Veterans may be required to pay back monies they received in part due to agency employee negligence in processing education benefits incorrectly.
VA OIG recently published a report that veterans were overpaid by a total of $4.5 million over the past two years based on overpayments from the agency. IG found the overpayments were largely the result of negligent VA employees not checking their email. Most employees were not even aware of the requirement to check email inboxes covering the benefits where the overpayments occurred.
The backstory of the benefits relates to Dependents’ Educational Assistance (DEA) program and veterans receiving 100 percent permanent and total service connection. These veterans’ dependents are eligible for educational benefits to attend college. The benefit is the second largest education program VA provides behind the well-known GI Bill.
Usually, veterans receiving payments at the 100 percent level cannot concurrently receive payments for their dependents, around $250 per month while in college, if those dependents are receiving DEA benefits.
A computer glitch did not prevent dual payments over the past two years. And, agency employees failed to check their email that could have contained notices to help stop the double payments.
Now, veterans implicated were overpaid by an average of $3,400 each. These veterans may be required to repay the amounts despite VA’s own negligence in processing the overpayment under the theory that veterans should have known they received more monetary benefits than they were entitled to receive.
It seems simple enough, but most veterans likely do not understand how that benefit works in connection with the normal monthly disability compensation payment. So, they would not have noticed the overpayment for two years and now may be required to repay the monies.
For veterans impacted, be sure to consider filing a dispute over an alleged overpayment if you believe the allegation is false. Even if the monies were improperly paid to you, you may also consider filing a waiver request given that VA is admittedly negligent.
Below is basically what happened according to the IG report, in italics.
Delays in the Processing of Survivors’ and Dependents’ Educational Assistance Program Benefits Led to Duplicate Payments
Delays in the processing of DEA-related compensation benefit adjustments led to duplicate payments. The OIG estimated that during the 2017 academic school year, 1,300 of 1,900 veterans’ (70 percent) received the additional school child allowance while their dependent received DEA Program benefits. This resulted in overpayments totaling approximately $4.5 million through February 1, 2018. If VBA staff were to continue to delay processing DEA related compensation benefits, an estimated $22.5 million in improper payments could occur over a five-year period. These overpayments will need to be repaid by those veterans.
The OIG found that VBA’s Office of Field Operations (OFO) and Compensation Service did not have a timeliness standard for processing DEA-related compensation benefit adjustments. The OIG considered 90 days to be a reasonable amount of time for VSRs to complete the DEA related compensation benefit adjustments once the VARO had received notification of a dependent’s receipt of DEA Program benefits.
The OIG found that duplicate payments occurred in three adjustment statuses—not established, pending, or completed. The OIG estimated:
- 830 veterans’ cases were considered not established when the VCEs sent an email notification of DEA benefit to the VARO; however, there was no evidence in the veteran file that the VARO processed the required benefit adjustment. The OIG further estimated that all these cases exceeded 90 days.
- 260 veterans’ cases were considered pending when VSRs identified that a duplication of benefits occurred, but the adjustment to the veteran’s compensation benefit to end the school child payments and stop the overpayments was still waiting to be assigned from National Work Queue (NWQ). The OIG further estimated that all these cases exceeded 90 days.
- 230 veterans’ cases were considered completed when VSRs identified that a duplication of benefits occurred and completed the necessary adjustment to the veteran’s compensation benefit to end the school child payments but not before an overpayment had occurred due to processing delays. An estimated 170 veterans’ cases exceeded 90 days.
Based on these results, the OIG reviewed the DEA Program mailboxes for all 58 VAROs and discovered that 25 had about 3,100 total unread DEA notification emails from VCEs, as of May 7, 2018. The remaining 33 VAROs did not have any unread DEA notification emails. These unread emails all potentially required DEA-related compensation benefit adjustments and, therefore, equate to an unidentified amount of benefit duplication and overpayments.
The OIG determined that VCEs generally processed DEA benefit payments accurately during the 2017 academic school year. VCEs correctly calculated payment amounts for an estimated 16,500 new DEA participants’ claims (97 percent). The OIG did identify five errors in calculation generating incorrect payment amounts for enrollment hours and incorrect final payment dates entered in the electronic claims processing system. Because of these errors, VCEs improperly paid participants $1,606 representing about .18 percent of total payments.
Why This Happened
The OIG determined that multiple causes contributed to delays in the processing of DEA-related compensation benefit adjustments. These causes included the lack of management over the electronic mailboxes at the VARO, and other regional and national levels; an ineffective notification process; and the lack of system functionality to flag cases with duplication of benefits. In addition, NWQ workload distribution rules caused duplication of benefits cases to be delayed even when they are ready for processing.
Some VAROs were not checking the DEA Program electronic mailboxes for a notification from the VCEs to stop the additional allowance to the veteran. The OIG determined that VBA did not have a specific requirement or timeliness standard for checking the mailboxes. The OIG interviewed veterans service center managers and VARO directors responsible for overseeing the DEA Program mailboxes and determined that each level of supervision failed to effectively monitor the mailboxes. For example, the Oakland, California, VARO Veterans Service Center Manager stated that the mailbox had not been monitored for three years because of changes in management and a lack of reassignment of duties.
A Supervisory Management Analyst with VBA’s OFO stated that national monitoring procedures did not exist for the DEA Program mailboxes. Although both OFO and Compensation Service staff conduct site visits periodically at each VARO, no protocols were created to review the DEA Program mailboxes. According to the same analyst, this was because the site visits cannot realistically include checking every aspect of what’s contained in VBA’s manual.
VBA did not have electronic system functionality in place to identify cases with potential duplication of benefits and relied on the outdated and ineffective email notification process to identify these cases. According to management and staff the OIG interviewed, a solution might be the addition of a Veterans Benefits Management System notification for DEA-related compensation benefit adjustments whenever VCEs paid DEA Program benefits to a dependent.
Workload distribution rules in the NWQ contributed to the overpayment of benefits. The NWQ is a rule-based workload distribution tool that assigns cases daily to VAROs nationwide based on staffing capacity, national claims processing priorities, and special missions. VA has established priority cases that, when ready for the next action, receive a higher priority than non-priority cases. High-priority cases include veterans who are homeless, terminally ill, seriously injured, former prisoners of war, Medal of Honor recipients, those who have amyotrophic lateral sclerosis, face financial hardship, or are over age 85. According to the NWQ Deputy Director, DEA-related compensation benefit adjustments are non-priority cases. The NWQ Deputy Director explained how the NWQ assigns non-priority cases as soon as they are ready for the next action if there is enough VARO capacity to assign them. If there is no capacity, the NWQ does not immediately assign the cases when they are ready for processing, even though these cases present a high risk of creating overpayments to veterans. The longer the DEA-related compensation benefit adjustments remain in the NWQ waiting to be assigned to a VARO for removal of the school child allowance, the greater the amount of the overpayment.
Finally, the OIG interviewed VCEs, RPO supervisors, and education officers regarding the small number of inaccurate DEA benefit payments to determine the reasons these incorrect payment calculations occurred. Reportedly, these errors occurred because VCEs rushed to complete claims in order to meet increased RPO productivity requirements. In addition, Education Service posited these errors were clerical errors made by the VCEs. The OIG determined that the number of errors in new DEA Program benefits claims were not significant to project to the entire universe of claims. Therefore, the OIG made no recommendations for improvement in this area.
The OIG recommended the Under Secretary for Benefits:
- Direct Compensation Service and Office of Field Operations to develop and implement processes and procedures that ensure monitoring of DEA Program electronic mailboxes and timely establishment of compensation adjustments.
- Direct Education Service to develop and implement an effective process to ensure receipt of DEA Program benefit notifications by VA Regional Office staff.
- Ensure Compensation Service and Education Service develop electronic system functionality to identify cases with potential duplication of benefits when a dependent begins receiving DEA Program payments.
- Ensure the National Work Queue and Compensation Service assign cases with compensation adjustments to remove the school child allowance as soon as the cases are ready for processing.
- Ensure Office of Field Operations takes prompt action to adjust benefits for cases in the OIG sample in which payment duplications had not been identified.
The Under Secretary for Benefits concurred with all the recommendations. The Under Secretary for Benefits provided acceptable action plans for all five recommendations. The OIG will monitor VBA’s progress and follow up on implementation of the recommendations until all proposed actions are completed.