1). In the average disability compensation claim, the veteran  claims about five disabilities. During our 2002 evaluation, we reviewed the Board’s methods for  selecting random samples of Board decisions and calculating accuracy  rates for its decisions. These practices  included not ensuring that decisions made near the end of the fiscal year  were sampled and not properly weighting quality review results in the  formula used to calculate accuracy rates. The quality review program now selects every 20th  original decision made by the Board’s veterans law judges and every 10th  decision they make on cases remanded by the court to the Board for  rework. However, we found that the Board had not revised its formula for  calculating accuracy rates in order to properly weight the quality review  results for original decisions versus the results for decisions on remanded  cases. However, to  avoid the potential for reporting a misleading accuracy rate in the future,  corrective action needs to be taken, and the Board agreed to correct this  issue in the very near future. In our 2002 evaluation, we also found that the Board included  nonsubstantive deficiencies (errors that would not be expected to result in  either a remand by the court or a reversal by the court) in calculating its  reported accuracy rates. Adjudicator Judgment Results in Inherent Variation in Decision- making

Adjudicators often must use judgment in making disability decisions. But it is reasonable to expect the extent of  variation to be confined within a range that knowledgeable professionals  could agree is reasonable, recognizing that disability criteria are more  objective for some disabilities than for others. In January 2003, we  reported that concerns about consistency had contributed to GAO’s  designation of the VA disability program as high-risk in 2003. Reacting  to these media reports, in December 2004, the Secretary instructed the  Inspector General to determine why average payments per veteran vary  widely from state to state. We support such efforts  but still believe VA needs to directly evaluate and measure consistency  across all levels of adjudication. While we believe the studies recently begun by the Office of Inspector  General and VBA are positive steps forward in addressing consistency  issues, the RBA 2000 data system, if found to be reliable, can provide VA  with the data needed to proactively and systematically target specific  impairments that have the widest variations in decision-making outcomes  among the regional offices and focus VA’s efforts to study reasons for  variations on those impairments. Related GAO Products

Veterans Benefits: VA Needs Plan for Assessing Consistency of  Decisions. Veterans Benefits Administration: Problems and Challenges Facing  Disability Claims Processing.
Why GAO Did This Study

The House Subcommittee on Disability Assistance and Memorial Affairs asked GAO to update a 2002 study to determine what VA has done to (1) correct reported weaknesses in methods used by the Board to select decisions for quality review and calculate the accuracy rates reported by the Board and (2) address the potential for inconsistency in decision-making at all levels of adjudication in VA, including VA's 57 regional offices and the Board. GAO said in 2002 that VA had not studied consistency even though adjudicator judgment is inherently required in the decision-making process, and state-to-state variations in the average disability compensation payment per veteran raised questions about consistency. In January 2003, in part because of concerns about consistency, GAO designated VA's disability program as high-risk.

What GAO Found

The Department of Veterans Affairs (VA) has taken steps to respond to GAO's 2002 recommendations to correct weaknesses in the methods for selecting decisions by the Board of Veterans' Appeals (Board) for quality review and calculating the accuracy rates reported by the Board. Specifically, the Board now ensures that decisions made near the end of the fiscal year are included in the quality review sample, and the Board now excludes from its accuracy rate calculations any errors that do not have the potential for resulting in a reversal by or remand from the court. GAO found that the Board had not yet revised its formula for calculating accuracy rates in order to properly weight the quality review results for original Board decisions versus the results for Board decisions on cases remanded by the court. However, GAO believes correcting this calculation method will not materially affect the Board's reported accuracy rates. VA still lacks a systematic method for ensuring the consistency of decision-making within VA as a whole, but has begun efforts to understand why average compensation payments per veteran vary widely from state to state. These efforts include studies underway by VA's Office of Inspector General and the Veterans Benefits Administration, which oversees the operations of VA's regional offices. Some variation is expected since adjudicators often must use judgment in making disability decisions, but VA faces the challenge of determining whether the extent of variation is confined within a range that knowledgeable professionals could agree is reasonable.