Half of Calif. Disability Claims Decided Wrong

Recent audits show California regional offices are not processing disability claims correctly 50 percent of the time.

On average, California regional offices made errors in 50 percent of the claims files evaluated. If California does that poor of a job with all the disability claims, disabled veterans in California are at a significant disadvantage.

A series of audits by the Department of Veterans Affairs evaluated Oakland regional office, San Diego regional office, and Los Angeles regional office.

On average, California regional offices made errors in 43 percent of the claims files evaluated. If California does that poor of a job with all the disability claims, disabled veterans in California are at a significant disadvantage.

Disabled veterans are better off having their claims evaluated almost anywhere else. For veterans reading this, be sure to look over your claim to ensure it was evaluated properly.

Below are excerpts from the Veterans Affairs Office Inspector General (OIG).

Veterans Affairs OIG inspection of Oakland regional office

Key summary:

• 39 percent of disability claims not processed accurately
• Staff inaccurately interpreted policy with traumatic braining injury claims
• Gulf war veterans’ claims were incorrectly processed

Here is what the Department of Veterans Affairs actually wrote:

“VARO performance was generally effective in processing herbicide exposure-related disability claims. However, it lacked accuracy in processing some disability claims. VARO staff did not accurately process 35 (39 percent) of 90 disability claims we sampled. These results do not represent the overall accuracy of disability claims processing at this VARO. The VARO lacked effective controls and accuracy in processing some disability claims. Inaccuracies in processing temporary 100 percent disability evaluations resulted when staff did not schedule or establish controls for future medical reexaminations. Staff incorrectly interpreted policy and used inadequate medical examinations to process traumatic brain injury claims. VARO management did not ensure staff timely completed all elements of Systematic Analyses of Operations, properly processed mail, accurately addressed Gulf War veterans’ entitlement to mental health treatment, and properly reviewed claims pending for more than a year.”

Veterans Affairs OIG inspection of Los Angeles regional office

Key summary:

• 60 percent of disability claims not processed accurately
• Insufficient medical examinations for traumatic brain injuries
• Staff inaccurately interpreted policy with Agent Orange type claims
• Mail was not processed properly
• Gulf war veterans’ claims were incorrectly processed
• Claims were closed early
• Claims, when delayed, were delayed longer than normal

Here is what the Department of Veterans Affairs actually wrote:

“We found the Los Angeles VARO staff provided adequate outreach to homeless shelters and followed the policy for correcting errors identified by Systematic Technical Accuracy Review staff. However, it lacked accuracy in processing some disability claims. VARO staff did not accurately process 54 (60 percent) of 90 disability claims we sampled as part of our inspection. These results do not represent the overall accuracy of disability claims processing at this VARO. The VARO lacked effective controls and accuracy in processing some disability claims. Staff used insufficient medical examination reports to process traumatic brain injury claims. Further, errors in herbicide exposure-related disability claims occurred because staff incorrectly interpreted policy. VARO management did not ensure staff properly processed mail, or accurately addressed Gulf War veterans’ entitlement to mental health treatment. Further, inadequate monitoring of corrective actions on prematurely closed claims and lack of management controls over the processing of oldest pending claims resulted in significant delays.”

Veterans Affairs OIG inspection of San Diego regional office

Key summary:

• 53 percent of disability claims not processed accurately
• Known errors were not corrected by VA staff
• Mail was not processed properly
• Gulf war veterans’ claims were incorrectly processed
• Claims, when delayed, were delayed longer than normal

Here is what the Department of Veterans Affairs actually wrote:

“OIG conducted this inspection to evaluate how well the San Diego VARO accomplishes its mission. We found the San Diego VARO staff provided adequate outreach to homeless shelters and service providers. However, it lacked accuracy in processing some disability claims. VARO staff did not accurately process 42 (53 percent) of 79 disability claims we sampled as part of our inspection. These results do not represent the overall accuracy of disability claims processing at this VARO. VARO staff did not always correct errors identified by the Veterans Benefits Administration’s Systematic Technical Accuracy Review program. Further, they did not always include all mandatory analyses or complete all elements of Systematic Analyses of Operations. VARO staff did not properly process mail or accurately address Gulf War veterans’ entitlement to mental health treatment. Delays occurred in processing claims pending more than 365 days when staff did not request adequate supporting evidence or timely follow up on past due actions.”