In December 2016, we evaluated the Atlanta, Georgia, VARO to determine how well staff processed disability claims, how timely and accurately they processed proposed rating reductions, how accurately they entered claims-related information, and how well they responded to special controlled correspondence.VSC staff did not consistently process one of the two types of disability claims we examined. We reviewed 30 of 1,590 veterans’ traumatic brain injury claims and found RVSRs accurately processed 27 cases. However, RVSRs did not always process entitlement to SMC and ancillary benefits consistent with VBA policy. We reviewed 30 of 67 special SMC claims and found RVSRs inaccurately processed four cases due to lack of experience evaluating these cases and ineffective oversight for higher-level SMC cases—resulting in 61 improper monthly payments of approximately $27,600. Staff generally processed proposed rating reductions accurately but needed better oversight to ensure timely actions. We reviewed 30 of 733 benefits reduction cases and found staff delayed or inaccurately processed 12 cases. As in our 2014 inspection, staff did not prioritize rating reduction cases. These delays and processing inaccuracies resulted in 101 improper monthly payments to 12 veterans of approximately $41,000.Staff needed to improve the accuracy of claims-related information input into the electronic systems at the time of claims establishment. We reviewed 30 of 3,287 claims. Staff did not correctly input claim information in 12 cases due to incomplete training—which did not provide specific details on associating disabilities with medical classifications—and an insufficient quality review process. Staff needed to improve controls and timeliness for processing special controlled correspondence. We reviewed 30 of 1,170 cases and found staff did not accurately process all 30 due to management’s deviation from VBA policy, as well as lack of adequate oversight. We recommended the VARO Director ensure SMC cases are distributed to the most qualified personnel, monitor the effectiveness of SMC training, ensure accurate signed second-level reviews, provide oversight and prioritization of proposed rating reduction cases, implement a plan to ensure claims assistants receive systems compliance training relevant to claims establishment, and modify the quality review checklist for claims assistants. The Director should ensure that staff properly maintain control of workload and provide timely responses for special controlled correspondence. Management’s planned actions for Recommendations 1-5, 7, and 8 are responsive; however, the Director’s response did not fully address Recommendation 6. We will follow up and continue to assess compliance with VBA policy.
Atlanta, GA
United States
