Federal Reports

For veterans seeking disability compensation benefits, the Veterans Benefits Administration (VBA) requires a disability exam to determine the severity of a disability or a medical opinion on whether a current condition can be connected to military service. VBA has committed an estimated total of $6.8 billion in contracts to complete disability examinations and medical opinions over a five-year period starting in 2016. Because medical opinion requests can be vital to ensuring veterans receive the benefits to which they are entitled, the VA Office of Inspector General (OIG) examined whether VBA staff correctly followed procedures when requesting medical opinions.The review team found that VBA can reduce inadequate medical opinions, incorrect or delayed claims decisions, and wasted resources by improving internal controls, personnel training, and monitoring of medical opinion requests. The team estimated that 27,900 of 41,100 requests (68 percent) did not follow required procedures during the review period (October 1, 2020–September 30, 2021). Claims processors did not consistently identify relevant medical evidence for the examiner’s review, did not always use clear and accurate language, did not regularly request all warranted medical opinions, and sometimes requested unnecessary medical opinions. These failings can lead to inaccurate medical opinions, incorrect decisions on veterans’ claims, delayed decisions for veterans, and inefficient use of resources (such as when the medical opinion requires rework).VBA concurred with OIG-identified deficiencies and recommendations to (1) implement electronic system enhancements to require claims processors to identify relevant evidence before a medical opinion request can be submitted, (2) enhance mandated training for all claims processors and demonstrate progress in achieving its intended impact, and (3) strengthen monitoring by refining quality review processes to help identify areas for improvement and show advancements in complying with required procedures.

What We Looked AtThe Federal Information Security Modernization Act of 2014 (FISMA) requires agencies to implement information security programs. FISMA also requires agencies to have annual independent evaluations performed to determine the effectiveness of their programs and report the results of these reviews to the Office of Management and Budget (OMB). To meet this requirement, the Surface Transportation Board (STB) requested that we perform its fiscal year 2022 FISMA review. We contracted with Williams Adley & Company-DC LLP (Williams Adley), an independent public accounting firm, to conduct this audit subject to our oversight. The audit objective was to determine the effectiveness of STB’s information security program and practices in five function areas—Identify, Protect, Detect, Respond, and Recover. What We FoundWe performed a quality control review (QCR) of Williams Adley’s report and related documentation. Our QCR disclosed no instances in which Williams Adley did not comply, in all material respects, with generally accepted Government auditing standards. RecommendationsWhile there are no new recommendations issued for fiscal year 2022, STB concurs with the audit’s findings with respect to the remaining eight open recommendations from the fiscal year 2021 FISMA audit.

The CSB's operations are challenged by vacancies in mission-critical positions and an inability to fully use the resources allocated by Congress.

During a prior review, the VA Office of Inspector General (OIG) discovered three scenarios in which the VA improperly collected debts from veterans without first providing them with legally required notice and due process and notified VA. This management advisory memorandum gives VA the information it needs to determine whether to take further action to address similarly situated veterans.VA provides veterans tax-free monthly compensation in recognition of disabilities incurred or aggravated during active military service. These payments may change over time for various reasons, such as improved or worsening conditions or a change in dependents. If a decision retroactively reduces a veteran’s payment rate, a veteran incurs a debt that may be repaid through reductions in the retroactive benefits or reductions in future monthly benefits. Regulations require that VA notify affected veterans of the amount and reasons for the debt. VA must also inform veterans they have the right to dispute the debt, request a waiver of collection, request a hearing on the waiver request, and appeal the decision that caused the debt.In three example cases in which VBA improperly collected debts without notifying veterans of the debt amount or of their right to dispute it or request a waiver, VA agreed the debts were collected improperly due to automated actions in VA’s electronic systems that triggered debt collection.VA agreed to review these systems to help prevent improper debt collection from veterans in comparable circumstances and ensure they receive required notice and due process. The OIG asked VA to report on what actions it takes as a result of these findings. VBA’s comments provided in the memorandum appendix propose corrective electronic system updates.