Inspection of VA Regional Office Cleveland, Ohio

OIG evaluated VARO Cleveland, OH, to see how well it accomplishes the mission of processing disability claims and providing services to veterans. OIG Benefits Inspectors conducted this work in December 2014. We found that VARO Cleveland did not consistently process the three types of disability claims we reviewed. Overall, staff did not accurately process 30 of 90 disability claims (33 percent) reviewed. As a result, 404 improper monthly payments were made to 18 veterans totaling approximately $737,231. We sampled claims we considered at increased risk of processing errors. These results do not represent the accuracy of all disability claims processing at this VARO. In our 2012 inspection report of this VARO, the most frequent errors associated with temporary 100 percent disability evaluations occurred because staff did not establish suspense diaries. During this 2014 inspection, we did not identify similar errors. However, in September 2012, the VARO management was provided with a list of 712 temporary 100 percent disability evaluations to process. As of December 2014, staff had not taken action on seven of those claims. Therefore, we find the actions taken by VARO staff, as it relates to VBA’s national review plan, ineffective. We also reported in 2012 that TBI claims processing errors resulted from staff misinterpreting VBA policy. During this inspection we found similar issues and determined the VARO management’s actions in response to our previous recommendation were not effective. VARO staff also established incorrect dates of claim in VBA’s electronic systems of record for 3 of 30 claims we reviewed. Staff also did not timely or accurately complete 24 of 30 proposed benefits reduction cases due to other higher workload priorities. We recommended the Director review the 880 temporary 100 percent disability evaluations pending as of October 8, 2014; certify action has been accomplished on the 7 cases from our 2012 inspection; and provide training on temporary 100 percent disability evaluations, SMC, and dates of claim. Further, we recommended the Director ensure staff follow VBA's second signature requirements for TBI claims, monitor the effectiveness of TBI training, and prioritize benefits reduction cases. The VARO Director concurred with our recommendations. Management’s planned actions are responsive and we will follow up as required.