Audit of VA Regional Office Rating Claims Processing Exceeding 365 Days

The Office of Inspector General conducted an audit of VA Regional Office (VARO) rating claims processing. The audit objective was to identify opportunities for VAROs to improve rating claims processing timeliness and minimize the number of rating claims with processing times exceeding 365 days. As of August 29, 2008, VBA had 11,099 claims that were pending more than 365 days. On average, these claims were pending 448 days. We projected that inefficient VARO workload management and/or claims processing activities performed by entities outside VARO control delayed 11,063 or almost all of the 11,099 claims. Inefficient VARO workload management caused avoidable processing delays averaging 187 days for a projected 10,046 (90.5 percent) of the 11,099 rating claims. We also projected that as of March 31, 2009, VAROs had completed 10,462 of the 11,099 claims and awarded retroactive payments totaling about $43 million for 3,501 of these claims. Of this $43 million, we estimated that $14.4 million (33.5 percent) represented monthly benefit payments unnecessarily delayed by an average of 8 months because of workload management deficiencies. Claim processing activities outside VARO control also delayed completion of rating claims. Of the 11,099 claims pending more than 365 days as of August 29, 2008, we projected that 7,843 (70.7 percent) had delays averaging 101 days caused by eight activities performed by entities outside VARO control. VA may be able to further reduce claims processing times by evaluating and taking actions to address delays by these entities. We made four recommendations to improve rating claims processing timeliness and minimize the number of rating claims with processing times exceeding 365 days. The Under Secretary for Benefits concurred with the report’s conclusions and recommendations. We consider the planned actions provided by the Under Secretary acceptable and will follow up on their implementation.