VA audit finds flaws in North Carolina disability office

02/14/2013 5:10 PM

08/05/2014 11:38 PM

The Department of Veterans Affairs’ regional office in Winston-Salem, N.C., processed a key category of disability claims improperly half the time, often because its workers didn’t properly schedule medical exams or otherwise follow up with veterans, according to a recent inspection.

The report from the VA’s inspector general, dated in September, is part of an ongoing, routine review of the VA’s 56 regional offices nationwide that process disability claims. The Winston-Salem office covers veterans who live in North Carolina. It had the full-time equivalent of 659 workers, the inspection report said.

The inspection focused on three key types of disability claims, and the findings are limited to those – not all activities or all kinds of claims. The inspector general’s review, which took place last May, looked at claims for veterans receiving temporary 100 percent disability benefits, veterans with traumatic brain injury and veterans exposed to herbicides such as Agent Orange. All three are important – and sometimes complex – conditions for the VA’s reviewers.

The inspector general said the regional office had incorrectly processed 20 of 90 cases it reviewed, resulting in $114,893 in overpayments to veterans and $35,612 in underpayments.

Among the temporary disability cases, 15 of 30 were incorrectly processed.The VA has struggled for years to speed up its slow, error-prone disability-claims process. The department is involved in a widespread transformation of its operations that it hopes will correct those problems by 2015.

At the time of the inspection, the Winston-Salem office’s overall error rate was 19 percent, among the lowest-performing of the VA’s regional offices and well below the VA’s long-term goal of 2 percent. The average processing time for a claim was 296 days, also among the VA’s lowest-performing offices.

The VA’s long-term goal is to ensure that no claim takes longer than 125 days to process.

The inspection report detailed the many small ways that claims get bogged down in the VA’s system:

– On Dec. 22, 2011, the Winston-Salem office received a request from a veteran to remove his deceased spouse from his compensation award. The mail was improperly handled, however, meaning that overpayments continued each month, since the spouse remained on the claim. At the time of the inspection, the VA had delayed taking action for five months.

– On Oct. 27, 2011, the office received medical evidence from a veteran to support his pending claim. But the VA improperly categorized the claim and didn’t put it in the proper folder. The VA then went ahead and decided the veteran’s claim on March 30, 2012, without considering the evidence the veteran had submitted.

– On Aug. 24, 2011, the VA received information on a veteran but put it in the wrong veteran’s folder. At the time of the inspection, the VA had inappropriately delayed the veteran’s claim by 260 days.

The VA, in its response to the inspector general’s report, said it was correcting the specific case errors cited and was modifying the procedures to minimize such errors.

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