Exam Verification Agent

Overview

Development stage

In development or acquisitionSource: a) Pre-deployment – The use case is in a development or acquisition status.

High-impact designation

High-impactSource: a) High-impact

Impact justification

Not reported

Start date

Not reported

Withheld from public reporting

Not reported

Mission

Topic area

Government Benefits Processing

Operational functions

No function tag matched Derived by keyword rules; see methodology

Problem the AI is intended to solve

The process for a Veteran Service Representative (VSR) to determine if an exam is warranted for a claim for increase (claims with end product [EP] 020) for a given contention requires that the VSR expend considerable effort and time to review extensive documentation within a Veteran or Claimant's eFolder. VSR needs review this documentation to identify whether sufficient evidence already exists for the claim to proceed to a rating or if an exam should be ordered to be able to rate the claim. The AI will reduce the time needed to review the evidence by providing a list of related evidence to the contention and a recommendation on whether an exam is needed.

Expected benefits

The Exam Verification Agent system will reduce the time needed to develop a claim, increasing efficiency in benefits processing. It transforms the complex and time-intensive process of determining medical exam necessity for disability claims for increase by deploying multiple specialized AI agents. The agents autonomously evaluate claim evidence and provide a recommendation and a summary of the reasoning for the recommendation to the user.

System outputs

The product will provide VSRs with: - An agentic AI tool that identifies whether an exam is required for each contention for which there is a Claim for Increase - A summary of evidence identified within the file and links to the documents identified within the Veteran’s file.

Technology

AI classification

Agentic AISource: Agentic AI: AI systems that perform tasks or make decisions autonomously with minimal human intervention.

System name(s)

Not reported

Custom-developed code

Not reported

Public source code

Not reported

Sourcing

How it was built

Not reported

Vendor (as reported)

Not reported

Vendors (standardized)

None on the standard list

A vendor is the supplier named by the agency. It does not identify the underlying model or AI technology.

Data and privacy

Involves PII

Not reported

Privacy Impact Assessment

Not reported

Authorization to Operate

Not reported

Demographic features

Not reported

Training and evaluation data

Not reported

Federal Data Catalog

Not reported

Governance

0 of 8 minimum-practice questions answered. A blank answer means the agency reported nothing; it does not mean the practice is absent.

Potential impacts and how they were identified

Not reported