$111M in Unnecessary Exams: C&P Contractors Profit While Veterans Suffer – Where's the VA Oversight?

Monte Fisher, CPA (retired)
Owner & Lead Consultant, Veterans Claims Analytics | VCAnalytics.ai
Posted: May 13, 2025

I’m Monte Fisher, CPA (Retired), and I’ve spent decades exposing the rot – fraud, waste, and control failures that would sink private companies. At Veterans Claims Analytics, we’re revolutionizing the VA claims process with a leading approach, utilizing open source secure AI-driven analytics – we’re applying an audit mindset and a relentless demand for accountability to the VA claims process.

We deliver data-driven insights from publicly available sources, identifying critical anomalies – deviations from regulations, contractor overreach – that the VA often misses. We empower veterans to take control, providing actionable data to fly solo, or to work alongside Veteran Service Officers or legal professionals. Let’s be clear: we don’t offer legal advice. We do offer the kind of precision and scrutiny that's frankly missing from the system. Many veterans are rightfully skeptical of traditional approaches, and that’s why VCAnalytics.ai stands apart – delivering the raw, unfiltered truth.

Our analytics reveal where the VA and its contractors fall short of regulatory compliance, enabling veterans to resolve issues with decisive action.

PUBLIC DATA EXPOSES A SCANDAL
$39–$111 million in unnecessary Compensation and Pension (C&P) exams – a direct consequence of contractors profiting from scheduling unneeded assessments. This isn’t VA caution – it's a fundamental conflict of interest where contractors control both the order and the execution of exams, demonstrably defying decision-making principles and regulations like 38 CFR § 3.159(c)(4). These systemic failures, compounded by VA oversight gaps, contribute to financial ruin, emotional trauma, and 6,407 veteran suicides in 2024 [VA, 2024]. In an era where the Department of Government Efficiency (DOGE), spearheaded by Elon Musk, is pursuing billions in savings, this is a conspicuous example of government waste. Here’s the data, the systemic issues, and a toolkit to empower veterans to act.”

THE VA’S MONEY DRAIN: $39–$111 MILLION IN ANNUAL CONTRACTOR ABUSE
The VA’s C&P exam contracts cost an average of $350 per exam, yet contractors handle 93% of over 1.1 million exams annually [VA Contract Data, 2024]. Public data indicates 10-20% of these exams – representing 111,600 to 223,200 examinations – are wholly unnecessary, incurring $39.06 million to $111.6 million in wasteful costs. A 2017 Office of Inspector General (OIG) report confirmed this, finding 37% of reexaminations were unjustified, amounting to $100.6 million in wasted funds from 2017-2021. Furthermore, a 2021 Government Accountability Office (GAO) report revealed 20% return rates for Traumatic Brain Injury (TBI) and Military Sexual Trauma (MST) exams due to preventable errors.

Recent data strongly suggests a significant financial incentive driving the proliferation of unnecessary exams within the VA’s claims processing. Analysis reveals that C&P contractors are strategically ordering Fully Developed Claims (FDCs) – designed for expedited approval with Disability Benefits Questionnaires (DBQs) – to undergo C&P exams, with the C&P contractor then earning between $200 and $500 per exam conducted. This creates a problematic ‘segregation of duties’ (SoD) issue, allowing contractors to essentially act as both judge and beneficiary, potentially ordering exams that contradict 38 CFR § 3.159(c)(4) – a violation of COSO Principle 10. This is clearly a conflict of interest.

VCAnalytics.ai’s review of publicly available data corroborate this concern, highlighting a potential conflict where contractors may bypass established VA processes and independent oversight. Since FY2017, C&P contracts have generated over $10.4 billion – a sustained “money tree” fueled by VA oversight gaps [VA Budget, 2024].

A recent DOJ investigation uncovering $9.1 million in VA education fraud (DOJ, 2025) is just the tip of the iceberg. It’s time for the GAO to conduct a full audit and stop this blatant abuse of taxpayer dollars. As Pete Hegseth said on the Shawn Ryan Show (Episode #143, 2024), the VA is “feeding the beast” with a bureaucracy that prioritizes its own growth over veterans’ care – a favorite reference I’ve used in other blogs to spotlight systemic waste [Shawn Ryan Show, 2024]. Where’s the VA’s oversight? DOGE must audit these contracts [GAO High-Risk List, 2025].”

UNQUALIFIED EXAMINERS, UNNECESSARY EXAMS: THE VA’S HIDDEN COSTS FRAUD
Public reports and veteran feedback expose a deeply troubling pattern: C&P contractors are exploiting a system to profit, often utilizing unqualified or unlicensed examiners – a clear misstep against 38 CFR § 4.1, which demands “competent examiners.” Veterans consistently report these contractors are unprepared, routinely ignoring Independent Medical Opinions (IMOs) and DBQs, and lacking the necessary specialty for conditions like PTSD or orthopedics. These exams feel like a waste of time and leave veterans angry after weeks of waiting and travel, only to face examiners seemingly seeking reasons for denial. Analysis by VCAnalytics.ai, using public data, highlights these anomalies – general practitioners denying PTSD claims despite specialist IMOs, or completely ignoring evidence – a pattern echoing concerns raised in Gambill v. Shinseki (2010). A 2021 GAO report found 20% error rates in TBI and PTSD exams by non-specialists, and a 2022 OIG report documented contractors failing to verify licenses, including a concerning case of an inactive license [GAO, 2021; OIG, 2022].

BEYOND THE EXAM ROOM: THE HUMAN COST OF SYSTEMIC FAILURE
This isn’t just about dollars—it’s costing lives. The 2024 VA Suicide Prevention Report reveals a devastating reality: 6,407 veteran suicides in 2022 (17.6 per day), with 72% involving firearms [VA, 2024]. Unnecessary exams, compounded by unprepared contractors — examining IMOs and FDCs without expertise — fuel mental health crises. As one veteran described, “The examiner didn’t know my condition, ignored my specialist’s IMO, and seemed to fish for denial reasons,” triggering suicidal ideation.

Adding to the crisis, a 2024 OIG report found 10,541 claims delayed over a year at the National Work Queue, mostly herbicide-related, primarily due to understaffing issues. Veterans report that delays and denials escalate stress and suicidal thoughts, with one widow asking, “How many others have given up?”

The consequences extend beyond individual suffering. A 2024 OIG audit estimates $100–$250 million in over/underpayments, with 75% of 100% disability claims improperly processed from May 2022–April 2023. Simultaneously, 27,000 veterans faced two-day payment delays, incurring overdraft fees. VCAnalytics.ai’s data highlights regulatory non-compliance, offering veterans a means to identify potential errors, though the system’s failures continue to drive claim abandonment, as Rep. Morgan Luttrell noted, “500 families were denied Dependency and Indemnity Compensation (DIC) after suicides, with appeals averaging 5.5 years.

STALLED CLAIMS, STALLED LIVES
Lets quantify it. Unnecessary exams add 20–35 days per claim, with contractor exams taking 30–45 days, versus 10 days for VA doctors [Warren, 2024]. Claims stretch 4–6 months post-exam (vs. 3–4 months), especially with non-expert errors requiring appeals [VA Data, 2024]. If 10–20% of 1.2 million exams are unneeded (120,000–240,000), that’s 2.4–4.8 million wait days annually. Public data shows a veteran’s PTSD FDC, complete with a private DBQ, was delayed six months after a non-expert’s denial, potentially misaligning with M21-1, Part III, Subpart iii, Chapter 1 for FDCs, fueling the suicide crisis. VCAnalytics.ai highlights such delays as potential anomalies for veterans to review alone or with VSOs or legal professionals.

In the private sector, $39–$111 million in fraud triggers immediate SEC probes and DOJ charges.

WHAT THE GOVERNMENT ALLOWS IS FRANKLY ILLEGAL IN THE PRIVATE SECTOR
In corporate America, $39–$111 million in fraud triggers immediate SEC probes and DOJ charges. Yet, the VA’s bureaucracy shields contractors, allowing a $10.4B haul to go unchecked, based on OIG and GAO reports (2017–2023). This systemic abuse – akin to Medicare or DoD mismanagement – leaves veterans facing suicides, abandoned claims, and missed benefits. VCAnalytics.ai’s audit expertise – utilizing public data – encourages DOGE action to recover billions and deliver justice.

VETERAN’S TOOLKIT: A DATA APPROACH TO ACTION
The VA system can be complex, but with the right information, you can challenge denials and advocate for your benefits. VCAnalytics.ai provides data-driven insights to help you identify potential issues with your claim. Here’s how to use this “toolkit”:

• Document Everything: Meticulously record details about each exam – the examiner’s credentials, their conduct (e.g., ignored your IMO/DBQ), and any concerns about the exam's necessity. Why: Public data suggests the VA shouldn’t schedule unnecessary exams – 38 CFR § 3.159(c)(4) limits exams to necessary cases; VCAnalytics.ai flags potential profit-driven scheduling or evidence dismissal for review.

• Verify Examiner Qualifications: Ensure the examiner has the appropriate credentials and expertise for your condition. Why: The VA must use competent examiners – 38 CFR § 4.1 requires competent examiners; VCAnalytics.ai identifies potential licensing or specialty issues as anomalies.

• Request Your C&P Report: Obtain your C&P report and scrutinize it for errors, ignored evidence, or inadequate preparation. Why: Inconsistencies can undermine your claim – VCAnalytics.ai can assess your C&P report for anomalies.

• Raise Reasonable Doubt: If evidence was dismissed or ignored, highlight this to the VA. Why: The VA should consider all available evidence.

• File a Formal Complaint: If you believe your rights have been violated, file a complaint with the VA Regional Office, VA OIG, or Congress. Cite potential violations of VA regulations, such as unnecessary exams or unqualified examiners. Why: Public data supports oversight requests.

VA MDEO: Report directly to Medical Disability Examination Office.
VA OIG: Call 1-800-488-8244 or submit online for potential abuse, including ignored evidence [38 U.S.C. § 731].
Congress: Contact your senator or congressman directly.
Resources: Work with a free Veteran Service Officer (VSO) through the American Legion (1-800-433-3318), Veterans of Foreign Wars (VFW, 1-800-839-1899), or Disabled American Veterans (DAV, 1-888-604-0234). For legal or medical advice, consult a licensed professional. If you’re in crisis, call the Veterans Crisis Line at 988, press 1.

In need of an audit...

AN APPEAL TO DOGE
DOGE’s mission to save billions makes the VA’s $39–$111 million abuse a prime target, contributing to suicides, claim dropouts, and missed benefits. VA Secretary Layne Collins’ 2025 pledge to redirect contract funds aligns with DOGE, but where’s the oversight? [VA Press, 2025] The 2025 GAO High-Risk List flags VA disability programs, and 2023 OIG confirms contractor overreach [GAO, 2025; OIG, 2023].

VCAnalytics.ai uses public data to call for DOGE audits of:

• Unnecessary exams potentially misalign with 38 CFR § 3.159(c)(4).
• Unqualified examiners potentially misalign with 38 CFR § 4.1, ignoring evidence like IMOs.
• SoD issues, requiring VA or independent evaluation of exam necessity [COSO Principle 10].

_________________________________________________

VETERANS CLAIMS ANALYTICS: EMPOWERING VETERANS WITH DATA-DRIVEN INSIGHTS
At Veterans Claims Analytics, we’re a non-accredited company and the leading veterans claims analytical provider, uniquely positioned to empower veterans with knowledge to make informed decisions. Our AI-driven analytics, built on decades of financial and process control expertise, efficiently process data to provide veterans and their VSOs with strategic information to help win their claims or make decisions. We don’t prepare or file claims – we provide data, not decisions – ensuring compliance with VA guidelines while giving veterans the tools to navigate the claims process. Our approach could help clear the VA’s backlog if adopted, offering a balanced solution that leverages AI without replacing human judgment. Ready to take control of your claim with data-backed insights? Visit VCAnalytics.ai to learn more.

_________________________________________________

REFERENCES:

Regulations:

• 38 CFR § 3.102: Reasonable doubt [Ortiz v. Principi, 2001].

• 38 CFR § 3.159(c)(4): Limits exams.

• 38 CFR § 3.100: VBA adjudication.

Case Law:

• Gambill v. Shinseki, 2010 (CAVC).

• Ortiz v. Principi, 2001 (CAVC).

Reports:

• OIG, 2017: 37% unwarranted exams, $100.6M [OIG, 2017].

• GAO, 2021: 20% TBI/MST exam errors [GAO, 2021].

• OIG, 2022: Licensing failures [OIG, 2022].

• OIG, 2023: Contractor overlap [OIG, 2023].

Media:

• Shawn Ryan Show, 2024: Episode #143, Pete Hegseth [Shawn Ryan Show, 2024].

• CNN, 2025: 500 DIC denials, 5.5-year appeals [CNN, 2025].

• Military.com, 2023: 32,000 delayed claims [Military.com, 2023].

Audit Standards:

• COSO Principle 10: SoD.

• Sarbanes-Oxley Section 404, 201: Internal controls, independence.

_________________________________________________

Disclaimer: MoFish LLC, DBA Veterans Claims Analytics, offers data, not legal advice or claim filing. As a retired CPA, I don’t prepare financials or guarantee outcomes. Data informs, you decide. Visit VCAnalytics.ai for details. © 2025 MoFish LLC, All Rights Reserved.