U.S. Sen. Richard Burr (R-NC) today announced the results of a new Department of Veterans Affairs Office of Inspector General report involving medical claims. This initiative was purportedly started by the Department to process long-pending claims more quickly, in part by issuing provisional decisions in cases where more evidence was required.

“This latest IG report confirms that VA’s ‘fix’ to its backlog process was just smoke and mirrors and another example of VA manipulating the data to make it appear as if veterans are being well served,” said Senator Burr. “It is absolutely shameful that a department charged with the care of our nation’s veterans would choose to resort to practices that negatively affect them and inaccurately portray the VA’s workload.”

Burr also disclosed some of the details of the IG report as well.

• Use of provisional ratings “allowed claims to be denied more quickly” but did not help provide benefits to veterans any more quickly
  – The Veterans Benefits Administration (VBA)  “actually created a new practice that adversely affected some veterans”
  – Some employees told the IG that “provisional ratings were a bad idea and negatively impacted veterans”
• “VBA created procedures involving provisional ratings that were inconsistent with existing workload practices and misrepresented VBA’s workload statistics and progress towards “eliminating the claims backlog”
  – Removing claims from the backlog after a provisional decision was issued led to VA inaccurately reporting several performance metrics, including the number of pending claims, the time it took to complete claims, the number of claims VA completed, and the average time claims were pending
• VBA did not place a priority on finishing claims that had received provisional decisions; VBA was focusing on claims still counted in the backlog
• VBA “did not have a way to guarantee they identified all provisional ratings to process the further actions needed.”
• VBA did not accurately process 83 percent of provisional decisions in the sample reviewed by the IG and did not accurately process 23 percent of the 2-year-old claims that received final decisions under this initiative
  -Errors occurred because employees “felt pressured to complete the Special Initiative claims within VBA’s 60-day processing deadline”
  -Some regional offices stopped quality reviews for these claims because of pressure to meet the deadline

The entire Office of Inspector General report can be viewed at this link.