Veterans' Benefits

Improvements Needed to Measure the Extent of Errors in VA Claims Processing Gao ID: HRD-89-9 April 13, 1989

In response to a congressional request, GAO assessed whether the Department of Veterans Affairs' (VA) Statistical Quality Control (SQC) System reliably estimated the extent of errors made in adjudicating veterans' claims for compensation and benefits.

GAO found that SQC did not have accurate and reliable information on claims processing accuracy, since: (1) VA regions did not randomly select case samples or review cases within the required time period; (2) VA regions used the same staff that adjudicated the claims to review them for errors; and (3) the VA central office did not adequately validate the regions' reported error rates or ensure that the regions complied with SQC procedures. GAO also found that VA often inappropriately used SQC data to estimate national claims processing errors, because SQC could not accurately project total claims processing error rates, specific program error rates, or payment accuracy.


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