The VA Office of Inspector General (OIG) conducted this review to determine whether claims processors are properly assigning effective dates when considering PACT Act–related claims. After reviewing a statistical sample of 100 PACT Act–related claims completed from August 10, 2022, through August 9, 2023, the OIG estimated that incorrect effective dates were assigned for about 31,400 of 131,000 (24 percent). In an estimated 26,100 of those claims, the assigned effective date was incorrect, resulting in at least $6.8 million in improper payments. At least 2,300 additional claims had date errors, but the review team could not determine their monetary impact, as claims processors prematurely decided them without enough evidence to definitively establish correct dates.
Although determining correct effective dates for PACT Act–related claims is inherently complicated for claims processors—requiring mastery of numerous sections of the United States Code, the Code of Federal Regulations, and VBA guidance—VBA failed to effectively prepare them. VBA did not provide detailed guidance in its PACT Act–related standard operating procedure, its two automated tools were unreliable for determining effective dates, and it did not initially provide the necessary training.
When granting benefits, claims processors must determine and apply the most advantageous effective date allowed by law for each claim or benefit awarded. The proper assignment of effective dates for disability compensation benefits is vital because an incorrect effective date can have a substantial financial effect on veterans.
The OIG recommended the under secretary for benefits create a job aid for claims processors on how to determine the correct effective date for PACT Act–related claims, remove the older tool and update the newer one, assess training effectiveness by monitoring the results to assess its effectiveness, and correct all errors on cases identified by the review team.
