Sorry for the mess!

The site is undergoing a massive update. All the content on the site still works but things just might look a little messy and disorganized. Most of the upgrades will probably be don by the end of the month. Thank you for your understanding!

Updated Jan 28, 2022

In This Section
This section contains the topic “Requests for Financial Audits.”

 1.  Requests for Financial Audits

Introduction

Change Date
September 1, 2021

VI.i.2.A.1.a.  Actions to Take in Response to an Audit Request
Follow the steps in the table below to process a request for an audit of financial payments and/or accounting from a beneficiary or a retired pay center (RPC).
Step
Action
1
  • Establish an end product (EP) 290, using the
    • date of the request’s receipt by the Department of Veterans Affairs (VA) as the date of claim, and
    • more appropriate of the following claim labels:
      • Audit Request (for compensation claims), or
      • PMC – Audit Request (for pension claims), and
  • enter Audit request as an associated contention.
2
Review the substance of the audit request and use the table below to determine the next action.
If the audit request raises …
Then …
questions concerning authorization-related matters that
  • necessitate a benefit entitlement determination, or
  • the authorization activity can easily answer or resolve without involving the finance activity
Examples:  Questions concerning
  • withholdings
  • recoupments
  • benefit entitlement
  • payment rates, and/or
  • effective dates.
  • review the beneficiary’s award history and payment record to determine if corrective action is needed
  • take any necessary award action to implement needed corrections
  • provide the beneficiary and/or RPC with a corresponding informational or decision notice
  • clear the pending EP 290, and
  • disregard the remaining steps in this table.
Note:  If an award adjustment is necessary to correct an error, change the EP 290 to an EP 930 and make the award adjustment under the latter EP.
more complex financial payment questions that exceed the authorization activity’s ability to resolve
proceed to Step 3.
Example:  A Veteran submits a request for a financial audit, indicating his recently adjudicated dependency claim was awarded from an incorrect date.  A review of the claims folder reveals the following:
  • The Veteran has been assigned a 40-percent evaluation since February 19, 2010.
  • His youngest child was born September 19, 2016.
  • He submitted a fully complete VA Form 21-686c on March 7, 2017.
  • An award action authorized May 1, 2017, awarded additional benefits for the child effective March 7, 2017 (payable April 1, 2017).
Analysis/Result:
  • In light of the timeliness of the claim’s filing, additional benefits for the dependent should have been awarded effective the date dependency arose (the date of the child’s birth), rather than the date of the claim’s receipt.
  • Because the substance of the request, although couched in terms that reference an audit, relates to an entitlement determination routinely made by the authorization activity, the request need not be referred for the finance activity’s review or action.
  • The authorization activity must process an award to adjust the effective date of the award of additional benefits for the dependent and provide the Veteran with a corresponding decision notice.
3
  • Send an encrypted e-mail requesting performance of an audit to the finance activity closest to the zip code of the geographical area where the Veteran currently resides
  • upload a copy of the e-mail to the beneficiary’s electronic claims folder (eFolder), and
  • add the appropriate tracked item, as identified in M21-4, Appendix D, with a 30-day suspense.
Reference:  For more information on the finance activity’s responsibilities with regard to audit requests, see M21-1, Part VI, Subpart v, 2.A.1.b.
4
Did the finance activity determine an award adjustment is necessary to resolve discrepancies in the beneficiary’s payments?
  • If yes, make the award adjustment under the pending EP 290.
  • If no, clear the pending EP 290.
5
Provide the beneficiary and/or RPC with a corresponding informational or decision notice.
 Notes:
  • There is no standard form requirement for a request for financial audit.
  • Do not include review rights when notifying a beneficiary of the outcome of a request for a financial audit unless the request resulted in an adjustment to the beneficiary’s award.

VI.i.2.A.1.b.  Finance Activity Responsibilities With Regard to Audit Requests
Following receipt of an audit request referral from a regional office (RO), the finance activity closest to the zip code of the geographical area where the Veteran currently resides will
  • conduct the audit by reviewing the beneficiary’s payment activity, and
  • take additional actions as outlined in the table below.
If the audit reveals …
Then the finance activity will …
that benefit payments have been processed appropriately
  • notify the beneficiary of the audit’s outcome
  • upload associated and supporting documentation to the eFolder, and
  • direct the RO to clear the pending EP 290.
discrepancies in the beneficiary’s payment activity
notify the RO of any award adjustments deemed necessary to reconcile the noted payment discrepancies.

VI.i.2.A.1.c.  Handling a Beneficiary’s Withdrawal of a Request for a Financial Audit
Treat a beneficiary’s withdrawal of a request for a financial audit like a request to withdraw a claim.