100% Disability Evaluations Under Fire, VAOIG No. 09-03359-71

VAOIG: We found the staff at the VA Regional Offices (VARO) are not correctly evaluating and monitoring 100 percent disability evaluations.


Audit of VBA's 100 Percent Disability Evaluations

Report Number 09-03359-71, 1/24/2011 | Full Report (PDF)

The OIG conducted an audit to determine whether Veterans Benefits Administration (VBA) correctly assigned 100 percent disability evaluations as either permanent or temporary and effectively monitored and adjusted temporary 100 percent disability evaluations. We found the staff at the VA Regional Offices (VARO) are not correctly evaluating and monitoring 100 percent disability evaluations. We identified approximately 239,000 veterans who had at least one service-connected condition rated 100 percent disabling as of September 2009. We eliminated from our review approximately 58,000 veterans with conditions that indicated no likelihood of improvement, such as double amputees. We projected that of the remaining 181,000 veterans, VARO staff did not correctly process evaluations for about 27,500 (15 percent). We further projected that since January 1993, VBA paid veterans a net amount of about $943 million without adequate medical evidence. If VBA does not take timely corrective action, it will overpay veterans a projected $1.1 billion over the next 5 years. We recommended the Acting Under Secretary for Benefits increase oversight by ensuring future exam dates are included in the electronic records and providing VARO staff the necessary training. VBA also needs to ensure claims folders with temporary evaluations are kept at the VARO and each temporary evaluation has a future exam date entered in the electronic record. The Acting Under Secretary for Benefits did not agree with the findings, particularly as they relate to the projected overpayment amounts, but agreed to implement the recommendations and provided responsive implementation plans. We maintain that the primary message in our report is VBA paid veterans without adequate medical evidence. We believe our projection is a reasonable and conservative estimate of overpayments based upon our review of compensation records available.