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Updated Jul 23, 2024

In This Section
This section contains the following topics:

1.  Overview of Erroneous Payments

Introduction
This topic contains an overview of erroneous payments, including

Change Date

 May 7, 2020

VI.i.2.B.1.a.  Definition:  Erroneous Payments
Erroneous payments are payments the Department of Veterans Affairs (VA) made to a beneficiary that are not authorized by law.

VI.i.2.B.1.b.  Definition:  Duplicate Payment
A duplicate payment is defined as a type of erroneous payment where VA concurrently made two or more payments to a beneficiary, one or more of which are not authorized by law.

VI.i.2.B.1.c.  Examples of Duplicate Payments
Examples of duplicate payments include
  • a payment of compensation and a payment of pension, or
  • two or more concurrent payments of
    • disability compensation
    • Dependency and Indemnity Compensation (DIC), or
    • pension.
Important:  The payment of disability benefits to a Veteran based on their own service, and the concurrent payment of disability or survivors benefits to or for the same Veteran based on a different Veteran’s service,

VI.i.2.B.1.d.  Examples of Erroneous Payments That Are Not Duplicate Payments
Examples of erroneous payments that are not duplicate payments include
  • assigning an incorrect effective date for the addition of a dependent to a Veteran’s award
  • payment of benefits in an amount exceeding a beneficiary’s entitlement that is due to claims-processing delays, or
  • a decision that resulted in payment but is later found to be clearly and unmistakably erroneous.

VI.i.2.B.1.e.  Actions to Take for Erroneous Payments
After discovering VA erroneously paid benefits to a beneficiary, determine whether the erroneous payment meets the definition of a duplicate payment.  If it

2.  Handling Cases That Involve the Duplicate Payment of Benefits

Introduction
This topic contains special instructions for for handling cases that involve the duplicate payment of benefits, including

Change Date

 July 27, 2023

VI.i.2.B.2.a.  Action to Take Upon Discovering Duplicate Payments
Upon discovering that VA is making a duplicate payment to a beneficiary, follow the steps in the table below.
Step
Action
1
Does the duplicate payment consist of the payment of disability compensation to a Veteran for one or more service-connected (SC) disabilities and a separate payment of disability compensation to the same Veteran for one or more other SC disabilities?
  • If yes, go to Step 3.
  • If no, go to the next step.
Rationale:  It would be improper to take the action described in the next step without issuing a notice of proposed adverse action if the Veteran is entitled to both payments (without regard to the disability ratings assigned to the several SC disabilities).
Examples:
  • Veteran is in receipt of disability compensation for amputation of the left leg at 30 percent and arthritis of the right knee at 10 percent under record “A.”  The same Veteran is in receipt of disability compensation for posttraumatic stress disorder (PTSD) at 50 percent and arthritis of the right knee at 10 percent under record “B.”  This should be considered an exception.  Skip Step 2 and follow the instructions in Step 3 since suspending either award would be taking adverse action without due process on an entitlement.
  • Veteran is in receipt of disability compensation for erectile dysfunction at 20 percent, diabetes mellitus at 10 percent, and special monthly compensation for loss of use of a creative organ under record “A.”  The same Veteran is in receipt of disability compensation for diabetes mellitus at 10 percent under record “B.”  Follow the instructions below in Step 2 as the Veteran is being paid for diabetes mellitus on record “A.”
2
Suspend the duplicate payment effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in the Veterans Benefits Management System (VBMS) 38 U.S.C. 5112(b)(10).
Important:
  • When suspending a duplicate compensation payment that involves the same disability with different disability ratings, suspend the award with the lower of the two disability ratings.
  • When suspending a duplicate pension award, suspend the lower payment.
3
Establish end product (EP) 600 to control for due process and propose to stop the duplicate payments from the effective date of the award.  Include appropriate language in the notice of proposed adverse action that states if the proposed adjustment is made, it may result in an overpayment of benefits.  Also include language about minimizing overpayments.
Important:
  • Due process is always required before the generation of an overpayment, even when the duplicate payment is suspended as described in Step 2.
  • Propose to stop the duplicate payment from the effective date of the award regardless of preliminary evidence that the duplicate payment was due to an administrative error.  Proposing to stop duplication of payment effective the date of the award allows VA the flexibility to evaluate all evidence of record after the due process period ends and make a final determination based on the evidence of record.
4
Did the beneficiary respond to the notice of proposed adverse action within 65 days?
  • If yes, go to the next step.
  • If no, go to Step 7.
5
Did the beneficiary request a hearing within 30 days of the date of the notice of proposed adverse action?
  • If yes, go to the next step after VA
    • holds the hearing, and
    • obtains any relevant evidence the beneficiary identified during the hearing (or determines the evidence is unavailable).
  • If no, go to the next step.
6
Did the beneficiary provide evidence showing no duplicate payments were made?
  • If yes,
    • notify the beneficiary that VA will not take the action it proposed, and
    • disregard the remaining steps in this table.
  • If no, go to the next step.
7
Does the evidence of record indicate the duplicate payment of benefits was due to administrative error?
  • If yes,
    • prepare an administrative decision to document that fact
    • submit the administrative decision for approval, according to the instructions in M21-1, Part VI, Subpart i, 2.B.3.h, and
    • go to Step 9 following receipt of approval.
  • If no, go to the next step.
References:  For more information on
8
  • Take the action proposed in Step 3.
  • Go to Step 10.
Important:  If a debt is created, ensure it is created on the correct record.
9
Take the action proposed in Step 3 while concurrently eliminating any resulting overpayment.
Reference:  For more information on eliminating an overpayment resulting from correction of an administrative error, see M21-1, Part VI, Subpart iii, 2.B.3.e.
10
Notify the beneficiary of the action taken.
11
Establish and clear an EP 960 as directed in M21-1, Part X, Subpart ii, 3.B.4.b.
For pension and Parents’ DIC cases only:  Ensure documentation of calculations made to determine the rate of benefits (such as calculations of medical expenses, net worth, and waived overpayments) are included in the electronic claims folder (eFolder).
Reference:  For more information on including documentation of pension and Parents’ DIC award calculations in the eFolder, see M21-1, Part VI, Subpart i, 1.A.

VI.i.2.B.2.b.  Consideration of Administrative Errors
Do not automatically consider duplicate payments as an administrative error.  In limited circumstances, a decision to waive the debt due to administrative error is appropriate.  In these situations, careful consideration is required and should include determining if the beneficiary could have had knowledge of any additional payments.

VI.i.2.B.2.c.  Types of Duplicate Payments That May Not Be Treated as an Administrative Error
Do not treat the following types of duplicate payments as administrative errors:
  • a payment of disability compensation and a payment of Veterans Pension
  • a payment of DIC and a payment of Survivors Pension under the same Veteran
  • more than one compensation payment when payment is based on the same disability, regardless of the disability rating assigned to the disability
  • more than one payment of DIC, or
  • more than one payment of pension, including
    • one payment under Section 306 Pension and one payment under current-law pension
    • one payment under Old Law Pension and one payment under current-law pension, or
    • more than one payment under current-law pension, regardless of the maximum annual pension rate or income for VA purposes.

VI.i.2.B.2.d.  Example 1:  Duplicate Payment That May Not Be Treated as an Administrative Error
Situation:
  • A surviving spouse is in receipt of Survivors Pension and the benefits were converted into a new electronic record without a Social Security number (SSN).
  • On May 1, 2012, during a record update, a new participant identification (PID) number is created by adding the spouse’s SSN.
  • On June 1, 2015, a Veterans Service Representative (VSR) processing a medical expense report discovers the surviving spouse is receiving two payments of Survivors Pension each month.
Actions:
  • Suspend the duplicate payment effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS.
  • Send the surviving spouse notice of VA’s proposal to discontinue the duplicate payment effective May 1, 2012.
  • Unless the surviving spouse submits evidence within 65 days that shows the proposed action should not be taken,
    • discontinue the duplicate payment effective May 1, 2012, and
    • notify the surviving spouse of the action taken.
Notes:
  • Do not treat the duplicate payment of benefits in this case as an administrative error.
  • The surviving spouse is responsible for repaying the overpayment.

VI.i.2.B.2.e.  Example 2:  Duplicate Payment That May Not Be Treated as an Administrative Error

 Situation:
  • A Veteran is in receipt of disability compensation for residuals of a shoulder injury that VA rated 10-percent disabling.
  • On December 1, 2013, the Veteran submits a new claim for an increased disability rating for their shoulder.
  • A Claims Assistant (CA) establishes the Veteran’s claim under a new PID.
  • VA increases the disability rating for the shoulder to 20 percent and begins paying the Veteran benefits under the new PID.  (The Veteran is now receiving two benefit payments:  one under the old PID and another under the new PID.)
  • While updating the Veteran’s address on June 1, 2015, a VSR discovers the Veteran is receiving two benefit payments from VA each month.
Actions:
  • Suspend the lower of the two benefit payments effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS.
  • Send the Veteran notice of VA’s proposal to discontinue the duplicate payment effective the date VA began paying it.
  • Unless the Veteran submits evidence within 65 days that shows the proposed action should not be taken,
    • discontinue the duplicate payment effective the date VA began paying it, and
    • notify the Veteran of the action taken.
Notes:
  • Do not treat the duplicate payment of benefits in this case as an administrative error.
  • The Veteran is responsible for repaying the overpayment.

VI.i.2.B.2.f.  Example 3:  Duplicate Payment That May Not Be Treated as an Administrative Error
Situation:
  • On December 1, 2013, a Veteran in receipt of Section 306 Pension submits a claim for current-law pension, including additional benefits for aid and attendance.
  • A CA establishes the claim under an incorrect PID.
  • On January 1, 2014, VA grants the Veteran’s claim for current-law pension.  (The Veteran is now receiving two benefit payments each month:  one for current-law pension and one for Section 306 Pension.)
  • On March 1, 2015, a VSR discovers the Veteran has been receiving two pension payments when the Veteran notifies VA of a medical facility change.
Actions:
  • Suspend the duplicate payment effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS.
  • Send the Veteran notice of VA’s proposal to discontinue the duplicate payment effective the date VA began paying it.
  • Unless the Veteran submits evidence within 65 days that shows the proposed action should not be taken,
    • discontinue the duplicate payment effective the date VA began paying it, and
    • notify the Veteran of the action taken.
Notes:
  • Do not treat the duplicate payment of benefits in this case as an administrative error.
  • The Veteran is responsible for repaying the overpayment.

VI.i.2.B.2.g.  Example 4:  Duplicate Payment That May Not Be Treated as an Administrative Error

 Situation:
  • On September 1, 2014, a surviving spouse in receipt of Survivors Pension applies for DIC.
  • A CA establishes the DIC claim under an incorrect PID.
  • On January 1, 2015, VA grants the surviving spouse’s claim for DIC and payments begin for DIC in addition to the payments being received for Survivors Pension.
  • On March 1, 2015, a VSR discovers that the surviving spouse has been receiving both Survivors Pension and DIC when the surviving spouse contacts VA to confirm a new address.
Actions:
  • Suspend the duplicate payment effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS.
  • Send the surviving spouse notice of VA’s proposal to discontinue the duplicate payment effective the date VA began paying it.
  • Unless the surviving spouse submits evidence within 65 days that shows the proposed action should not be taken,
    • discontinue the duplicate payment effective the date VA began paying it, and
    • notify the surviving spouse of the action taken.
Notes:
  • Do not treat the duplicate payment of benefits in this case as an administrative error.
  • The surviving spouse is responsible for repaying the overpayment.

VI.i.2.B.2.h.  Example:  Duplicate Payment That Should Be Treated as an Administrative Error
Situation:
  • On May 1, 2012, VA begins paying disability compensation to a Veteran for SC PTSD, based on a disability rating of 30 percent.
  • On August 12, 2014, a CA establishes a new claim under a new PID, based on the Veteran’s submission of a claim for service connection (SC) for coronary artery disease.
  • On October 1, 2014, VA grants SC for coronary artery disease and assigns a disability rating of 30 percent.  (The Veteran now begins receiving two benefit payments, one under each PID).
  • While updating the Veteran’s address on August 1, 2016, a VSR discovers the Veteran is receiving two benefit payments from VA each month.
Actions:
  • Send the Veteran notice of VA’s proposal to consolidate the two awards into one.
  • Unless the Veteran submits evidence within 65 days that shows the proposed action should not be taken,
    • consolidate the two awards into one, and
    • notify the Veteran of the action taken.
Notes:
  • The duplicate payments referenced in this example should be treated as an administrative error.
  • The Veteran is not responsible for repaying any overpayment resulting from consolidation of the two awards.

3.  Handling Cases Involving Administrative Error

Introduction
This topic contains special instructions for handling cases involving administrative error, including

Change Date

 July 23, 2024

VI.i.2.B.3.a.   Definition:  Administrative Error
An administrative error occurs when VA pays benefits to a beneficiary in an amount that exceeds their entitlement due to actions VA took that usually, but not always, stem from misapplication of the law.
Administrative errors include errors in judgment on the part of VA employees.

VI.i.2.B.3.b.  Determining Whether to Attribute the Erroneous Payment of Benefits to Administrative Error
Before attributing the erroneous payment of benefits to administrative error, it is necessary to rule out the existence of the conditions described in the table below.  When taking this action, consider all the available evidence of record, such as
  • correspondence VA sent to the beneficiary, including
    • cost-of-living adjustment letters
    • decision notices, and
    • development letters, and
  • statements the beneficiary and others made to VA.
Condition
Description
The beneficiary is at fault for the error.
VA erroneously paid benefits because the beneficiary
  • knowingly took a wrongful action (an act of commission), or
  • failed to take an action or held something back from VA (an act of omission).
The beneficiary had knowledge of the error.
The beneficiary knew or should have known (based on, for example, VA correspondence of the type referenced in the opening paragraph of this block) that they were not entitled to the benefits VA erroneously paid.
The beneficiary acted with fraudulent intent.
The beneficiary attempted to wrongfully deceive VA (through an act of commission or omission) with the intent of achieving financial or personal gain.
Notes:
  • If careful consideration of the evidence of record results in a finding that the beneficiary
  • Situations may arise in which both the beneficiary and VA are at fault for the erroneous payment of benefits.  In such cases, attribute to administrative error only the results of incorrect actions VA took.
Example:  VA erroneously awarded pension to a Veteran with no wartime service.  When the Veteran applied for pension, the Veteran failed to report Social Security income, and VA calculated the monthly rate of benefits accordingly.
Outcome:
  • The grant of entitlement to pension constitutes an administrative error.
  • The higher rate of payment that is based on the Veteran’s failure to report Social Security income is not attributable to administrative error.  Accordingly, claims processors must not waive that portion of the overall overpayment because of administrative error.

VI.i.2.B.3.c.  Erroneous Payment of Benefits Due to a System Malfunction or Programming Error
The erroneous payment of benefits because of a system malfunction or programming error is not considered an administrative error under 38 CFR 3.500(b)(2) and should not be treated as such.
Exceptions:  The following system-related errors are considered administrative errors under 38 CFR 3.500(b)(2).  They require the preparation of an administrative decision and adjustment of the beneficiary’s award according to the instructions in this topic.
  • The automated processing of a legislative increase in benefits results in the payment of a higher rate of pension than the rate to which a beneficiary is entitled.
  • The Rules-Based Processing System generates an incorrect rate of payment.
Note:  An erroneous payment of benefits made by the automated processing of pension claims may be considered an administrative error.  However, before an erroneous payment is attributed to administrative error, a review of the evidence of record is required to verify none of the conditions exist that are described in the table in M21-1 Part VI, Subpart i, 2.B.3.b.

VI.i.2.B.3.d.  Erroneous Payment of Benefits Due to Claims-Processing Delays
The payment of benefits in an amount exceeding a beneficiary’s entitlement that is due to claims-processing delays is not considered an administrative error.
Example:
  • A Veteran notifies VA of a divorce to their spouse three months ago.
  • Almost one year passes before VA adjusts the Veteran’s award to remove the spouse.
Result:  The payment of additional benefits for the spouse beyond the date the Veteran notified VA of the divorce is not considered an administrative error.  The Veteran remains responsible for repaying the overpayment that resulted from the delay in adjusting the award.

VI.i.2.B.3.e.  Example:  Administrative Error on the Part of VA

 Situation:
  • On May 1, 2008, VA assigns a 50-percent disability rating to a Veteran for  SC disabilities.
  • On August 12, 2010, the Veteran gives birth to a child.
  • The Veteran doesn’t notify VA of the new dependent until November 10, 2013.
  • A claims processor erroneously adds the child to the Veteran’s award effective the date of the child’s birth.
Result:  This is considered an administrative error because VA should have added the child to the Veteran’s award effective November 10, 2013, as more than one year had passed since the birth of the child when the Veteran reported the birth to VA.
Reference:  For more information on determining the proper effective date for awarding additional compensation for dependents, see M21-1, Part VII, Subpart i, 1.C.2.

VI.i.2.B.3.f.  User Entry of a Child’s DOB That Differs From the Date the Beneficiary Provided
Follow the instructions in the table below after discovering the corporate record shows a date of birth (DOB) for a child that differs from the DOB the beneficiary provided.
Step
Action
1
Will correction of the error reduce the beneficiary’s current rate of payment or create an overpayment in the beneficiary’s account?
Notes:
  • Overpayments are most commonly created when correction of a child’s DOB results in
    • adding the child to the beneficiary’s award with a later effective date, or
    • retroactively removing a child from a beneficiary’s award from an earlier effective date.
  • Because a child’s income is a factor in determining the amount of pension VA may pay a beneficiary,
    • adding a child to a beneficiary’s award does not always increase the beneficiary’s rate of payment, and
    • removing a child from a beneficiary’s award does not always decrease the beneficiary’s rate of payment.
2
Has VA determined the child is permanently incapable of self-support, as indicated in M21-1, Part X, Subpart ii, 6.B?
  • If yes, go to the next step.
  • If no, go to Step 4.
3
Did VA underpay the beneficiary because of the incorrect DOB?
  • If yes, go to the next step.
  • If no,
    • update the corporate record, using VBMS Core, to reflect the DOB the beneficiary provided, and
    • disregard the remaining steps in this table.
4
Establish EP 960, using the date VA discovered the error as the date of claim.
5
Update the corporate record, using VBMS Core, to reflect the DOB the beneficiary provided.
6
Generate and authorize an award that reflects the corrected DOB.
7
Notify the beneficiary of the action taken.
Note:  If the correct DOB is later than the DOB previously entered in the corporate record, also notify the beneficiary of any additional benefits to which they may be entitled by virtue of the action taken.
Example:  A school child dropped off a beneficiary’s award at age 23 based on a DOB in the corporate record of August 2, 1993.  The correct DOB, however, is August 2, 1994.  The beneficiary may be entitled to additional benefits for the child if a VA Form 21-674, Request for Approval of School Attendance, is submitted showing the child remained in school beyond August 2, 2016.
References:  For more information on

VI.i.2.B.3.g.  Instructions for Handling an Administrative Error
Follow the instructions in the table below following identification of an administrative error in a decision other than a rating decision.
Exceptions:
  • Follow the instructions in M21-1, Part VI, Subpart i, 2.B.2.a (instead of the instructions in the table below) if the administrative error involves the duplicate payment of benefits, as defined in M21-1, Part VI, Subpart i, 2.B.1.b.
  • Disregard the instructions in the table below if
    • simultaneous award adjustments – one of them being correction of an administrative error – are made in a single legal transaction
    • all award adjustments stem from related factual circumstances, and
    • the other award adjustment(s) has the effect of eliminating the overpayment that correction of the administrative error would have otherwise created.
References:  For more information on
Step
Action
1
Establish an EP 600.
Important:
  • Select the correct claim label, either rating or non-rating, for routing purposes.
  • Follow  the instructions in M21-1, Part II, Subpart i, 2.D.3, for determining whether Potential Under/Overpayment should be added as a special issue under the EP 600.
2
Prepare a notice of proposed adverse action and send it to the beneficiary.  In the notice,
  • propose to retroactively adjust the beneficiary’s award to correct the error
  • provide the effective date of the proposed adjustment
  • advise the beneficiary that the proposed action, if taken, could create an overpayment that VA might require the beneficiary to repay, and
  • inform the beneficiary that they have 60 days from the date of the notice to provide evidence showing VA should not take the proposed action.
Important:  If correction of the administrative error will affect the beneficiary’s current rate of payment, include instructions in the notice of proposed adverse action for minimizing the potential overpayment of benefits.
Reference:  For more information on preparing and sending a notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.A.
3
Did the beneficiary respond to the notice of proposed adverse action within 65 days?
  • If yes, go to the next step.
  • If no, go to Step 6.
4
Did the beneficiary request a hearing within 30 days of the date of the notice of proposed adverse action?
  • If yes, go to the next step after VA
    • holds the hearing, and
    • obtains any relevant evidence the beneficiary identified during the hearing (or determines the evidence is unavailable).
  • If no, go to the next step.
Reference:  For more information on hearings requested in response to a notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.B.3.
5
Did the beneficiary provide evidence showing there was no error in payment?
  • If yes,
    • notify the beneficiary that VA will not take the action it proposed
    • clear the EP 600, and
    • disregard the remaining steps in this table.
  • If no, go to the next step.
6
Does the evidence of record indicate VA was at fault for the error?
  • If yes, go to the next step.
  • If no,
    • retroactively adjust the beneficiary’s award to correct the error, and
    • go to Step 11.
Reference:  For more information on preparing administrative decisions, see M21-1, Part X, Subpart v, 1.C.
7
Prepare an administrative decision, documenting the fact that VA was at fault for the error.
In the Reasons and Bases section of the administrative decision provide
  • a brief description of the error
  • the date the error occurred, and
  • the amount of additional benefits VA paid as a result of the error.
Notes:
  • If correction of the administrative error resulted in a reduction in the beneficiary’s current rate of payment, cite 38 CFR 3.500(b)(2) in the Pertinent Laws and Regulations section of the administrative decision.
  • When the procedures in this table are applied to administrative errors addressed in rating decisions, there is no requirement to complete an administrative decision.  The rating decision serves as sufficient documentation of the reasons and bases for a rating-related administrative error.
References:  For more information on
8
  • Submit the administrative decision for approval, according to the instructions in M21-1, Part VI, Subpart i, 2.B.3.h.
  • Go to the next step following receipt of approval.
9
Did the administrative error involve the assignment of an improper effective date for an award, reduction, or discontinuation of benefits?
  • If yes,
    • adjust the beneficiary’s award to reflect the correct effective date while concurrently eliminating any resulting overpayment, and
    • go to Step 11.
  • If no, go to the next step.
Reference:  For more information on eliminating an overpayment, see M21-1, Part VI, Subpart iii, 2.B.3.e.
10
Adjust the beneficiary’s award by
  • retroactively correcting the administrative error while concurrently eliminating any resulting overpayment, and
  • reducing or discontinuing (whichever is appropriate) benefit payments effective the first of the month following the month for which VA last paid the beneficiary.
Note:  Use the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS to determine the month for which VA last paid benefits to the beneficiary.
Reference:  For more information on eliminating an overpayment, see M21-1, Part VI, Subpart iii, 2.B.3.e.
11
Notify the beneficiary of the actions taken, and
Note:  If the error resulted from the entry of an incorrect DOB in the award-processing system when adding a child to a beneficiary’s award, and the correct DOB is later than the DOB previously entered, also notify the beneficiary of any additional benefits to which they may be entitled by virtue of the action taken.
Example:  A school child dropped off a beneficiary’s award at age 23 based on a DOB in the corporate record of August 2, 1993.  The correct DOB, however, is August 2, 1994.  The beneficiary may be entitled to additional benefits for the child if a VA Form 21-674 is submitted showing the child remained in school beyond August 2, 2016.

VI.i.2.B.3.h.  Approval of Administrative Decisions Involving Administrative Error
Use the table below to determine who must approve administrative decisions involving an administrative error that resulted in the erroneous payment of benefits to a beneficiary.
If the total amount of benefits VA erroneously paid to the beneficiary is …
Then the decision must be approved by …
$24,999 or less
a specified designee of the Veterans Service Center Manager (VSCM) or Pension Management Center Manager (PMCM).
$25,000 or more
Compensation Service’s Program Review Staff or P&F Service’s Quality and Oversight Staff.
Important:  Do not refer an administrative decision to Compensation Service or P&F Service until after a VSCM, PMCM, or designee has approved and signed it.
Reference:  For more information on obtaining approval from Compensation Service’s Program Review Staff or P&F Service’s Quality and Oversight Staff, see M21-1, Part VI, Subpart i, 2.B.3.i.
Notes:
  • Before referring a case to Compensation or P&F Service for approval of an administrative decision involving an erroneous payment of $25,000 or more,
  • For pension and Parents’ DIC cases only:  Ensure documentation of calculations made to determine the rate of benefits (such as calculations of medical expenses, net worth, and waived overpayments) are included in the eFolder.
  • When calculating the total amount of benefits VA erroneously paid to a beneficiary, multiply the amount of benefits VA erroneously paid each month by the number of months VA made the erroneous payments, up to and including the last day of the month following the 60-day period VA gave the beneficiary to respond to the notice of proposed adverse action.
Example:  If VA issued a notice of proposed adverse action on November 27, 2019, the timeframe the calculation covers must go through January 31, 2020.
Reference:  For more information on including documentation of pension and Parents’ DIC award calculations in the eFolder, see M21-1, Part VI, Subpart i, 1.A.2.c.

VI.i.2.B.3.i.  Requesting Compensation or P&F Service’s Approval of Administrative Decisions
If approval of an administrative decision by Compensation or P&F Service is necessary according to the instructions in M21-1, Part VI, Subpart i, 2.B.3.g,
  • extend the suspense date of the EP that was established in connection with the administrative decision to a date that is 60 days in the future, and
  • follow the instructions in the table below.
If the decision requires approval by …
Then …
Compensation Service
add the special issue Compensation Service Review-Over $25K to the EP.
Notes:
  • National Work Queue (NWQ) will automatically route the EP to the appropriate team within Compensation Service following addition of the referenced special issue.
  • If the EP is being processed outside of NWQ, claims processors must manually broker it to Compensation Service (Washington DC) in VBMS Awards.
Reference:  For more information on the action described in the preceding bullet, see the VBMS Core User Guide.
P&F Service
notify the Quality and Oversight Staff by e-mail (VAVBAWAS/CO/P&F TNG QUAL OVRST) that an administrative decision requiring approval is available in the beneficiary’s eFolder.

4.  Correcting Errors That Neither Involve the Duplicate Payment of Benefits nor Are Administrative in Nature

Introduction

 This topic contains instructions for correcting errors that neither involve the duplicate payment of benefits nor are administrative in nature, including

Change Date

 January 22, 2020

VI.i.2.B.4.a.  Instructions for Correcting an Error in the Payment of Benefits
Follow the instructions in the table below upon identification of an error in the payment of benefits that neither involves the duplicate payment of benefits nor is administrative in nature.
Step
Action
1
Use the information contained in M21-4, Appendix B, to select and establish the appropriate EP.
Note:  Use the date VA identified the error as the date of claim.
2
Follow the instructions in the table below.
If …
Then …
the beneficiary notified VA of the error
  • correct the error under the EP established in Step 1, and
  • go to Step 9.
VA learned of the error from a source other than the beneficiary
go to the next step.
3
  • Clear the EP established in Step 1.
  • Establish EP 600.
4
Prepare and send to the beneficiary a notice of proposed adverse action that
  • proposes to retroactively adjust the beneficiary’s award to correct the error, and
  • contains the elements set forth in M21-1, Part X, Subpart ii, 3.A.
5
Did the beneficiary respond to the notice of proposed adverse action with 65 days?
  • If yes, go to the next step.
  • If no, go to Step 8.
6
Did the beneficiary request a hearing within 30 days of the date of the notice of proposed adverse action?
  • If yes, go to the next step after VA
    • holds the hearing, and
    • obtains any relevant evidence the beneficiary identified during the hearing (or determines the evidence is unavailable).
  • If no, go to the next step.
7
Did the beneficiary provide evidence showing there was no error in payment?
  • If yes,
    • notify the beneficiary that VA will not take the action it proposed, and
    • disregard the remaining steps in this table.
  • If no, go to the next step.
8
Take the proposed action to correct the error.
9
Notify the beneficiary of the action taken.
Note:  M21-1, Part VI, Subpart i, 2.B.4.b contains references to additional instructions for correcting an error in the payment of benefits that neither involves the duplicate payment of benefits nor is administrative in nature.

VI.i.2.B.4.b.  Additional Instructions for Correcting an Error in the Payment of Benefits
The table below contains references to additional instructions for correcting an error in the payment of benefits that neither involves the duplicate payment of benefits nor is administrative in nature.
If the error in payment involves or requires an award adjustment based on …
Then see …
incarceration
the additional benefits payable for a dependent
an income verification match
a notice of death