When examiners don’t get veterans’ records, bad decisions aren’t a mistake—they’re a systemic failure.
In a blistering oversight hearing this week, members of Congress openly questioned whether the VA’s contracted medical examination system has become so dysfunctional that examiners may be conducting—and billing for—exams without the full evidence required. Several lawmakers drew attention to behavior that edges disturbingly close to False Claims Act (FCA) territory.
At the heart of the problem is testimony showing that contracted examiners are often not receiving the full claims file, despite VA leadership insisting otherwise. That missing evidence has led to flawed DBQs, incorrect denials, and potentially millions in improper incentive payments.
Rep. Mark Greenman McGarvey (Ranking Member) did not mince words:
“This is a massive program… and we’re hearing way too many stories of how it’s not working for our veterans.”
He went further, describing the system as one where vendors are rewarded despite poor performance, noting that the Government Accountability Office (GAO) reported $2.3 million in incorrect incentive pay delivered to contractors.
Rep. Morgan McGarvey later underscored the ethical danger:
“If the contracted provider gets the paperwork right and they get it in, they’ll get their incentive pay… Is this the standard of care that our veterans should experience or that we want to incentivize?”
When you combine this with GAO...
When examiners don’t get veterans’ records, bad decisions aren’t a mistake—they’re a systemic failure. In a blistering oversight hearing this week, members of Congress openly questioned whether th...