The Medical Disability Examination Office Needs to Better Monitor Mileage Requirements for Contract Exams

The VA Office of Inspector General (OIG) reviewed how the Medical Disability Examination Office (MDEO) is monitoring mileage requirements in the contract exam process because veterans reported on satisfaction surveys that they had to travel excessive distances to attend exams. Contracts with providers require that veterans expressly consent to traveling farther for exams than the set limits: 50 miles for non-specialist exams and 100 miles for specialist exams. That express consent must be documented and included in the record available to Veterans Benefits Administration (VBA) employees. The OIG found MDEO is not monitoring whether vendors obtain and document veterans’ express consent to travel beyond contractual mileage limits for exams. The OIG also found MDEO is not sufficiently monitoring vendor portals to ensure all required details of mileage reimbursements are available to veterans. MDEO is not monitoring compliance because its leaders do not consider it a priority given the small percentage of veterans affected. However, MDEO is responsible for ensuring vendors comply with all contract requirements, including mileage requirements and reimbursements. Without monitoring, VBA cannot identify or implement improvements that will make a positive impact for veterans. If vendors do not obtain and document express consent to exceed contractual mileage limitations, veterans may not be aware of their right to undergo an exam within a reasonable distance of their homes. This potentially burdens veterans who are elderly or have disabilities that make it difficult to travel long distances. The OIG recommended the under secretary for benefits implement a process to monitor and demonstrate progress in assessing vendors’ compliance with contractual mileage and travel reimbursement requirements, collaborate with vendors to ensure portals include proper documentation of express consent, and collaborate with vendors to ensure mileage reimbursement information is available in vendor portals.