Friday, July 22, 2011

West Virginia-RO, 38% Error Rate in Claim Processing, VAOIG Report #11-00522-231

"Overall, the staff did not accurately process 36 of the 95 disability claims reviewed."

Inspection of the VA Regional Office Huntington, West Virginia


Summary
Report Number 11-00522-231, 7/20/2011

We found Huntington VARO management ensured staff followed VBA’s policy for establishing dates of claim, processing incoming mail, and completing Systematic Analyses of Operations. The average time to complete claims was 146 days, 29 days better than the national target of 175 days. The VARO was generally effective in processing post traumatic stress disorder claims, handling mail, and correcting errors identified through the Systematic Technical Accuracy Reviews. However, management lacked effective controls and accuracy in processing temporary 100 percent disability evaluations, traumatic brain injury claims, and herbicide exposure-related claims. Overall, the staff did not accurately process 36 of the 95 disability claims reviewed. The recent implementation of the Quality Review and Training Team is a step toward addressing these deficiencies. Although they were not timely in recording Notices of Disagreement for appealed claims, it was better than the national average regarding appeals processing timeliness. Further, processing of competency determinations was not fully effective, resulting in unnecessary delays in making final decisions and improper benefits payments. We recommended management monitor the effectiveness of its quality review process and provide refresher training on traumatic brain injury and herbicide exposure-related claims processing. VARO management also needs to ensure accurate processing of final competency determinations.