VA performs disability reevaluations for disabilities required by regulation  and whenever it determines that it is likely that a disability has improved,  or if evidence indicates there has been a material change in a disability or  that the current rating may be incorrect. VBA’s Operational Controls Do Not Ensure That Disability Reevaluations Occur, but VBA Is Planning to Update Some of Its Processes and Procedures

VBA’s operational controls do not adequately ensure that staff schedule or  conduct disability reevaluations as necessary. VBA’s claims processing  software does not ensure that diary dates are established. VBA plans on improving some of its  control mechanisms through its new claims management system,  VETSNET. The diary date is the only VBA procedural trigger  that alerts regional offices that a claim needs to be reviewed. Some Disability Reevaluations Not Tracked or Reviewed

Once the regional office receives the paper notice that a reevaluation is  due, staff perform a preliminary assessment of the veteran’s claim file to  determine if more comprehensive reevaluation should be conducted. If  staff determine during this preliminary assessment that a reevaluation is  no longer needed, they can cancel the reevaluation. Also, cancelled  reevaluations are not subject to quality assurance reviews. VBA plans on  improving its ability to track cancellations using VETSNET. VBA Lacks Adequate Program Information to Effectively Manage the Disability Reevaluation Process

VBA cannot effectively manage the disability reevaluation process because  some of the data it collects are not consistent and it does not  systematically collect and analyze key management data. While VBA  collects data on the amount of time regional offices take to conduct  disability reevaluations, these data are not reliable. Also, VBA does not  know the number of reevaluation diary dates that mature in a year or the  types of disabilities being reevaluated, the length of time before  reevaluations are conducted, or if the reevaluation decisions result in an  increase, decrease, or no change in the severity of veterans’ disabilities. Timeliness Data Are Inconsistent

VBA’s disability reevaluation timeliness data are inconsistent because  regional offices use different starting points for measuring how long it  takes to complete reevaluations. VBA should develop a plan to collect and analyze data on the results of  disability reevaluations.
Why GAO Did This Study

To help ensure that veterans are properly compensated for disabilities, VA is required to perform disability reevaluations for specific disabilities. VA also performs reevaluations whenever it determines there is a need to verify either the continued existence or current severity of veterans' disabilities. VBA completed about 17,700 reevaluations in fiscal year 2005. GAO was asked to review the Veterans Benefits Administration's (VBA) disability reevaluation program. This report assesses (1) the operational controls VA uses to ensure the effectiveness of the disability reevaluation process and (2) the management information VA collects and uses to manage the disability reevaluation process. To conduct this study, GAO analyzed VBA data, reviewed federal regulations and VBA procedures, conducted site visits, and interviewed VBA officials.

What GAO Found

VBA's operational controls do not adequately ensure that staff schedule or conduct disability reevaluations as necessary; however, VBA is planning to improve some of the controls. VBA claims processing software does not automatically establish or prompt regional office staff to schedule a time - known as a diary date - to determine whether a disability reevaluation should proceed. Consequently, some cases that require a reevaluation may never receive it. After the diary date matures, staff perform a preliminary review of a veteran's claim file to determine if a more comprehensive reevaluation should be conducted. If staff determine during this review that a reevaluation is no longer needed, the reevaluation is cancelled. However, cancellations are not tracked or subject to quality assurance reviews to ensure adherence to program policies and procedures. VBA plans on improving some of its control mechanisms through its new claims management system, the Veterans Service Network (VETSNET), including developing the ability to track cancellations. However, VBA has no plans to include a prompt for scheduling reevaluation diary dates in VETSNET. VBA cannot effectively manage the disability reevaluation process because some of the data it collects are inconsistent and it does not systematically collect and analyze key management data. While VBA collects data on the amount of time regional offices take to conduct disability reevaluations, these data are not consistentbecause regional offices use different starting points for measuring timeliness. Also, VBA does not know the types of disabilities being reevaluated, the length of time before reevaluations are conducted, or the results of the reevaluations. As a result, VBA cannot ensure that it is effectively and appropriately using its resources.