Audit of High-Risk Areas in the Veterans Health Administration's (VHA) Workers' Compensation Program

AUDIT OFHIGH RISK AREAS IN THEVETERANS HEALTH ADMINISTRATION’S (VHA)WORKERS’ COMPENSATION PROGRAM (WCP)VHA’s WCP costs can be reduced with enhancedmanagement and oversight of claims in certainhigh risk areas.Report No.: 99-00046 16Date: December 21, 1999Office of Inspector GeneralWashington DC 20420Memorandum to the Acting Under Secretary for Health (10)Audit of High Risk Areas in the Veterans Health Administration’s (VHA)Workers’ Compensation Program (WCP)1. The purpose of the audit was to assist the Department of Veterans Affairs (VA) VeteransHealth Administration (VHA) in assessing the risks for abuse, fraud, and unnecessary costsassociated with certain types of Workers’ Compensation Program (WCP) claims. The audit wascompleted as part of the Office of Inspector General’s (OIG) continued effort to enhance theeffectiveness of VHA’s review and oversight of WCP claims. Specifically, the audit reviewedVHA WCP claims involving the following three high-risk areas:• Dual Benefits – Concurrent payments of VA and WCP compensation benefits for the sameinjury.• Non-VHA Employee – WCP Claimants that were not employed by VHA at time work-related injury occurred.• Deceased WCP Claimants – Deceased WCP claimants whose WCP compensation was notproperly terminated or continued entitlement to survivor’s benefits was not properly verified.2. VHA is a major employer with the largest healthcare system in the United States thatprovides medical service at over 1 ...