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Review of Timeliness of the Appeals Process

Report Information

Issue Date
Report Number
16-01750-79
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General (OIG) conducted this review to determine whether opportunities continued to exist for Veterans Benefits Administration (VBA) staff to improve the timeliness of appeals processing. The review focused on 210 appeals in seven phases where VBA was required to take action after receipt of a notice of disagreement, substantive appeal, or decision from the Board of Veterans’ Appeals (Board). The OIG found VBA staff did not always timely process the appeals workload. Generally, periods of inactivity occurred because: (1) VBA senior leadership prioritized the rating claims backlog over other workload and did not dedicate sufficient resources to timely address appeals; (2) VBA had an ineffective procedure for notifying VA Regional Offices when they were required to process Board grants; (3) some appeals were prematurely closed because VBA staff failed to update, or incorrectly updated, the electronic system and relied on an automated function to close some appeals; and, (4) VBA staff failed to follow the Board’s remand instructions due to inattention to detail and ineffective oversight. In some cases, delays caused by VBA resulted in appellants waiting years to receive favorable decisions and compensation. The OIG estimated that VBA staff issued favorable decisions in 29 percent of appeal stages completed during the first quarter of fiscal year 2016, resulting in additional compensation averaging approximately $32,800 through January 2016 and $650 in recurring additional monthly payments as of February 2016. Delaying decisions also resulted in some appellants paying more of their benefits to accredited attorneys and agents, and some appellants died before receiving final decisions on their appeals. Furthermore, processing errors resulted in loss of control of some appeals, misrepresented VA’s reported statistics, and caused unnecessary delays. The OIG made four recommendations and the Executive in Charge concurred with each one.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
The OIG recommended the acting Under Secretary for Benefits continue to monitor the effectiveness of the Veterans Benefits Administration’s appeals realignment and increased resources, towards meeting its established targets related to appeals processing timeliness.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
The OIG recommended the acting Under Secretary for Benefits monitor the effectiveness of the Caseflow application to ensure Board of Veterans’ Appeals decisions are timely controlled and assigned to the appropriate VA Regional Office or the Appeals Resource Center.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
The OIG recommended the acting Under Secretary for Benefits implement a plan to amend Veterans Benefits Administration’s procedures for closing appeals records to prevent appeals being closed prematurely.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
The OIG recommended the acting Under Secretary for Benefits remind staff of their responsibilities when processing remands and recertifying appeals to the Board of Veterans’ Appeals, and implement a plan to ensure compliance.