VA Admits 25,000 Veterans Received Improper Brain Injury Screening

VA guidelines require one of four specialists to diagnose TBI.

ByABC News
June 9, 2016, 4:48 PM
The Phoenix VA Health Care Center is seen here, April 28, 2014.
The Phoenix VA Health Care Center is seen here, April 28, 2014.
Ross D. Franklin/AP Photo

— -- Almost 25,000 veterans were examined for traumatic brain injuries by Veterans Affairs medical providers who were not qualified to diagnose them, the U.S. Department of Veterans Affairs has admitted.

Since 2007, VA guidelines have required one of four specialists -- psychiatrists, physiatrists, neurosurgeons or a neurologists -- to diagnose traumatic brain injury in patients. These specialists generally have the most experience with the symptoms and treatments of traumatic brain injury (TBI). However, according to a VA statement, the VA “issued a series of guidance documents that created confusion regarding the policy,” and led to more than 24,000 examinations conducted by unqualified medical personnel.

In response, VA Secretary Robert McDonald granted "equitable relief" to all of those affected, a policy that will allow veterans to undergo new TBI exams, conducted by a qualified specialist, and receive disability benefits for diagnosed TBIs from the effective date of the original claim.

The VA will send a letter, a draft of which was obtained by ABC News, to each of the affected 25,000 veterans.

“You are receiving this letter because your initial TBI exam was not performed by one of these specialists,” the draft reads, “and we are offering you the option to undergo a new TBI exam by an appropriate specialist.”

The letter gives recipients one year to request a new exam.

But some veterans said they feel the measures are not enough. Retired U.S. Army Captain Charles Gatlin was injured by a car bomb explosion in Iraq in 2006. The Army conducted extensive neurological testing on Gatlin, determined his brain injuries were permanent and ultimately discharged him with a 70 percent disability rating.

But when Gatlin went to the VA in Fort Harrison, Montana, to receive his VA disability rating, a brief screening conducted by a psychologist, not one of the four qualified specialists, dropped Gatlin’s disability rating to 30 percent, attributing some of his difficulties to post-traumatic stress disorder.

Gatlin challenged that rating before the VA Board of Appeals and the Montana Board of Psychologists. Though the Montana Board of Psychologists agreed that Gatlin’s VA test results were flawed, the VA objected.

“It took me 3 years, it caused problems in my marriage, stress in my life,” Gatlin told ABC News.

But he was ultimately victorious, was re-evaluated and his disability benefits were re-instated.

Still, Gatlin and his wife, Ariana Del Negro, said they feel that the brain injury examinations conducted by the VA are not thorough enough. Though a veteran’s examination must be conducted by one of the four specialists, subsequent examinations conducted for disability evaluation purposes may be conducted by other types of clinicians. And though nearly 25,000 veterans will receive the opportunity to be re-evaluated, Del Negro pointed out that the brief screenings are limited in scope.

“I don’t have a great deal of hope things will change significantly,” she said.

Veterans service organizations expressed a mix of disappointment and optimism.

“We’re really disappointed that the VA conducted all these examinations using non-certified physicians or health care professionals to examine veterans who claimed TBI," Jerry Manar of the Veterans of Foreign Wars told ABC News. "On the other hand, we’re glad that the VA is finally responding and is voluntarily undertaking this review that should be helpful to most, if not all affected veterans.”

Jonathan Schleifer, policy director of Iraq and Afghanistan Veterans of America, said, “The VA makes mistakes like any large organization. What we’re pleased about is that we’ve seen a real shift in the last year in the way they deal with their mistakes and the way they’re focusing on improving the quality of care.”

On Capitol Hill, officials said the House Committee on Veterans’ Affairs had been investigating this issue for years. Rep. Jeff Miller, the chairman of the committee, commended Secretary McDonald for rectifying the issues.

“While it is unacceptable that the department allowed this issue to persist for years amid a chorus of complaints voiced by veterans, our committee and the media, I am hopeful that with McDonald’s leadership VA will be more proactive in responding to stakeholders’ concerns," Miller told ABC News in a statement. "I look forward to hearing from VA officials regarding the steps they are taking to hold those responsible for VA’s TBI struggles accountable, as this is the only way to prevent similar problems in the future.”