VAOIG Finds Error in 25% of Denver VARO Claim Decisions

Overall, VARO staff did not accurately process disability claims for 25 (21 percent) of 118 claims reviewed.

Full Article at: Report Summary, Inspection of the VA Regional Office Denver, CO

Report Number 10-01530-196, 7/19/2010 | Full Report (PDF)

The Benefits Inspection Division conducts onsite inspections at VA Regional Offices (VAROs) to review disability compensation claims processing and Veterans Service Center (VSC) operations.

The Denver VARO correctly processed post-traumatic stress disorder (PTSD) claims. Staff generally followed the Veterans Benefits Administration’s (VBA) policy for processing traumatic brain injury (TBI) and disabilities related to herbicide exposure claims. Management ensured staff followed VBA policy to establish correct dates of claims in the electronic record and accurately complete all Systematic Analysis of Operations (SAOs). Further, in accordance with policy, staff corrected errors identified by VBA’s Systematic Technical Accuracy Review (STAR) program. VARO management needs to improve the control and accuracy of disability claims processing for temporary 100 percent disability evaluations. Overall, VARO staff did not accurately process disability claims for 25 (21 percent) of 118 claims reviewed Management also needs to strengthen controls over the recording of Notices of Disagreement (NODs) for appealed claims in the Veterans Appeals Control and Locator System (VACOLS) and the handling of claims mail.

We observed an unusually large amount of mail in the Triage Team. A portion of this mail resulted from the Denver VA Medical Center (VAMC) not timely returning claims folders to the VARO after staff completed medical examinations. VARO management informed us that despite their efforts to resolve this condition, excessive delays continue and have affected claims processing timeliness.

We recommended VARO management ensure staff correctly establish future medical examination dates for temporary 100 percent evaluations. We recommended management implement a training plan to ensure timely establishment of NODs in the electronic system. In addition, we issued a Management Advisory to recommend the Director of the Eastern Colorado Health Care System develop procedures to ensure the prompt return of veterans’ claims folders to the Denver VARO upon completion of medical examinations. The Director of the Denver VARO concurred with all recommendations. Management’s planned actions are responsive and we will follow-up as required on all actions."