Inspection of the VA Regional Office St. Louis, Missouri

The Benefits Inspection Division conducts onsite inspections at VA Regional Offices (VAROs) to review disability compensation claims processing and Veterans Service Center operations. We found the St. Louis VARO staff correctly processed post-traumatic stress disorder disability claims, properly established the correct dates of claim in the electronic record, and ensured staff corrected errors identified by the Veterans Benefits Administration’s Systematic Technical Accuracy Review Program. The VARO was generally effective in recording Notices of Disagreement for appealed claims and timely in completing Systematic Analyses of Operations. However, VARO management lacked effective controls and accuracy in processing temporary 100 percent disability evaluations, traumatic brain injury claims, and herbicide exposure-related claims. Overall, VARO staff did not accurately process 38 (32 percent) of the 117 disability claims reviewed. Management also lacked effective controls over handling mail and processing final competency determinations. We recommended St. Louis VARO management implement controls to ensure the Veterans Service Center staff establishes suspense diaries to request the medical reexaminations for temporary 100 percent disability reevaluations as needed. In addition, we recommended VARO management implement oversight plans to ensure staff return inadequate medical examination reports to healthcare facilities to obtain the evidence needed to support traumatic brain injury claims rating decisions, improve accuracy and quality review of herbicide exposure-related claims processing. Also, management needs to ensure the staff obtains supporting medical evidence in cases involving court declarations of incompetency. Finally, we recommended VARO management strengthen controls to ensure proper mail handling. The Director of the St. Louis VARO concurred with all recommendations. Management’s planned actions are responsive and we will follow up as required on all actions.