Audit Of Veterans Benefits Administration

[carlie]

March 12, 2009

http://www.va.gov/oig/52/reports/2009/VAOIG-08-02073-96.pdf

[Capt.]

Hello Carlie, Thank you for posting this. It seems that the Inspector General knows the VA is lieing to them. They even point it out thruout this report. The problem is that both the House and Senate cannot do anything to the VA to discipline them, or to correct the problems. Not only that but both the House and the Senate are incapable of making the VA to follow the law. Again the VA wins and the Veteran looses. Does Secretary Dr. Shenseki really care? Maybe CBS and Dr. Phil need to follow up. Certainly Veterans are not to be surprised by these reports. Once again thank you Carlie for posting this and keeping our Veterans informed of the dogs we call the VA. God Bless, NEVER GIVE UP. C.C.

[cvsp]

Long story short.

1 out of 4 rated claims are rated wrong. Meaning 203,000 claims were rated wrong last year. VBA claimed 87% accuracy, auditors said 78%.

VA is lying about it's own audits of internal rating reviews.

VA did nothing to ensure improve accurate ratings in 2008.

Error rated for brokered claims (RO sends the claim to another RO). The VA itself reported that brokered claims have a 69% accuracy rate versus a 87% rate if not brokered (auditors found a 78% accuracy rate). Due to brokering 39,000 claims were in error.

Of the 9000 claims that were requested by STAR for review. ROs did not send in 600 or about 7%. RO claims that some of the claims could of been lost or had no idea where they where at. Auditors found 54 of those missing claims and 12 had benefit errors.

After a rating reviewer reviews a rating they send it back to the RO for action. Yet there is no follow up by the STAR reviewer. Of a sample of 33 claims reviewed by STAR and returned to the RO, no action was further taken by the RO.

VA as not plans yet as ordered by law to insure accurate ratings.

No formal training for reviewers or ratings has been established or implemented.

[cvsp]

I really wish someone would clear up the below paragraph for me (contained in the report).

If I am reading this correct the claim was put in on May 2007. Yet the auditors are saying that the claim should be the earlier effective date of 1998???

I thought that your effective date was the date you initiated your claim or the date of your ETS if you filed a claim within one year of your ETS.

What am I missing here?

For example, in May 2007, a veteran filed a claim and informed the regional office that

treatment records for his claimed condition were located at a VA medical center. The

effective date for service-connection was the date of claim. The STAR reviewer’s

comment stated that efforts should be made to obtain the information from the medical

center to determine if the veteran is entitled to an earlier effective date. However, for the

claimed condition, treatment records from 1998 in the claims folder already indicated the

condition was probably due to his service-connected condition of diabetes mellitus.

Therefore, the veteran was entitled to the earlier effective date. VBA officials agreed the

STAR reviewer should have categorized this as an error instead of a comment.

[bbknor]

VA should be held accountable using ISO 9001 standards as most companies are using as a stetement of quality now a days. Heck the military uses it now. Its a nice tool for QA/QC. Maybe the claims at VA should be privatized. Then employees could be held accountable from top to bottom, not bottom to top, I then think stupervisors will wake up and smell the coffee.

[pacmanx1]

For example, in May 2007, a veteran filed a claim and informed the regional office that

treatment records for his claimed condition were located at a VA medical center. The

effective date for service-connection was the date of claim. The STAR reviewers

comment stated that efforts should be made to obtain the information from the medical

center to determine if the veteran is entitled to an earlier effective date. However, for the

claimed condition, treatment records from 1998 in the claims folder already indicated the

condition was probably due to his service-connected condition of diabetes mellitus.

Therefore, the veteran was entitled to the earlier effective date. VBA officials agreed the

STAR reviewer should have categorized this as an error instead of a comment.

I may be wrong and I would hope someone would correct me but when Star reviewers, reviewed the claim they found the veteran already had this information (evidence) in his records to award him/her the disability, Based on the VCAA of 2006

How VA Determines the Effective Date

If we grant your claim, the beginning date of your entitlement or increased entitlement to benefits will generally be based on the following factors:

When we received your claim; or

When the evidence shows a level of disability that supports a certain rating under the rating schedule or other applicable standards.

If you filed your claim with VA within one year of your separation from the military, entitlement will be from the day following the day you left the military. Generally payments are effective from the first of the month following the date of your entitlement or increased entitlement based on the above criteria.

Examples of evidence that you should tell us about or give to us that may affect how we determine the effective date of any benefits we give you on your claim include the following:

Information about continuous treatment or when treatment began;

Service medical records in your possession that you may not have sent us; or

Reports of treatment for your condition while attending training in the Guard or Reserve.

the key words are underlined, some claims have many volumes and when a veteran file a claim the Rating board is supposed to review the entire file. I have eight volumes and I know they hate it when I file a claim for increase. The rating specialist just work on the latest volume which has the most up to date evidence but they screw up the effective date by not reviewing the entire file to see if the veteran had treatment records prior to applying for an increase. Sometimes when developing the evidence the development team make new volumes which is normal but the Rater is still supposed to view the entire file. The report said the condition was probably due to his service-connected condition of diabetes mellitus. VA should have requested more evidence but they most likely overlooked this or did not review this at all. He already had the evidence in his records so it proved he met the EED. I hope this makes since and I hope I am right. If I am wrong please correct me and put me on the right track.

Pete992

[Rockhound]

I like or rather dislike the the part in the report that says the VA may have with held a claim for audit if it suspected the claim had mistakes. It just goes to show how the VA continues to coverup their mistakes even during an audit to expose thier mistakes.

Lost, shredded, hidden away, or just kept from the auditors eyes. It's business as usuall with the VA.

Rockhound Rider B) :P