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VOL. 37 | NO. 13 | Friday, March 29, 2013

Audit: Vet benefits wrongly processed in Nashville

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NASHVILLE (AP) - An audit of the Veterans Affairs regional office in Nashville found that staff did not always accurately process medical disability and traumatic brain injury claims filed by veterans and said more outreach was necessary to reach homeless veterans outside Nashville.

The audit results, released by the VA's Office of Inspector General on Thursday, stemmed from an inspection last September. The regional office director said several changes were made to address the findings.

The auditors sampled 59 claims. The claims were related to traumatic brain injury or involved granting veterans temporary 100 percent disability evaluations. The two areas are considered high risk for errors, and the results don't reflect the overall accuracy of VA disability claims processed in Nashville.

Of the sample cases reviewed, auditors found that about 41 percent were incorrectly processed.

Veterans Benefits Administration policy requir es that veterans receive a temporary 100 percent disability evaluation after a surgery or when specific treatment is needed. A re-examination is required after veteran's recovery period to determine whether benefits should continue.

The audit found long delays in scheduling the re-examinations, and auditors could not always determine whether the benefits should have continued because of lack of a follow-up.

"For cases requiring medical reexaminations, delays ranged from approximately 11 months to two years and three months," the report stated.

In one case, auditors found the VA underpaid a veteran more than $10,000 over two years.

The director of the VA regional office in Nashville, Edna MacDonald, told the OIG's office in a response to the findings that software has been upgraded to determine whether re-examinations are required for claims.

In the traumatic brain injury claims, staff incorrectly processed about a third of the sampled claims, the audit found. Auditors found errors when staff used the same symptoms under multiple diagnostic codes to evaluate veterans' disabilities and assigned evaluations or established a TBI-related disability that was unsupported by medical evidence.

The local office reorganized in November to assign TBI claims to a special operations team and required additional training for processing those claims.

The audit also said that Gulf War veterans were not always made aware of their possible entitlement to treatment for mental disorders.

The Nashville VA regional office has jurisdiction over all 95 counties in the state, but staff did not regularly contact or provide information to homeless shelters outside of the Nashville area, the audit found. The staff also was incorrectly flagging some veterans' claims as financial hardship cases, instead of labeling them as homeless. The labels, called flashes, help the VBA track homeless veterans and to ensure those cases are ide ntified for expedited processing.

This mislabeling occurred when veterans changed their addresses, participated in veteran housing initiatives, or were lived in transitional housing. MacDonald told the OIG that staff still expedited those claims.