Inspection of VA Regional Office Nashville, Tennessee

We evaluated the Nashville VARO to see how well it accomplishes this mission. We found VARO staff, overall, did not accurately process 24 (41 percent) of 59 disability claims we reviewed. We sampled claims for certain types of medical disabilities that we considered to be at higher risk of processing errors, so these results do not represent the overall accuracy of disability claims processing at this VARO. Specifically, 47 percent of the 30 temporary 100 percent disability evaluations we reviewed were inaccurate. Generally, these errors occurred because VARO staff did not schedule medical reexaminations or take actions to reduce benefits as appropriate. Further, staff incorrectly processed 34 percent of 29 traumatic brain injury claims. Most errors occurred when peers rather than Quality Review Team staff conducted second-level reviews of TBI claims. Management generally ensured SAOs were complete and timely. However, staff did not always properly address Gulf War veterans’ entitlement to mental health care. Staff also did not provide outreach to homeless veterans in their entire area of jurisdiction or always accurately identify their claims. The VARO Director concurred with our recommendations. Management’s planned actions are responsive and we will follow up as required.