A special initiative by the Veterans Benefits Administration to process all claims over two years old by issuing provisional ratings and closing them within 60 days was less effective that its existing ratings process in terms of providing benefits to veterans quickly, the VA inspector general has said.
Further, it said the VBA removed all provisional claims from its pending inventory, despite more work being needed to complete them, thereby misrepresenting the agency’s actual workload of pending claims and its progress toward eliminating the overall claims backlog.
The findings were presented to the House Veterans Affairs Committee and drew criticism from lawmakers, including the ranking member on the Senate Veterans Affairs Committee, Richard Burr, R-N.C., who called the findings “particularly damning,” in that they call into question the department’s statistics on reducing the disability claims backlog.
According to the IG, 7,823 provisionally rated claims were removed from the inventory even though they still awaited final decisions, VAROs failed to prioritize finalization once the provisional ratings were issued, and because VBA did not ensure existing controls were functioning as needed to effectively identify and manage provisionally rated claims, some veterans may never have received final rating decisions if it weren’t for the audit.
It also said the agency did not accurately process 77 out of a sample of 240 rating decisions under the initiative because of pressure to complete them within 60 days.
VARO staff inaccurately processed 17,600 of 56,500 claims, resulting in $40.4 million in improper payments during the Initiative period, the IG concluded.
The undersecretary for benefits agreed with recommendations to establish controls for all provisionally-rated claims, reflect those in the agency’s pending workload statistics, expedite finalization of provisional ratings, and review for accuracy all claims that received provisional ratings under the special initiative.
