Inspection of VA Regional Office Waco, Texas

We evaluated the Waco VARO to see how well it accomplishes its mission. We found the VARO staff did not accurately process 24 (40 percent) of 60 disability claims we reviewed. We sampled claims we consider at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Specifically, 15 of 30 temporary 100 percent disability evaluations were inaccurate. Generally, these errors occurred because VARO staff did not establish controls to request future medical reexaminations. Also, errors in processing 9 of 30 traumatic brain injury claims occurred primarily due to ineffective training and inexperienced staff rating these complex claims. Further, Systematic Analyses of Operations were incomplete, generally because the work performed did not include recommendations. The VARO’s performance was generally effective in addressing Gulf War veterans’ entitlement to mental health treatment. Waco VARO staff also provided adequate outreach to homeless veterans; however, VBA needs a measure to assess its outreach program. We recommended the VARO Director develop and implement a plan to review all remaining temporary 100 percent disability evaluations identified during our inspection and take appropriate action. The Director should provide refresher training on processing traumatic brain injury claims and monitor the effectiveness of the training. In addition, actions should be taken to ensure staff comply with VBA’s policy requiring second-level review of traumatic brain injury claims decisions by more experienced decision makers. The Director should also ensure staff includes recommendations for addressing problems identified through Systematic Analyses of Operations. The VARO Director concurred with our recommendations.