Overview
In This Section |
This section contains the following topics:
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1. General Information About Paper Claims Folders Storage and Control
Introduction |
This topic contains an overview of paper claims folders storage and management, including
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Change Date |
July 12, 2018 |
III.ii.4.A.1.a. General Policies for Storing Paper Claims Folders |
Adhere to the following policies for storing claimant or beneficiary paper claims folders:
References: For more information on
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2. Misfiled Paper Claims Folders
Introduction |
This topic contains information about misfiled paper claims folders, including
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Change Date |
August 9, 2018 |
III.ii.4.A.2.a. Definition: Misfiled Paper Claims Folder |
A misfiled paper claims folder is a paper claims folder that is not stored in the proper numerical sequence.
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III.ii.4.A.2.b. Checking for Misfiled Paper Claims Folders |
Check for misfiled paper claims folders during
Reference: For more information on locked files for paper claims folders, seeM21-1, Part III, Subpart ii, 4.A.3.a.
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III.ii.4.A.2.c. Handling a Misfiled Paper Claims Folder |
After finding a misfiled paper claims folder,
References: For more information about
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III.ii.4.A.2.d. Action to Take if BIRLS Shows a Different Paper Claims Folder Location |
If BIRLS shows another RO as the current location of a misfiled paper claims folder,
Reference: For more information on using the BIRLS UPDATE command, see theShare User Guide.
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3. Paper Claims Folders Requiring Restricted Access and Employee Certification of Veteran Status
Introduction |
This topic contains information on locked files, including
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Change Date |
December 17, 2015 |
III.ii.4.A.3.e. Organizing and Controlling Paper Claims Folders in Locked Files |
Organize paper claims folders in locked files according to the instructions in M21-1, Part III, Subpart ii, 4.A.1.b. Control the movement of paper claims folders in and out of locked files by updating
Reference: For more information about updating VA Form 3025, see M21-1, Part III, Subpart ii, 4.A.7.c.
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III.ii.4.A.3.f. Paper Claims Folders That Must Be Stored in Local Locked Files |
Paper claims folders that must be stored in an RO’s locked files include
Important: RO and VSC/PMC management may choose to secure other records in local locked files simply because of the nature of their content.
Reference: For more information on the VA definition of a relative, see M21-1, Part III, Subpart ii, 4.A.4.a.
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4. Storing Paper Claims Folders at a RACC
Introduction |
This topic contains information on storing paper claims folders at a RACC, including
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Change Date |
February 19, 2019 |
III.ii.4.A.4.a. Restricted Record and Sensitive Access Designations |
Veteran’s folders and claims must be stored at and worked by one of the restricted-access claims centers (RACCs) listed in M21-1, Part III, Subpart ii, 4.A.4.e if he/she is a
Exception: Scenarios in which a paper claims folder does not need to be stored at a RACC are documented in M21-1, Part III, Subpart ii, 4.A.4.c.
Use the table below to determine the population that must be marked as a restricted access record, the level of sensitivity and length of time assigned to the individual, and the employees authorized to access the record.
Important: Witness Protection Program claims folders must be maintained in a paper claims folder format, as described in M21-1, Part III, Subpart ii, 4.A.5.b.
Notes:
References: For more information on
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III.ii.4.A.4.b. Storing Other Paper Claims Folders at a RACC |
RO management may decide to store a Veteran’s paper claims folder at a RACC for reasons other than those described in M21-1, Part III, Subpart ii, 4.A.4.a. The VSCM, PMCM, or a designee must e-mail the appropriate RACC a formal memorandum containing the following:
Reference: For a list of RACCs and their e-mail addresses, see M21-1, Part III, Subpart ii, 4.A.4.e.
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III.ii.4.A.4.c. Exceptions to the Policy Regarding the Storage of Paper Claims Folders at a RACC |
The table below describes exceptions to the policy expressed in M21-1, Part III, Subpart ii, 4.A.4.a regarding the storage of paper claims folders at a RACC.
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III.ii.4.A.4.d. Paper Claims Folders That ROs Store in Locked Files Until Receipt of a Claim or Legacy NOD |
The RO storing a paper claims folder in its locked files (until it receives an associated claim or legacy NOD) must take the actions described in the table below following receipt of such a claim or legacy NOD.
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III.ii.4.A.4.e. RACC Locations, Jurisdiction, and Addresses |
The table below displays the
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III.ii.4.A.4.f. Temporary Transfer of a Paper Claims Folder From a RACC to an RO |
When a RACC transfers a paper claims folder back to the SOO (for an examination, personal hearing, etc.), the receiving RO must ensure the
Reference: For more information about handling claims from employees and their relatives, see M21-1, Part III, Subpart ii, 1.C.6.
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III.ii.4.A.4.g. VSO Interaction With RACCs |
When a VSO has a question regarding a claim that a RACC is processing, the VSO may contact the RACC by e-mail, using the e-mail addresses shown in M21-1, Part III, Subpart ii, 4.A.4.e.
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III.ii.4.A.4.i. VA Forms 20-0344 Requiring RO Action |
The table below describes the action an RO must take when an employee indicates on VA Form 20-0344 that he/she
Important: For the purposes of this block, an employee includes any of the individuals listed in M21-1, Part III, Subpart ii, 4.A.4.a.
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III.ii.4.A.4.j. Annual Recertification Requirement |
VBA requires the same individuals listed in M21-1, Part III, Subpart ii, 4.A.4.h to annually recertify
Individuals may recertify by submitting a signed memorandum or a digitally signed e-mail unless any of the information VA Form 20-0344 requests has changed since the last submission. If the information has changed, VBA requires completion and resubmission of the form.
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5. Safeguarding Records Containing Restricted Information
Introduction |
This topic contains information about safeguarding records containing restricted information, including
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Change Date |
June 19, 2018 |
III.ii.4.A.5.a. Handling Paper Claims Folders Containing Restricted Information |
Additional measures must be taken upon identification of a paper claims folder containing information that is of such a confidential nature that
Example: A confidential report from the Federal Bureau of Investigation.
Follow the steps in the table below to properly safeguard the restricted information.
Reference: For more information about locked files, see M21-1, Part III, Subpart ii, 4.A.3.
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III.ii.4.A.5.b. Maintaining a Paper Claims Folder for Witness Protection Program Cases |
VA is required to maintain the folder of a claimant in the Witness Protection Program in a paper claims folder format.
When the U.S. Marshals Service notifies the RACC that a claimant has entered the Witness Protection Program, the actions below must be taken when electronic documents exist in the eFolder for the old identity.
Important: Cancel any EP that is pending under the old identity and re-establish it under the new identity and continue processing the claim electronically. If development was already initiated under the old identity/EP, claims processors must replicate the tracked item(s) under the new pending EP.
References: For more information on
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6. Records Pertaining to HIV or AIDS, Alcohol Abuse, Drug Abuse, or Sickle Cell Anemia
Introduction |
This topic contains information about handling records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia, including
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Change Date |
June 10, 2015 |
III.ii.4.A.6.a.Confidentiality Requirement Under 38 U.S.C. 7332 |
The statutory guidelines of 38 U.S.C. 7332 require the confidentiality of VA records pertaining to human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), alcohol abuse, drug abuse, or sickle cell anemia.
This statute also requires the confidentiality of information received, obtained, or maintained by an employee or contractor of VA for the purpose of performing HIV, AIDS, alcoholism, drug abuse, or sickle cell anemia program functions regarding an identifiable patient.
For the purpose of this block, a program function includes
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III.ii.4.A.6.b. VHA Responsibilities for Identifying and Maintaining Certain Original VA Records |
VHA is responsible for identifying and permanently maintaining any original VA records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia.
VHA specifically identifies these records as falling under the purview of 38 U.S.C. 7332.
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III.ii.4.A.6.c.Copies of Records on Loan From VHA |
For the purpose of processing benefit claims, VHA loans copies of records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia to the RO.
RO personnel must
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III.ii.4.A.6.d. Records a Claimant or Beneficiary Submits to an RO |
It is acceptable for an RO to keep VA records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia in a claimant’s or beneficiary’s paper claims folder if the claimant or beneficiary submits them to the RO. However, the RO must advise the claimant/beneficiary that because the RO may request and obtain copies of the same records from the VA medical facility having custody of them, the records do not need to remain in the paper claims folder unless the claimant/beneficiary so desires.
Important: Do not disclose the records without the claimant’s/beneficiary’s consent. Send him/her VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, if consent is necessary.
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III.ii.4.A.6.e. Other Records That May Be Kept in the Paper Claims Folder |
It is acceptable to keep the following records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia in a paper claims folder:
Important: Do not disclose these records without the claimant’s or beneficiary’s consent.
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III.ii.4.A.6.f. POA Access to Confidential Records |
A representative holding a valid POA may not access records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia unless the claimant has
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7. Control of Paper Claims Folders
Introduction |
This topic contains information about the control of paper claims folders, including
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Change Date |
June 10, 2015 |
III.ii.4.A.7.a. Tracking Paper Claims Folders Using COVERS |
All ROs must use COVERS to track the location of paper claims folders. This includes paper claims folders an RO moves to an offsite, government- or privately-owned storage facility.
Individual ROs may customize the names they assign to most paper claims folder locations in COVERS to fit their individual circumstances and needs. The more specific the location and its corresponding name, the more useful COVERS will be in locating paper claims folders.
Examples: An RO may identify the location of paper claims folders it
Reference: For information about using COVERS, see the COVERS User Guide.
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III.ii.4.A.7.b. Schedule for Updating COVERS |
RO management must ensure all paper claims folders that are charged out of the file bank are scanned at least once each week to ensure the current location of these folders is correctly reflected in COVERS.
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III.ii.4.A.7.c. Tracking the Removal of Paper Claims Folders From the File Bank |
Always update COVERS when removing a paper claims folder from the file bank. ROs may also update VA Form 3025 in addition to COVERS, to reflect the
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III.ii.4.A.7.d. Requisitioning Individual Paper Claims Folders |
To requisition individual paper claims folders, use either
Note: As required, VA Form 3770 may also serve as a record of paper claims folders located within an operating element.
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III.ii.4.A.7.e. Tracking the Movement of Paper Claims Folders Outside Their Normal Storage Area |
Update COVERS to reflect the movement of individual paper claims folders from one organizational element to another or, within an operating element, from one individual to another.
Note: If COVERS is unavailable, use VA Form 3770.
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8. Sequence Checks
Introduction |
This topic contains information on sequence checks, including
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Change Date |
February 19, 2019 |
III.ii.4.A.8.a. Definition: File Sequence Check |
A file sequence check consists of a review of paper claims folders in the file bank and locked files to ensure
Note: Active DEA folders used by the RPOs in Buffalo, Muskogee, and St. Louis are now all paperless.
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III.ii.4.A.8.b. Schedule for Conducting Sequence Checks |
RO management must establish a schedule to ensure periodic completion of a sequence check of all paper claims folders in the file bank and locked files.
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III.ii.4.A.8.c. Steps for Conducting a Sequence Check |
Follow the steps in the table below when conducting a sequence check.
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Historical_M21-1III_ii_4_SecA_12-17-15.docx | May 11, 2019 | 103 KB |
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Historical_M21-1III_ii_4_SecA_8-9-18.docx | May 11, 2019 | 90 KB |
Historical_M21-1III_ii_4_SecA_6-19-18.docx | May 11, 2019 | 90 KB |
9-15-17_Key-Changes_M21-1III_ii_4_SecA.docx | May 11, 2019 | 81 KB |
12-17-15_Key-Changes_M21-1III_ii_4_SecA.docx | May 11, 2019 | 80 KB |
Historical_M21-1III_ii_4_SecA_3-16-18.docx | May 11, 2019 | 87 KB |
8-9-18_Key-Changes_M21-1III_ii_4_SecA.docx | May 11, 2019 | 70 KB |
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6-19-18_Key-Changes_M21-1III_ii_4_SecA.docx | May 11, 2019 | 72 KB |
2-19-19_Key-Changes_M21-1III_ii_4_SecA.docx | May 11, 2019 | 74 KB |
Change-December-19-2014-Transmittal-Sheet-M21-1MRIII_ii_4_SecA_TS.docx | May 11, 2019 | 38 KB |
Transmittal-Sheet-M21-1MRIII_ii_4_SecA_TS.docx | May 11, 2019 | 42 KB |
Change-June-11-2015-Transmittal-Sheet-M21-1_III_ii_4_SecA_TS.docx | May 11, 2019 | 40 KB |
in Chapter 4 Files and Folder Control, Part III General Claims Process, Subpart ii Initial Screening and Determining Veteran Status
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