	The TDIU Beneficiary Population and Benefit Costs Are Growing, Especially Among Older Veterans

As we reported in June 2015, in fiscal year 2013, 332,934 veterans  received TDIU benefits, an increase of 22 percent since fiscal year 2009. Overall, TDIU beneficiaries make up a substantial portion (45 percent) of  the group of all veterans who receive benefit payments at the 100 percent  disability compensation rate. We estimated that, in fiscal year 2013, the TDIU benefit was a $5.2 billion  supplemental payment above what beneficiaries would have received in  the absence of TDIU benefits. VBA’s Benefit Decision-Making Procedures Do Not Ensure TDIU Decisions Are Well Supported

In our June 2015 report, we found that VBA’s guidance, quality assurance  approach, and income verification procedures do not ensure that TDIU  decisions are well supported. Thus, rating specialists lack a definitive source for TDIU  benefit decision guidance. While we recognize that TDIU benefit decisions have an inherently  subjective component, in June 2015, we recommended that VA identify  other quality assurance approaches to comprehensively assess TDIU  benefit claim decisions. Self-Reported income eligibility information is not verified: VBA  requires TDIU claimants and beneficiaries to provide information on  their employment earnings, but it places the benefits at risk of being  awarded to ineligible veterans by not using third-party data sources to  independently verify self-reported earnings. To begin receiving and  remain eligible for TDIU benefits, veterans must meet certain income  eligibility requirements. Options for Revising TDIU Eligibility Requirements

With regard to the options for revising TDIU eligibility requirements and  the benefit structure, in our June 2015 report, we identified a number of  options proposed by others as described in table 1. More specifically,  six options focused on revising eligibility such as changing existing  requirements in various ways, for example, setting age limits, lowering the  disability rating requirement, or increasing the income threshold. A  seventh option would affect the benefit structure by lowering—but not  immediately eliminating—the TDIU benefit payments as beneficiaries  earn income beyond the eligibility limit. In  light of VA’s agreement with the committee’s recommendations, we  subsequently recommended in our June 2015 report that VBA develop a  plan to study (1) whether age should be considered when deciding if  veterans are unemployable and (2) whether it is possible to disallow TDIU  benefits for veterans whose vocational assessment indicated they would  be employable after rehabilitation.recommendation and stated that Compensation Service initiated a review  of TDIU policies and procedures in April 2015 including consideration of  age and vocational assessments in claim decisions. Moreover, VA has the opportunity to benefit from the attention the TDIU  benefit has received by various experts, including its own advisory  committee.
Why GAO Did This Study

The population of veterans who receive these supplemental benefits has been growing. GAO was asked to testify on its recent review of VA’s management of these benefits. GAO issued a report in June 2015 that discussed the results of its review.
Like the June 2015 report, this statement (1) examined age-related trends in the population of TDIU beneficiaries and benefit payments; (2) assessed the procedures used for benefit decision-making; and (3) described suggested options for revising the benefit.

What GAO Found

The number of veterans receiving Total Disability Individual Unemployability (TDIU) benefits has been increasing, as has the total amount of benefit payments, especially among older veterans. VA generally provides TDIU benefits to disabled veterans who are unable to maintain employment with earnings above the federal poverty guidelines due to service-connected disabilities. To be eligible for TDIU benefits, a veteran must have a single service-connected disability rated at least 60 percent or multiple disabilities with a combined rating of at least 70 percent (with at least one disability rated at 40 percent or higher). In addition, the veteran must be unable to obtain or maintain “substantially gainful employment” as a result of these service-connected disabilities. In fiscal year 2013, over 330,000 veterans received this benefit, a 22 percent increase from fiscal year 2009, while the TDIU disability payments increased by 30 percent. GAO estimated that $5.2 billion was spent in fiscal year 2013 for the supplement. These trends occurred alongside GAO also found that VA’s procedures do not ensure that TDIU benefit decisions are well supported. Specifically, (1) VBA’s guidance for determining unemployability, and thus benefit eligibility, is incomplete and formatted and delivered inefficiently; (2) VBA’s quality assurance approach may not comprehensively assess TDIU benefit decisions; and (3) self-reported income eligibility information is not verified with third-party earnings data. GAO also identified seven options proposed by experts for revising TDIU eligibly requirements and the benefit structure. Six options focus on eligibility requirements, such as considering additional criteria when determining unemployability and applying an age cap of 65. A seventh option would affect the benefit structure by lowering—but not immediately eliminating—the TDIU benefit payments as beneficiaries earn income beyond the eligibility limit.

What GAO Recommends

In its June 2015 report, GAO recommended that VA issued updated guidance to determine eligibility; identify a comprehensive quality assurance approach to assess benefit decisions; verify veterans’ self-reported income; and move forward on studies suggested by its advisory committee. VA concurred with all of GAO’s recommendations.