The IG found one or more problems with 1,200 of 1,300 cases reviewed that were decided from late 2021 - early 2022. Image: Pamela Au/Shutterstock.com
By: FEDweek StaffMany benefit claims of the sort that the VA considers to be complex are reviewed by employees who are not fully qualified to handle such cases, an inspector general audit has said.
Those cases often include conditions such amyotrophic lateral sclerosis, military sexual trauma and traumatic brain injury, said the report, which was done in response to a whistleblower allegation regarding a Veterans Benefits Administration office that reviews appeals of initial decisions on such claims.
In a review of some 1,300 such cases decided over late 2021-early 2022, found that in 760 cases the rated did not have the required designation as a specialized processor, in 780 the rater had not completed all the mandatory training courses concerning the appealed issue, and 820 cases lacked a required second signature. In all, there was one or more of those problems with 1,200 of the 1,300.
“When raters do not meet requirements, inaccurate decisions can result which can lead to improper payments”—either overpayments or underpayments, it said. “This underscores the importance of ensuring raters meet requirements when deciding complex appeals.”
It said that issues included lack of monitoring of whether raters were fully qualified to handle a case, including a routing system that has to be manually updated. VA management agreed with recommendations including that it periodically ensure decisions issued for complex appeals are completed by employees who meet all requirements associated with them.
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