In October 2016, OIG evaluated the New Orleans VARO to see how VSC staff processed disability claims, timely and accurately processed proposed rating reductions, input claim information, and responded to special controlled correspondence. Staff did not consistently process one of the two types of disability claims we reviewed. OIG reviewed 30 veterans’ TBI claims and found staff accurately processed all 30 claims. OIG reviewed 30 SMC benefits claims and found VSC staff incorrectly processed four claims because second signature reviews were ineffective. The four claims with errors had the required secondary reviews; however, the reviewers did not identify the errors. Overall, VSC staff accurately processed 56 of the 60 disability claims OIG reviewed—the four errors resulted in 25 improper payments to four veterans totaling approximately $25,500. OIG reviewed 30 rating reductions cases and found VSC staff delayed or incorrectly processed six of the cases. Delays occurred because VSC managers prioritized other workload. Delays and inaccuracies resulted in eight improper payments, representing approximately $2,800 in overpayments. OIG reviewed 30 newly established claims and found VSC staff entered inaccurate or incomplete information into the electronic systems in 21 of 30 claims because VSC staff did not complete all required training related to establishing claims, and the quality review process for this function was ineffective. OIG reviewed 30 special controlled correspondences, finding inaccuracies in 21 cases because management was unaware that staff did not follow VBA policy when processing the correspondence. Specifically, staff did not send interim responses when required or ensure consent to release records to third parties were of record prior to releasing records. Staff also used incorrect dates to establish workload controls and did not associate the correspondence with the electronic record as required. In addition, errors occurred because training for staff on processing controlled correspondence did not exist. OIG recommended the New Orleans VARO Director assess the effectiveness of secondary reviews for SMC claims; train VSC staff responsible for establishing claims to do so using accurate and complete information; and strengthen the quality review over the course of this process. The VARO Director should ensure staff comply with VBA policy when processing special controlled correspondence and ensure they are trained in processing this workload. Additionally, OIG recommended the Continental District Director ensure the timely processing of the rating reduction workload. The VARO Director and Continental District Director concurred with our recommendations; planned corrective actions are responsive.
New Orleans, LA
United States
