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March 23, 2026 | By Cope | 16 min read

The VA Built an AI to Find Fraud in Your Claims. Here's What Their Own Inspector General Found in Theirs.

In March 2026, the VA announced it would scan over a million private-provider DBQs for fraud indicators. Before you worry about their tool, look at what the VA's own Office of Inspector General and the federal courts found when they audited the VA.

DISCLAIMER
This article cites publicly available government reports, federal court data, and peer-reviewed academic research. Every number links to its source. Claim Recon is an educational tools platform. Not affiliated with the VA. Not legal or medical advice.

The Numbers

These are not opinions. These are findings from the VA's own Inspector General, the Government Accountability Office, the U.S. Court of Appeals for Veterans Claims, and Stanford University's peer-reviewed research.

$2.2B
Improper payments across VA programs in FY2024
VA OIG Report #24-03777-113 (May 2025)
$4,170/mo
Maximum underpayment from VA's broken SMC calculator
VA OIG Report #24-01083-112 (May 2025)
80%
BVA decisions remanded by the federal court (FY2020-2022)
GAO Report GAO-24-106156 (November 2023)
93.5%
BVA self-reported 'accuracy' rate in the same period
BVA Annual Report to Congress; Stanford, 2019

The Broken Calculator

In May 2025, the VA Office of Inspector General published Report #24-01083-112, documenting that the Special Monthly Compensation (SMC) calculator inside the Veterans Benefits Management System produced incorrect results. The calculator, in use since 2017, generated underpayments ranging from $132.74 to $4,170.59 per month for severely disabled veterans. VA officials could not determine the cause of the errors or how long they had been occurring. The calculator was disabled in October 2024.

Source: VA OIG, "VBA's Special Monthly Compensation Calculator in VBMS for Rating Did Not Always Produce Accurate Results," Report #24-01083-112, May 29, 2025

The OIG tested hypothetical disability scenarios, not actual veteran records, so the total number of affected veterans remains unknown. Some claims processors used a separate legacy calculator that worked correctly. No retroactive payment corrections have been announced. The OIG's recommendation to identify and correct all erroneous scenarios remains open.

$2.2 Billion in Improper Payments

The VA OIG's FY2024 Payment Integrity review (Report #24-03777-113, May 2025) estimated $2.2 billion in improper and unknown payments across seven VA programs. Of that total, $1.1 billion represented monetary loss. Two programs had improper payment rates exceeding 10%, causing the VA to fail one of six federal compliance requirements.

Source: VA OIG, "Review of VA's Compliance with the Payment Integrity Information Act for Fiscal Year 2024," Report #24-03777-113, May 21, 2025

Separately, congressional testimony established that VA issued approximately $5.1 billion in compensation and pension overpayments between FY2021 and FY2024 combined.

The 93.5% Accuracy Illusion

The Board of Veterans' Appeals has reported accuracy rates above 90% to Congress for years. In FY2018, the BVA claimed 93.5% accuracy. But a peer-reviewed Stanford University study analyzed nearly 600,000 BVA cases from 2003-2016 and found that the BVA's quality review process "had no appreciable effects on appeals or remands." The quality review was, in the researchers' words, "inefficacious by design" because the accuracy metric conflicted with actual error correction.

Source: Daniel E. Ho et al., "Quality Review of Mass Adjudication," Journal of Law, Economics, & Organization, Vol. 35, No. 2, pp. 239-288 (2019)

In that same year, the U.S. Court of Appeals for Veterans Claims received 4,842 appealed BVA decisions. Only 382 (7%) were affirmed. Approximately 80% were remanded in whole or in part. The GAO confirmed this pattern continues: between FY2020 and FY2022, CAVC remanded roughly 80% of appealed Board decisions, "often because CAVC found the Board's explanation of its findings to be inadequate."

Source: GAO, "VA Disability Benefits: Board of Veterans' Appeals Should Address Gaps in Its Quality Assurance Process," GAO-24-106156, November 2023

The BVA reports 93.5% accuracy internally while federal courts reverse or remand 80% of the decisions they review. Those two numbers cannot both be right.

Now They're Scanning Your DBQs

In March 2026, Stars and Stripes reported that the VA developed a data analytics tool to scan over 1 million private-provider Disability Benefits Questionnaires accumulated since 2010. VBA Deputy Executive Director James W. Smith testified at a House Veterans' Affairs Subcommittee hearing that the tool flags indicators including: high-volume submissions from the same provider, boilerplate language across multiple veterans, document alteration, and examiner addresses more than 100 miles from the veteran.

Source: Linda F. Hersey, "VA plans to scan a million veterans claims for signs of fraud," Stars and Stripes, March 9, 2026

Veterans advocates raised alarm. DAV issued a formal statement of concern. The 100-mile distance flag could incorrectly flag legitimate telehealth appointments, particularly for mental health care where provider shortages are severe. The VA later clarified the tool is "forward-looking only" and will not be used to reopen previously finalized decisions.

What This Means for You

The VA is building tools to audit your claims. That is their prerogative. But the documented record shows the VA's own systems have errors that cost veterans thousands of dollars per month, that their internal accuracy metrics are contradicted by federal court outcomes, and that $2.2 billion in improper payments flowed through their programs in a single fiscal year.

You have every right to understand the same regulations, rating criteria, and case law that VA raters use. You have every right to check your own rating decision for errors. You have every right to show up to your C&P exam knowing what the examiner is required to measure. That is not fraud. That is preparation.

"The VA's own calculator underpaid severely disabled veterans by up to $4,170 a month for years before the Inspector General caught it. Their Board claims 93.5% accuracy while federal courts remand 80% of the decisions they review. Now they're building AI to scan your paperwork for fraud. We built tools that read the same regulations their raters use — so you can check their work before they check yours."
— Cope, U.S. Army Veteran (101st Airborne), Founder of Claim Recon
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Sources

1. VA OIG Report #24-03777-113 — Payment Integrity FY2024 (May 21, 2025)
2. VA OIG Report #24-01083-112 — SMC Calculator Errors (May 29, 2025)
3. GAO Report GAO-24-106156 — BVA Quality Assurance Gaps (Nov 2023)
4. Ho et al., "Quality Review of Mass Adjudication," JLEO Vol.35 No.2 (2019)
5. Stars and Stripes — "VA plans to scan a million claims" (Mar 9, 2026)
6. CAVC Annual Report FY2018 (uscourts.cavc.gov)
7. House Veterans' Affairs Subcommittee Hearing (Feb 3, 2026)
Not affiliated with the U.S. Department of Veterans Affairs. Educational tools only — not legal or medical advice. All statistics sourced from publicly available government reports, federal court data, and peer-reviewed academic research.