What the Review Found The OIG substantiated the allegation that supplemental claims were not always established within 48 hours of higher-level reviews being completed.9 The review team identified approximately 47,100 higher-level reviews completed in calendar year 2022 and nearly 5,100 higher-level reviews completed in January 2023 alone. From this population, the team reviewed a statistical sample of 190 random higher-level reviews stratified by month.
The OIG estimated from its statistical samples that 44,500 of 47,100 higher-level reviews in 2022 (94 percent) did not have a supplemental claim established within 48 hours of the higher-level review being completed. However, the review team did not find any instances in which a supplemental claim was not eventually established from a higher-level review closed in 2022. The period for establishing the supplemental claims ranged from one to 423 days, with an average of 41 days.
For higher-level reviews completed in January 2023 (when some corrective actions were initiated by VA), an estimated 4,600 of 5,100 (about 91 percent) did not have a supplemental claim established within 48 hours of completion.11 The time to establish the supplemental claims ranged from one to 71 days, with an improved average of 16 days. Despite the improvement, continued failures to meet the 48-hour timeline potentially delayed eligible veterans’ receipt of benefits.
An OAR senior management and program analyst stated that around October 2022, he discovered the time for establishing supplemental claims was significantly higher than the time to establish other claims. As a result of this discovery, VA’s Office of Information and Technology (OIT) conducted an analysis to determine what was keeping the supplemental claims…
Not Yet a Premium Partner/Sponsor? Learn more about the OS AI Premium Corporate and Individual Plans here. Plans start at $250 annually.