Inspection of the VARO Boise, Idaho

In October 2016, we evaluated the VARO Boise, Idaho, to determine how well VSC staff processed disability claims, how timely and accurately they processed proposed rating reductions, how accurately they entered claims-related information, and how well they responded to special controlled correspondence. Staff did not consistently process one of two types of disability claims. We reviewed 30 of 144 veterans’ TBI claims and found that RVSRs accurately processed 29 of them. However, RVSRs did not always process entitlement to SMC and ancillary benefits consistent with VBA policy. We reviewed all 13 veterans’ SMC claims and found that RVSRs incorrectly processed eight. This resulted in 84 improper monthly payments made to three veterans totaling approximately $24,300. This occurred because of ineffective training and a misinterpretation of VBA policy. Staff generally processed proposed rating reductions accurately. However, after reviewing 30 of 89 benefits reductions cases, we found that staff delayed or incorrectly processed 15 of them. Delays occurred because the VSC manager and supervisory VSRs prioritized other workload. Delays and processing inaccuracies resulted in roughly $11,300 in overpayments and an underpayment of approximately $320, representing eight improper monthly payments from July to September 2016. Staff needed to improve the accuracy of claims-related information input into the electronic systems at the time of claims establishment. We reviewed 30 of 156 newly established claims and found that staff did not correctly input claim and claimant information into the electronic systems in nine of them because of an ineffective review process and infrequent refresher training. Consequently, the potential existed for claims to be misrouted and processing to be delayed. Also, a claims assistant did not update the correct code in the electronic systems, resulting in a veteran’s PII being sent to a POA who was not representing him. VARO staff processed special controlled correspondence timely but needed to improve accuracy. We reviewed 30 of 115 special controlled correspondences and found that staff incorrectly processed three of these cases because of a lack of training and inadequate oversight. The errors affected data integrity, misrepresented workload performance, and provided inaccurate information. We recommended the VARO director provide regular refresher training for SMC, claims establishment procedures, and special controlled correspondence processing; implement plans to ensure oversight of proposed rating reduction cases; strengthen the claims establishment review process; and refer the violation to the privacy officer. The director concurred with our recommendations; planned actions are responsive.