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M21-1, Part III, Subpart ii, Chapter 4, Section A – Paper Claims Folders Storage and Control

Overview


In This Section

This section contains the following topics:
Topic
Topic Name
1
2
3
4
5
6
7
8

1.  General Information About Paper Claims Folders Storage and Control


Introduction

This topic contains an overview of paper claims folders storage and management, including

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:
  • Store paper claims folders only in designated cabinets.
  • Do not store paper claims folders in desks or other unauthorized places.
  • Do not remove claimant/beneficiary paper claims folders from the Department of Veterans Affairs (VA) premises for any purpose unless authorized by regional office (RO) management.
  • Paper claims folders stored at an offsite facility are considered on VA premises and must be treated accordingly.  RO management must ensure
  • the offsite location, whether a government or private facility, meets all onsite security requirements and standards, and
  • all paper claims folders are tracked in the Control of Veterans Records System (COVERS).
References:  For more information on

III.ii.4.A.1.b.  Organizing Paper Claims Folders Numerically

When storing paper claims folders, organize them first based on the terminal (last two) digits of the claims folder number that each folder bears and then numerically within each set of terminal digits.
Notes:
  • Depending on a when a paper claims folder was first established, the claims folder number will be either the Veteran’s eight-digit claim number or nine-digit Social Security number (SSN).
  • Interfile paper claims folders bearing an SSN as the claims folder number with those bearing a claim number as the claims folder number.
  • Disregard leading zeroes in the claims folder number when numerically organizing paper claims folders within each set of terminal digits.
  • When two paper claims folders have similar claims folder numbers, one bearing an SSN as the claims folder number and the other bearing a claim number as the claims folder number, place the paper claims folder bearing the eight-digit claim number before the one bearing the nine-digit SSN.

III.ii.4.A.1.c.  DEA and CER Paper Claims Folders

The regional processing offices (RPOs) in Buffalo, Muskogee and St. Louis establish and maintain all Dependents’ Educational Assistance (DEA) folders,which are now all paperless.
Exceptions:
  • The Manila RO maintains DEA paper claims folders as a separate file series for those DEA recipients attending school in the Philippines.
  • Vocational Rehabilitation and Employment divisions establish and maintain their own Counseling/Evaluation/Rehabilitation (CER) paper claims folders at their respective ROs.

2.  Misfiled Paper Claims Folders


Introduction

This topic contains information about misfiled paper claims folders, including

Change Date

August 9, 2018

III.ii.4.A.2.a.  Definition:  Misfiled Paper Claims Folder

misfiled paper claims folder is a paper claims folder that is not stored in the proper numerical sequence.

III.ii.4.A.2.b.  Checking for Misfiled Paper Claims Folders

Check for misfiled paper claims folders during
  • normal paper claims folder servicing (such as dropping mail, pulling folders, etc.)
  • paper claims folder sequencing checks
  • reconciliation of paper claims folders in locked files
  • paper claims folder retirement projects, and
  • other special projects that require the handling/rearrangement of paper claims folders located in locked files or the RO’s general paper claims folder storage area (commonly referred to as the file bank).
Reference:  For more information on locked files for paper claims folders, seeM21-1, Part III, Subpart ii, 4.A.3.a.

III.ii.4.A.2.c.  Handling a Misfiled Paper Claims Folder

After finding a misfiled paper claims folder,
  • attempt to locate the VA Form 3025, File Charge Card, that belongs to the paper claims folder, and
  • follow the instructions in the table below.
If the charge card …
Then …
shows a request for circularization
return the paper claims folder and charge card to their proper location in storage after all necessary development actions have been completed.
indicates that a rebuilt paper claims folder is located at the RO
follow the instructions in M21-1, Part III, Subpart ii, 4.D.1.d.
  • does not exist, or
  • does not indicate the existence of a
    • circularized paper claims folder, or
    • rebuilt paper claims folder
  • use the Beneficiary Identification and Records Locator Subsystem (BIRLS) inquiry in Share to determine what BIRLS shows as the paper claims folder’s current location, and
  • follow the instructions in the table below.
If BIRLS shows the paper claims folder location as …
Then …
the RO
return the paper claims folder and charge card to their proper location in storage after all necessary development actions have been completed.
another RO
follow the instructions in M21-1, Part III, Subpart ii, 4.A.2.d.
References:  For more information about

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,
  • check with the other RO to determine if another paper claims folder exists, and
  • follow the instructions in the table below.
If another paper claims folder …
Then …
exists
transfer the misfiled paper claims folder to the RO with possession of the other paper claims folder.  That RO is then responsible for
  • consolidating the paper claims folders, and
  • using the BIRLS UPDATE command to change the rebuilt paper claims folder indicator from Yto N.
Note:  The REBUILD field is located on the FOLDER LOCATION tab in Share.
does not exist
the RO with current, physical custody of the misfiled paper claims folder is responsible for updating COVERS (which, in turn, updates BIRLS) to reflect the correct location of the paper claims folder.
Reference:  For more information on using the BIRLS UPDATE command, see theShare User Guide.

3.  Paper Claims Folders Requiring Restricted Access and Employee Certification of Veteran Status


Introduction

This topic contains information on locked files, including

Change Date

December 17, 2015

III.ii.4.A.3.a.  Definition:  Locked Files

The term locked files represents a locked room or locked cabinet(s) where ROs must secure paper claims folders to which access is restricted.
Note:  This definition, and the requirement to lock this category of records in a room or cabinet, also applies to paper claims folders the RO maintains at offsite facilities.

III.ii.4.A.3.b.  Location of Locked Files

Locked files must be located in, or in close proximity to, the office of the Veterans Service Center Manager (VSCM) or Pension Management Center Manager (PMCM).

III.ii.4.A.3.c.  Responsibility for Managing Locked Files

The VSCM/PMCM or his/her designee is the sole custodian of all material stored in locked files and is responsible for the proper handling of it.  Specific responsibilities include
  • filing, safeguarding, and releasing (upon proper request) paper claims folders stored in locked files, and
  • maintaining a log showing the
    • date of removal of a paper claims folder from locked files
    • claims folder number associated with the paper claims folder
    • name of the employee with temporary custody of the paper claims folder, and
    • date of return of the paper claims folder to locked files.
Important:
  • Paper claims folders removed from locked files must be returned by the end of each business day.
  • If a document is added to or removed from a paper claims folder in locked files, the log referenced in this block must be updated to show the folder was charged out and back in, even if the folder never left the locked files area.

III.ii.4.A.3.d.  Releasing Paper Claims Folders Stored in Locked Files

A paper claims folder stored in locked files may be released only to
  • Veterans Service Center (VSC) or pension management center (PMC) employees with a business need to access the record
  • the chief (or properly designated alternate) of the division requiring use of the record, or
  • the beneficiary’s or claimant’s recognized service organization or other power of attorney (POA).
Important:  The individual or entity to which the paper claims folder is released is responsible for
  • safeguarding the paper claims folder while in its custody, and
  • returning the paper claims folder to locked files by the end of each day.

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.

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
  • the paper claims folders described in M21-1, Part III, Subpart ii, 4.A.4.c, and
  • the paper claims folders of Veterans who are
    • currently employed by the Veterans Health Administration (VHA) or National Cemetery Administration who
      • are co-located with Veterans Benefits Administration (VBA) offices, or
      • interact regularly with VBA employees (such as VHA physicians who conduct examinations on a regular basis)
    • currently employed as a VBA contractor
    • a relative of a VBA contractor, or
    • a celebrity or an individual about whom there is significant public/media interest, such as a candidate for a prominent public office.
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.

4.  Storing Paper Claims Folders at a RACC


Introduction

This topic contains information on storing paper claims folders at a RACC, including

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
  • current or former VBA employee
  • current or former intern or participant in a VA work-study program who works in close proximity to VBA employees
  • relative of one of the individuals specified in the preceding two bullets
  • Veteran on whose service a current or former non-Veteran, VBA employee’s VA benefits are based
  • current employee or relative of a current employee of a Veterans service organization (VSO), or
  • high-ranking government official, to specifically include those requiring the assignment of a sensitivity level of 8 or 9.
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.
Level of Sensitivity and Sensitivity Expiration Date
VA Records Including Employees, Veterans or Their Beneficiaries
Authorized Employees
Level 9 Sensitivity
Sensitivity expiration date:  indefinite
  • The President/Vice President of the U.S.
  • Members of the Cabinet
  • U.S. Senators and Members of Congress
  • U.S. Supreme Court Justices
  • VA Secretary
  • VA Deputy Secretaries
  • VA Under Secretaries
  • VA Assistant Secretaries
  • other high-profile individuals, and
  • special cases, e.g. witness protection.
  • Under Secretary for Benefits (USB)
  • Deputy USBs
  • Service Directors
  • Security and Infrastructure Protection Office Director, and
  • Directors and Assistant Directors of facilities having jurisdiction over records with a level of sensitivity equal to 9.
Level 8 Sensitivity
Sensitivity expiration date: three years after leaving public office
  • VA Senior Executive Service
  • Directors and Assistant Directors
  • Regional Counsel
  • Division Chiefs or equivalent
  • persons of national prominence
  • Governors
  • Lt. Governors
  • Attorneys General of states or commonwealths, and
  • locally prominent persons or officials.
  • Facility Directors and Assistants
  • District Directors
  • VSC Managers and Assistants, and
  • all other Division Chiefs.
Level 7 Sensitivity
Sensitivity expiration date: three years after leaving public/government service
VBA employees
  • Information Security Officers (ISOs), Assistant ISOs, and System Security Officers
  • supervisory accredited VSO representatives
  • all VA supervisors with a business need, and
  • 10 percent of VBA entities’ non-supervisory staff with a business need.
Level 6 Sensitivity
Sensitivity expiration date: three years after leaving public/government service
  • VA employees (other than VBA employees)
  • VSO employees
  • relative of employee
  • VA work-study/interns employed at a VBA location, and
  • high-profile claims, at the discretion of the Directors.
  • journeyman-level employees having a business need on a daily basis, not to exceed 25 percent of a VBA entities’ non-supervisory staff, and
  • non-supervisory accredited VSO representatives.
Level 5 Sensitivity
Sensitivity expiration date: until the Attorney Fee designation for a particular claim no longer exists
private attorney fee cases
  • private attorneys
  • all VA supervisors with a business need, and
  • 10 percent of VBA entities’ non-supervisory staff with a business need.
Level 4 Sensitivity
Local Use Determination
Level 3 Sensitivity
Local Use Determination
Level 2 Sensitivity
Local Use Determination
Level 1 Sensitivity
Local Use Determination
Level 0 Sensitivity
Open files (accessible by all VA employees)
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:
  • The National Work Queue and the Veterans Benefits Management System (VBMS) will only allow users with appropriate sensitive access authorizations to receive claims or view folders with restricted access designations.
  • relative, for the purpose of this section, includes a living or deceasedspouse, child, parent, or sibling.
  • RO management may choose to store a Veteran’s paper claims folder at a RACC for reasons other than those described in this block.
  • If a paper claims folder meets the criteria for storage in local locked filesand at a RACC, store the paper claims folder at a RACC.
References:  For more information on

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:
  • the reason for categorizing the paper claims folder as sensitive, and
  • a rationale for storing the paper claims folder at a RACC.
Reference:  For a list of RACCs and their e-mail addresses, see M21-1, Part III, Subpart ii, 4.A.4.e.

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.
If …
Then the paper claims folder will be stored in the locked files of …
the paper claims folder is associated with a claim for pension, burial benefits, or Dependency and Indemnity Compensation
the PMC RACC of jurisdiction as outlined in M21-1, Part III, Subpart ii, 4.A.4.e.
an attorney-fee agreement is in place
the station of origination (SOO).
the claim is restricted access due to high-level media inquiries
the SOO.
the paper claims folder is associated with a claim that is being or will be processed in a pilot program
the SOO.
the paper claims folder is associated with a claim that is being or will be processed as part of a special mission, such as the Integrated Disability Evaluation System (IDES)
an RO (other than the one where the claimant is employed) that processes the same type of claim.
Example:  If a claimant working at the Seattle Disability Rating Activity Site (DRAS) has an IDES claim pending, his/her paper claims folder must be stored at the Providence DRAS.
Reference:  For more information onclaim and claims folder jurisdiction, seeM21-1, Part III, Subpart ii, 5.A.
  • the Veteran’s record has been assigned a sensitivity level of 6, and
  • storage of the corresponding paper claims folder in local locked files is not mandated
the SOO until a claim or legacy notice of disagreement (NOD) is filed.
References:  For more information on

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.
Step
Action
1
Verify the validity of the assigned sensitivity level with the RO’s ISO.
2
Follow the instructions in the table below.
If the correspondence the RO received represents a …
Then …
claim
place the claim under end product (EP) control.
legacy NOD
  • establish EP 170
  • create a record in the Veterans Appeals Control and Locator System (VACOLS), and
  • use VACOLS to transfer the appeal to the appropriate RACC, using the station numbers provided in M21-1, Part III, Subpart ii, 4.A.4.e.
Reference:  For information on using VACOLS, see the VACOLS User Guide.
3
Add the Restricted Access corporate flash to the corresponding corporate record.
4
Permanently transfer the paper claims folder and correspondence to the appropriate RACC.

III.ii.4.A.4.e.  RACC Locations, Jurisdiction, and Addresses

The table below displays the
  • name and VACOLS station number of each RACC
  • claims folders over which each RACC has jurisdiction, and
  • the mailing and e-mail address of each RACC.
Name
Jurisdiction
Address
St. Paul RACC (RO76)
  • all ROs except the ROs in
    • Milwaukee, and
    • St. Paul
  • all district offices
  • decision review operations centers
  • all human resources centers
  • VBA Central Office, and
  • any other office/center not specifically assigned to the Milwaukee or Philadelphia RACCs
Mailing:
St. Paul VA Regional Office
Bishop Henry Whipple Federal Building
Restricted Access Claims Center (RO 076)
PO Box 11940
St. Paul, MN 55111
E-mail:  VAVBASPL/RO/RACC
St. Paul PMC RACC (RO83)
  • Philadelphia PMC employees, and
  • all PMC RACC claims except St. Paul and Milwaukee PMC employee RACC claims
Mailing:
St. Paul VA Regional Office
Bishop Henry Whipple Federal Building
PMC Restricted Access Claims Center (RO 083)
PO Box 11940
St. Paul, MN 55111
Milwaukee RACC (RO75)
St. Paul RO
Mailing:
Milwaukee VA Regional Office
Restricted Access Claims Center (RO 075)
5400 W National Avenue
Milwaukee, WI 53214
Milwaukee PMC RACC (RO82)
St. Paul PMC employee RACC claims
Mailing:
Milwaukee VA Regional Office
PMC Restricted Access Claims Center (RO 082)
5400 W National Avenue
Milwaukee, WI 53214
Philadelphia RACC (RO74)
Milwaukee RO
Mailing:
Philadelphia Regional Office
Restricted Access Claims Center (RO 074)
5000 Wissahickon Avenue
Philadelphia, PA 19101
E-mail:  VAVBAPHI/RO/RACC
Philadelphia PMC RACC (RO81)
Milwaukee PMC employee RACC claims
Mailing:
Philadelphia Regional Office
PMC Restricted Access Claims Center (RO 081)
5000 Wissahickon Avenue
Philadelphia, PA 19101

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
  • VSCM is aware of the transfer
  • transfer was for a valid reason and is only temporary, and
  • paper claims folder is
    • secured in locked files, and
    • returned to the RACC after the SOO has completed the required local action.
Reference:  For more information about handling claims from employees and their relatives, see M21-1, Part III, Subpart ii, 1.C.6.

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.

III.ii.4.A.4.h.  Means of Identifying Paper Claims Folders That Must Be Stored in Locked Files or at a RACC

The following individuals must complete VA Form 20-0344, Annual Certification of Veteran Status and Veteran-Relatives, on the first day of employment/reemployment at, or transfer into, an RO:
  • VA employees and contractors
  • VSO employees
  • VA interns, and
  • participants in VA work-study programs.
Notes:
  • The individuals listed in the above paragraph are responsible for immediately notifying their supervisors (who, in turn, must notify the RO’s ISO) if a paper claims folder is created for them or a relative afteremployment begins.
  • Human Resources Liaisons at each RO are responsible for notifying the ISO if an employee, intern, or work-study participant stops working for VBA or transfers out of the RO.
  • Each RO must establish local
    • procedures to ensure the RO and ISO are timely notified of the termination of employment or transfer of any non-VBA employee for whom the RO possesses a VA Form 20-0344, and
    • policy for periodically reviewing a list (obtainable from the local ISO) of all paper claims folders in its custody that require storage in locked files or at a RACC.
  • Relocate any paper claims folders that are being stored in the wrong location.

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
  • is a Veteran, and/or
  • has a relative who is a Veteran.
Step
Action
1
The RO’s ISO prepares VA Form 20-0344aNotification of an Employee or Employee-Relative Claims File, for the paper claims folder of each
  • employee who is a Veteran, and
  • Veteran who is the relative of an employee.
Exception:  The ISO does not prepare VA Form 20-0334a for
  • the paper claims folders of relatives of VA employees in non-VBA positions, or
  • electronic claims folders (eFolders). If an eFolder exists, the ISO will note this on the corresponding VA Form 20-0344.
2
The ISO links the employee’s claim number to his/her VBA computer system account if
  • the employee is a Veteran, and
  • a computer system account exists.
Note:  If a non-Veteran employee is receiving VA benefits as a dependent of a Veteran, the ISO links that Veteran’s claim number to the employee’s VBA computer system account.
3
The ISO assigns the appropriate level of sensitivity to each Veteran’s corporate record.
4
The ISO routes a photocopy of each VA Form 20-0334a to the VSCM/PMCM of the RO where the corresponding paper claims folder is located.
5
The VSCM/PMCM or designee will take the followings actions upon receipt of VA Form 20-0334a:
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.

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
  • their status as a Veteran, and
  • the existence of relatives (living or deceased) who are Veterans.
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.

III.ii.4.A.4.k.  Disposition of the Paper Claims Folder After Death or After Employment Ends

The paper claims folder of a former VBA employee and his/her relative(s) must remain at the RACC for three years after
  • employment ends, or
  • the employee or relative dies.
The table below describes the process that takes place once storage at the RACC or in locked files is no longer required because of death or termination of employment.
Stage
Description
1
The ISO at the RO where the employee worked takes the actions described in the table below.
If …
Then the ISO …
  • employment ended, or
  • the employee died
  • enters the date employment ended or the date of death (whichever is applicable) in Part II of the VA Form 20-0344a the ISO initially created for the
    • employee, and/or
    • employee’s relative(s), and
  • routes the form to the RACC or VSCM/PMCM of the RO with custody of the corresponding paper claims folder.
the relative of an employee died
  • enters the date of death in Part II of the relative’s VA Form 20-0344a, and
  • routes the form to the RACC or VSCM/PMCM of the RO with custody of the relative’s paper claims folder.
2
Following receipt of VA Form 20-0344a, the RACC or VSCM/PMCM (or designee) of the RO with custody of the paper claims folder files down the form in the corresponding paper claims folder.
3
  • If a RACC has custody of the paper claims folder, the RACC permanently transfers the paper claims folder back to the location from which it originated (an RO or VA’s Records Management Center).
  • If an RO has custody of the paper claims folder, the VSCM/PMCM (or a designee) moves the paper claims folder out of locked files and into the RO’s general file bank.
Important:
  • The date of departure of an employee on terminal sick leave does notrepresent the date employment ended.
  • ROs may not transfer out paper claims folders to another RO basedsolely on receipt of VA Form 20-0344a.

5.  Safeguarding Records Containing Restricted Information


Introduction

This topic contains information about safeguarding records containing restricted information, including

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
  • restricting access to the record is warranted, and
  • filing the record in a paper claims folder would not adequately safeguard it from being accessed by those without a business need to view it.
Example:  A confidential report from the Federal Bureau of Investigation.
Follow the steps in the table below to properly safeguard the restricted information.
Step
Action
1
Place the record containing restricted information in an opaque and windowless envelope.
2
Label the front of the envelope with the claim number and a brief description of the envelope’s contents.
3
Important:
  • VA Form 3797 must remain on top of all other material in the paper claims folder at all times.
  • If the paper claims folder is temporarily unavailable when VA Form 3797 is completed, retain the form in the same storage location vacated by the paper claims folder.
4
Secure the restricted paper claims folder in locked files.
Reference:  For more information about locked files, see M21-1, Part III, Subpart ii, 4.A.3.

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.
Step
Action
1
Create a paper claims folder using the claimant’s new identity.
2
Print all documents from the prior identity’s eFolder and associate them with the new paper claims folder.
Important:  Do not transfer electronic documents from the prior identity’s eFolder to the new identity’s eFolder.
3
E-mail YourIT@va.gov and request deletion of the prior identity’s eFolder and its contents.  The subject line must read “HIGH PRIORITY – eFolder Deletion Request.”
4
Follow existing procedures for processing sensitive level 9 and locked file claims.
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

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

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
  • treatment
  • rehabilitation
  • education
  • training
  • evaluation, and
  • research.

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.

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

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.

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:
  • reports of VA examinations conducted for the purpose of evaluating HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia (The provisions of 38 U.S.C. 7332 do not apply to these reports.), and
  • records pertaining to HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia that originated from non-VA programs.
Important:  Do not disclose these records without the claimant’s or beneficiary’s consent.

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

7.  Control of Paper Claims Folders


Introduction

This topic contains information about the control of paper claims folders, including

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
  • sets aside for local quality review by naming the location QRVIEW, or
  • moves to a Federal records center by naming the location FRC.
Reference:  For information about using COVERS, see the COVERS User Guide.

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.

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
  • mail routing symbol of the organizational element to which the paper claims folder will be delivered
  • type of mail or form number that necessitated pulling the paper claims folder
  • date the paper claims folder was pulled from storage, and
  • initials of the person who pulled the paper claims folder.

III.ii.4.A.7.d.  Requisitioning Individual Paper Claims Folders

To requisition individual paper claims folders, use either
  • COVERS, or
  • VA Form 3770, Request for Numbered Folder/Notice of Recharge.
Note:  As required, VA Form 3770 may also serve as a record of paper claims folders located within an operating element.

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.

 

8.  Sequence Checks


Introduction

This topic contains information on sequence checks, including

Change Date

February 19, 2019

III.ii.4.A.8.a.  Definition:  File Sequence Check

file sequence check consists of a review of paper claims folders in the file bank and locked files to ensure
  • every paper claims folder is in strict numerical sequence within each terminal digit, and
  • DEA folders are properly interfiled with paper claims folders.
Note:  Active DEA folders used by the RPOs in Buffalo, Muskogee, and St. Louis are now all paperless.

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.

III.ii.4.A.8.c.  Steps for Conducting a Sequence Check

Follow the steps in the table below when conducting a sequence check.
Step
Action
1
Remove charge cards that are eligible for disposal.
2
Pull and fix paper claims folders in need of repair.
3
Shift paper claims folders to avoid overcrowding.
4
Maintain documentation of the sequence checks performed.
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