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M21-1, Part III, Subpart v, Chapter 6, Section E – Institutional Awards Specific to Incompetent Veterans

Overview


In This Section

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

1.  General Information on Institutional Awards for Incompetent Veterans


Introduction

This topic contains general information on institutional awards that are made in cases involving incompetent Veterans, including

Change Date

April 10, 2007

III.v.6.E.1.a.  Regulatory Provisions of 38 CFR 3.852(a)

Under the provisions of 38 CFR 3.852(a), when an incompetent Veteran is admitted to an institution for the purpose of hospital treatment, domiciliary, or nursing home care (public or private), an award of all or any part of the pension, compensation, or retirement pay payable may be made to the chief officer of the institution.
Although an institutional award is generally restricted to a situation in which a fiduciary has not been appointed or recognized, it may also be made on behalf of a Veteran for whom a fiduciary has been appointed, but only if specifically requested by a fiduciary hub.

III.v.6.E.1.b.  Institutional Personnel to Whom Payments May Be Authorized

The table below identifies the person to whom payment of an institutional award may be authorized.
Type of Institution
Person to Whom Payments May Be Authorized
Department of Veterans Affairs (VA) medical center (VAMC)
VAMC Director
non-VA institution
chief officer as appointed under 38 CFR 13.61 by the fiduciary activity
Notes:
  • Payment on behalf of the primary beneficiary
    • may be made to a VA institution simultaneously with a request to a fiduciary hub for appointment of a fiduciary, but
    • may not be made to a non-VA institution until the fiduciary hub appoints a fiduciary.
  • VA may not appoint the chief officer of a non-VA nursing home for an institutional award under 38 CFR 13.61 if the Veteran is being maintained in that home under contract, as provided by 38 U.S.C. 1720.
  • VA will continue to pay the institutional award to the Director of the VAMC until the fiduciary hub appoints a different fiduciary.
Reference:  For more information on transfers to nursing home care under 38 U.S.C. 1720, see M21-1, Part III, Subpart v, 6.E.4.

III.v.6.E.1.c.Reviewing CAPRI Reports

Use the Compensation and Pension Record Interchange (CAPRI) system to obtain reports of Veterans who have been found incompetent through judicial proceedings or rated incompetent for VA purposes.
Review each report to determine what actions, if any, are required.
Reference:  For information on using CAPRI, see the CAPRI User Guide.

III.v.6.E.1.d.Rating of Incompetency Subsequent to Admission to a Medical Institution

If a Veteran is rated incompetent subsequent to admission to a medical institution, request any information, reports, or summaries that may be required as a result of the Veteran’s incompetency.
Note:  Request information from a VAMC via CAPRI.

2.  General Information on Preparing an Institutional Award


Introduction

This topic contains general information on the appropriate actions to take when preparing institutional awards under various circumstances, including

Change Date

May 25, 2018

III.v.6.E.2.a.Providing VA Form 21-592 to a Fiduciary Hub

Following receipt of notice of commitment constituting a judicial determination of incompetency, furnish VA Form 21-592, Request for Appointment of a Fiduciary, Custodian, or Guardian, to the fiduciary hub of jurisdiction and give consideration to
  • apportionment to dependents, or
  • an institutional award.
Note:  VA Form 21-592 is required for the fiduciary hub to appoint a fiduciary prior to an award to a non-VA institution.
Reference:  For information on apportionments to dependents, see M21-1, Part III, Subpart v, 6.E.5.b.

III.v.6.E.2.b.Notifying the Fiduciary Hub When a Veteran Is Transferred to Another Institution

Following receipt of notice that a Veteran with an institutional award has transferred from one medical institution to another, forward the notice to the fiduciary hub of jurisdiction.
Reference:  For information on transfers to nursing home care, see M21-1, Part III, Subpart v, 6.E.4.

III.v.6.E.2.c.Others VA Must Notify  of an Institutional Award

After authorizing an institutional award, notify the following of the award:
  • the chief officer of the corresponding medical institution, and
  • VA’s insurance center in Philadelphia.
Note:  The authorization activity must notify the insurance center when
References:  For more information about

III.v.6.E.2.d.  Use of VA Form 21-592 for Private and VA Institutions

Use the table below to determine the appropriate use of VA Form 21-592 when interacting with both private and VA institutions.
If the Veteran is maintained at …
Then …
a private medical institution, to include a nursing home, notat VA expense
do not make an institutional award until
  • the regional office (RO) releases VA Form 21-592to the fiduciary hub with geographical jurisdiction over the location of the Veteran’s residence, and
  • the fiduciary hub sends to the RO VA Form 21-555.
a VA institution
send VA Form 21-592 and a copy of the institutional award to the fiduciary hub with geographical jurisdiction over the associated VAMC for
  • appointment of the VAMC Director as fiduciary, or
  • appointment of an alternate fiduciary.
Note:  Payment to the Director of a VAMC may be made concurrently with submission of a request to a fiduciary hub for appointment of a fiduciary. There is no need to delay award action pending receipt of the appointment of the fiduciary on VA Form 21-555.

III.v.6.E.2.e.Maintaining Controls for Future Hospital Adjustments

Maintain system control for return of VA Form 21-555 from a fiduciary hub with end product 290.
If the fiduciary hub fails to provide the appointment of a fiduciary within 60 days,
  • send a follow-up inquiry, and
  • extend the control date an additional 30 days.

III.v.6.E.2.f.Assigning a Payee Number for Institutional Awards

Assign payee number 00 (Veteran) for an institutional award on behalf of a Veteran.  However, assign payee number 99 when
Handle an institutional award under payee number 99 as an apportionee award, which creates an apportionee corporate record.
Under payee number 00, show any amounts not paid under that award as amounts withheld, including the amount paid under payee number 99, which is carried as an allotment on the payee 00 award.
Example:  An award under payee number 99 may be required in a situation in which an active corporate record exists under payee number 00 in the name of a fiduciary, but an institutional award is deemed necessary to ensure funds are available for the Veteran’s welfare.

3.  Institutional Awards to VA and Non-VA Institutions


Introduction

This topic contains information on institutional awards to both VA and non-VA institutions, including

Change Date

May 25, 2018

III.v.6.E.3.a.Institutional Awards to VAMC Directors

When preparing an institutional award to the Director of a VAMC
  • prepare the award at the full-rate otherwise payable, subject to any amounts apportioned or amounts withheld under 38 CFR 3.551 due to hospitalization
  • pay the award effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share or, on initial or resumed awards, effective the date of entitlement, as provided under 38 CFR 3.401(d)(2), and
  • send VA Form 21-592 to the fiduciary hub with geographical jurisdiction over the VAMC.
Note:  These awards are not subject to an allotment for personal funds of patients (PFOP).  However, the Director places all funds not expended for the Veteran to the Veteran’s credit in the PFOP account maintained at that institution.
Reference:  For more information on the handling of PFOP funds, see 38 CFR 13.103.

III.v.6.E.3.b.Obtaining Appointment of an Official When Paying an Institutional Award to the Chief Officer of a Non-VA Institution

Prior to authorizing an institutional award to the chief officer of a non-VA institution, obtain an appointment of fiduciary of the name and title of the official authorized to receive and disburse funds.
Reference:  For more information on receiving appointment of a fiduciary on VA Form 21-555, see M21-1, Part III, Subpart v, 6.E.2.d.

III.v.6.E.3.c.Preparing an Award to a Non-VA Institution

When preparing an award to a non-VA institution
  • make the award effective the later of the following dates, as provided under 38 CFR 3.401(d)(1):
    • the first day of the month in which the award is approved, or
    • the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share
  • create an allotment under payee number 00 (for deposit in the PFOP account maintained at the Hines Information Technology Center (ITC)) of all sums otherwise payable in excess of the amount paid as an apportionment or awarded to the institution, and
  • do not authorize a monthly rate in excess of $60.00 a month.
Notes:
  • When creating an allotment, be sure to include amounts payable for any period prior to the effective date of the Veteran’s benefits being paid to the chief officer of the corresponding medical institution.
  • If a Veteran’s pension award is apportioned, and payments to the institution are reduced to no more than $25.00 monthly under 38 CFR 3.852(b), enter the additional allotted amount under other withholding.

III.v.6.E.3.d.Effect of Dependents on an Award to a Non-VA Institution

Use the table below to determine the requirements for an award to a non-VA institution when the Veteran does or does not have dependents.
If the Veteran …
Then …
has a
  • spouse
  • child, or
  • dependent parent
the Veterans Pension payable as an institutional award may not exceed $25.00 per month. Benefits not paid to the Veteran may be apportioned to the dependents.
References:
does not have a
  • spouse
  • child, or
  • dependent parent
the amount payable as an institutional award must not exceed $60.00 per month, unless a fiduciary hub recommends the payment of all or any part to the chief officer for the Veteran’s use and benefit when required to
  • provide adequately for the needs of the Veteran, and
  • avoid the necessity for appointment of a fiduciary.

III.v.6.E.3.e.  Awards to a Non-VA Institution That Involve a Withholding for PFOP

If an original or reopened award involving an allotment for PFOP is prepared with a future commencing date, it must not be authorized for processing in any cycle before the first processing cycle of the month in which the withholding is to become effective.
Reference:  The current processing cycle can be found in the Schedule of Operations.

4.  Award Adjustments After a Veteran Transfers to Contract Nursing Home Care Under 38 U.S.C. 1720


Introduction
This topic contains information on award adjustment after a Veteran transfers to nursing home care under 38 U.S.C. 1720, including

Change Date

May 25, 2018

III.v.6.E.4.a.Applicability of 38 U.S.C. 1720 for Nursing Home Care

VA may provide for the cost of private or public nursing home care under 38 U.S.C. 1720 for
  • a service member
    • who has been furnished care in an Armed Forces hospital, and
    • who will become a Veteran on discharge from the Armed Forces hospital, or
  • a Veteran
    • who has been furnished VA hospital care, or
    • who is directly admitted to a nursing home if the nursing home care is for a service-connected disability.

III.v.6.E.4.b.Awards Subject to Reduction Under 38 CFR 3.551 and 3.552

Awards for Veterans transferred or directly admitted for care at VA expense are subject to reduction and discontinuance under

III.v.6.E.4.c.Action to Take If an Award Was in Effect at the Time of the Veteran’s Transfer

If an institutional award to the Director of a VAMC was in effect at the time of a Veteran’s transfer to a contract nursing home, continue the award until
  • VA Form 21-555 is received from a fiduciary hub authorizing payments to a different fiduciary, or
  • payment may be made directly to the Veteran.
Note:  Follow the instructions in M21-1, Part III, Subpart v, 6.E.8.d if a Veteran is rerated as competent.

III.v.6.E.4.d.Handling Notification From a VAMC of a Change in a Veteran’s Competency

If there is a change in a Veteran’s competency, the VAMC of jurisdiction will furnish a hospital summary to the appropriate RO upon the Veteran’s transfer to a nursing home.

III.v.6.E.4.e.Referring Evidence of a Veteran’s Competency to the Rating Activity

Follow the steps in the table below to refer evidence of a Veteran’s competency to the rating activity.
Step
Action
1
Forward the summary provided by the VAMC to the rating activity for a determination as to
  • the competency status of the Veteran, and
  • whether or not the Veteran may be entitled to either
    • the A&A allowance, or
    • housebound benefits.
2
If the rating activity determines the Veteran is
  • competent, go to Step 3, or
  • incompetent, go to Step 4.
3
  • Follow the procedures in M21-1, Part III, Subpart v, 6.E.8.d if
    • VA has not appointed the Veteran a fiduciary, or
    • VA has not appointed the Veteran a fiduciary, but there is a court-appointed fiduciary.
  • Disregard the remaining step in this table.
4
If VA has not yet appointed a fiduciary, then
  • send VA Form 21-592, if not previously sent, to the fiduciary hub with geographical jurisdiction over the VAMC, showing
    • the nursing home placement
    • the date of the Veteran’s transfer to the nursing home
    • a notation of possible release in six months, and
    • the name and address of the next of kin, and
  • attach a copy of the hospital summary to VA Form 21-592.
Note:  If a fiduciary is already appointed to the Veteran, send a copy of the hospital summary to the fiduciary hub with geographical jurisdiction over the VAMC.

III.v.6.E.4.f.Handling Notification of a Veteran’s Release or Termination of Care at VA Expense

The transferring VAMC authorizes and administratively controls nursing home care and notifies the appropriate RO of the Veteran’s release from the contract nursing home or when care at VA expense is terminated.
Following receipt of such notification
  • make any adjustment in the Veteran’s award that is necessitated by the release
  • continue the institutional award to the Director of the VAMC if a different fiduciary has not yet been appointed, and
  • send the fiduciary hub of geographical jurisdiction a copy of the notice of release.

5.  Awards to Dependents of Incompetent Veterans


Introduction

This topic contains information on awards to dependents of incompetent Veterans, including

Change Date

May 25, 2018

III.v.6.E.5.a.Apportionment to Dependents of Non-Institutionalized, Incompetent Veterans

If VA grants a claim for apportionment of an incompetent Veteran’s benefits (based on demonstrated hardship), but VA has not yet appointed the Veteran a fiduciary,38 CFR 3.452 allows for payment of the apportionment without waiting for the appointment of a fiduciary.
Reference:  For information about claims for apportionment of a Veteran’s benefits, see M21-1, Part III, Subpart v, 3.A.

III.v.6.E.5.b.  Awards to Dependents of Institutionalized, Incompetent Veterans

Generally, the full monthly rate otherwise payable, less the reduced rate paid to the institution, may be apportioned to the dependent(s) of an institutionalized, incompetent Veteran.  An apportionment of the Veteran’s withheld benefits may notbe authorized unless evidence of a hardship on the part of the dependent is received.
The table below provides references to blocks within this topic that describe the action to take when an incompetent Veteran
  • is receiving institutional care by the United States or a political subdivision thereof, and
  • has a spouse, child, or dependent parent who is not being adequately provided for by an award to a fiduciary.
For information on the apportionment of …
See …
an institutional award of Veterans Pension
benefits to an estranged spouse
benefits to a dependent parent

III.v.6.E.5.c.Apportioning an Institutional Award

When an institutional award of Veterans Pension is being made to a non-VA institution, apply the provisions of 38 CFR 3.454(a), limiting the institutional payment to no more than $25.00, with the balance apportioned to the Veteran’s dependents.

III.v.6.E.5.d.  Award Adjustments for an Incompetent Veteran With an Estranged Spouse

If an incompetent, married Veteran, who is receiving Veterans Pension at the rate payable for a Veteran with no dependents because the Veteran and his/her spouse are estranged, is institutionalized at VA expense, reduce the Veteran’s award under38 CFR 3.551 on the basis of the Veteran’s
  • estrangement from his/her spouse, or
  • failure to reasonably contribute to the support of his/her spouse.
If the Veteran’s spouse submits a claim for an apportionment and demonstrates he/she is experiencing financial hardship per 38 CFR 3.452(c)(1) and 38 CFR 3.454(b), apportion to the estranged spouse the difference between the rate payable to
  • an institutionalized Veteran, and
  • a Veteran with a spouse.
Reference:  For information on apportioning benefits to an estranged spouse when consideration of the spouse’s income would result in a reduction in the Veteran’s pension rate, see M21-1, Part V, Subpart iii, 1.F.2.n.

III.v.6.E.5.e.  Apportioning an Award to a Dependent Parent

When an incompetent Veteran, having neither spouse nor child, is hospitalized by the United States or any political subdivision thereof, pay all or any part of the benefit otherwise payable to a dependent parent under 38 CFR 3.451.
If the case involves
  • compensation, the payment to the dependent parent must be no less than the amount of additional compensation payable for the parent, or
  • pension for an incompetent Veteran subject to reduction under 38 CFR 3.551, the amount payable must not exceed the institutional rate.
Reference:  For information on apportioning benefits to the parent of a competent Veteran, see M21-1, Part III, Subpart v, 3.A.1.

III.v.6.E.5.f.  Effect of the Suspension of Benefits on Apportionments

An initial action to suspend payments pending appointment of a fiduciary does not prohibit the payment of apportionments that are otherwise proper and equitable.
If an apportionment is made prior to appointing a fiduciary, furnish the fiduciary hub of jurisdiction with a copy of the apportionee award and a request for expedited appointment.

6.  Handling Funds in PFOP) Accounts


Introduction

This topic contains instructions for handling funds in PFOP accounts, including

Change Date

April 10, 2007

III.v.6.E.6.a.  Types of PFOP Accounts

There are two types of PFOP accounts, as outlined in the table below.
Veteran Status
Explanation/Description
hospitalized in a VAMC
On August 31, 1950, all balances in Funds Due Incompetent Beneficiaries (FDIB) accounts that represented compensation or pension accruing on or after August 8, 1946, were transferred to the Directors of the VAMCs in which the Veterans were hospitalized for credit to PFOP accounts.  VAMC Directors are responsible for maintaining these accounts.
  • committed/confined to a non-VA institution, or
  • whereabouts are unknown
On April 30, 1951, money that accrued on or after August 8, 1946,
  • was transferred from FDIB to PFOP accounts under RO control, and
  • is now maintained and controlled by the Hines ITC for cases in which
    • the Veteran is confined or committed to a non-VA institution, or
    • the whereabouts of the Veteran are unknown.
Note:  August 8, 1946, was the date of passage of Public Law 662, 79th Congress.

III.v.6.E.6.b.Taking Award Action on the Two Types of PFOP Accounts

Because there are two types of PFOP accounts, a distinction must be made in taking award action.  The distinctions for award action on each type of account are listed below:
  • An award should never include an allotment when it is an institutional award to the Director of a VAMC.
    • Award the total amount payable to the Director, VAMC, for the Veteran’s account.
    • The Director will deposit into the PFOP accounts under his/her control all money not immediately required for the Veteran’s needs.
  • Money is not placed into a PFOP account under the control of the Hines ITC, unless an adjustment is made to the Veteran’s award that allots a definite sum to the PFOP account.  This is done only when a Veteran is institutionalized in a non-VA institution.

III.v.6.E.6.c. Use of Funds for Necessary Comforts and Desires by VAMCs and Non-VA Institutions

Use the table below to determine how funds from PFOP accounts needed for the comforts and desires of a Veteran are obtained by
  • the Director of a VAMC, or
  • a non-VA institution.
If funds from a PFOP account for the comforts and desires of a Veteran are needed by a …
Then …
Director of a VAMC
he/she may use funds in the PFOP account at his/her VAMC.
non-VA institution
funds are released on the basis of a memorandum from a fiduciary hub authorizing partial or full release of money on deposit.
Notes:
  • Take award action to release funds as provided in M21-1, Part III, Subpart v, 6.E.8.g.
  • Computer processing of the amended award generates a notice to the Hines ITC Accounting Section.  At the request of the accounting section, the fiduciary hub authorizes the release or transfer of the money on deposit in the PFOP account.

III.v.6.E.6.d.  Payment of Funds in a PFOP Account as Accrued Benefits Upon the Death of a Veteran

For information on the payment of funds in a PFOP account as accrued benefits upon the death of a Veteran, see M21-1, Part VIII, 5.6 and 7.

7.  Adjusting an Institutional Award During Non-Bed Care Status


Introduction

This topic contains information on adjusting institutional awards during non-bed care status of a Veteran, including

Change Date

April 10, 2007

III.v.6.E.7.a.  Definition:  Non-Bed Care

Non-bed care is a temporary release from a hospital to determine
  • the Veteran’s ability to make a satisfactory adjustment outside the hospital, and
  • whether the Veteran should be discharged from or returned to the hospital, based on his/her ability to make that adjustment.
Note:  Release on furlough by non-VA institutions is synonymous with release to non-bed care status.

III.v.6.E.7.b.  Receiving and Forwarding Notice of Non-Bed Care

When an RO requests a notice of discharge from a VAMC, the VAMC responds by notifying the RO of the Veteran’s departure on, or return from, a period of non-bed care of 30 days or more.
Follow the instructions in the table below after receiving the notice referenced in the preceding paragraph.
If the Veteran …
Then forward the report to the fiduciary hub having jurisdiction over …
has a fiduciary
the Veteran’s fiduciary.
does not have a fiduciary
the geographical area in which the VAMC is located.

III.v.6.E.7.c.  Continuing Awards While on Non-Bed Care

Because a Veteran for whom no fiduciary has been appointed is considered to be in the constructive custody of the chief officer of the corresponding medical institution while on non-bed care, continue
  • the institutional award on the Veteran’s behalf,
  • special apportionments to the Veteran’s dependents.
The chief officer is authorized to
  • provide funds to a Veteran on non-bed care for whom no other fiduciary has been appointed, or
  • pay the person into whose custody the Veteran is released.
Note:  Use this procedure for non-VA institutions if arrangements have been made by the fiduciary hub with officials of the non-VA institutions to comply with the same rules that bind Directors of VAMCs.

III.v.6.E.7.d. Adjustments for Release to Non-Bed Care or Absences of 30 Days or More

Use the table below to determine how to make various adjustments to awards for
  • release to non-bed care, or
  • an authorized absence of 30 days or more.
If …
Then …
notice showing release to non-bed care or authorized absence of 30 days or more is received
  • pay the full amount on the basis of the last rating decision, effective the date of departure, and
  • discontinue any allotment for PFOP, subject to the prior approval of the fiduciary hub, when required.
  • notice showing release to non-bed care or authorized absence of 30 days or more is received, and
  • the total award amount is being paid either
    • to the Director of a VAMC, or
    • by special apportionment between the institution and dependents
take no action unless the facts show
  • the Veteran’s or apportionee’s situation has changed, and
  • a new, special apportionment decision should be made.
  • notice showing release to non-bed care or authorized absence of 30 days or more is received
  • funds in excess of the Veteran’s monthly entitlement are required, and
  • entitlement has been terminated
provide funds from PFOP accounts in accordance with M21-1, Part III, Subpart v, 6.E.6.c.

III.v.6.E.7.e.  Extension of Non-Bed Care

If the original period of non-bed care or authorized absence is extended, make no further adjustment of a special apportionment or the institutional award pending the expiration of the extension.
The chief officer of the corresponding medical institution must carefully review each case in which there is an extension to ascertain if any special circumstances exist that
  • relate to the safeguarding of the interests of the Veteran and his/her dependents, or
  • may indicate continuance of the existing payments is not justifiable.
If the facts warrant it, the chief officer will submit appropriate recommendations to the RO as to any action or adjustment considered advisable.

8.  Discontinuing an Institutional Award When a Veteran Is Discharged From a Hospital


Introduction

This topic contains information on discontinuing institutional awards and authorizing payment to a Veteran or fiduciary when a Veteran is discharged from a hospital, including

Change Date

May 25, 2018

III.v.6.E.8.a.  Preventing the Interruption of Award Payments

Avoid interruption of payments when an incompetent Veteran in receipt of an institutional award is finally discharged from the hospital.
This requires close coordination between the medical institution and the RO.

III.v.6.E.8.b.  Instructions for Discontinuing an Institutional Award

When a Veteran is discharged from a hospital, discontinue an institutional award effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share, per 38 CFR 3.501(j).
If another fiduciary has been appointed, discontinue the institutional award by amending the award to the fiduciary per 38 CFR 3.852.  Make payment of all funds due the incompetent Veteran, including money on deposit in PFOP, to the fiduciary, if otherwise in order.
Note:  Notify the Director of the VAMC when an institutional award is discontinued.
Reference:  For information concerning transfers to a nursing home, see M21-1, Part III, Subpart v, 6.E.4.

III.v.6.E.8.c.  Awaiting the Determination of a Contemplated Discharge Date Before Requesting a Fiduciary

Due to the indefinite period during which non-bed care status may continue, and the possibility that competency may be regained, do not request for the appointment of a fiduciary until a contemplated date of discharge has been determined.
When a Veteran without a fiduciary, for whom an institutional award has been authorized, is discharged from a hospital, the VAMC
  • advises the RO of an impending discharge, and
  • furnishes the RO an interim discharge summary.
Following submission of this report, the chief officer of the corresponding medical institution will retain the patient on non-bed care status until the necessary rating and guardianship procedures have been concluded.

III.v.6.E.8.d.  Referring the Hospital Summary to the Rating Activity

Following receipt of a hospital summary indicating a medical opinion of regained competency, refer the summary to the rating activity for consideration.
Use the table below to determine the appropriate action to take based on the determination by the rating activity.
Reference:  For more information on evaluating competency, see M21-1, Part III, Subpart iv, 8.A.1.
If the rating activity makes a determination of …
Then …
competency
follow the instructions in M21-1, Part III, Subpart v, 9.B.6.a.
incompetency
  • inform the fiduciary hub with geographical jurisdiction over the RO of the rating and impending discharge, and
  • request the appointment of a fiduciary using
Note:  The fiduciary hub will request a field examination to determine the need for a fiduciary.
References:  For more information on

III.v.6.E.8.e.  Requesting a Field Examination and Possible Reconsideration by the Rating Activity

Following receipt of a copy of a hospital summary based on an impending discharge, along with the rating decision referenced in M21-1, Part III, Subpart v, 6.E.8.d, a fiduciary hub may initiate a field examination to determine the need for appointment of another fiduciary.
The table below describes the process for
  • requesting a field examination, and
  • submitting an opinion for possible reconsideration by the rating activity.
Reference:  For more information on the field examination process, see theFiduciary Program Manual.
Stage
Description
1
Following receipt of VA Form 21-592 requesting the appointment of a fiduciary, the fiduciary hub requests a field examination to determine
  • the need for appointment of a fiduciary, and
  • if necessary, the most appropriate type of fiduciary.
2
Based on the results of the field examination, the fiduciary hub concludes the Veteran is
  • incompetent and proceeds with the appointment of a fiduciary, or
  • competent to administer funds payable and refers the facts supporting that opinion to the RO of jurisdiction for further consideration by its rating activity.
3
The rating activity may
  • consider the facts and opinion the fiduciary hub submitted and determine whether they are sufficient to support a finding of competency
  • request further development, including an “at once” examination or period of examination and observation, or
  • confirm the prior finding of incompetency.
Note:  The procedure for requesting an “at once” examination through CAPRI is no different than the procedure for requesting any other type of examination. CAPRI does not have a specific option for “at once” examinations.
4
If the rating activity determines the Veteran remains incompetent, the authorization activity authorizes
Note:  Do not make direct payments to a Veteran who has not regained competency by VA rating, unless
  • a fiduciary hub has appointed the case as a supervised direct pay case, or
  • a court has adjudicated the Veteran as competent per 38 CFR 3.850(a).
5
The authorization activity notifies the following of the award or of anyother type of action(s) taken:
  • fiduciary hub
  • appointed fiduciary, and
  • chief officer of the corresponding medical institution involved.

III.v.6.E.8.f.  Notification Requirements for Payments Made Directly to a Veteran or to a Fiduciary

If a fiduciary hub furnishes a VA Form 21-555, notify the fiduciary hub when payments are made
  • directly to the Veteran
    • under supervised direct pay, per 38 CFR 13.56, or
    • based on regained competency, or
  • to a fiduciary.

III.v.6.E.8.g.  Terminating PFOP Allotments

Discontinue an allotment for PFOP to release accumulated funds or to provide for direct payment of current benefits when
Authorize payments to the Veteran or fiduciary.
Discontinue the allotment effective
  • the date the allotment was first put into effect, when full release is in order, or
  • from the first of the month following the month for which VA last paid benefits to the current fiduciary, when only the release of current benefits is in order.
Historical_M21-1III_v_6_SecE_7-23-15.doc May 16, 2019 229 KB
5-25-18_Key-Changes_M21-1III_v_6_SecE.docx May 16, 2019 91 KB
Change-July-23-2015-Transmittal-Sheet-M21-1MRIII_v_6_SecE-TS.docx May 16, 2019 41 KB
Historical_M21-1MRIII_v_6_SecE_8-29-2011.docx May 16, 2019 73 KB
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