Review of Alleged Data Manipulation at the VA Regioinal Office Houston, TX

On July 10, 2014, the Office of Inspector General received an allegation from Veterans Benefits Administration (VBA) senior leadership in VA Central Office that a Houston VA Regional Office (VARO) employee inappropriately changed or removed system controls for benefits claims without taking proper actions on the claims. VBA uses electronic system controls to identify types of claims, and manage and measure its pending and completed workloads. Generally, such controls should remain in place until all required actions are completed on claims, including providing notices of benefits decisions to the claimants. We substantiated the allegation that the employee inappropriately cleared, changed, and cancelled controls in the electronic record used to track and identify benefits claims without taking proper actions to complete the claims. The VARO’s independent review team determined the employee incorrectly cleared system controls in 136 (44 percent) of 308 claims, making these unfinished claims appear to be completed. We sampled 60 of the 308 cases and determined the independent review team accurately identified whether corrective actions were needed and established new controls where required. Further, we found the employee incorrectly changed or cancelled system controls in 38 of 51 additional claims we sampled. The employee believed the actions were appropriate and would improve production, but conceded making mistakes during what he said was a period of immense stress. To address the issue, VBA leadership initiated administrative action, to include removal of the employee’s system access. These inappropriate actions misrepresented the VARO’s claims inventory and timeliness measures, and impaired its ability to measure and manage its workloads. Further, some veterans may never have received decisions on their claims if the VARO’s independent review team had not discovered the improper actions by the employee. Our review did not identify any fraud resulting in personal financial gain; however, the inappropriate actions described in this report undermine program effectiveness. Therefore, we recommended the Houston VARO Director take immediate action to fully review and correct, as appropriate, all actions the employee took to clear, change, or cancel controls for claims. We also recommended the Director confer with VA Regional Counsel to determine the appropriate administrative action to take, if any, against this employee.