Veterans Benefit Administration (VBA) Disability Compensation Program Department of Veterans Affairs (VA)

VBA’s Compensation program provides monthly benefit payments to eligible Veterans in recognition of the effects of mental and physical disabilities incurred or aggravated from trauma, diseases, injuries, or events during active military service.

Agency Accountable Official: Mr. Edward J. Murray, Acting Assistant Secretary for Management and Acting Chief Financial Officer

Program Accountable Official: Mr. Danny Devine, Deputy Director Compensation Policy and Procedures

Total Payments
$63.9B
Improper Payments
$0.4B
Improper Payment Rate
0.59%

Supplemental Measures

Current Measure: As of March 31, 2017, 19.29 percent of temporary 100 percent disability compensation claims are pending over 125 days. As temporary 100 percent disability evaluations have been a specific focus by the Office of Inspector General (OIG) over the past year, Compensation Service has worked with OIG to set goals and improve timeliness.

Target: No more than 15 percent of claims pending over 125 days

Description: By September 30, 2017, reduce the number of temporary 100 percent disability claims pending for more than 125 days to no more than 15 percent of the total claims. Veterans are assigned temporary 100 percent evaluations for disabilities warranting 100 percent disability compensation for a finite period of time. Untimely processing may result in a Veteran keeping their 100 percent disability longer than potentially needed, resulting in an improper payment. Historically, VBA was not able to consistently achieve this standard when processing the temporary 100 percent disability claims. VBA is working to eliminate claims older than 125 days through routine monitoring of the pending workload. VBA has also implemented tools to help track aging claims and promptly take necessary actions. VBA’s goal to reduce the number of claims over 125 days by 4 percent by the end of fiscal year (FY) 2017. This goal was chosen as a realistic stretch goal as these types of claims require time-consuming follow-up medical examinations required to support the Veteran’s evaluation. At the end of a mandated period of convalescence or treatment, VBA is required to request a follow-up medical examination if available evidence is not adequate to help determine whether to continue the veteran’s 100 percent disability evaluation. This has been an issue OIG has targeted and when Compensation’s High Priority Designation was made, VBA was already working diligently to make improvements. Based on trending/tracking the average days pending, VBA thinks this will be an achievable/realistic goal.

Update Frequency: Quarterly

Data Current as of: March 2017

Current Measure: As of March 31, 2017, errors related to inaccurate disability evaluations accounted for 1.75 percent of quality assurance errors..

Target: 1.12%

Description: By September 30, 2017, reduce the errors related to inaccurate disability evaluations from 1.15 percent to no more than 1.12 percent. The number of known errors in disability evaluations is based on quality assurance testing and includes instances where (1) the veteran is being underpaid disability compensation (under-evaluations) and (2) the veteran is being overpaid disability compensation (over-evaluations). The error rate for the under/over-evaluations in FY 2014 was 1.25 percent and dropped to 1.15 percent in FY 2015. VA is targeting a 2 percent decrease in the FY 2016 error rate to get to the target error rate of 1.12 percent. VBA has made strides in improving quality and consistency of Veterans’ disability evaluations through the use of standardized and automated evaluation tools. Historically, Veterans have been evaluated and assigned a disability rating either higher or lower than they are entitled under the Schedule for Rating Disability leading to improper payments. VBA is taking steps to increase quality, which will impact the accuracy of the disability evaluations and impact improper payments related to these errors.

Update Frequency: Semi-annually

Data Current as of: March 2017

Current Measure: VBA’s dependency claim inventory is 87,779 as of March 31, 2017.

Target: Reduce inventory to 100,000 claims (about 56 percent)

Description: By September 30, 2017, reduce the inventory of dependency claims by approximately 127,000 (about 56 percent) to 100,000. Dependency claims are among the major drivers of improper payments. At the end of FY 2015, the dependency claims inventory was almost 227,000. At the end of FY16, the dependency claims inventory was 114,789. Veterans may be entitled to receive additional benefits for their dependents. Veterans are required to provide the necessary evidence to add a dependent(s) into their monthly benefit and notify VA of changes in their dependent status (i.e. birth, death, divorce). Improper payments occur when dependents are not added/removed timely when VA had the evidence on file of the change. Processing dependency claims more timely will ultimately impact the amount of improper payments. VBA has an aggressive plan to reduce the inventory to 100,000 by the end of FY 2017. As the dependency claim inventory is reduced, claims are processed more timely and erroneous omissions of dependents from monthly benefit payments is also reduced. This ensures Veterans are receiving the accurate benefit payment they are eligible for, reducing the number of errors and, ultimately, the amount of improper payments.

Update Frequency: Quarterly

Data Current as of: March 2017


Program Comments

To determine payment accuracy, VBA samples its disability compensation payment universe to ensure payments to Veterans are correct. VBA uses a statistically valid sample to determine the payment accuracy rates. In FY 2015, VBA introduced a more robust methodology to test sampled compensation payments that continues in FY 2017. As a result, additional claims’ decisions were reviewed, increasing estimated improper payments. VBA’s Compensation Service will implement corrective actions to ensure greater compliance.

VBA is working on processing payments more timely, prioritizing claims to be processed, and using contractors to reduce the amount of time it takes to process dependency claims, to include the use of a rules-based processing system. VBA is also using automation to help process claims more timely, monitoring the age of the pending inventory, and identifying priority cases. Additionally, VBA is performing highly rigorous consistency studies, providing training, and standardizing tools to help drive the accuracy of processing Veterans’ benefits. Additional information on the program and detail on the progress of corrective actions can be found in VA’s Agency Financial Report located at https://www.va.gov/finance/afr/index.asp.