audits, and the healthcare inspections.  When you have 18 defendants in a bribery scheme, where 15 plead guilty, who defrauded untold Millions of dollars in Florida, the problem is not so much with the employees, but the organization that allowed this to occur since 2009!  A noteworthy criminal investigation indeed.

The highlights (lowlights) of November 2020 also include a VA physician from West Virginia being indicted for abusive sexual contact and simple assault and a surgical supervisor in Northern Ohio who defrauded the VAMC of approximately $3.2 Million in two separate schemes.  Regarding financial audits and the importance of improving that ancient technology, a VA Fiduciary has been indicted for misappropriating government funds from Pennsylvania to the tune of more than $155,000.  Best of all, a husband and wife team from California, technical school owners, bilked the GI-Bill of more than $29 Million since 2015.

The criminal issues the VA is facing regularly are not a one-off issue, but an organizational design problem as the frauds, thefts, and malfeasance reported is ever only the very top 1% of the problem that is ongoing and systemic in the Department of Veterans Affairs!  The November 2020 report discussed an incredible number of canceled patient appointments because veterans and COVID mask mandates do not play well together.  Yet, the VA Federal Police cannot stop persecuting veterans for their physical inabilities to wear a mask.

Thus, where are the elected officials from the legislative bodies who possess oversight and funding responsibilities?  Where is the executive branch of government in correcting and demanding specific action from the legislative branch?  Where are the administrators at the Federal, VISN, and Local levels in performing their jobs?  The designed incompetence must cease forthwith to allow for practical changes to be made and the organizational design to be corrected.  For the VA-OIG to be forced to accept the same tired, lame, and detestable excuses, year-over-year is the epitome of abuse to the taxpayer and veteran alike!

The Duty of AmericansWorst of all, this condensed version did not even scratch the surface of the issues reported in just three VA-OIG reports.  Shame!  Shame! Shame!  Shame on the elected officials, Republican, Independent, and Democrat, who have allowed this problem to grow and done nothing!  Shame on the myriad of presidents who have done nothing but throw good money after bad, without demanding progress and holding real people responsible for real results!  Shame on every single VA employee who shirks their job for easiness to the pain and suffering of a veteran, dependent, or spouse!

© Copyright 2020 – M. Dave Salisbury
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