Problems with workers compensation claims initiation and monitoring persist at the Veterans Health Administration, the VA inspector general has said in calling for improved case management.
Based on the most recently available data from 2012, the IG said WCP case files lacked initial or sufficient medical evidence to support connections between claimed injuries and medical diagnoses.
It said VHA inaccurately initiated about 56 (7 percent) of 793 WCP claims, that WCP claims were not consistently monitored to timely return employees to work, and that VHA WCP specialists did not make job offers or take actions to detect fraud.
Further, about 60 percent of the 793 active claims were inadequately monitored, and VHA lacks a fraud detection process, according to the IG.
It said the VHA continues to lack standard guidance and a clear chain of command to ensure compliance with WCP statutory requirements and VA policy, and that opportunities exist for VHA to reduce WCP costs by about $95.2 million with improved claims management.
The acting under secretary for healthconcurred with the findings and plans to complete corrective actions by next May.
