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VA Disability Benefits: Actions Needed to Further Examine Racial and Ethnic Disparities in Compensation

GAO-23-106097 Published: Jul 26, 2023. Publicly Released: Jul 26, 2023.
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Fast Facts

The Veterans Benefits Administration provided more than $112 billion in disability benefits to about 5.4 million veterans and their families in FY 2022. The agency has faced longstanding challenges managing claims and has been on our High Risk List since 2003.

Our analysis of agency disability compensation from 2010 through 2020 found that Non-Hispanic Black veterans had the lowest approval rates among all racial and ethnic groups—61% versus 75% for White veterans.

Our recommendations include that the agency comprehensively study the root causes of these disparities so that it has the information it needs to ensure equitable decisions.

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Highlights

What GAO Found

The Department of Veterans Affairs (VA) has taken steps to improve how it collects race and ethnicity data to understand the experiences of veterans who may apply for disability compensation through the Veterans Benefits Administration (VBA). For example, VA created a working group that specifically focused on improving demographic data collection. VA's collection efforts could enhance the data available to VBA to assess racial and ethnic disparities in disability compensation. However, VA has not developed a documented plan for how it will improve the availability of data for certain racial and ethnic groups who may not be accessing VA services and benefits. Without a plan to identify and document concrete actions, VA will not have the data it needs to ensure veterans are treated equitably.

GAO's analysis of fiscal year 2010 through 2020 compared initial claims approval rates for all racial and ethnic groups to Non-Hispanic White (White) veterans—the largest group with decisions. GAO found that Non-Hispanic Black or African American (Black) veterans had the lowest approval rate among all groups (see figure). Similarly, GAO's analysis of selected medical conditions most frequently decided by VA found that differences in approval rates were particularly prominent between Black male and White male veterans, with Black male veterans' rates being 3 to 22 percentage points lower. These differences were prevalent for nine of the 10 conditions GAO analyzed such as tinnitus and posttraumatic stress disorder. VBA has conducted studies on racial and ethnic disparities in disability compensation for some conditions and found disparities. However, it has not comprehensively studied the root causes of the disparities it has found or potential disparities in the provisions of compensation more broadly. As a result, VA lacks the information it needs to ensure equitable decisions.

VA Disability Compensation Approval Rates for Initial Claims, by Race and Ethnicity (Fiscal Years 2010–2020)

VA Disability Compensation Approval Rates for Initial Claims, by Race and Ethnicity (Fiscal Years 2010–2020)

Note: GAO grouped individuals of Hispanic ethnicity under that designation regardless of race.

Why GAO Did This Study

Veterans from historically disadvantaged racial and ethnic groups comprised almost 24 percent of the total veteran population in 2017, according to a VA report. By 2045, this group of veterans will make up over 36 percent of all living veterans, according to VA projections.

Public Law 117-66 includes a provision for GAO to assess whether there are racial and ethnic disparities with respect to disability compensation, among other areas. This report examines the extent to which (1) VA has taken steps to collect and assess data about the racial and ethnic composition of veterans who may apply for disability compensation; and (2) racial and ethnic disparities exist in the provision of compensation, and what factors could contribute to disparate outcomes.

GAO reviewed relevant federal laws, regulations, and VA policies; analyzed VA's claims data by race, ethnicity, and sex from fiscal year 2010 through 2020 (the most recent full year of data available); and interviewed VA officials and representatives from a VA advisory group and selected veterans service organizations.

Recommendations

GAO is making three recommendations to VA, including that it develop a plan to address limitations with its race and ethnicity data, and to conduct a comprehensive assessment of disability compensation to identify the root causes that could contribute to racial and ethnic disparities. VA agreed with the recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of VA should develop a documented plan that details specific actions, time frames, and procedures to address the limitations it has identified with its race and ethnicity data for veterans from historically disadvantaged racial and ethnic groups. (Recommendation 1)
Open
VA agreed with this recommendation. VA's Veterans Experience Office led the development of an Enterprise Demographics Implementation and Integration Strategic Plan with the goal of creating demographic collection standards and integrating collected demographic data across VA. However, the plan lacked specificity of actions to be taken and procedures to address limitations with the agency's race and ethnic data. While ensuring data integration across VA can help the agency better serve veterans, we will consider closing this recommendation when VA identifies additional actions needed to address known limitations for race and ethnicity data.
Department of Veterans Affairs The Secretary of VA should conduct a comprehensive assessment of disability compensation to identify the root causes that could contribute to any racial and ethnic disparities. Such an assessment could be completed internally or contracted out by VA. Also, it could include factors we identified in this report and any other factors VA considers relevant. (Recommendation 2)
Open
VA stated that it is in the planning phase to contract a comprehensive assessment of compensation benefits. VBA's goal is to award the contract prior to the end of FY2024. VBA will use information from its equity dashboards, which they use to provide information on veterans' outcomes and access across VBA benefits and services by race, ethnicity, and sex, and a recent mental health disability compensation benefit study to inform future assessments. VBA also stated it is establishing an Equity Assurance Office to address benefit disparity issues, among other things. We will continue to monitor the agency's progress on these efforts.
Department of Veterans Affairs The Secretary of VA should, after completing a comprehensive assessment of disability compensation, develop a plan to guide and coordinate VA's actions to address the identified root causes of any racial and ethnic disparities. (Recommendation 3)
Open
VA officials stated it will develop an action plan upon completion of the comprehensive assessment of disability compensation. We will continue to monitor the agency's progress on this effort.

Full Report

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Topics

African AmericansDisability claimsDisability compensationPhysical disabilitiesRacial and ethnic groupsRacial disparitiesVeteransVeterans affairsVeterans disability benefitsAdvisory committees