VA Should Ensure Veterans’ Records in the New Electronic Health System Are Reviewed before Deciding Benefits Claims

Report Information

Issue Date
Report Number
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Questioned Costs
Better Use of Funds
Congressionally Mandated


Veterans Benefits Administration (VBA) staff need access to the full range of Veterans Health Administration (VHA) records for proper benefits claims processing. In October 2020, VBA officials emailed a memo instructing processors to search for, identify, and “flash” claims (affix electronic tags) from veterans with records in VA’s new electronic health system for proper routing to a select group of staff with access to those records. The Office of Inspector General (OIG) assessed whether claims processors followed VBA guidance for identifying and routing claims from veterans with records in the new electronic health system. The OIG found 21,057 rating decisions were completed for veterans with records in the new system from August 1, 2021, through July 31, 2022. Of those, 5,605 claims (27 percent) were either missing a flash or the flash was added after staff decided the claim. The review team found, however, from a judgmental sample of 30 decisions that the missing flashes did not ultimately affect veterans’ benefits in those instances. Still, VBA leaders must ensure all benefits claims from veterans with records in the new electronic health system are checked before they are decided by VBA personnel with access. Staff must satisfy their duty to assist veterans in obtaining all evidence, including relevant VA medical records, before deciding a claim. If not completed, veterans may not receive the benefits to which they are entitled. Therefore, the OIG concluded VBA should strengthen its oversight to confirm a flash is applied to all claims from veterans with records in the new system. VBA concurred with the OIG’s two recommendations to conduct refresher training and update written guidance to improve VBA staff’s handling of claims involving records in the new electronic health system and strengthen oversight by clarifying staff accountability for failure to consider all evidence.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Benefits Administration (VBA)
Conduct national refresher training on the Electronic Health Record Modernization National Process Memorandum and assess training effectiveness
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)

Consider updating VA Manual 21-4 to reflect that quality assurance measures include addressing failures to consider all Veterans Health Administration records as directed in the Adjudication Procedures Manual that are subject to an enterprise-wide search in the Compensation and Pension Records Interchange system whether or not directed to those records by the claimant and ensure staff are advised of the changes.