IG report: Major changes needed at Anchorage VA office

A recent Veterans Affairs Inspector General’s Office report recommends changes to the disability claims processing procedures at the Anchorage Veterans Affairs Regional Office.

The report, conducted during June 2012 and released earlier this month, found that a “lack of management oversight resulted in staff delays in gathering evidence and processing old claims” at the Anchorage regional office, or VARO.

VA inspectors determined Anchorage VARO staff erred in processing 18 of the 38 disability claims reviewed, according to the report.

Of the claims reviewed, 30 were temporary 100 percent disability evaluations and the remaining eight were traumatic brain injury claims. VARO staff incorrectly processed 15 of the 30 temporary disability evaluations and three of the traumatic brain injury claims.

Six of those claims affected veterans’ benefits, resulting in overpayments to veterans that totaled $139,000 and underpayments of $19,000, according to the report. It was determined that the remaining nine had “potential” to affect benefits.

All three brain injury claims were found to have potential to affect veterans’ benefits.

The report also detailed the two cases of the largest over and underpayments.

Overpayment: “VARO staff did not schedule a medical reexamination to evaluate a veteran’s breast cancer. VA medical records showed the veteran had completed treatment, warranting a reduction in benefits effective August 2005. In the absence of the required follow-up medical reexamination, VA continued processing monthly benefits and ultimately overpaid the veteran $96,135 over a period of 5 years and 11 months.”

Underpayment: “VARO staff did not grant a veteran entitlement to an additional special monthly benefit based on evaluations of multiple disabilities, as required. As a result, VA underpaid the veteran a total of $19,220 over a period of 5 years and 1 month. We discussed this underpayment with VARO officials who agreed to take corrective action.”

VA statistics from 2010 reported 76,000 veterans living in Alaska. Of those, more than 13,000 received pension or disability compensation payments totaling $147 million.

The report calls for the Anchorage VARO director to develop and implement a plan to “assess the effectiveness of training for properly processing” both temporary disability and brain injury claims. The report states that the Anchorage director concurred with its recommendations and agreed to make training and management adjustments.

Attempts to reach VA officials in Alaska and Washington, D.C., for comment on the report and procedural changes were not returned.

According to the report, the payment errors stemmed from a lack of mandatory follow-up evaluations after a veteran’s treatment or surgery to determine whether the temporary 100 percent disabled status is still appropriate.

When veterans meet temporary 100 percent disabled criteria and their benefit payments do not change; Veterans Service Center staff is responsible for generating a “suspense diaries” into the VBA’s electronic database. A suspense diary is a processing tool that establishes a date for a veteran’s reexamination and electronically notifies Service Center staff to schedule a reexamination, the report states. The exam will then determine what disability rating the veteran qualifies for and in turn what benefit payment is appropriate.

Shortly after the report was released Sen. Mark Begich’s office issued a press release commenting on the report.

“As a member of the Senate Veterans Affairs Committee, I have fought for additional funding and administrative changes to ensure our veterans get the care and support they earned. This report highlights the need to do more, starting right here in Alaska,” Begich stated in the release.

Rep. Don Young expressed concern over the report’s findings in a written statement from his office to the Journal: “I am disappointed at the results of this report and I believe that the recommendations, when implemented, will greatly improve the Anchorage VA. I also understand that there is always more work to be done to improve how we care for our veterans. It is important that the VA get things right today, so that as more and more Alaskans come home, we are continuing to innovate and improve how we care for those that defend our freedom.”

An April 2012 Veterans Benefits Administration, or VBA, review found the Anchorage VARO’s compensation rating-related decisions accuracy at 80.5 percent, or 6.5 percent below the Administration’s goal of 87 percent accuracy.

The report also uncovered a backlog of claims awaiting processing. VA’s goal is for all claims to be handled within 125 days of filing. In April 2012, 47 percent — 948 of 2,004 — pending claims at the Anchorage VARO were older than 125 days.

When VA inspectors reviewed the 10 oldest claims they found the claims spent an average of 523 days in the evidence-gathering phase of processing, in which staff obtain information with which to make a rating decision on a claim. The national average for the time a claim spends in this phase is 83 days, according to the report.

The report cited “inadequate management oversight and non-compliance” with VA workload management plans.

It recommended that the Anchorage VARO director compose and institute controls to make sure policy is followed for all pending claims older than one year.

Again, the director concurred with the recommendation and formed a Special Operations Team to handle the Anchorage VARO’s 12 oldest claims, the report stated.

The sheer number of claims is partially to blame for backlog. Seven of the 10 pending claims reviewed were forwarded to a brokering center for processing, taking them out of VARO control. VBA began sending claims to 13 different brokering centers nationwide to reduce VARO staff workloads.

01/24/2013 - 6:02am