Report Summary

Title: VA Needs Better Internal Communication and Data Sharing to Strengthen the Administration of Spina Bifida Benefits
Report Number: 20-00295-61 Download
Issue Date: 2/23/2021
VA Office: Veterans Health Administration (VHA)
Veterans Benefits Administration (VBA)
Report Author: Office of Audits and Evaluations
Report Type: Review
Release Type: Unrestricted

The VA Office of Inspector General (OIG) reviewed key aspects of VA’s spina bifida program in response to congressional and other concerns that eligible individuals may not be receiving the compensation, healthcare, home services, and other benefits to which they are entitled. Monthly payments under this relatively small but critical program (serving more than 1,000 beneficiaries) exceeded $20.8 million in 2019, with medical reimbursements of over $45 million.

Spina bifida occurs when a fetus’s spine and spinal cord do not form properly. Children born with spina bifida may receive VA benefits such as monthly payments, home services, and health care if one of their biological parents is a veteran presumed to have been exposed to herbicides during the Vietnam War.

The Veterans Benefits Administration (VBA) determines eligibility for spina bifida benefits and issues monthly payments. The Veterans Health Administration (VHA) covers all medically necessary health care.

The OIG found VBA staff generally decided spina bifida benefit claims accurately. However, program offices in VBA and VHA did not adequately communicate or share data, contributing to beneficiaries receiving improper payments after their deaths and delays in new beneficiaries being enrolled in health care. Further, individuals with spina bifida and their caretakers did not receive needed information about benefits because VA did not consistently reach out and accurately communicate with them.

The OIG made four recommendations related to preventing payments to deceased beneficiaries through better coordination between the Denver VBA regional benefits office and VHA’s Office of Community Care, ensuring all eligible beneficiaries are promptly enrolled in health care, making certain that agents for national call centers consistently provide accurate and comprehensive benefits information, and engaging eligible beneficiaries who are not aware of or using services.