VA Mismanagement In Over 60 Percent Of Workers Compensation Claims

VA Mismanagement

Benjamin Krause

VA OIG – This week, Veterans Affairs released a report about its Workers Compensation program, which documented similar mismanagement of the program similar to other programs administered by VA.

Oversight revealed  that over 60% of all claims evaluated were not monitored properly. VA lacked a fraud detection process, which is surprising in light of VA’s perpetual focus on veterans potentially defrauding the disability compensation program. Apparently its own workers get a pass for fraud. OIG concluded VA could save over $92 million if it improves management of the program.

The report is summarized:

We determined whether VHA improved Workers’ Compensation Program (WCP) case management to better control costs in chargeback year 2012, which represented the most current audit data available at the time we began work. We identified issues with claims initiation and monitoring similar to those disclosed in our 2004 and 2011 audit reports. Specifically, WCP case files lacked initial or sufficient medical evidence to support connections between claimed injuries and medical diagnoses. We estimated VHA inaccurately initiated about 56 (7 percent) of 793 WCP claims. WCP claims also were not consistently monitored to timely return employees to work. VHA WCP specialists did not make job offers or take actions to detect fraud. We projected 489 (61.7 percent) of 793 active claims were inadequately monitored. These issues occurred because VHA still lacked standard guidance and a clear chain of command to ensure compliance with WCP statutory requirements and VA policy. VHA also lacked a fraud detection process. Overall, we estimated VHA can reduce WCP costs over the next 5 chargeback years by $11.9 million through improved claims initiation and $83.3 million by increasing efforts to return medically able staff to work. In total, opportunities exist for VHA to reduce WCP costs by about $95.2 million with improved claims management. We also identified $2.3 million in unrecoverable payments due to VHA’s lack of oversight to return medically able employees to work.

We recommended the Acting Under Secretary for Health ensure clear oversight, standard guidance, adequate staffing, and fraud detection procedures to improve VHA’s WCP case management. The Acting Under Secretary for Health concurred with our findings and recommendations and plans to complete all corrective actions by May 29, 2015.

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  1. Ben, you following up as to whether Obama is looking to use empty VA medical facilities to house illegal aliens?

    Obama will more than likely threaten the media from reporting on the hostile takeover of these closed VA hospitals, and he will definitely institute a gag-order on the heavily armed security police and healthcare workers that will be forced to care for these illegal aliens.

    If Obama is going to deliberately sacrifice veterans healthcare needs for illegal aliens, then I think you might have yourself a Matt Drudge-like Monica-Lewinsky-Clinton-stained-dress-news exclusive.

    You might want to get a wailing siren .gif to headline your blog here when this news story breaks wide open!

    1. Breitbart is now reporting the following criteria needed for illegal aliens to be permanently housed in our country.

      1. a 24,000 square foot building,

      2. 15 acres of land “level and clear,”

      3. and access to utilities

      Many closed VA facilities definitely fit the bill here.

      I’m unsure if the American citizens forced at gunpoint to work at these slum dumps will qualify for workers’ compensation once they contract the contagious diseases raging through the illegal alien populace.

  2. I guess that is what is meant by the old adage, “robbing peter to pay paul”. those in the IN-CROWD will always look out for their CRONIES.

  3. With full sarcastic intent, I wonder how many VA employees received workers’ compensation for carpal tunnel syndrome after they deliberately typed in an altered Progress Note in CPRS to screw over a disabled veteran?

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