Veterans Benefits
VA Needs Plan for Assessing Consistency of Decisions
Gao ID: GAO-05-99 November 19, 2004
In the past, we have reported concerns about possible inconsistencies in the disability decisions made by the 57 regional offices of the Department of Veterans Affairs (VA). In 2002, we reported that VA did not systematically assess the consistency of decision making for any specific impairments included in veterans' disability claims. We recommended that VA conduct such assessments to help reduce any unacceptable variations that VA might find among regional offices. VA agreed that decision-making consistency is an important goal and concurred in principle with our recommendation. However, VA did not discuss how it would measure consistency. In January 2003, in part because of concerns about consistency, we designated VA's disability program, along with other federal disability programs, as high-risk. In fiscal year 2005, VA estimates it will pay about $25 billion in disability compensation benefits to about 2.7 million disabled veterans. In this context, we determined (1) the actions that VA has taken to assess the consistency of regional office decisions on disability compensation claims and (2) the extent to which VA program data can be used to measure the consistency of decision making among regional offices.
In summary, we found that VA still does not systematically assess decision-making consistency among the 57 regional offices. We also found that data contained in VA's Benefits Delivery Network system, which was designed for the purpose of paying benefits, do not provide a reliable basis for identifying indications of possible decision-making inconsistencies among regional offices. However, according to VA officials, as of October 2004, a newly-implemented nationwide information system (known as RBA 2000) could provide VA such an opportunity if the system proves over time to reliably collect data needed to determine each regional office's denial rates and average disability ratings for specific impairments. VA will need to collect several years of data with RBA 2000 in order to have sufficient data to reliably identify indications of impairment-specific inconsistencies among regional offices. Still, even if the RBA 2000 system permits VA to identify indications of such inconsistencies, VA will need to systematically study and determine the extent and causes of such inconsistencies and identify ways to reduce any variations among regional offices that VA may consider unacceptable.
Recommendations
Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.
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GAO-05-99, Veterans Benefits: VA Needs Plan for Assessing Consistency of Decisions
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Report to Congressional Requesters:
United States Government Accountability Office:
GAO:
November 2004:
Veterans Benefits:
VA Needs Plan for Assessing Consistency of Decisions:
GAO-05-99:
Contents:
Letter:
Appendix I: Briefing Slides:
Abbreviations:
BDN: Benefits Delivery Network:
STAR: Systematic Technical Accuracy Review:
VA: Department of Veterans Affairs:
United States Government Accountability Office:
Washington, DC 20548:
November 19, 2004:
The Honorable Henry E. Brown, Jr.:
Chairman:
Subcommittee on Benefits:
Committee on Veterans' Affairs:
House of Representatives:
The Honorable Mike Simpson:
House of Representatives:
In the past, we have reported concerns about possible inconsistencies
in the disability decisions made by the 57 regional offices of the
Department of Veterans Affairs (VA). In 2002, we reported that VA did
not systematically assess the consistency of decision making for any
specific impairments included in veterans' disability claims.[Footnote
1] We recommended that VA conduct such assessments to help reduce any
unacceptable variations that VA might find among regional offices. VA
agreed that decision-making consistency is an important goal and
concurred in principle with our recommendation. However, VA did not
discuss how it would measure consistency.
In January 2003, in part because of concerns about consistency, we
designated VA's disability program, along with other federal disability
programs, as high-risk.[Footnote 2] In fiscal year 2005, VA estimates
it will pay about $25 billion in disability compensation benefits to
about 2.7 million disabled veterans. In this context, you asked us to
determine (1) the actions that VA has taken to assess the consistency
of regional office decisions on disability compensation claims and (2)
the extent to which VA program data can be used to measure the
consistency of decision making among regional offices.
To address these issues, we (1) identified key data fields in VA's
Benefits Delivery Network system--such as the level of benefits awarded
for each claimed impairment--which VA uses to manage the delivery of
disability benefits to veterans; (2) obtained from VA an electronic
file of these key data fields for all veterans receiving compensation
benefits as of March 2004; (3) conducted electronic testing of key data
fields to determine their reliability for identifying indications of
possible inconsistency in regional office decisions; and (4) reviewed
VA records and documents and interviewed VA officials. We conducted our
review from November 2003 through October 2004 in accordance with
generally accepted government auditing standards. On October 28, 2004,
we briefed your office on the results of our work. This letter formally
conveys the information provided during that briefing. Appendix I
contains the briefing slides.
In summary, we found that VA still does not systematically assess
decision-making consistency among the 57 regional offices. We also
found that data contained in VA's Benefits Delivery Network system,
which was designed for the purpose of paying benefits, do not provide a
reliable basis for identifying indications of possible decision-making
inconsistencies among regional offices. However, according to VA
officials, as of October 2004, a newly-implemented nationwide
information system (known as RBA 2000) could provide VA such an
opportunity if the system proves over time to reliably collect data
needed to determine each regional office's denial rates and average
disability ratings for specific impairments. VA will need to collect
several years of data with RBA 2000 in order to have sufficient data to
reliably identify indications of impairment-specific inconsistencies
among regional offices. Still, even if the RBA 2000 system permits VA
to identify indications of such inconsistencies, VA will need to
systematically study and determine the extent and causes of such
inconsistencies and identify ways to reduce any variations among
regional offices that VA may consider unacceptable.
We recommend that the Secretary of Veterans Affairs develop a plan, and
include it in VA's annual performance plan, that contains a detailed
description of how VA will (1) use data gathered through the new RBA
2000 system to identify indications of possible inconsistencies among
regional offices in the award and denial of disability compensation
benefits for specific impairments and (2) conduct systematic studies of
consistency for specific impairments for which RBA 2000 data reveal
indications of possible decision-making inconsistencies among regional
offices.
In oral comments on a draft of this report, VA agreed with our findings
and conclusions and concurred with our recommendation. We also made
technical revisions as appropriate.
We are sending copies of this report to the Chairman and Ranking
Democratic Member, House Committee on Veterans' Affairs; the Chairman
and Ranking Democratic Member, Senate Committee on Veterans' Affairs;
and the Secretary of Veterans Affairs. We will also make copies
available upon request. In addition, the report will be available at no
charge on GAO's Web site at http://www.gao.gov.
If you or your staffs have any questions about this report, please
contact me on (202) 512-7215 or Irene Chu, Assistant Director, on (202)
512-7102. Ira Spears, Joseph Natalicchio, Joan Vogel, Walter Vance, and
Vanessa Taylor also made key contributions to this report.
Signed by:
Cynthia A. Bascetta:
Director, Education, Workforce, and Income Security Issues:
[End of section]
Appendix I: Briefing Slides:
[See PDF for images]
[End of slide presentation]
[End of section]
FOOTNOTES
[1] GAO, Veterans' Benefits: Quality Assurance for Disability Claims
and Appeals Processing Can Be Further Improved, GAO-02-806 (Washington,
D.C.: Aug. 16, 2002).
[2] GAO, High-Risk Series: An Update, GAO-03-119 (Washington, D.C.:
Jan. 2003).
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