Review of Alleged Manipulation of Quality Review Results at VA Regional Office San Diego, CA

In February 2015, the Office of Inspector General received allegations that data integrity and mismanagement issues were occurring at the San Diego VA Regional Office (VARO). The complainant alleged VARO staff altered individual quality review results and hid claims from the quality review process by completing them during overtime hours. To support the allegations, the complainant provided 23 individual quality reviews completed by Quality Review Team (QRT) staff that VARO management had inappropriately overturned. We assessed the merits of the allegations and did not substantiate that VARO management inappropriately overturned, altered, or interfered with established procedures for reconsideration of individual quality review errors. We also did not substantiate the allegation that staff at the San Diego VARO worked some cases during overtime hours to avoid having the cases undergo individual quality reviews by QRT staff. During the course of our review, we observed that VARO management did not provide adequate oversight to ensure staff followed its local policy to correct individual quality review errors within 5 days. Of the 50 errors sampled, 39 required corrective actions, such as revised decision documents, while the 11 remaining errors related to actions, such as improper development for evidence, and did not require revised decision documents. We also confirmed that VBA did not have a timeliness standard for staff to correct individual quality review errors at its 56 VAROs. Delays in correcting the individual quality review errors at the San Diego VARO resulted in improper benefits payments to some veterans. We recommended the San Diego VARO Director implement a plan to ensure staff comply with local policy to correct individual quality review errors, as well as take action to correct the backlog of individual quality review errors pending correction. Furthermore, we recommended the Under Secretary for Benefits establish a timeliness standard for VBA staff to correct individual quality review errors. The Under Secretary for Benefits and VARO Director concurred with our findings and the corrective actions were responsive to the recommendations.