Quality Assurance for Disability Claims Processing
GAO-01-930R: Published: Aug 23, 2001. Publicly Released: Sep 17, 2001.
Congress, the Department of Veterans Affairs, and veterans service organizations have all raised concerns about the accuracy of claims processing in the Veterans Benefits Administration (VBA). In 1998, VBA launched its systematic technical accuracy review (STAR) system to better measure the accuracy of claims processing. The system determines accuracy rates for (1) the nation as a whole, (2) each VBA service delivery network, and (3) each VBA regional office. GAO reported in 1999 that the accuracy rates for claims processing at regional offices was being determined by regional staff who themselves were involved in processing claims and who reported to managers responsible for claims processing. This arrangement did not meet either the government's internal control standard calling for the segregation of key duties or the performance audit standard calling for organizational independence for those who review and evaluate program performance. Congress subsequently required VBA to institute a quality assurance program that met government standards. VBA plans to modify the STAR system by October 1, 2001, to bring it into compliance with the standards on the segregation of duties and organizational independence. All STAR reviews will be done by staff of the Compensation and Pension Service who themselves do not process claims and do not report to managers responsible for claims processing. If implemented as planned, this change should bring the STAR system into compliance with government standards.