A different outcome for different problems
VA’s response to a federal audit of contracted disability examinations contains two different kinds of change: tighter payment and feedback controls, and a longer interval between reviews of three complex claim categories. Treating all of those changes as either a complete fix or complete inaction would miss what the follow-up record shows.
The Medical Disability Examination Office changed its review cycle for traumatic brain injury, military sexual trauma and Gulf War Illness from every two years to every three years in September 2025, according to the Government Accountability Office’s current recommendation tracker. That lengthens the planned interval for each category by 50%.
Across a complete six-year cycle, a consistently applied two-year schedule would provide three reviews per category; a three-year schedule would provide two. This is a comparison of the stated schedules, not a count of reviews actually missed. VA said resource constraints prompted the change.
Why the timetable matters
These focused reviews examine the quality of disability-examination paperwork and the accuracy of examination requests for claims that can be particularly challenging. They can lead to changed instructions, training or forms. A subsequent review is intended to determine whether corrective measures worked.
GAO’s original 2025 report found the office had not kept its biennial schedule. By May 2025, each of the three categories had received one review but none had received a second. Military sexual trauma and Gulf War Illness reviews were behind schedule; a traumatic-brain-injury review due that fiscal year had no expected start date.
The newer follow-up record changes that picture. GAO reports a military sexual trauma review completed in September 2025 under the revised cycle. It describes the recommendation as open and partially addressed, explaining that a regular three-year schedule may be preferable to erratic or discontinued reviews. It would consider closing the recommendation as the office continues performing reviews on that schedule. VBA also said the extra time helps ensure changes from one review take effect before the next review of that claim type.
That is a conditional assessment, not a conclusion that longer intervals produce equivalent oversight. The public record does not quantify how a third year between reviews affects veterans’ outcomes. It does establish that the adopted response reduces the scheduled frequency per claim category.
Payment controls changed more decisively
The original audit separately identified almost $2.3 million in excess incentive payments on two contracts in the first quarter of fiscal 2024. Staff had entered incorrect incentive percentages. An informal verification process caught five other errors before finalization but missed these two.
By September 2025, the office had finalized procedures using locked spreadsheet formulas and a separate management recalculation to verify incentives. GAO now lists that recommendation as implemented. This is a material improvement: calculation checks are documented, and managers must independently recalculate the amounts before they become final.
Another recommendation remains open for a narrower reason. VA told GAO it had recalculated incentives back to 2022. A VA official testified in November 2025 that the identified overpayments were recouped and no additional overpayments were found. GAO says it needs supporting documentation before closing the item. It would be inaccurate to report that VA still definitely has not recovered the money; the unresolved issue in the tracker is verification.
Feedback improved; quality still needs evidence
GAO also closed its recommendation for direct examiner feedback. In September 2025, VA put a feedback form on its examiner training website, notified examiners and established procedures to route, track and document responses. The original audit had found that relying on contractors to pass along examiner concerns could leave conflicting instructions unresolved.
The scale of the program makes follow-through consequential. Contractors conducted approximately 3.2 million examinations in fiscal 2024, compared with 1.8 million in 2022, according to the VA figures in the audit—a calculated increase of about 78%. This comparison describes exam volume, not the number of individual veterans or a current caseload.
Nor should every paperwork error be treated as an incorrect benefits decision. In one quarterly analysis described in the report, 88% of identified errors did not affect the claim decision; 6% required a new exam. Those results concern that set of identified errors and cannot be generalized into an overall examination failure rate.
The record therefore supports a specific accountability question: whether the revised review schedule delivers consistent follow-up as examination volume grows. Completed controls deserve recognition. So does the remaining need for documented repayments, completed complex-claim reviews and evidence that their recommendations improve the decisions veterans receive.