Veterans' Benefits:

Allegations Concerning Claims Adjudication at Wilmington, Delaware, Center

HRD-89-135BR: Published: Aug 31, 1989. Publicly Released: Oct 13, 1989.

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Pursuant to a congressional request, GAO investigated certain allegations regarding the adjudication of disability compensation claims by the Department of Veterans Affairs (VA) Medical and Regional Office Center in Wilmington, Delaware.

GAO found that the Center: (1) cited reduced staffing, decentralized claims handling, and delayed medical examinations as primary reasons why it did not meet VA timeliness standards for processing initial disability benefit claims; (2) established a maximum period for completing and reporting medical examinations that was shorter than the national VA maximum and realigned its work load with neighboring regional offices; (3) processed 65 percent of initial claims and 84 percent of reopened claims within 180 days for the 12 months ending March 1989, compared with VA standards of 70 percent and 86 percent, respectively; and (4) increased its number of medical examinations by about 300 per year, restricted medical examination contracts to psychiatric and orthopedic examinations, eliminated routine ordering of medical specialty examinations for initial claims, and incorporated timeliness standards into the regional office and medical center directors' performance contracts. In addition, GAO found that there was no: (1) basis for questioning differences between veterans' VA disability ratings and Social Security Disability Insurance program ratings, since the programs had different laws and rules; and (2) evidence to substantiate allegations regarding an unqualified rating board physician, improper documentation of service connection, or quotas for denied claims.

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