Inspection of VA Regional Office San Diego, California

Overall, VA Office of Inspector General (OIG) benefits inspectors determined San Diego VA Regional Office (VARO) claims processing staff incorrectly processed 23 of the 90 (26 percent) disability claims selected for review. The claims processing errors resulted in over $111,000 in improper benefits payments from April 2012, until October 2014. The OIG benefits inspectors sample disability claims considered at increased risk of processing errors so inspection results do not represent the accuracy of all disability claims processed at the San Diego VARO. OIG staff found VARO staff incorrectly processed 10 of 30 claims related to temporary 100 percent disability evaluations but processed 28 of the 30 traumatic brain injury claims correctly. Results in these two areas showed significant improvement since the VARO was last inspected in 2012. However, OIG reported 11 of the 30 sample cases relating to Special Monthly Compensation and ancillary benefits contained errors. San Diego VARO staff followed policy and accurately established claims in an electronic system of records using correct dates of claims for the 30 claims sampled. Inspectors also determined VARO staff delayed or incorrectly processed 7 of the 30 benefits reduction cases which resulted in approximately $7,900 in improper benefit payments from November 2013 until October 2014. The improper payments resulted from delays in taking actions to reduce the benefits because VARO management considered other work to be a higher priority. The Director of the San Diego VARO concurred with all recommendations; however, OIG indicated the Director’s planned corrective actions were inadequate because they did not adequately address the recommendations. OIG has plans to follow up with the VARO to determine if the effectiveness of the corrective actions.