The VA still fails to make the best use of its disability benefit questionnaires, resulting in higher potential for fraud in claims and incurring unneeded costs for medical exams, according to an IG report.
The report was a follow-up to 2012 recommendations to strengthen controls over those so-called DBQs and to use them more effectively. The department’s Veterans Benefits Administration has not fully complied with those recommendations, it said, estimating that during the six months ending in March 2014, claims processors did not identify approximately 23,100 of about 24,700 claims (93 percent) including DBQs.
“Specifically, we found they did not consistently and correctly record special issue indicators in VBAs electronic systems to identify claims that included DBQs. VBA controls also did not electronically capture DBQ information, adequately ensure DBQs provide notification that information is subject to verification, confirm claims processors consistently and correctly identify claims including DBQs, or ensure DBQ clinician information was complete,” it said.
“VBA also lacked adequate policies and procedures and quality assurance reviews. As a result, VBA lacked reasonable assurance of detecting potential fraud when processing claims including DBQs. Further, unnecessary medical examinations caused veterans and VA to needlessly expend time and money and may have delayed veterans receiving benefits,” it said.
It recommended that the VA develop controls to electronically capture DBQ information, revise DBQ forms, establish and revise policies and procedures, and revise quality assurance reviews.