The VA Office of Inspector General (OIG) reviewed whether the Veterans Benefits Administration (VBA) complied with legal requirements to reinstate disability benefits questionnaire forms from non-VA medical providers. The forms are used to submit medical information needed for processing veterans’ disability claims. The OIG also examined whether VBA claims processors followed VA procedures for using the published questionnaires.Previous OIG reports found significant internal control problems with publicly available questionnaires. In February 2020, the OIG issued a report responsive to allegations that some veterans’ benefits claims using publicly available questionnaires were potentially fraudulent. The report noted that while VBA had taken some steps to mitigate this risk, there were further internal control and procedural deficiencies.This report finds that VBA complied with the requirements of the law by reinstating 69 questionnaires on its public-facing website. However, disability benefits questionnaires that were incomplete, inaccurate, or of questionable authenticity from non-VA medical providers were not always processed correctly when determining benefits entitlement—causing underpayments of about $13,900 and overpayments of $74,800 over the nine months studied.Improper processing occurred because VBA lacked sufficient controls to ensure disability benefits questionnaires from non-VA medical providers were properly relied on when determining entitlement to benefits.VBA concurred with the OIG’s five recommendations, including that VBA correct all identified processing errors and report back the results. Additionally, the VBA’s adjudication procedures manual should be revised and updated to clarify and communicate steps claims processors must take to verify all certification elements on the publicly available questionnaires; clarify the intent of guidance involving authenticity, face value, and validation of the questionnaires; and define valid rationale to ensure medical opinions are well supported. Finally, the OIG recommended VBA ensures claims processors understand the need to document the evaluation of evidence when using publicly available benefits questionnaires.
| Report Date | Agency Reviewed / Investigated | Report Title | Type | Location | |
|---|---|---|---|---|---|
| Department of Veterans Affairs | Public Disability Benefits Questionnaires Reinstated but Controls Could Be Strengthened | Review | Agency-Wide | View Report | |
| Tennessee Valley Authority | Gas and Hydro Human Performance Events | Inspection / Evaluation | Agency-Wide | View Report | |
| Department of Defense | Management Advisory: DoD Support for the Relocation of Afghan Nationals at Camp Atterbury, Indiana | Other | Agency-Wide | View Report | |
| Internal Revenue Service | Results of the 2021 Filing Season | Audit | Agency-Wide | View Report | |
| Architect of the Capitol | Architect of the Capitol (AOC) Supervisor threatened a subordinate employee and misused AOC issued Information Technology Division (ITD) resources to portray nudity. | Investigation |
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View Report | |
| Department of Agriculture | Market Facilitation Program | Audit | Agency-Wide | View Report | |
| Department of Housing and Urban Development | HUD Did Not Implement Adequate Grant Closeout and Reporting Processes To Ensure Consistent Application of GONE Act Requirements | Audit | Agency-Wide | View Report | |
| U.S. Agency for International Development | Closeout Financial Audit of the Democracy and Governance Program in Paraguay, Managed by Centro de Estudios Ambientales y Sociales, Cooperative Agreement AID-526-A-13-00003, January 01, 2021, to September 30, 2021 | Other |
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View Report | |
| U.S. Agency for International Development | Audit of the Fund Accountability Statement of Leo Baeck Education Center, Building Shared Communities Program in West Bank and Gaza, Cooperative Agreement 294-19-CA-00004, September 3, 2019 to December 31, 2020 | Other |
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View Report | |
| Department of Justice | Investigative Summary: Findings of Misconduct by a then-Immigration Judge in the Executive Office for Immigration Review for an Inappropriate Comment to a Party during a Court Proceeding | Investigation | Agency-Wide | View Report | |