Ask Your VA Claims Question | Current Forum Posts | Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users
- 0
If you are having problems with the VA ordering unnecessary
Rate this question
Question
Mr cue
Report
For veterans seeking disability compensation benefits, the Veterans Benefits Administration (VBA) requires a disability exam to determine the severity of a disability or a medical opinion on whether a current condition can be connected to military service. VBA has committed an estimated total of $6.8 billion in contracts to complete disability examinations and medical opinions over a five-year period starting in 2016. Because medical opinion requests can be vital to ensuring veterans receive the benefits to which they are entitled, the VA Office of Inspector General (OIG) examined whether VBA staff correctly followed procedures when requesting medical opinions.
The review team found that VBA can reduce inadequate medical opinions, incorrect or delayed claims decisions, and wasted resources by improving internal controls, personnel training, and monitoring of medical opinion requests. The team estimated that 27,900 of 41,100 requests (68 percent) did not follow required procedures during the review period (October 1, 2020–September 30, 2021). Claims processors did not consistently identify relevant medical evidence for the examiner’s review, did not always use clear and accurate language, did not regularly request all warranted medical opinions, and sometimes requested unnecessary medical opinions. These failings can lead to inaccurate medical opinions, incorrect decisions on veterans’ claims, delayed decisions for veterans, and inefficient use of resources (such as when the medical opinion requires rework).
VBA concurred with OIG-identified deficiencies and recommendations to (1) implement electronic system enhancements to require claims processors to identify relevant evidence before a medical opinion request can be submitted, (2) enhance mandated training for all claims processors and demonstrate progress in achieving its intended impact, and (3) strengthen monitoring by refining quality review processes to help identify areas for improvement and show advancements in complying with required procedures
Link to comment
Share on other sites
Top Posters For This Question
8
3
2
1
Popular Days
Oct 6
7
Oct 7
2
Oct 8
2
Oct 5
1
Top Posters For This Question
Mr cue 8 posts
john999 3 posts
Foxhound6 2 posts
Vync 1 post
Popular Days
Oct 6 2022
7 posts
Oct 7 2022
2 posts
Oct 8 2022
2 posts
Oct 5 2022
1 post
Popular Posts
Mr cue
Title: VBA Could Improve the Accuracy and Completeness of Medical Opinion Requests for Veterans’ Disability Benefits Claims Report Number: 22-00404-207 D
john999
If VA orders an exam you better go because failure to appear is an automatic denial in my experience. I know you have a special case CUE.
Vync
A 68% rate of issues... Try having that kind of rate of mistakes in the private sector...
13 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now