M21-1, Part III, Subpart i, Chapter 4, Section D – Claims to Add a Dependent That Are Filed Through eBenefits or Processed by a Contractor

Introduction

• purpose of the Rules-Based Processing System (RBPS)
• how RBPS receives data necessary to process a claim
• how RBPS sorts and processes claims
• claims that are not eligible for automated processing through RBPS
• handling claims
  • that are not eligible for automated processing through RBPS
  • from a Veteran with a paper claims folder, and
  • with missing claim documents, and
• automatic release of decision notices that reflect a denial of entitlement to additional benefits.

Change Date

III.i.4.D.1.a.  Purpose of RBPS

III.i.4.D.1.b.  How RBPS Receives Data Necessary to Process a Claim

III.i.4.D.1.c.  How RBPS Sorts and Processes Claims

• If an EP 130 is already pending when RBPS places a claim under EP control, RBPS will establish an incremental EP, such as EP 131 or EP 132.
• Veteran Service Centers (VSCs) are responsible for generating a VETSNET Operations Report (VOR) each week that displays the EPs 130 that remain pending and represent claims that were not eligible for automated processing.

III.i.4.D.1.d.  Claims That Are Not Eligible for Automated Processing Through RBPS

• claims to add
  • an adopted child
  • a child over age 18 that is permanently incapable of self-support
  • a child over age 18 that is homeschooled, or
  • a school child whose tuition is being paid by the Federal government, or
• claims to add a dependent when
  • the payment of benefits may be subject to a withholding for attorney fees, or
  • the claimant or Veteran has a foreign address.

• handling claims that are not eligible for automated processing, see M21-1, Part III, Subpart i, 4.D.1.e, and
• processing claims to add
  • an adopted child, see M21-1, Part III, Subpart iii, 5.G.2-4
  • a child over age 18 that is permanently incapable of self-support, see M21-1, Part III, Subpart iii, 7
  • a child over age 18 that is homeschooled, see M21-1, Part III, Subpart iii, 6.A.3
  • a school child whose tuition is being paid by the Federal government, see M21-1, Part III, Subpart iii, 6.A.2.i
  • a dependent when the payment of benefits may be subject to withholding for attorney fees, see M21-1, Part I, 3.C, or
  • a dependent when the claimant or Veteran has a foreign address, see M21-1, Part III, Subpart vi, 3.B.

III.i.4.D.1.e.  Handling Claims That Are Not Eligible for Automated Processing Through RBPS

III.i.4.D.1.f.  Handling Claims From a Veteran With a Paper Claims Folder

• send any documents from the paper claims folder that were used to process the Veteran’s claim to a scanning vendor (for conversion to an electronic format and upload into the Veteran’s eFolder), and
• do not print out (for the purpose of filing down in the paper claims folder) the documents VDC uploaded into the Veteran’s eFolder.

III.i.4.D.1.g.  Handling Claims With Missing Claim Documents

III.i.4.D.1.h. Automatic  Release of Decision Notices That Reflect a Denial of Entitlement to Additional Benefits

• a 130-series EP is pending without a concurrently pending rating EP, or
• an EP 020 and a 130-series EP are concurrently pending.

• clears the 130-series EP, and
• uploads a copy of the decision notice into the Veteran’s electronic claims folder.

III.i.4.D.2.a.  VA Contract for Processing Claims for and Correspondence Affecting Entitlement to Benefits for Dependents

• allows regional offices to allocate more resources to the reduction of claims in their inventory that require a rating decision, and
• ensures timely award adjustments for the addition or removal of dependents from a beneficiary’s award.