KevinTheJedi thanks for the suggestion. The log does show the following: "Mail Fetcher - the single id was not found in response". Looking at the code this error is only triggered in one location.
In testing I thought there was some connection between manually entering an email in vs using the mail client autocomplete, so I devised a test:
Test 1: external email sends to internal email using autocomplete to select 'To' address. Internal email cc's support email using autocomplete to select 'cc' address
Test 2: external email sends to internal email using autocomplete to select 'To' address. Internal email cc's support email using manual typing of 'cc' address
Test 3: external email sends to internal email using manual typing to select 'To' address. Internal email cc's support email using autocomplete to select 'cc' address
Test 4: external email sends to internal email using manual typing to select 'To' address. Internal email cc's support email using manual typing to select 'cc' address
I did this with forwarding as well, and tried multiple rounds of testing. There was never any consistency among rounds except for the fact that I never got 100% of the emails to result in tickets. The average of the tests was about 50% successful ticket creation. One important thing I found is that the mail fetcher notification in the log was not always present when a ticket failed to create.
Any ideas?