Review of Alleged Use of Incorrect Effective Dates at VBA's VARO in Chicago, IL

We assessed the merits of a December 2015 Office of Inspector General (OIG) Hotline allegation that claims processors at the Chicago VA Regional Office (VARO) assigned incorrect effective dates when processing claims associated with “intent to file” (ITF) submissions. An ITF provides claimants the opportunity to submit minimal information related to their claim for benefits and allows up to one year for the claimant to provide additional information and evidence necessary to complete the claim. If benefits are subsequently established, VA may use the date the VARO received the ITF as the basis for an earlier effective date for benefits payments. We substantiated the allegation that Rating Veterans Service Representatives (RVSRs) at the Chicago VARO did not always assign the correct effective dates when they received an ITF. Overall, RVSRs established incorrect effective dates for 15 of the 30 disability claims (50 percent) we sampled from a universe of 616 claims. Five of the errors resulted in 15 improper benefits payments totaling approximately $5,700; 10 of the errors had incorrect effective dates but did not affect benefits payments. The majority of effective date errors occurred when the claimant submitted an ITF electronically. In these cases, the Veterans Benefits Administration (VBA) automatically updates the corporate database; however, there is no standardized form within the electronic claims folder, which increases the likelihood the VARO overlooks the ITF. Although a notification letter is generated, it is stored in a separate VBA system. Generally, we attributed the errors to a lack of guidance within VBA policy on how to identify ITF filings and insufficient analysis of effective date errors, which led to weaknesses in training. Using incorrect effective dates may result in incorrect benefits payments. However, subsequent to our review, VBA updated its policy to include instructions on identifying ITFs and made additional ITF training available nationwide. We recommended the Chicago VARO Director conduct a review and take appropriate actions on the 586 claims associated with ITFs remaining from our universe. In addition, we recommended the Director implement a plan to ensure sufficient analysis is completed to identify effective date errors related to ITFs. Furthermore, we recommended the VARO Director ensure claims processors receive training on how to identify ITFs. The VARO Director concurred with the recommendations and provided sufficient evidence to close the recommendations.