Inspection of VA Regional Office San Juan, Puerto Rico

We evaluated the San Juan VARO to see how well it accomplishes its mission. We found the VARO staff did not accurately process 26 (59 percent) of 44 disability claims we reviewed. We sampled claims that we considered to be at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Specific to the claims we reviewed, 21 of 30 temporary 100 percent disability evaluations were inaccurate. Generally, these errors occurred because VARO staff did not establish suspense diaries in the electronic record as required. Management also did not provide effective oversight of second-signature reviews and therefore staff incorrectly processed 5 of 14 traumatic brain injury claims. Further, Systematic Analyses of Operations were incomplete and untimely. This was due to the fact that VARO managers lacked adequate measures to ensure staff addressed all required elements of the annual analyses and submitted them by the due dates. In addition, staff did not always address or document decisions regarding Gulf War veterans’ entitlement to mental health treatment. VARO staff provided adequate outreach to homeless veterans in the VARO’s area of jurisdiction. We recommended the VARO Director implement a plan to ensure staff enter suspense diaries in the electronic record and review for accuracy the 132 temporary 100 percent disability evaluations that we provided at the end of this inspection. Management should also develop and implement plans to ensure effective second-signature reviews of traumatic brain injury claims and to ensure staff completely and timely address all required elements of Systematic Analyses of Operations. The VARO Director generally concurred with our recommendations but nonconcurred in part with the recommendation to review 132 temporary 100 percent disability evaluations because VBA is tracking these at a national level.