Report Summary

Title: Inspection of VA Regional Office Wilmington, Delaware
Report Number: 12-04328-211
Issue Date: 6/11/2013
City/State: Wilmington, DE
VA Office: Veterans Benefits Administration (VBA)
Report Author: Office of Audits and Evaluations
Report Type: Benefits Inspection
Release Type: Unrestricted
Summary: We evaluated the Wilmington VARO to see how well it accomplishes this mission. We found the VARO staff did not accurately process 17 (50 percent) of 34 disability claims we reviewed. We sampled claims for certain types of medical disabilities that we considered to be at higher risk of processing errors, so these results do not represent the overall accuracy of disability claims processing at this VARO. Claims processing that lacks compliance with VBA procedures can result in the risk of paying inaccurate and unnecessary financial benefits.

Specific to the claims we reviewed, 17 of 30 temporary 100 percent disability evaluations were inaccurate. Generally, these errors occurred because VARO staff did not input suspense diaries, or take timely actions to schedule medical reexaminations, or reduce benefits as appropriate. All four traumatic brain injury claims that VARO staff completed from April through June 2012 were correctly processed. Further, Management ensured Systematic Analyses of Operations were complete and timely. However, staff did not always annotate Gulf War veterans’ entitlement to mental health care on decision documents. Staff also did not provide adequate outreach to homeless veterans in their area of jurisdiction.

We recommended the VARO Director develop and implement a plan to ensure staff input suspense diaries, schedule medical reexaminations, and follow up to reduce benefits for temporary 100 percent disability evaluations when appropriate. The Director should also ensure staff review the temporary 100 percent disability evaluations to determine if reexaminations are required for those claims not reviewed as part of the OIG statistical sample. Management should also implement a plan to provide adequate outreach to homeless shelters and service providers. The VARO Director concurred with our recommendations.