Federal Reports

In 2018, the VA Office of Inspector General (OIG) reported that nearly half of disability benefit claims that were denied service connection for posttraumatic stress disorder (PTSD) and were related to military sexual trauma were not processed properly. In contrast, this review focuses on PTSD claims that were unrelated to military sexual trauma. Most PTSD claims fall into this category. To decide that a veteran is eligible for disability benefits, claim processors for the Veterans Benefits Administration (VBA) must establish a connection between the disability and the veteran’s military service. The review team found that claims processors inaccurately processed about 18,300 of 118,000 PTSD claims completed in fiscal year 2019 (16 percent). Most errors occurred because claims processors did not verify or ask veterans to provide the disorder’s cause, known as an in-service stressor. In other cases, claims processors did not request a medical examination, medical opinion, or clarification of inconsistencies in the examination as required.Claims processors made these errors because they did not fully understand PTSD stressor types and the stressor verification process. VBA’s Compensation Service did not mandate any national training for claims processors on these subjects except during the first year in the position. In addition, VBA’s procedures manual was not effectively organized to allow staff to locate this information and lacked specific guidance for some aspects of PTSD claim processing.The OIG recommended that the under secretary for benefits determine the actions needed to ensure staff understand the requirements for gathering evidence and verifying stressor requirements for PTSD claims and, once the actions are implemented, monitor the results to ensure effectiveness. VBA should also assess whether its adjudication procedures manual needs to be reorganized and amended to help staff process PTSD claims accurately.

The Postal Service uses the Time and Attendance Collection System (TACS) to capture the number of workhours employees spend working in various Postal Service operations. Employees record the times and types of operation they work by swiping their employee identification card on a badge reader at the facility. Each swipe updates their timecard record in TACS and is referred to as a clock ring. Our objective was to assess whether timecard adjustments were made in accordance with Postal Service policy and to assess enhancements to the timecard system.

To determine whether the Social Security Administration (SSA) was incorrectly issuing Old-Age, Survivors and Disability Insurance (OASDI benefits to individuals who were recorded as deceased on the Agency’s Supplemental Security Record (SSR).

Prior OIG audits found that New York did not effectively monitor its Medicaid personal care services program and, as a result, made more than $375 million in Federal Medicaid payments for services that did not comply with Federal and State requirements. This audit was conducted to determine whether New York made improvements to its monitoring of the program and whether any of those improvements were effective.Our objective was to determine whether New York claimed Medicaid reimbursement for personal care services that complied with Federal and State requirements.