Breadcrumb

Inspection of the VA Regional Office Atlanta, Georgia

Report Information

Issue Date
Report Number
16-05468-282
VISN
State
Georgia
District
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Recommendations
8
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
In December 2016, we evaluated the Atlanta, Georgia, VARO to determine how well 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. VSC staff did not consistently process one of the two types of disability claims we examined. We reviewed 30 of 1,590 veterans’ traumatic brain injury claims and found RVSRs accurately processed 27 cases. However, RVSRs did not always process entitlement to SMC and ancillary benefits consistent with VBA policy. We reviewed 30 of 67 special SMC claims and found RVSRs inaccurately processed four cases due to lack of experience evaluating these cases and ineffective oversight for higher-level SMC cases—resulting in 61 improper monthly payments of approximately $27,600. Staff generally processed proposed rating reductions accurately but needed better oversight to ensure timely actions. We reviewed 30 of 733 benefits reduction cases and found staff delayed or inaccurately processed 12 cases. As in our 2014 inspection, staff did not prioritize rating reduction cases. These delays and processing inaccuracies resulted in 101 improper monthly payments to 12 veterans of approximately $41,000. Staff needed to improve the accuracy of claims-related information input into the electronic systems at the time of claims establishment. We reviewed 30 of 3,287 claims. Staff did not correctly input claim information in 12 cases due to incomplete training—which did not provide specific details on associating disabilities with medical classifications—and an insufficient quality review process. Staff needed to improve controls and timeliness for processing special controlled correspondence. We reviewed 30 of 1,170 cases and found staff did not accurately process all 30 due to management’s deviation from VBA policy, as well as lack of adequate oversight. We recommended the VARO Director ensure SMC cases are distributed to the most qualified personnel, monitor the effectiveness of SMC training, ensure accurate signed second-level reviews, provide oversight and prioritization of proposed rating reduction cases, implement a plan to ensure claims assistants receive systems compliance training relevant to claims establishment, and modify the quality review checklist for claims assistants. The Director should ensure that staff properly maintain control of workload and provide timely responses for special controlled correspondence. Management’s planned actions for Recommendations 1-5, 7, and 8 are responsive; however, the Director’s response did not fully address Recommendation 6. We will follow up and continue to assess compliance with VBA policy.

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 Atlanta VA Regional Office Director implement aplan to ensure higher-level Special Monthly Compensation and AncillaryBenefits cases are appropriately distributed to the most qualifiedpersonnel.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Atlanta VA Regional Office Director implement aplan to monitor the effectiveness of training on higher-level SpecialMonthly Compensation and Ancillary Benefits.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Atlanta VA Regional Office Director implement aplan to ensure higher-level Special Monthly Compensation and AncillaryBenefits cases receive an accurate, signed second-level review.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Southeast District Director implement a plan toensure the Atlanta VA Regional Office Director provides oversight andprioritization of proposed rating reductions claims for completion at theend of the due process period.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended that the Atlanta VA Regional Office Director ensureclaims assistants receive all systems compliance related training relevantto claims establishment.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended that the Atlanta VA Regional Office Directorimplement a plan to modify the quality review checklist on claimsestablishment to include claim label and claimed issue classification indicators for all claims.
No. 7
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Atlanta VA Regional Office Director implement aplan to ensure claims processing staff properly establish and maintainend product 500s for control of special controlled correspondence.
No. 8
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
We recommended the Atlanta VA Regional Office Director implement aplan to ensure staff adhere to Veterans Benefits Administration policyand acknowledge special controlled correspondence with a timely interimor full response.