Overview
In This Section |
This section contains the following topics:
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1. Operational Performance and Establishing Controls
Introduction |
This topic contains general information on operational performance and establishing controls, including |
Change Date |
January 25, 2017
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X.9.E.1.b. Overview of the Match |
The table below provides an overview of the match.
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X.9.E.1.c. OPA&I Filtering of Matches |
OPA&I selects eligible beneficiary records to send to Hines ITC. Prior to selecting records, OPA&I will automatically exclude records in which the beneficiary
Note: The first two bullets apply to EP series 180s and 190s only.
Reference: For information on FTI eligible EP claims, see the Upfront Verification User Guide.
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X.9.E.1.e. PAA Worksheets |
Hines ITC will produce worksheets and upload them with the secured category description of IRS/SSA – Verification within the secured FTI folder in LCM for all matched cases, including those that were filtered by Hines ITC.
Note: The worksheets associated with the matches filtered by Hines ITC require no further action.
Reference: For more information pertaining to the data shown on the worksheets, see M21-1, Part X, 9.E.4.
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X.9.E.1.f. PAA EP |
For those matches not excluded, Hines ITC automatically establishes an EP 154 with the claim label,
Notes:
Important:
Example: An EP 154 is established on 12/16/2016 due to a PAA. A review of the record shows that a second EP 154, established 10/05/2012, is due to an income verification match. Clear the EP that was established 12/16/2016 and work the PAA and the IVM under the EP established 10/05/2012.
Reference: For more information on when a fiduciary may verify FTI, see M21-1, Part X, 9.B.4.
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2. Notification and Verification Requests
Introduction |
This topic contains information on the notification and verification letters, including |
Change Date |
January 25, 2017
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X.9.E.2.b. Due Process |
Due process procedures require VA to give the beneficiary 60 days to submit evidence to show why a reduction or discontinuance should not be made.
Reference: For more information on due process, see
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X.9.E.2.c. Compression Letter |
Beginning in fiscal year (FY) 2016, the matching agreements with IRS (unearned income) and SSA (earned income) allow for compression of independent verification and due process. This is different from the income verification matches (IVMs) in which two separate steps were required. The compressed letter allows VA to reduce the time it takes to process the match.
Reference: For more information on how to process IVMs, see M21-1, Part X, 9. F.
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X.9.E.2.d. Automatic Generation of Compressed Letter |
Hines ITC will automatically issue a compressed letter to the beneficiary at the time the EP is automatically established. The letter provides the beneficiary of the identified income 60 days to respond.
Notes:
References: For information on
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X.9.E.2.e. Effective Date of Proposed Action for the Compressed Letter |
For the purposes of the compressed letter, VA
Important: Although the most adverse action is proposed, claims processors must take the most appropriate action based on the evidence of record.
Reference: For examples on final award actions, see M21-1, Part X, 9.E.3.d ande.
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X.9.E.2.f. Attachments Mailed with Beneficiary Letter |
VA forms will be attached to the beneficiary letter based on the IRS Source and IRS Income Type identified. The chart below indicates the VA Forms mailed to the beneficiary.
Exception: Beneficiaries of Parent’s DIC will not receive VA Form 21P -8049.
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3. Final Action for PAA
Introduction |
This topic contains information on final action of the award
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Change Date |
February 19, 2019
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X.9.E.3.a. When to Take Final Action |
Do not take final action until a reasonable income verification process is completed. In most cases, the verification process is considered completed when the compressed letter is sent to the beneficiary and the 60-day response period has expired.
Note: In all cases, final action may be taken prior to the expiration of the 60-day due process period if the beneficiary waives the due process rights.
Reference: For an example of when further development may be required, seeM21-1, Part X, 9.E.3.d.
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X.9.E.3.b. Additional Development |
In some instances, further development may be required. The EP must be left pending until the issue is finalized.
If further development is required, but evidence received from the beneficiary could be used to adjust the benefit, take interim action while resolving the discrepancy. The effective date of the interim action should be based on the evidence of record.
Reference: For an example of when further development may be required, seeM21-1, Part X, 9.E.3.d.
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X.9.E.3.c. Finalizing the PAA Claim |
Once the verification and due process period are complete for PAA, take final action based on the table below.
Notes:
Important: PMCs must maintain FTI created for PAA in the secured FTI folder in LCM. Additionally, for the electronic claims folder (eFolder) in LCM, IRS/SSA Verification folders will contain FTI related to PAA.
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X.9.E.3.d.Example 1 of Final Award Action |
Scenario: The Veteran’s income for VA purposes (IVAP) is $0. The PAA discovered income of $1,000 in wages (considered recurring income) and $2,000 in gambling winnings (considered nonrecurring income). Veteran states as related to the wages, he’s a victim of identity theft. He provided no evidence pertaining to the identity theft and he did not dispute the gambling winnings.
Result: Take interim action to count the gambling winnings, removing the gambling winnings after it has been counted for 12 months. In the decision notice,
After the 30 days has expired,
Reference: For more information on decision notification requirements, see M21-1, Part III, Subpart v, 2.B.1.b.
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4. PAA Worksheet
Introduction |
This topic contains information on the PAA worksheet, including |
Change Date |
February 10, 2017
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X.9.E.4.a. PAA Worksheet Data |
PAA Worksheets may contain the following:
References: For information on
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X.9.E.4.b. PAA Worksheet Data Definitions |
The chart below explains the data received on the PAA worksheet. Review the income, as reported by IRS, for
Reference: For more information on determining how long the income should be counted on the award, see M21-1, Part X 9.E.4.c.
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X.9.E.4.c. Determining Income Classification |
Claims processors must consider how long the FTI should be counted when determining the final award. Review the PAA worksheet and see the table below to determine how long the income should be counted.
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X.9.E.4.d. Sample PAA Worksheet (Page One) |
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X.9.E.4.e. Sample PAA Worksheet (Additional Pages) |
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5. Omnibus Budget Reconciliation Act (OBRA) and Reporting Requirements
Change Date |
January 25, 2017
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X.9.E.5.a. OBRA and Reporting Requirements |
The Omnibus Budget Reconciliation Act (OBRA) of 1990 requires that VA pay the cost of administering the FTI match from compensation and pension funds rather than from the general operating expenses account. To do so, Regional Offices must identify PAAs and report information related to overpayments and savings. This process is identical to the IVM.
Reference: For more information on reporting requirements, see M21-1, Part X, 9.F.14.
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1-23-17_Key-Changes_M21-1X_9_SecE.docx | May 19, 2019 | 112 KB |
1-25-17_Key-Changes_M21-1X_9_SecE.docx | May 19, 2019 | 108 KB |
Historical_M21-1X_9_SecE_1-25-17.docx | May 19, 2019 | 126 KB |
Historical_M21-1X_9_SecE_3-14-17.docx | May 19, 2019 | 112 KB |
Historical_M21-1X_9_SecE_2-10-17.docx | May 19, 2019 | 126 KB |
2-19-19_Key-Changes_M21-1X_9_SecE.docx | May 19, 2019 | 95 KB |
2-10-17_Key-Changes-M21-1X_9_SecE.docx | May 19, 2019 | 109 KB |
12-21-17_Key-Changes_M21-1X_9_SecB.docx | May 19, 2019 | 102 KB |
7-20-18_Key-Changes_M21-1X_9_SecB.docx | May 19, 2019 | 91 KB |
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