Veterans' Disability Benefits
VA Has Improved Its Programs for Measuring Accuracy and Consistency, but Challenges Remain Gao ID: GAO-10-530T March 24, 2010For years, in addition to experiencing challenges in making disability claims decisions more quickly and reducing its claims backlog, the Department of Veterans Affairs (VA) has faced challenges in improving the accuracy and consistency of its decisions. GAO was asked to discuss issues surrounding VA's Systematic Technical Accuracy Review (STAR) program, a disability compensation and pension quality assurance program, and possible ways, if any, this program could be improved. This statement focuses on actions VA has taken; including those in response to past GAO recommendations, to (1) address identified weaknesses with STAR and (2) improve efforts to monitor the consistency of claims decisions. This statement is based on GAO's prior work, which examined several aspects of STAR, as well as VA's consistency review activities, and on updated information GAO obtained from VA on quality assurance issues that GAO and VA's Office of Inspector General (OIG) have identified. GAO also reviewed VA's OIG March 2009 report on STAR. GAO is not making any new recommendations.
Over the past several years, GAO has identified several deficiencies with the Veterans Benefit Administration's (VBA) STAR program, and although VBA has taken actions to address these issues, it continues to face challenges in improving claims accuracy. For example, GAO found that STAR reviewers lacked organizational independence, a basic internal control principle. In response to our finding, VA began utilizing organizationally independent reviewers that do not make claims decisions. GAO also found that sample sizes for pension claims were insufficient to provide assurance about decision accuracy. In response to GAO's recommendation, in fiscal year 2009, VA began increasing the number of pension claims decisions it reviews annually at each of its offices that process pension decisions. VA has also taken a number of other steps to address weaknesses that VA's OIG found in the STAR program, including (1) establishing minimum annual training requirements for reviewers and (2) requiring additional supervisory review of STAR reviewers' work. Although it has made or has started making these improvements, VBA remains challenged to improve its decision accuracy for disability compensation decisions, and it has not met its stated accuracy goal of 90 percent. VBA's performance has remained about the same over the past several fiscal years. In addition, VA has taken steps to address deficiencies that GAO and the VA's OIG have identified with consistency reviews--assessments of the extent to which individual raters make consistent decisions on the same claims. For example, in prior work, GAO reported that VA did not conduct systematic studies of impairments that it had identified as having potentially inconsistent decisions. In response to GAO's recommendation, in fiscal year 2008, VBA's quality assurance staff began conducting studies to monitor the extent to which veterans with similar disabilities receive consistent ratings across regional offices and individual raters. However, last year, VA's OIG reported that VA had not followed through on its plans to conduct such reviews. In response to this and other OIG findings and recommendations, VA took a number of actions, including developing an annual consistency review schedule and hiring additional quality assurance staff. However, VBA has only recently begun these programs to improve consistency, and it is too early to assess the effectiveness of their actions.
GAO-10-530T, Veterans' Disability Benefits: VA Has Improved Its Programs for Measuring Accuracy and Consistency, but Challenges Remain
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Testimony:
Before the Subcommittee on Disability Assistance and Memorial Affairs,
Committee on Veterans' Affairs, House of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery:
Expected at 2:00 p.m. EDT:
Wednesday, March 24, 2010:
Veterans' Disability Benefits:
VA Has Improved Its Programs for Measuring Accuracy and Consistency,
but Challenges Remain:
Statement of Daniel Bertoni, Director:
Education, Workforce, and Income Security:
GAO-10-530T:
GAO Highlights:
Highlights of GAO-10-530T, a testimony before the Subcommittee on
Disability Assistance and Memorial Affairs, Committee on Veterans‘
Affairs, House of Representatives.
Why GAO Did This Study:
For years, in addition to experiencing challenges in making disability
claims decisions more quickly and reducing its claims backlog, the
Department of Veterans Affairs (VA) has faced challenges in improving
the accuracy and consistency of its decisions.
GAO was asked to discuss issues surrounding VA‘s Systematic Technical
Accuracy Review (STAR) program, a disability compensation and pension
quality assurance program, and possible ways, if any, this program
could be improved.
This statement focuses on actions VA has taken; including those in
response to past GAO recommendations, to (1) address identified
weaknesses with STAR and (2) improve efforts to monitor the
consistency of claims decisions. This statement is based on GAO‘s
prior work, which examined several aspects of STAR, as well as VA‘s
consistency review activities, and on updated information GAO obtained
from VA on quality assurance issues that GAO and VA‘s Office of
Inspector General (OIG) have identified. GAO also reviewed VA‘s OIG
March 2009 report on STAR.
What GAO Found:
Over the past several years, GAO has identified several deficiencies
with the Veterans Benefit Administration‘s (VBA) STAR program, and
although VBA has taken actions to address these issues, it continues
to face challenges in improving claims accuracy. For example, GAO
found that STAR reviewers lacked organizational independence, a basic
internal control principle. In response to our finding, VA began
utilizing organizationally independent reviewers that do not make
claims decisions. GAO also found that sample sizes for pension claims
were insufficient to provide assurance about decision accuracy. In
response to GAO‘s recommendation, in fiscal year 2009, VA began
increasing the number of pension claims decisions it reviews annually
at each of its offices that process pension decisions. VA has also
taken a number of other steps to address weaknesses that VA‘s OIG
found in the STAR program, including (1) establishing minimum annual
training requirements for reviewers and (2) requiring additional
supervisory review of STAR reviewers‘ work. Although it has made or
has started making these improvements, VBA remains challenged to
improve its decision accuracy for disability compensation decisions,
and it has not met its stated accuracy goal of 90 percent. VBA‘s
performance has remained about the same over the past several fiscal
years.
In addition, VA has taken steps to address deficiencies that GAO and
the VA‘s OIG have identified with consistency reviews”assessments of
the extent to which individual raters make consistent decisions on the
same claims. For example, in prior work, GAO reported that VA did not
conduct systematic studies of impairments that it had identified as
having potentially inconsistent decisions. In response to GAO‘s
recommendation, in fiscal year 2008, VBA‘s quality assurance staff
began conducting studies to monitor the extent to which veterans with
similar disabilities receive consistent ratings across regional
offices and individual raters. However, last year, VA‘s OIG reported
that VA had not followed through on its plans to conduct such reviews.
In response to this and other OIG findings and recommendations, VA
took a number of actions, including developing an annual consistency
review schedule and hiring additional quality assurance staff.
However, VBA has only recently begun these programs to improve
consistency, and it is too early to assess the effectiveness of their
actions.
What GAO Recommends:
GAO is not making any new recommendations.
View [hyperlink, http://www.gao.gov/products/GAO-10-530T] or key
components. For more information, contact Daniel Bertoni at (202) 512-
7215 or bertonid@gao.gov.
[End of section]
Mr. Chairman and Members of the Subcommittee:
I am pleased to have the opportunity to comment on the Department of
Veterans Affairs' (VA) efforts to improve the accuracy and consistency
of its disability compensation and pension benefit decisions. As we
and other organizations have reported over the last decade, VA's
claims processing challenges are not limited to making decisions more
quickly and reducing its claims backlog; but also includes improving
the accuracy and consistency of its decisions. The number of veterans
awaiting decisions could grow as service members returning from
ongoing conflicts and aging veterans submit claims. According to VA,
about 35 percent of veterans from ongoing hostilities file claims. It
is important not only that decisions be timely, but also accurate.
Accurate initial claims decisions can help ensure that VA is paying
cash disability benefits to those entitled to such benefits and also
help prevent lengthy appeals. Meanwhile, consistent decisions help
ensure that comparable medical conditions of veterans are rated the
same, regardless of which VA regional benefits office processes the
claim.
You asked us to discuss issues surrounding VA's disability
compensation and pension quality assurance programs; particularly, the
Systematic Technical Accuracy Review (STAR) program. My statement
focuses on STAR, which deals with accuracy, and two other VA quality
assurance activities that focus on consistency.[Footnote 1] More
specifically, my remarks will focus on actions VA has taken to (1)
address deficiencies identified with STAR and (2) improve efforts to
monitor the consistency of claim decisions. This statement is based on
our prior work, which examined several aspects of STAR, as well as
VA's consistency review programs, and on updated information we
obtained from VA on quality assurance vulnerabilities that we and VA's
Office of Inspector General (OIG) have identified. We also reviewed VA
OIG's March 2009 report on STAR and consistency reviews.[Footnote 2]
Our work was conducted in accordance with generally accepted
government auditing standards. Those standards require that we plan
and perform the audit to obtain sufficient, appropriate evidence to
provide a reasonable basis for our findings and conclusions based on
our audit objectives. We believe the evidence obtained provides a
reasonable basis for our findings and conclusions based on our audit
objectives.
Background:
Through its disability compensation program, VA pays monthly benefits
to veterans with service-connected disabilities.[Footnote 3] Under its
disability pension program, VA pays monthly benefits to low-income
veterans who have disabilities not related to their military service
or are age 65 or older. VA also pays compensation to the survivors of
certain veterans who had service-connected disabilities and of
servicemembers who died while on active duty.
Veterans and their survivors claim benefits at one of the Veterans
Benefits Administration's (VBA) 57 regional offices. Once the claim is
received, a service representative assists the veteran in gathering
the relevant evidence to evaluate the claim. Such evidence includes
the veteran's military service records, medical examinations, and
treatment records from VA medical facilities and private medical
service providers. Also, if necessary for reaching a decision on a
claim, the regional office arranges for the veteran to receive a
medical examination. Once all necessary evidence has been collected, a
rating specialist evaluates the claim and determines whether the
claimant is eligible for benefits. If so, the rating specialist
assigns a percentage rating. Veterans with multiple disabilities
receive a single composite rating. Since 2001, VBA has created 15
resource centers that are staffed exclusively to process claims or
appeals from backlogged regional offices. Most of these centers focus
either on making rating decisions, or on developing the information
needed to evaluate claims.
In addition to the traditional claims process, any member of the armed
forces who has seen active duty--including those in the National Guard
or Reserves--is eligible to apply for VA disability benefits prior to
leaving military service through VA's Benefits Delivery at Discharge
(BDD) program or the related Quick Start program.[Footnote 4] In 2006,
VA completed its consolidation of BDD rating activity into its Salt
Lake City, Utah, and Winston-Salem, North Carolina, regional offices,
to increase the consistency of BDD claims decisions. Also, under the
Department of Defense (DOD)-VA disability evaluation system pilot
program, servicemembers undergoing disability evaluations, if found
medically unfit for duty, receive VA disability ratings. This rating
covers both the unfitting conditions identified by the military
service and conditions identified by the servicemember during the
process. The rating is used by both DOD and VA to determine
entitlement for disability benefits.[Footnote 5]
Enacted in October 2008, the Veterans' Benefits Improvement Act of
2008 required VA to contract for an independent, 3-year review of
VBA's quality assurance program.[Footnote 6] This review is to
include, among other items, assessments of the accuracy of disability
ratings and their consistency across VA regional offices. VA
contracted with the Institute for Defense Analyses (IDA) to conduct
this study. According to VA, IDA will provide preliminary findings in
the Summer of 2010, and VA is scheduled to report to the Congress in
October 2011.
STAR Program:
Under the STAR program, which was implemented in fiscal year 1999, VBA
selects a random sample of completed claims decisions each month from
each of its regional offices to review for accuracy. STAR reviewers
assess decision accuracy using a standard checklist. For decisions
affecting benefit entitlement, this review includes an assessment of
whether (1) all issues in the claim were addressed; (2) assistance was
provided to the claimant, as required by the Veterans Claims
Assistance Act of 2000; and (3) the benefit entitlement decision was
correct. If a claim has any error, VBA counts the entire claim as
incorrect for accuracy rate computation purposes. The STAR reviewer
then returns the case file and the results of the review to the
regional office that made the decision. If an error was found, the
regional office is required to either correct it or request
reconsideration of the error determination. VBA uses the national
accuracy rate from STAR reviews of compensation entitlement decisions
as one of its key claims processing performance measures. VA also uses
STAR data to estimate improper compensation and pension benefit
payments.
Consistency Review Activities:
One VA consistency review activity involves conducting studies of
regional offices' decisions on specific conditions such as post-
traumatic stress disorder where VBA found differences, such as in
benefit grant rates, across regional offices through comparative
statistical analysis. VBA uses the results of these reviews to
identify root causes of inconsistencies and to target training. Under
another VA consistency review activity, called inter-rater reliability
reviews, VBA provides rating specialists a sample case file to assess
how well raters from various regional offices agree on an eligibility
determination when reviewing the same body of evidence. These reviews
allow VBA officials to target a single rating issue and take remedial
action to ensure the consistent application of policies and procedures
nationally.
VA Has Implemented Procedures to Address Deficiencies Identified with
the STAR Program, but Continues to Face Challenges in Improving
Accuracy:
Over the past decade, VBA has taken several actions to improve its
STAR program and to address deficiencies identified by both GAO and
VA's OIG. For example, in March 1999, we found that STAR review staff
lacked sufficient organizational independence because they were also
responsible for making claims decisions and reported to regional
office managers responsible for claims processing.[Footnote 7] In
response to our findings, VBA took steps to address this by utilizing
reviewers who do not process claims and who do not report to managers
responsible for claims processing. More recently, in February 2008, we
found that STAR was not sampling enough initial pension claims to
ensure the accuracy of pension claims decisions.[Footnote 8] Because
initial pension claims constituted only about 11 percent of the
combined compensation and pension caseload subject to accuracy review,
few were likely to be included in the STAR review sample. We
recommended that VBA take steps to improve its quality assurance
review of initial claims, which could include reviewing a larger
sample of pension claims. According to VBA, it has addressed this
issue by consolidating pension claims processing in its three Pension
Management Centers[Footnote 9] and establishing a separate STAR sample
for pension claims. During fiscal year 2009, VBA began reviewing more
pension claim decisions and reported that, for fiscal year 2009, its
pension entitlement accuracy was 95 percent, exceeding its goal.
In a September 2008 report, we noted that VA lacked sufficient and
specific performance measures for assessing the accuracy of decisions
on BDD claims and recommended that VA consider options for separately
estimating the accuracy of such claims decisions.[Footnote 10] VA
conducted an analysis of the costs of sampling pre-discharge claims as
part of STAR and concluded that the costs would outweigh possible,
unquantifiable benefits. VA also noted that the two sites that rate
BDD claims surpassed the national average in accuracy for claims
overall.[Footnote 11] While generally responsive to our
recommendation, VA's analysis did not specifically review the accuracy
of BDD claims relative to traditional claims. Moreover, because BDD
claims do not comprise all claims reviewed at the two rating sites, we
continue to believe VA's analysis was not sufficient to estimate the
relative accuracy of BDD claims at these sites. While we agree that
the benefits of reviewing accuracy are difficult to measure, if VA had
better information on the accuracy of BDD claims, VA could use such
information to inform training and focus its monitoring efforts. In
contrast, VA currently performs STAR reviews that target rating
decisions made by its Baltimore and Seattle offices under the DOD-VA
disability evaluation system pilot program. Such a targeted review
could also be conducted for BDD claims.
In its March 2009 report, VA's OIG also identified several
deficiencies in the STAR program and recommended corrective actions.
The OIG found that (1) regional offices did not always submit all
requested sample cases for review, (2) reviewers did not evaluate all
documentation in sample files, and (3) reviewers were not properly
recording some errors. The OIG also found that VBA was not conducting
STAR reviews of redistributed cases (for example, claims assigned to
resource centers for rating). The OIG reviewed a sample of
redistributed claims and found that 69 percent had accurate
entitlement decisions, well below VBA's reported rate of 87 percent
for the 12-month period ending in February 2008. Further, the OIG
found that VBA did not have minimum training requirements for STAR
reviewers.
As of March 2010, VBA had taken actions to respond to all of the OIG's
recommendations related to STAR, including (1) implementing procedures
to follow up on cases not submitted by regional offices; (2) adding a
mechanism to the STAR database to remind reviewers of key decision
points; (3) requiring a second-level review of STAR reviewers' work;
and (4) establishing a requirement that STAR reviewers receive 80
hours of training per year. In addition, during fiscal year 2009,
based in part on the OIG's recommendation, VBA also began monitoring
the accuracy of claims decided by rating resource centers as it does
for regional offices. As we noted in our January 2010 report, VBA has
significantly expanded its practice of redistributing regional
offices' disability claims workloads in recent years,[Footnote 12] and
gathering timeliness and accuracy data on redistributed claims could
help VBA assess the effectiveness of workload redistribution.
In addition, as the Congress has provided more resources to VBA to
increase compensation and pension staffing, VBA has devoted more
resources to quality review. In fiscal year 2008, VBA more than
doubled the size of the quality assurance staff, allowing it to
increase the scope of quality assurance reviews. VA states that in the
12-month period ending in May 2009, STAR staff reviewed over 14,000
compensation and pension benefit entitlement decisions.
Although VBA has taken steps to address deficiencies in the STAR
program, the accuracy of its benefit entitlement decisions has not
improved. The accuracy rate was 86 percent in fiscal year 2008 and 84
percent in fiscal year 2009, well short of VBA's fiscal year 2009 goal
of 90 percent.[Footnote 13] VA attributed this performance to the
relatively large number of newly hired personnel conducting claims
development work and a general lack of training and experience. Human
capital challenges associated with providing the needed training and
acquiring the experience these new claims processors need to become
proficient at their jobs will likely continue in the near future.
According to VBA officials, it can take 3 to 5 years for rating
specialists to become proficient.
VA Has Taken Actions to Strengthen Efforts to Monitor Consistency of
Claims Decisions:
VA has taken actions to address deficiencies identified with its
consistency review programs, but it is still too early to determine
whether these actions will be effective. In prior work, we reported
that VBA did not systematically assess the consistency of decision
making for any specific impairments included in veterans' disability
claims. We noted that if rating data identified indications of
decision inconsistency, VA should systematically study and determine
the extent and causes of such inconsistencies and identify ways to
reduce unacceptable levels of variations among regional offices. Based
on our recommendation, VBA's quality assurance staff began conducting
studies to monitor the extent to which veterans with similar
disabilities receive consistent ratings across regional offices and
individual raters.[Footnote 14] VBA began these studies in fiscal year
2008. VBA identified 61 types of impairments for consistency review
and conducted at least two inter-rater reliability reviews, which
found significant error rates.
In its March 2009 report, the OIG noted that, while VBA had developed
an adequate rating consistency review plan, including metrics to
monitor rating consistency and a method to identify variances in
compensation claim ratings, it had not performed these reviews as
scheduled. In fact, VBA had initiated only 2 of 22 planned consistency
reviews in fiscal year 2008. The OIG reported that VBA had not
conducted these reviews because STAR staffing resources were not
sufficient to perform all of their assigned responsibilities and noted
that VBA's quality review office had not staffed all of its authorized
positions. In addition, the OIG found that inter-rater reliability
reviews were not included in VBA's quality assurance plan. The OIG
recommended that VBA (1) develop an annual rating consistency review
schedule and complete all planned reviews as scheduled; (2) dedicate
sufficient staff to conduct consistency reviews in order to complete
planned workload and reviews; and (3) include inter-rater reliability
reviews as a permanent component of its consistency review program.
VBA reported that it has developed an annual consistency review
schedule and is in the process of conducting scheduled fiscal year
2010 reviews. As of January 2010, VBA also added six staff members to
perform quality assurance reviews. Further, VBA incorporated inter-
rater reliability reviews into its fiscal year 2009 quality assurance
plan. Because VBA has only recently implemented these initiatives, it
is too early to determine their impact on the consistency of claims
decisions.
Conclusion:
Over the years, VA has been challenged in its efforts to ensure that
veterans get the correct decisions on disability claims the first time
they apply for them, regardless of where the claims are decided.
Making accurate, consistent, and timely disability decisions is not
easy, but it is important. Our veterans deserve timely service and
accurate decisions regardless of where their claims for disability
benefits are processed. To fulfill its commitment to quality service,
it is imperative that VA continue to be vigilant in its quality
assurance efforts, as this challenge will likely become even more
difficult as aging veterans and veterans returning from ongoing
conflicts add to VA's workload.
Mr. Chairman, this concludes my prepared statement. I would be pleased
to respond to any questions you or Members of the Subcommittee may
have at this time.
GAO Contact and Staff Acknowledgments:
[End of section]
For further information about this testimony, please contact Daniel
Bertoni at (202) 512-7215 or bertonid@gao.gov. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this testimony. In addition to the contact named
above, key contributors to this statement include Shelia Drake,
Jessica Orr, Martin Scire, and Greg Whitney.
[End of section]
Related GAO Products:
Veterans' Disability Benefits: Further Evaluation of Ongoing
Initiatives Could Help Identify Effective Approaches for Improving
Claims Processing. [hyperlink,
http://www.gao.gov/products/GAO-10-213]. Washington, D.C.: January 29,
2010.
Veterans' Disability Benefits: Preliminary Findings on Claims
Processing Trends and Improvement Efforts. [hyperlink,
http://www.gao.gov/products/GAO-09-910T]. Washington, D.C.: July 29,
2009.
Military Disability System: Increased Supports for Servicemembers and
Better Pilot Planning Could Improve the Disability Evaluation Process.
[hyperlink, http://www.gao.gov/products/GAO-08-1137]. Washington,
D.C.: September 24, 2008.
Veterans' Disability Benefits: Better Accountability and Access Would
Improve the Benefits Delivery at Discharge Program. [hyperlink,
http://www.gao.gov/products/GAO-08-901]. Washington, D.C.: September
9, 2008.
Veterans' Benefits: Improved Management Would Enhance VA's Pension
Program. [hyperlink, http://www.gao.gov/products/GAO-08-112].
Washington, D.C.: February 14, 2008.
Veterans' Benefits: Further Changes in VBA's Field Office Structure
Could Help Improve Disability Claims Processing. [hyperlink,
http://www.gao.gov/products/GAO-06-149]. Washington, D.C.: December 9,
2005.
Veterans Benefits: VA Needs Plan for Assessing Consistency of
Decisions. [hyperlink, http://www.gao.gov/products/GAO-05-99].
Washington, D.C.: November 19, 2004.
VA Disability Benefits: Routine Monitoring of Disability Decisions
Could Improve Consistency. [hyperlink,
http://www.gao.gov/products/GAO-06-120T]. Washington, D.C.: October
20, 2005.
Veterans' Benefits: Improvements Needed in the Reporting and Use of
Data on the Accuracy of Disability Claims Decisions. [hyperlink,
http://www.gao.gov/products/GAO-03-1045]. Washington, D.C.: September
30, 2003.
Veterans' Benefits: Quality Assurance for Disability Claims and
Appeals Processing Can Be Further Improved. [hyperlink,
http://www.gao.gov/products/GAO-02-806]. Washington, D.C.: August 16,
2002.
Veterans' Benefits: Quality Assurance for Disability Claims
Processing. [hyperlink, http://www.gao.gov/products/GAO-01-930R].
Washington, D.C.: August 23, 2001.
Veterans' Benefits Claims: Further Improvements Needed in Claims-
Processing Accuracy. [hyperlink,
http://www.gao.gov/products/GAO/HEHS-99-35]. Washington, D.C.: March
1, 1999.
[End of section]
Footnotes:
[1] These are (1) reviews of consistency of claims decisions across
VA's Veterans Benefits Administration, which is responsible for
administering VA's disability compensation and pension programs, by
type of disabling condition; and (2) inter-rater reliability reviews,
which examine the consistency of raters when evaluating the same
condition based on a comparable body of evidence.
[2] Office of Inspector General, Department of Veterans Affairs, Audit
of Veterans Benefits Administration Compensation Accuracy and
Consistency Reviews (Washington, D.C.: Mar. 12, 2009).
[3] The amount of disability compensation depends largely on the
severity of the disability, which VA measures in 10 percent increments
on a scale of 0 percent to 100 percent. In 2010, basic monthly
payments for veterans range from $123 for 10 percent disability to
$2,673 for 100 percent disability.
[4] In order to be eligible for the BDD program, servicemembers must
meet several requirements, which include filing a VA claim 60 to 180
days prior to an honorable discharge and completing a medical
examination. Under BDD, the examination also serves as Department of
Defense's separation physical examination. Quick Start is for those
servicemembers-primarily members of the National Guard and Reserve--
who cannot meet the BDD timeframe.
[5] For our review of the DOD-VA disability evaluation system pilot
program, see GAO, Military Disability System: Increased Supports for
Servicemembers and Better Pilot Planning Could Improve the Disability
Evaluation Process, [hyperlink,
http://www.gao.gov/products/GAO-08-1137] (Washington, D.C.: Sept. 24,
2008).
[6] Pub. L. No. 110-389, §224; 38 U.S.C. §7731(c).
[7] GAO, Veterans' Benefits Claims: Further Improvements Needed in
Claims-Processing Accuracy, [hyperlink,
http://www.gao.gov/products/GAO/HEHS-99-35] (Washington, D.C.: Mar. 1,
1999).
[8] GAO, Veterans' Benefits: Improved Management Would Enhance VA's
Pension Program, [hyperlink, http://www.gao.gov/products/GAO-08-112]
(Washington, D.C.: Feb. 14, 2008).
[9] The Pension Management Centers are located in St. Paul, Minnesota;
Philadelphia, Pennsylvania; and Milwaukee, Wisconsin.
[10] GAO, Veterans' Disability Benefits: Better Accountability and
Access Would Improve the Benefits Delivery at Discharge Program,
[hyperlink, http://www.gao.gov/products/GAO-08-901] (Washington, D.C.:
Sept. 9, 2008).
[11] BDD claims are rated at the regional offices in Winston-Salem,
North Carolina, and Salt Lake City, Utah.
[12] VBA refers to the practice of redistributing claims as
"brokering."
[13] This rating-related accuracy measure includes original and
reopened claims for disability compensation and dependency and
indemnity (survivor) compensation benefits. Reopened claims include
cases where a veteran seeks a higher rating for a disability or seeks
compensation for an additional condition.
[14] GAO, Veterans' Benefits: Quality Assurance for Disability Claims
and Appeals Processing Can Be Further Improved, [hyperlink,
http://www.gao.gov/products/GAO-02-806] (Washington, D.C.: Aug. 16,
2002).
[End of section]
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E-mail: fraudnet@gao.gov:
Automated answering system: (800) 424-5454 or (202) 512-7470:
Congressional Relations:
Ralph Dawn, Managing Director, dawnr@gao.gov:
(202) 512-4400:
U.S. Government Accountability Office:
441 G Street NW, Room 7125:
Washington, D.C. 20548:
Public Affairs:
Chuck Young, Managing Director, youngc1@gao.gov:
(202) 512-4800:
U.S. Government Accountability Office:
441 G Street NW, Room 7149:
Washington, D.C. 20548:
