The Department of Veterans Affairs may have mistakenly paid out more than $5 million in benefits to veterans claiming to suffer from Gulf War Syndrome, according to an inspector general report published Thursday.

The report asserts that the agency failed to appropriately assess whether claimants met the requirements for receiving compensation before issuing the payments. Investigators estimate that the Veterans Benefits Administration “prematurely” approved around a quarter of the 13,800 Gulf War Syndrome claims filed between Oct. 1, 2021, and Mar. 31, 2022. The report’s authors note, however, that the under-examined applicants may have been eligible for the benefits they received, even if their claims were mistakenly approved.

The errors could complicate treatment for an illness already clouded in ambiguity. Gulf War Syndrome encompasses a medley of unexplained chronic afflictions found in tens of thousands of veterans who served in the Persian Gulf during Operations Desert Storm and Desert Shield. Common symptoms include diarrhea, fatigue, rashes, joint pain and cognitive issues, though experts have struggled to pinpoint an exact cause for any of them. The VA announced in April that it would conduct a five-year study into the illness’ origins and impacts.

The VA first authorized disability checks for victims of Gulf War Syndrome in 1995. Gradual regulatory tweaks over the ensuing decades attempted to refine definitions for “unexplained illnesses” and the pathways to receive benefits for them. A 2003 rule change established the working definition of a “medically unexplained illness” as a diagnosed ailment lacking a clear cause and “characterized by overlapping symptoms and signs,” including fatigue, pain, and other disabilities.

The Promise to Address Comprehensive Toxics (PACT) Act, signed into law in 2022, expanded welfare provisions for maladies connected to toxin exposure in Iraq and Afghanistan, Vietnam, and nuclear testing sites.

Investigators say the questionnaires used by agency adjudicators to evaluate claims for Gulf War Syndrome and other mysterious ailments don’t collect enough information to reliably determine who deserves benefits.

“(Veterans Benefits Administration) lacked evidence needed to decide the claims because its examination requests and disability benefits questionnaires do not elicit the information needed by claims processors to determine whether a veteran is eligible for benefits under the regulation,” they wrote.

The inspector general report also faulted “confusing and inconsistent” guidelines on how and when claims processors should seek out more information to fill those gaps. These oversights, it warned, could result in around $25.6 million in undue payments between fiscal year 2022 and September 2024.

Simple fixes, such as updating questionnaires and instructions for examiners with the full, latest definitions for medically unexplained illnesses, could save millions, investigators stressed.

The VA accepted the inspector general’s recommendations and is expected to implement the suggested reforms by the end of September.

Jaime Moore-Carrillo is an editorial fellow for Military Times and Defense News. A Boston native, Jaime graduated with degrees in international affairs, history, and Arabic from Georgetown University, where he served as a senior editor for the school's student-run paper, The Hoya.

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