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Blue Water Navy Outreach Requirements Were Met, but Claims Processing and Procedures Could Improve

Report Information

Issue Date
Closure Date
Report Number
20-03938-208
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Report Topic
Claims and Appeals
Major Management Challenges
Benefits for Veterans
Recommendations
3
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
Since 1991, veterans who served in the Republic of Vietnam are presumed to have been exposed to herbicides such as Agent Orange. The Blue Water Navy Vietnam Veterans Act of 2019 extended this presumption to include veterans who served within 12 nautical miles of Vietnam. The objective of this OIG review was to determine whether Veterans Benefit Administration (VBA) employees (1) notified Navy veterans of their potential eligibility to receive medical benefits under the act; (2) correctly determined the eligibility of the veterans who filed claims for benefits; and (3) made accurate decisions on claims. The OIG found that VBA met the outreach requirements outlined in the act. VBA employees also generally determined Blue Water Navy veterans’ eligibility for benefits correctly. However, VBA has not established procedures for its employees to follow when the computer search tool they use to determine ship locations during claimant service dates returns unlikely results (for example, providing an inland location in a search for an aircraft carrier). In addition, VBA employees inaccurately decided approximately 46 percent of veterans’ claims (2,100 of 4,600) from April through June 2020, which led to about $37.2 million in improper payments to veterans ($25.2 million in overpayments and $12 million in underpayments) during that period. About 95 percent of these errors resulted from VBA employees deviating from policies governing disability-rating decisions. The OIG made three recommendations to the under secretary for benefits: (1) establish procedures to follow when the ship locator tool provides unlikely results based on deck log coordinates, (2) ensure VBA employees understand how to accurately decide and evaluate herbicide-related medical conditions, and (3) begin periodic local reviews of rating decisions involving such medical conditions to mitigate error trends identified.

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: 9/2/2021
The OIG recommendated the under secretary for benefits develop and distribute procedures for when the ship locator tool provides results based on deck log coordinates for unlikely locations of herbicide exposure.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 1/7/2022
The OIG recommended the under secretary for benefits determine and execute additional actions to ensure employees processing Blue Water Navy claims understand how to accurately evaluate and decide herbicide-related medical conditions.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
Closure Date: 12/27/2021
The OIG recommended the undersecretary for benefits implement a plan for centralized regional offices to conduct local reviews on the accuracy of rating decisions involving herbicide-related medical conditions that will mitigate error trends identified.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 37,200,000.00