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Inspection of the VA Regional Office Indianapolis, Indiana

Report Information

Issue Date
Report Number
16-04918-263
VISN
State
Indiana
District
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Recommendations
7
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
In October 2016, we evaluated the Department of Veterans Affairs Regional Office (VARO) in Indianapolis, Indiana, to determine how well Veterans Service Center (VSC) staff processed disability claims, how timely and accurately they processed proposed rating reductions, how accurately they entered claims-related information, and how well they responded to special controlled correspondence. Indianapolis VSC staff did not consistently process one of the two types of disability claims we reviewed. We reviewed 30 traumatic brain injury claims and found that Rating Veterans Service Representatives (RVSRs) accurately processed 29 of the claims. However, RVSRs did not always process entitlement to special monthly compensation (SMC) and ancillary benefits consistent with policy. Three of the 30 SMC claims reviewed were in error because RVSRs misinterpreted policy for evaluating a neurological disease. This resulted in 33 improper monthly payments totaling approximately $66,500. VSC staff generally processed proposed rating reductions accurately but staff needed better oversight to ensure timely actions. We reviewed 30 benefits reductions and determined VSC staff delayed or incorrectly processed 12 cases, resulting in 99 improper monthly payments totaling approximately $156,000. The delays occurred because management prioritized other workload higher to meet performance goals. We also reviewed 30 newly established claims and found VSC staff did not correctly input information in 16 claims due to insufficient quality review processes and ineffective training. Lastly, VSC staff timely processed and responded to special controlled correspondence; however, improved controls are needed. Our review of 30 special controlled correspondences found that VSC staff did not establish the proper end product controls to monitor this workload in all 30 cases. They also did not upload follow-up correspondence in 13 of the cases. The errors occurred because management did not perform thorough quality reviews, nor did they ensure that the congressional liaison received training. We recommended the VARO Director provide training for SMC and medical classifications; monitor the effectiveness of this training; implement plans to ensure oversight of proposed rating reduction cases; and modify the quality review process for claims establishment. In addition, the VARO Director needs to ensure special controlled correspondence is managed and the VARO congressional liaison receives training. The Director should also assess the effectiveness of the special controlled correspondence checklist. The VARO Director concurred with our recommendations and management’s planned actions for were generally responsive. However, the Director’s planned actions did not fully address one of the recommendations. OIG will follow up as required.

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 Indianapolis VA Regional Office Director ensure and implement local training that complies with Veterans Benefits Administration policy and implement plans to ensure the effectiveness of that training for evaluation of higher-level Special Monthly Compensation claim and ancillary benefits.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Midwest District Director implement a plan to ensure the Indianapolis VA Regional Office Director provides oversight and prioritization of proposed rating reduction cases for completion at the end of the due process time period.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended that the Indianapolis VA Regional Office Director provide training to Claims Assistant on how to assign the correct medical classification to claimed disabilities and monitor the effectiveness of that training.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended that the Indianapolis VA Regional Office Director implement a plan to modify the quality review checklist on claims establishment to include “claimed issue with classification” and “special issue” indicators for all claims.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Indianapolis VA Regional Office Director implement a plan to comply with Veteran Benefits Administration policy for managing and processing special controlled correspondence.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Indianapolis VA Regional Office Director provide training to the Congressional Liaison responsible for processing special controlled correspondence.
No. 7
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Indianapolis VA Regional Office Director develop and implement a plan to assess the effectiveness of the special controlled correspondence checklist.