We conducted this inspection to evaluate how well the Winston-Salem VARO accomplishes its mission. We found the VARO accurately processed most herbicide exposure-related claims but needed to improve accuracy in processing traumatic brain injury claims. VARO staff inaccurately processed 50 percent of the temporary 100 percent disability evaluations because medical reexaminations were not scheduled as required. Although our results show VARO staff did not accurately process 20 (22 percent) of the 90 disability claims, these results do not represent the overall accuracy of disability claims processing at this VARO as we sample selected types of claims at higher risk of processing errors. VARO staff corrected errors identified by the VBA’s STAR program, and management ensured staff completed all elements of SAOs. VARO staff correctly processed incoming mail but errors occurred in other stages of mail processing. VARO staff did not always advise Gulf War veterans of their entitlement to mental health treatment, however the VARO’s outreach to homeless veterans was provided. The VARO lacked adequate space for approximately 37,000 claims folders.