Recent VA inspector general findings revealed that over 50% of all rejected military sexual trauma (MST) claims are processed in error. In an effort to fix the problem, US Army reserve veteran and Republican Representative Troy Nehls has introduced a bill proposing much-needed revisions to the VA's exam process.
Military sexual violence is an ever-growing problem. In 2018, there were over 20,500 reports of sexual assault or rape (7,500 men and 13,000 women), up 40% from 2016. Actual numbers could be twice as high since reporting sexual assault during service is discouraged due to threats or negative stigma.
MST can manifest as debilitating depression, substance abuse, sexual dysfunction, hypervigilance, suicidal ideation, and PTSD, rendering veterans unable to function fully in civilian society – and sometimes occurring years after service.
The effects of MST are so well known that the VA offers automatic physical and mental health care benefits to survivors.
But a 2018 inspector general's report found that the VA's MST claims processing tools and protocols violated rules set forth by the Veterans Benefits Administration, causing premature claim denials that "could have resulted in veterans not receiving the benefits they deserved."
Specifically, the VA report revealed 57% of denied MST PTSD disability claims were rejected due to incorrect processing.
A reevaluation in August 2021 said VA benefits administrators were still failing to follow policies, and VA was continuing to process MST claims incorrectly.
VA MST examiners must meet certain training qualifications and credentials to evaluate MST cases. But Nehls says an overwhelmed VA will often contract military sexual trauma exams out to non-VA examiners, raising concerns around whether these outside examiners have the proper training and credentials in sexual trauma and the effects of MST to perform the exams.
On November 19, Nehls submitted HR 6064 before the House Disability Assistance and Memorial Affairs subcommittee. The bill requests that the National Academies of Sciences, Engineering, and Medicine perform a comprehensive review of the VA's current MST disability exam process. Specifically, the review would evaluate:
- The adequacy of MST exam tools and protocols, including disability benefits questionnaires, the schedule of rating disabilities, whether certain MST-related conditions should require referral for both mental and physical health examinations, whether internal pelvic examinations should be required to diagnose certain MST-related conditions, and whether exam alternatives should be offered when a veteran can't participate in such exams.
- The training and credentials necessary to perform exams related to physical MST-related conditions like pelvic dysfunction, sexual dysfunction, pelvic pain, heart conditions, stroke, and musculoskeletal disabilities.
- The training and credentials necessary to perform exams related to mental MST-related conditions.
- The quality of MST training for examiners.
The bill also asks for recommendations for improvements in the MST examination process, including:
- Improvements in MST training for examiners.
- Administrative or legislative action to improve the adjudication of MST-related VA claims
By their nature, MST disability claims are challenging to prove. In many cases, service members fail to report military sexual trauma during service – either due to threats or negative stigma. Without a military record of sexual trauma, many MST claims must rely on indirect evidence – such as sudden changes in behavior or performance, evidenced by military disciplinary action or witness statements.
Because of the challenging nature of MST disability claims, it is crucial the VA have adequate tools and protocols in place to ensure veterans receive the disability benefits they deserve.