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Review of Automated Decisions for Veterans’ Service-Connected Death Claims

Report Information

Issue Date
Report Number
25-00153-47
VA Office
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Report Topic
Claims and Appeals
Claims and Fiduciary
Major Management Challenges
Benefits for Veterans
Information Systems and Innovation
Recommendations
3
Questioned Costs
$2,727,764
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary

The VA Office of Inspector General (OIG) reviewed whether the Veterans Benefits Administration’s (VBA) automated Pension and Fiduciary Service decisions correctly granted survivors’ entitlement to service-connected death benefits from September 2023 through August 2024. The OIG found legal and procedural deficiencies in automated rating decisions and notification letters. At least 8,000 decisions or letters omitted favorable findings and had issues such as incomplete evidence summaries and incorrect formatting. At least 2 percent of decisions had legal errors, resulting in an estimated $2.7 million in improper payments. A review of additional cases through November 2025 confirmed similar errors. The quality review process for automated claims was less rigorous than for traditional claims, and VA’s modernization plan to Congress did not fully explain how some claims were completely processed from beginning to end by automation.

Deficiencies stemmed from flaws in automation rules and processes that, if not addressed, will recur because the system applies predefined rules without human involvement. Oversight tools were inadequate, and procedural guidance changes did not fully address risks.

The OIG made three recommendations to the under secretary for benefits to strengthen automation processes and oversight. These include improving legal compliance in automated decisions, enhancing quality review standards, and ensuring transparency in reporting automation practices to Congress. VBA concurred in part with the first recommendation, concurred with the second, and concurred in principle with the third.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Benefits Administration (VBA)

Strengthen and monitor the automation process to ensure that automated Dependency and Indemnity Compensation rating decisions and notifications fully comply with all legal requirements and procedural guidance.

No. 2
Open Recommendation Image, Square
to Veterans Benefits Administration (VBA)

Ensure the Pension and Fiduciary Service revises the quality review checklist for automated death benefits decisions so that those decisions undergo the same scrutiny as traditionally processed claims.

No. 3
Open Recommendation Image, Square
to Veterans Benefits Administration (VBA)

Consult with VA’s Office of General Counsel to determine whether the modernization plan submitted to Congress—regarding service-connected death benefit grants—complies with section 701(b) of the PACT Act and take appropriate corrective action if needed.

Total Monetary Impact of All Recommendations
Open: $ 2,727,764.00
Closed: $ 0.00