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Veterans' Disability Benefits: Improvements Needed to Better Ensure VA Unemployability Decisions Are Well Supported

GAO-15-735T Published: Jul 15, 2015. Publicly Released: Jul 15, 2015.
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Highlights

What GAO Found

The number of veterans receiving Total Disability Individual Unemployability (TDIU) benefits has been increasing, as has the total amount of benefit payments, especially among older veterans. VA generally provides TDIU benefits to disabled veterans who are unable to maintain employment with earnings above the federal poverty guidelines due to service-connected disabilities. To be eligible for TDIU benefits, a veteran must have a single service-connected disability rated at least 60 percent or multiple disabilities with a combined rating of at least 70 percent (with at least one disability rated at 40 percent or higher). In addition, the veteran must be unable to obtain or maintain “substantially gainful employment” as a result of these service-connected disabilities. In fiscal year 2013, over 330,000 veterans received this benefit, a 22 percent increase from fiscal year 2009, while the TDIU disability payments increased by 30 percent. GAO estimated that $5.2 billion was spent in fiscal year 2013 for the supplement. These trends occurred alongside GAO also found that VA’s procedures do not ensure that TDIU benefit decisions are well supported. Specifically, (1) VBA’s guidance for determining unemployability, and thus benefit eligibility, is incomplete and formatted and delivered inefficiently; (2) VBA’s quality assurance approach may not comprehensively assess TDIU benefit decisions; and (3) self-reported income eligibility information is not verified with third-party earnings data. GAO also identified seven options proposed by experts for revising TDIU eligibly requirements and the benefit structure. Six options focus on eligibility requirements, such as considering additional criteria when determining unemployability and applying an age cap of 65. A seventh option would affect the benefit structure by lowering—but not immediately eliminating—the TDIU benefit payments as beneficiaries earn income beyond the eligibility limit.

Why GAO Did This Study

The population of veterans who receive these supplemental benefits has been growing. GAO was asked to testify on its recent review of VA’s management of these benefits. GAO issued a report in June 2015 that discussed the results of its review.

Like the June 2015 report, this statement (1) examined age-related trends in the population of TDIU beneficiaries and benefit payments; (2) assessed the procedures used for benefit decision-making; and (3) described suggested options for revising the benefit.

Recommendations

In its June 2015 report, GAO recommended that VA issued updated guidance to determine eligibility; identify a comprehensive quality assurance approach to assess benefit decisions; verify veterans’ self-reported income; and move forward on studies suggested by its advisory committee. VA concurred with all of GAO’s recommendations.

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Topics

BeneficiariesClaims processingClaims settlementCompensationDisability benefitsEligibility criteriaEligibility determinationsQuality assuranceVeterans benefitsVeterans disability compensationVeterans pensions