A majority of Veterans Benefits Administration claims processors did not follow proper procedure while processing disability claims for VA benefits.
That’s the conclusion of a report released Wednesday by the Department of Veterans Affairs Inspector’s General office.
“Based on the team’s review of the statistical sample, an estimated 15,600 of 41,100 medical opinion requests (38 percent) submitted during the review period did not include any relevant evidence within the request,” the report reads.
A disability exam is used for evaluation purposes to determine the severity of a disability. A medical opinion is used to determine whether a current disability can be connected to military service.
The report concluded that by improving internal controls, training, and monitoring of medical opinion requests, VBA could reduce inadequate medical opinions, incorrect or delayed claims decisions, and wasted resources.
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VBA concurred with OIG-identified deficiencies and recommendations to implement electronic system enhancements to require claims processors to identify relevant evidence before a medical opinion request can be submitted; enhance mandated training for all claims processors and demonstrate progress in achieving its intended impact, and strengthen monitoring by refining quality review processes to help identify areas for improvement and show advancements in complying with required procedures.
Reach Julia LeDoux at Julia@connectingvets.com.
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