Deficiencies in the Quality Review Team Program

Quality review team (QRT) program specialists oversee employees in the Veterans Benefits Administration (VBA) who process disability compensation claims. The VA Office of Inspector General (OIG) examined whether QRT specialists conducted accurate quality reviews; regional office managers decided employee requests for reconsideration of errors appropriately; and employees corrected claims-processing errors based on established standards. The OIG found that QRT specialists, who are supposed to identify claims-processing errors made by employees, missed errors in approximately 9,900 of the 28,400 quality reviews (35 percent) completed during the review period. Furthermore, the process in which QRT specialists review one another’s work was inadequate to identify errors missed during the initial quality review. Performance reviews of QRT specialists also did not ensure competency for identifying errors. Regional office managers did not follow VBA procedures by overturning errors identified by QRT specialists. The OIG estimated that during the review period, regional office managers inappropriately overturned errors in 430 of 870 quality reviews (about 50 percent) where claims processors requested a reconsideration of QRT specialist- identified errors. Finally, VBA has not established adequate oversight or accountability to ensure the timeliness of error corrections. The OIG estimated that during the review period 2,000 of 4,400 identified errors (45 percent) were not corrected in a timely manner and 810 of 4,400 identified errors (18 percent) were not corrected at all. The OIG recommended the under secretary for benefits (1) revise the current peer review process to make certain all errors are identified during quality reviews, (2) revise the QRT specialist performance review process to for competency in identifying errors, (3) revise the error reconsideration process to adhere to VBA procedures and promote objectivity, and (4) improve oversight of the error correction process.