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Inspection of VA Regional Office Albuquerque, New Mexico

Report Information

Issue Date
Report Number
13-00993-274
VISN
State
New Mexico
District
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Recommendations
3
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
We evaluated the Albuquerque VARO to see how well it accomplishes its mission. We found the VARO staff did not accurately process 23 (40 percent) of 58 disability claims reviewed. We sampled claims we considered at higher risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Specifically, 13 of 30 temporary 100 percent disability evaluations we reviewed were inaccurate. These errors generally occurred because VARO staff did not establish controls to request future medical reexaminations. Further, VARO staff incorrectly processed 10 of 28 traumatic brain injury claims. These errors occurred primarily because staff misinterpreted VBA policy for rating a traumatic brain injury with a coexisting mental condition and used insufficient VA medical examination reports to evaluate traumatic brain injury claims. Three of the 11 Systematic Analysis of Operations were either untimely or not completed due to a lack of management oversight. VARO staff did not always properly grant Gulf War veterans entitlement to mental health treatment, but provided adequate outreach to homeless veterans. Due to a lack of performance measures, we could not fully assess the effectiveness of the VARO’s homeless veterans outreach efforts. We recommended the VARO Director develop and implement a plan to review all temporary 100 percent disability evaluations remaining from our inspection universe of related claims and take appropriate action. The Director should provide refresher training on processing traumatic brain injury claims and monitor its effectiveness. The Director should also develop and implement a plan to ensure staff return insufficient medical reports to examiners to obtain the evidence needed to support traumatic brain injury claims. The Director concurred with our recommendations, although VARO staff did not agree with 5 of the 23 claims processing errors identified.

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 recommend the Albuquerque VA Regional Office Director conduct a review of the 190 temporary 100 percent disability evaluations remaining from our inspection universe and take appropriate action.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Albuquerque VA Regional Office Director conduct refresher training on processing traumatic brain injury claims and implement a plan to monitor the effectiveness of this training.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommend the Albuquerque VA Regional Office Director develop and implement a plan to ensure staff return insufficient medical examination reports to obtain the evidence required to support traumatic brain injury evaluations.