Report Summary

Title: Required Medical Reexaminations Canceled
Report Number: 22-01503-231 Download
Report
Issue Date: 9/20/2022
City/State:
VA Office: Veterans Benefits Administration (VBA)
Report Author: Office of Audits and Evaluations
Report Type: Management Advisory Memo
Release Type: Unrestricted
Summary:

The Veterans Benefits Administration (VBA) provides disability compensation benefits to eligible veterans and may require medical examinations to determine the severity of their conditions. Some conditions may change or improve over time, which may require veterans to be reexamined. In a July 2018 report, the VA Office of Inspector General (OIG) found claims processors did not consistently follow VBA policy that requires reexaminations of veterans be requested only when necessary. VBA has taken steps to reduce the number of unwarranted reexaminations with the creation of “batch jobs” intended to automatically cancel reexaminations meeting certain parameters. However, the OIG found that VBA carried out two batch cancellation jobs that mistakenly included reexaminations that should not have been canceled because they were required by law. This resulted in required future reexaminations being canceled, potentially causing veterans to receive monthly compensation benefits that are not consistent with their current levels of disability—higher or lower. After the OIG raised concerns, VBA suspended a scheduled batch cancellation job and reestablished workload controls to determine if reexaminations were necessary.

The OIG recognizes VBA’s efforts to be responsive to prior OIG recommendations and to use automation, when possible, to minimize unnecessary medical reexamination requests. Since VBA took responsive action, the OIG did not further review the batch cancellation jobs. The OIG provided this memorandum to formally convey the information necessary for VBA leaders to further research the matter, assess the magnitude of the issue, and determine if additional actions are warranted. The OIG requested that VBA inform the OIG what action is taken to address the issues identified in this memorandum regarding batch cancellations involving medical reexaminations and appreciates VA’s response as to planned improvements.