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Audit of VA Regional Offices' Appeals Management Processes

Report Information

Issue Date
Report Number
10-03166-75
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Recommendations
6
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
We determined whether opportunities exist to improve VARO timeliness in processing appeals of rating decisions. The nationwide inventory of appeals increased over 30 percent to about 209,000 in FY 2010 and the inventory of compensation rating claims also increased by 40 percent to 532,000 claims. Opportunities exist to improve appeals processing at regional offices. Regional office managers did not assign enough staff to process appeals, diverted staff from appeals processing, and did not ensure appeals staff acted on appeals promptly because compensation claims processing was their highest priority. We found the de novo review process results in quicker decisions on the veterans’ appeals because decision review officers can render new decisions without awaiting new evidence as required with traditional reviews. VARO staff did not properly record 145 appeals in Veterans Appeal Control and Locator System (VACOLS) that delayed processing for an average of 444 days. The Under Secretary for Benefits generally agreed opportunities exist to improve appeals processing and stated VBA was conducting a pilot program to assess the feasibility of implementing most of our recommendations. We will follow up on the implementation of the corrective actions.

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)
We recommended the Under Secretary for Benefits identify and request the staffing resources needed to meet Veterans Benefits Administration’s processing goals and conduct de novo reviews on all appeals.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Under Secretary for Benefits revise productivity standards for decision review officers assigned to appeal processing to limit credit to actions that progress the appeal such as Notices of Disagreement, issuance of Statements/Supplemental Statements of the Case, conducting requested hearings, and certification of appeals.
No. 3
Not Implemented Recommendation Image, X character'
to Veterans Benefits Administration (VBA)
We recommended the Under Secretary for Benefits implement criteria requiring appeals staff to initiate a review or development for Notices of Disagreement and certified appeals within 60 days of receipt.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Under Secretary for Benefits revise current policy to require de novo reviews on all appeals.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Under Secretary for Benefits develop and implement a plan to provide adequate oversight to ensure staff record Notices of Disagreement into the Veterans Appeals Control and Locator System.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Under Secretary for Benefits establish a mechanism to ensure VA Regional Offices¿ staff take appropriate action to complete the appeal and provide a decision on the 145 appeals that were not processed.