OIG conducted this inspection to evaluate how well the Pittsburgh VARO accomplishes its mission. We found the Pittsburgh VARO staff corrected errors identified by the VBA’s STAR program. VARO performance was generally effective in processing herbicide exposure-related claims. However, it lacked accuracy in processing some disability claims. VARO staff did not accurately process 36 (41 percent) of 88 disability claims we sampled as part of our inspection. These results do not represent the overall accuracy of disability claims processing at this VARO. Also, VARO management did not always provide oversight to ensure staff addressed all elements of SAOs, considered Gulf War veterans’ entitlement to mental health treatment, and provided outreach to homeless shelters and service providers. Oversight and policy guidance needed for proper mail-handling were lacking as well. Finally, delays in making final competency determinations occurred when staff did not prioritize these decisions. The VARO Director concurred with our findings and recommendations. The planned corrective actions are responsive and we will follow up as required on all actions.