Software Delayed the Establishment of Supplemental Claims for Appeals of Benefits Decisions

The Veterans Benefits Administration (VBA) provides monthly compensation for service-connected disabilities based on a review of veteran information and documentation. Veterans may disagree with the outcome of this review.

When they disagree, veterans have several options, including a higher-level review: a new examination of the same evidence for an issue or multiple issues previously decided by VA. If additional evidence is needed, a supplemental claim is created after the higher-level review is closed. This supplemental claim is automatically established by software and must be done within 48 hours of higher-level review completion.

In December 2022, a hotline complaint alleged it took weeks for supplemental claims from higher-level reviews to be established. The OIG substantiated this allegation from a random statistical sample of 190 higher-level reviews completed in calendar year 2022 and January 2023. The team estimated 94 percent of this sample in 2022 did not have a supplemental claim established within 48 hours; the average time for establishment was 41 days. In January 2023, about 91 percent were not established within 48 hours, but the average improved to 16 days.

The Office of Information and Technology (OIT) determined that a software synchronization issue was delaying supplemental claims, creating a backlog of claims waiting to be established more than four times greater than those that had been established.

VBA’s Office of Administrative Review (OAR) took corrective actions in January 2023, reducing but not eliminating delays. OAR anticipates transitioning to another web-based software application in fiscal year 2024. While the team planned to recommend VBA document and maintain a formal process for establishing supplemental claims in the interim, VBA officials shared before providing their comment on the report that they had proactively done so. After verifying documentation of this procedure, the review team determined an official recommendation was unnecessary.