Audit of VHA’s Workers’ Compensation Case Management

VHA has nearly doubled its timeliness in initiating WCP claims since 2001. However, evidence was sometimes lacking and VHA had not consistently updated files or made job offers to employees who could work. Fraud detection was lacking due to competing priorities. We projected VHA could reduce costs by $264 million over five years. Additionally, converting claimants 65 years of age or older to more appropriate benefit programs could reduce VHA’s costs about $463.9 million over five years but would require legislative action. We recommended the Under Secretary for Health provide adequate staff, clear oversight, standard guidance, and fraud detection procedures to improve WCP case management. We recommended the Assistant Secretary for Human Resources and Administration propose legislation to move retirement age individuals to appropriate retirement programs.