KEMPNER, Texas — “That’s a total lie!” said an angry and frustrated Harry Payne after receiving a benefits denial letter from the VA claiming he failed to show up for a required exam.
Records obtained by KARE 11 show the VA itself had cancelled the exam.
Payne, of Kempner, Texas, is one of thousands of veterans who had disability claims pending with the Department of Veterans Affairs when the COVID-19 pandemic struck the nation in force in March.
He had been scheduled for an in-person Compensation and Pension (C&P) exam with a VA medical contractor in late April.
However, before his scheduled appointment a KARE 11 investigation exposed how veterans were being told to report to exams – even to exams in New York City – as the coronavirus crisis worsened. Veterans said they should not be forced to choose between the risk of exposure to the coronavirus and having their benefits claims denied or drastically reduced.
On April 3rd, VA ordered that in-person benefits exams be cancelled due to health risks during the coronavirus crisis.
Veterans were promised on the VA website that, “We won’t deny a claim solely for failure to report for an exam at this time.”
But Harry Payne says that’s exactly what happened to him.
“The VA sent me a letter saying my claim was denied,” Payne said when he reached out to KARE 11 Investigates asking for help. “And then you read the reason why, and I get even madder because it’s a flat out lie!”
The Denial Letter
Harry Payne is a 21-year veteran of the U.S. armed services. He spent four years in the Marines and was stationed in Beirut when the Marine barracks there was bombed in 1983.
He later reenlisted in the Army where he served another 17 years. “I went to Iraq for 16 months as a hazardous response team leader for all of Baghdad,” he said.
Payne’s service impacted him in ways he’s still discovering. He describes distancing himself from friends and family. A private doctor recently diagnosed him with combat-related PTSD.
With his military record and his medical diagnosis, VA benefits seemed assured.
Records show he was scheduled for a C&P exam on April 21st by VA contractor QTC.
However, after VA put a stop to in-person exams on April 3rd, Payne says he received a phone call from QTC informing him his appointment was cancelled.
He thought his claim was just on hold until it was safe to do the exam.
He was wrong.
The Veterans Benefits Administration (VBA) sent him a letter informing him his PTSD claim had been denied.
The letter conceded he has PTSD caused by his service, but stated he was denied because, “We received notification from QTC Medical Services, Inc. that you declined to participate in the examination process for your claim.”
“I, in no way, refused to cooperate,” exclaimed Payne. He was concerned the denial would force him to go through a lengthy appeals process.
The Response
KARE 11 began questioning VA, the contractor QTC, and members of congressional VA oversight committees about Payne’s case.
In an emailed statement, the Department of Veterans Affairs acknowledged Payne should not have been denied benefits based on the already cancelled exam.
The statement says in part; "VBA erred in the processing of this claim … We have retrained the staff involved in this incident …”
A spokesperson for QTC, the private business with multi-billion-dollar a year contracts with the VA to do benefits exams, told KARE 11 that despite what the denial letter stated, they did not communicate to the VA that Mr. Payne declined to participate in his exam.
Tom Doheny, Director of Media Relations for QTC’s parent company Leidos told KARE 11 by email, “We extended our research and worked closely with the VA and have verified that no other claimants were affected. It appears the veteran you cited was an anomaly and we cannot find any similar occurrences.”
Both VBA and QTC vowed to make things right for Mr. Payne.
Other Denials
KARE 11 has repeatedly asked the VBA how many claims they denied citing missed exams since April 3rd when in-person exams were cancelled.
The question has gone unanswered.
But records indicate Harry Payne isn’t the only veteran who was wrongfully denied.
“It’s not right, and I’m not taking this lying down!” said Vietnam-era Army medic James Wood.
The West Virginia veteran provided records to KARE 11 showing he had been scheduled for an April 17th C&P exam. But on April 4th, he received a text from QTC stating, “Due to coronavirus, VA has ordered QTC to postpone in-clinic exams until further notice. We will update you as we receive more info.”
Wood, who lost a family member to the coronavirus, said he heard nothing else until he received a denial of benefits letter in the mail.
That letter stated he was denied because, “We have been informed you missed the VA examination scheduled in support of your claim.”
“That’s nonsense,” said Wood, “How can I miss an exam that was cancelled before I was even supposed to be there?”
“How does that make sense?” KARE 11 investigative reporter A.J. Lagoe asked U.S. Senator Joe Manchin of West Virginia.
“Well, not to anybody from a grade school on up it doesn’t make any sense,” Manchin replied. “It’s ridiculous to do that to them.”
Manchin sits on the United States Senate Committee on Veterans’ Affairs.
He, along with five other Senators on the committee, sent a letter to VA Secretary Robert Wilkie on May 12th expressing concern about how VA has been handling compensation and pension exams during the COVID-19 pandemic.
They told the VA Secretary his department must issue clear guidance so “veterans are not needlessly confused or harmed during this unprecedented time.”
Manchin told KARE 11 he fully expects Secretary Wilkie will get the problem fixed. He said if not, they’re prepared to call him in for a hearing.
“This will be taken care of immediately because we’re very much concerned,” Manchin said.
The House Committee on Veterans’ Affairs has also been hearing of cases in which veterans’ claims are being denied after a C&P exam was cancelled due to the pandemic, according to staffers briefed on the situation.
They said committee representatives have spoken to the VA several times and that the Undersecretary for Benefits, Dr. Paul Lawrence, has informed them he is trying to correct it wherever it happens.
Committee Chairman, Rep. Mark Takano (D-CA) sent KARE 11 the following statement: “No veteran should be denied their benefits claim as a result of this pandemic – postponing an exam because it is unsafe to meet in person is not grounds for a denial. Veterans have earned these benefits – I’m committed to working with VA to clear up the uncertainty.”
Takano also said that later this month the House Subcommittee on Disability and Memorial Affairs will hold a virtual forum to discuss how they can safely resume the critical C&P exams and tackle the backlog that has built up as a result of this pandemic.
Righting the Wrong
After KARE 11 began asking questions about his case, Harry Payne received a phone call from the VA apologizing for what happened.
“Evidently your decision was cancelled in error. Denied in error,” the VA representative said. He added, “And I apologize for the confusion.”
QTC quickly scheduled Payne for a video conference exam for his PTSD claim, and two business days later the veteran received another call from the VA informing him he had been approved and would begin receiving benefits immediately.
“Man, that was quick,” Payne said. “I couldn’t believe how fast the whole process went once you brought this to light.”
If you’re one of the veterans impacted by VA scheduling benefits exams during the COVID-19 crisis, contact the team working on this investigation at: investigations@kare11.com