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Audit of VAQ Regional Office Rating Claims Processing Exceeding 365 Days
Kent Wrathall (ed)
The Veterans Admin. (VA) Office of Inspector Gen. (OIG) conducted an audit to identify opportunities for VA regional offices (VARO) to improve rating claims processing timeliness and minimize the number of rating claims with processing times exceeding 365 days. As of Aug. 2008, VBA had 11,099 claims that were pending rating decisions more than 365 days. On average, these claims were pending 448 days. The OIG projected that inefficient VARO workload mgt. and/or claims processing activities performed by entities outside VARO control delayed 11,063, almost all of the 11,099 claims. Workload mgt. is a coordinated system used to control how claims and other work move through the adjudicative process. Inefficient VARO workload mgt. caused avoidable processing delays averaging 187 days for a projected 10,046 (90.5%) of the 11,099 rating claims. VAROs could minimize the number of rating claims processed that exceed 365 days and reduce processing times for most other rating claims by addressing workload mgt. deficiencies. OIG also projected that as of March 31, 2009, VAROs had completed 10,462 of the 11,099 claims and awarded retroactive payments totaling about $43 million for 3,501 of these claims. Of this $43 million, OIG estimated that $14.4 million (33.5%) represented monthly benefit payments unnecessarily delayed by an average of 8 months because of claims processing deficiencies. The worst cases were delayed benefit payments totaling $64,990 for one claimant and a benefit payment delay of 27 months for another claimant. These delayed benefit payments have the potential to adversely affect the economic status and quality of life for veterans who are eligible for benefits. Includes recommended ways that VARO can reduce rating claims processing times. Figures.
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