Veterans' Benefits: Quality Assurance for Disability Claims and Appeals Processing Can Be Further Improved.

摘要

For fiscal year 2002, the Department of Veterans Affairs (VA) estimates that it will pay about $25 billion in cash disability benefits to about 3.3 million disabled veterans and their families. When veterans submit disability claims, VAs 57 regional offices make decisions to either grant or deny the requested benefits. Veterans who are dissatisfied with regional office decisions may file appeals with VAs Board of Veterans Appeals, and in about half of such appeals, the Board has either granted the benefits denied by the regional offices or remanded (returned) the cases to the regional offices for rework. Additionally, VA reported an accuracy rate of less than 70 percent for regional office disability decisions when it tested a new quality assurance program in fiscal year 1998. As a result, we issued two prior reports at your request on VAs system for measuring and improving the accuracy of regional office decisions. Recently, questions have arisen about the quality of Board decisions. When the Board itself denies benefits requested by veterans, they may appeal to the U.S. Court of Appeals for Veterans Claims. In over half of such appeals, the court has either granted the benefits denied by the Board or remanded the decisions to the Board for rework. As a result, you now have asked that we examine VAs efforts to ensure the quality of decisions made by the Board. Specifically, you asked that we assess the effectiveness of VAs system for (1) measuring and improving the accuracy of the Boards decisions and (2) determining the consistency (extent of variation) in decision making across the spectrum of regional office and Board disability adjudicators.