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Inspection of VA Regional Office Wilmington, Deleware

Report Information

Issue Date
Report Number
12-04328-211
VISN
State
Delaware
District
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
We evaluated the Wilmington VARO to see how well it accomplishes this mission. We found the VARO staff did not accurately process 17 (50 percent) of 34 disability claims we reviewed. We sampled claims for certain types of medical disabilities that we considered to be at higher risk of processing errors, so these results do not represent the overall accuracy of disability claims processing at this VARO. Claims processing that lacks compliance with VBA procedures can result in the risk of paying inaccurate and unnecessary financial benefits. Specific to the claims we reviewed, 17 of 30 temporary 100 percent disability evaluations were inaccurate. Generally, these errors occurred because VARO staff did not input suspense diaries, or take timely actions to schedule medical reexaminations, or reduce benefits as appropriate. All four traumatic brain injury claims that VARO staff completed from April through June 2012 were correctly processed. Further, Management ensured Systematic Analyses of Operations were complete and timely. However, staff did not always annotate Gulf War veterans’ entitlement to mental health care on decision documents. Staff also did not provide adequate outreach to homeless veterans in their area of jurisdiction. We recommended the VARO Director develop and implement a plan to ensure staff input suspense diaries, schedule medical reexaminations, and follow up to reduce benefits for temporary 100 percent disability evaluations when appropriate. The Director should also ensure staff review the temporary 100 percent disability evaluations to determine if reexaminations are required for those claims not reviewed as part of the OIG statistical sample. Management should also implement a plan to provide adequate outreach to homeless shelters and service providers. The VARO Director concurred with our recommendations.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Wilmington Regional Office Director develop and implement a plan to ensure claims processing staff input suspense diaries in the electronic record and timely schedule medical reexaminations when the reminder notifications generate.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Wilmington Regional Office Director develop and implement a plan to ensure claims processing staff take timely actions to finalize reductions in benefits when appropriate.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Wilmington VA Regional Office Director conduct a review of the 57 temporary 100 percent disability evaluations remaining from our inspection universe and take appropriate action.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Wilmington VA Regional Office Director develop and implement a plan to ensure staff update the resource directory and regularly contact and provide outreach to homeless shelters and service providers under the VA Regional Office's jurisdiction.