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Disability Compensation Benefit Adjustments for Hospitalization Need Improvement

Report Information

Issue Date
Closure Date
Report Number
19-06249-94
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Major Management Challenges
Benefits for Veterans
Recommendations
6
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General (OIG) conducted this audit to determine whether veterans received accurate compensation when hospitalized by VA for more than 21 days for service-connected disabilities. The OIG also examined whether claims processors met requirements to document the competency of veterans to handle VA funds who were admitted for service-connected mental health conditions. Veterans hospitalized for more than 21 days are entitled to receive temporary increases to 100 percent in tax-free disability compensation. Veterans Benefits Administration (VBA) employees process the compensation adjustments based on hospital admission and discharge reports. Staff’s failure to properly start or end the temporary compensation increases can lead to underpayments or overpayments. The OIG estimated VARO employees did not adjust or incorrectly adjusted disability compensation benefits in about 2,500 of the estimated 5,800 cases eligible for adjustments, creating an estimated $8 million in improper payments in calendar year 2018. The OIG estimated 1,900 cases did not have competency determinations documented for service-connected mental health conditions. The deficiencies occurred because employees did not consistently generate required reports and maintain report logs. Managers also provided ineffective oversight. As a result, veterans risked not receiving the proper benefits. Employees who processed benefit adjustments also lacked proficiency. They lacked sufficient ongoing experience and training to maintain requisite knowledge. This is also why employees were unclear on the requirement to document the relevant competency of veterans admitted for service-connected mental health conditions. The OIG made six recommendations to the under secretary for benefits, including ensuring proper admission and discharge reporting, as well as making certain that employees receive refresher training when needed to properly process temporary benefit adjustments for eligible veterans.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 1/28/2021
The OIG recommended the under secretary for benefits correct disability compensation benefits for the veterans identified in the sample whose benefits were not adjusted or were incorrectly adjusted.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 9/2/2020
The OIG recommended the under secretary for benefits develop and implement a plan to ensure all VA regional offices generate and process the weekly Admission Report for Service Connected Veterans and maintain coordinators’ logs to complete required benefit adjustments.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 9/2/2020
The OIG recommended the under secretary for benefits continue to develop and implement a plan to nationally generate and process the Admission Report for Service Connected Veterans.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 9/2/2020
The OIG recommended the under secretary for benefits determine if a statutory or regulatory change is required to ensure lawful, consistent, and timely processing of benefits for veterans entitled to temporary increases of benefits to 100 percent.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 11/17/2020
The OIG recommended the under secretary for benefits develop and implement a plan to ensure staff receive refresher training when needed to properly process temporary disability compensation benefit adjustments for veterans hospitalized for more than 21 days that includes monitoring the effectiveness of the training.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 8/6/2021
The OIG recommended the under secretary for benefits develop a plan to determine which veterans required adjustment of compensation benefits for hospitalization for a service connected condition, using the Admission Report for Service Connected Veterans for fiscal years 2018 and 2019, and make the required adjustments.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 40,000,000.00