We evaluated the Muskogee VARO to see how well it accomplishes its mission. We found the VARO staff did not accurately process 25 (42 percent) of 60 disability claims we reviewed. We sampled claims we consider to be at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Specifically, 12 of 30 temporary 100 percent disability evaluations we reviewed were inaccurate; however, we identified no systemic trend associated with these processing errors. Additionally, staff misinterpreted VBA policy and inaccurately processed 13 of 30 traumatic brain injury claims. VARO management ensured Systematic Analyses of Operations were complete and timely, but did not ensure staff properly addressed Gulf War veterans’ entitlement to mental health treatment. VARO staff provided adequate outreach to homeless veterans; however, we could not fully assess the effectiveness of VBA’s outreach activities because VBA needs performance measures for its homeless veterans outreach program. We recommended the VARO Director develop a plan to review the 304 temporary 100 percent disability evaluations remaining from our inspection universe of related claims. The Director should provide and monitor the effectiveness of training on processing traumatic brain injury claims. The Director should implement a plan to ensure accurate second-signature reviews of traumatic brain injury claims. The Director should also ensure staff address Gulf War veterans’ entitlement to mental health treatment. The Director concurred with our recommendations, although VARO staff did not agree with 6 of 13 traumatic brain injury claims processing errors we identified.