Tomah VA contacting patients whose neurological disorders may have been improperly dismissed

The Tomah VA Medical Center is working to contact patients who may have had their neurological disorders improperly dismissed by a former doctor.

Minneapolis-based TV station KARE11 started reporting over a year ago that veterans being seen at the VA had their care and benefits reduced because of a Neurology Compensation and Pension, or C&P, exam completed by Dr. Mary Jo Lanska.

According to the VA, the C&P exam is an administrative review where the examiner looks at the evidence of an injury or condition and makes an opinion on whether the medical issue is related to the veteran’s military service. That information is then provided to the Veterans Benefits Administration for review and can affect a veteran’s disability status.

For months, federal lawmakers including Democratic U.S. Sen. Tammy Baldwin and Republican U.S. Rep. Derrick Van Orden have been calling on the VA to respond to the reports of misdiagnoses and reconsider the protocol for how traumatic brain injuries and other conditions are evaluated.

On April 21, the U.S. Department of Veterans Affairs announced that the Tomah VA was reaching out to veterans after “an initial review” of C&P exams conducted by Lanska “determined some of those examinations were considered incomplete.”

In the press release, officials announced a phone line had been set up for veterans who had been seen by Lanska to request a reexamination.

The Tomah VA declined Wisconsin Public Radio’s request for an interview. In an email, a spokesperson said more than 25 veterans have called the review line so far. The spokesperson said the medical center is working with the Veterans Benefits Administration to determine if each veteran is eligible for potential reexamination.

When asked whether the VA has an estimate for how many veterans were affected, VA Press Secretary Terrence Hayes replied only that Lanska is not seeing patients at the VA currently and that “plans are in place to ensure that Dr. Lanska’s reassignment does not impact or interrupt” delivery of care and timely access to benefits for veterans.

In a press release last month, Van Orden said he is working with others on the House Committee on Veterans’ Affairs to investigate the matter. A letter from Van Orden and the committee’s chair said that VA officials reported that a review of 72 C&P exams done by Lanska found that 22 of them were incomplete. It also criticized the VA for identifying the errors “almost three years after the provider stopped completing C&P exams, and only after these concerns were brought forward publicly.” The representatives questioned whether the problems were limited to Lanska or were indicative of “a possible systemic failure” to provide traumatic brain injury evaluations.

“As a retired U.S. Navy SEAL and 100% service-connected disabled veteran who receives care at the Tomah VA, these accusations are deeply troubling. Our veterans who have been injured in the line of duty must receive the benefits to which they are entitled, plain and simple,” Van Orden said in a statement.

This is not the first time the VA health care system has faced criticism for how its doctors identify traumatic brain injuries. According to a letter from Baldwin last August, the VA’s Office of Inspector General found in 2019 that the department failed to implement procedures to ensure veterans were receiving adequate TBI — or traumatic brain injury — evaluations. Baldwin expressed concerns that the more than 24,000 veterans affected by the inconsistencies may not have been able to access new examinations and care through a request process similar to the one being offered to Lanska’s patients.

The Tomah VA’s press release from April pointed out that county veterans service officers raised concerns about Neurology C&P exams at the Tomah VA in 2018, but said reviews conducted at the time did not identify any concerns. The medical center said additional reviews of those exams are underway.