Wayne Neal II

Alamogordo Daily News

ALAMOGORDO – Sen. Tom Udall held a press conference call Tuesday to discuss the recent shootings in Dallas, Minnesota and Louisiana and talk about the recently released Office of Inspector General report of an investigation of practices at the VA medical center in Albuquerque.

The Department of Veterans Affairs Office of Inspector General audited the VA Regional Office in Albuquerque and found staff members did not accurately process 23 of 58 (40 percent) disability claims that were reviewed, according to the report.

Udall said the director is taking the appropriate actions to develop his staff and make sure these errors are corrected.

“I think what’s happened is since the OIG report came out even well before that the director of the facility there has been working on improving working on changes," he said. "The director takes this very seriously and I think he takes his mission to help our veterans very seriously."

The report shows the clinic inaccurately processed 10 of the 28 claims for Traumatic Brain Injury and inaccurately processed 13 of 30 temporary 100 percent disability evaluations. The report recommended VA Regional Office (VARO) Director develop and implement a plan to review all temporary 100 percent disability evaluations remaining from the inspection and take appropriate action.

“The New Mexico VA Health Care System takes very seriously our mission to provide top quality care to our veterans in a timely manner,” said Andrew Welch, NMVAHCS Director. “We are making lasting improvements in access to VA care by expanding capacity, focusing on staffing, space, productivity and VA Community Care. We want to hear from those veterans to assure they have information to consider their options for care within the NMVAHCS or through the Veterans Choice Program.

The Office of Inspector General inspected the Albuquerque VA in March 2013 and focused on disability claims processing, management controls, eligibility determinations and public contact. Within those areas, the report stated, the inspection looked at two high risk claims processing areas: Traumatic Brain Injury (TBI) claims and temporary 100 percent disability evaluations.

The report states, for temporary 100 percent disability evaluations, including confirmed and continued (C&C) evaluations where rating decisions do not change veterans’ payment amounts, Veteran's Service Center (VSC) staff must input suspense diaries in Veterans Benefit Administration (VBA’s) electronic system. A suspense diary is a processing command that establishes a date when VSC staff must schedule a medical reexamination.Public Affairs Speicalist Bill Armstrong said the clinic is continuing to make strides and improvements.

"Staffing at NMVAHCS is up to more than 2,822 employees, including more than 207 physicians and 667 nurses. Combined with our 13 community based outpatient clinics (including Alamogordo’s) spread across New Mexico," Armstrong said. "We provide care to approximately 58,000 Veterans at more than 685,375 outpatient visits completed annually. As suggested in the report, VA has made significant investments in training, field reviews and enhanced scheduling practices. In June 2014, NMVAHCS began aggressively training and retraining all of our personnel responsible for scheduling patients to ensure that there is no confusion in scheduling procedures."

According to the report, three errors occurred when staff did not establish suspense diaries in the electronic system, thereby removing the possibility that the staff would receive reminder notifications to schedule medical examinations. Three errors occurred when a Rating Veterans Service Representative (RVSR’s) assigned improper effective dates for veterans’ disabilities, resulting in incorrect benefit payments. Two errors occurred when staff proposed to reduce veterans’ benefits payments but did not establish controls to manage the proposed reductions.

Due to the inaccuracy of the evaluations, 169 improper payments to seven veterans totaling $134,918 from April 2001 until February 2013 were given out. Without effective management of temporary 100 percent disability ratings, the Veterans Benefit Administration(VBA) is at increased risk of paying inaccurate financial benefits, the report shows.

The report stated, available medical evidence showed 6 of the 13 processing errors that were identified affected veterans’ benefits.

Also in the report, staff incorrectly processed 10 of 28 TBI claims that affected a veteran’s benefits and resulted in an over payment of $320. The remaining 9 of the 10 errors had the potential to affect veterans’ benefits.

The inspection also examined three operational activities: Systematic Analyses of Operations (SAO), Gulf War veterans’ entitlement to mental health treatment and the homeless veterans outreach program.

Three of the 11 SAO’s were untimely or not completed, according to the report. Two were due to inadequate oversight and staff did not properly grant entitlement to mental health treatment in two of four claims reviewed.

The outreach to homeless veterans’ programs had no recommendations to make as the VA maintained liaisons with homeless outreach facilities and provided information for benefits and services.

The VARO Director agreed with the assessment despite some staff members disagreeing with 5 of the 23 claims processing errors that were identified, the report shows. A few recommendations the report suggested were to conduct refresher training and processing traumatic brain injury claims and implement a plan to monitor the effectiveness of the training. Develop and implement a plan to ensure staff return insufficient medical examination reports.

Some of the staff did not agree with two of the errors associated with temporary 100 percent disability evaluations and three errors associated with TBI claims processing, according to the report.

The Inspector General's report is online at http://www.va.gov/oig/pubs/VAOIG-13-00993-274.pdf