We evaluated the Albuquerque VARO to see how well it accomplishes its mission. We found the VARO staff did not accurately process 23 (40 percent) of 58 disability claims reviewed. We sampled claims we considered at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Specifically, 13 of 30 temporary 100 percent disability evaluations we reviewed were inaccurate. These errors generally occurred because VARO staff did not establish controls to request future medical reexaminations. Further, VARO staff incorrectly processed 10 of 28 traumatic brain injury claims. These errors occurred primarily because staff misinterpreted VBA policy for rating a traumatic brain injury with a coexisting mental condition and used insufficient VA medical examination reports to evaluate traumatic brain injury claims. Three of the 11 Systematic Analysis of Operations were either untimely or not completed due to a lack of management oversight. VARO staff did not always properly grant Gulf War veterans entitlement to mental health treatment, but provided adequate outreach to homeless veterans. Due to a lack of performance measures, we could not fully assess the effectiveness of the VARO’s homeless veterans outreach efforts. We recommended the VARO Director develop and implement a plan to review all temporary 100 percent disability evaluations remaining from our inspection universe of related claims and take appropriate action. The Director should provide refresher training on processing traumatic brain injury claims and monitor its effectiveness. The Director should also develop and implement a plan to ensure staff return insufficient medical reports to examiners to obtain the evidence needed to support traumatic brain injury claims. The Director concurred with our recommendations, although VARO staff did not agree with 5 of the 23 claims processing errors identified.