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Updated Nov 06, 2023

In This Chapter

  
This chapter contains the following topics:
 
Topic
Topic Name
1
2
 

1.  General Information on the Routine Review of Running Awards to 100-Year-Old Beneficiaries

Introduction

  
This topic contains general information on the routine review of running awards to 100-year-old beneficiaries, including

Change Date

  
November 6, 2023

XIV.3.1.a.  Purposes of the Review

  
The purposes of the review discussed in this chapter are to verify
  • the accuracy of dates of birth (DOBs) in the Department of Veterans Affairs (VA) corporate record
  • beneficiaries are alive, and
  • Social Security income is being properly counted on the VA award in income-dependent cases.
Note:  Questions about the review may be e-mailed to VAVBAWAS/CO/212A.

XIV.3.1.b.  Identification of 100-Year-Old Beneficiaries

  
On an annual basis, the Hines Information Technology Center will auto-establish an end product (EP) 130 100-Year Review for compensation claims or PMC 100-Year Review for pension and survivor claims, for all Veterans and beneficiaries who are age 100 or older based on the payee’s DOB in the corporate record.
 
Notes:
  • The individuals the system identifies may not actually be 100 years old.  This occurs when a fictitious or erroneous DOB exists in the corporate record.  If the DOB is erroneous, update the erroneous data elements using the appropriate VA systems.
  • Pension and survivor benefit recipients are only reviewed every five years starting at age 100.  However, all foreign pension and survivor beneficiaries are reviewed annually starting at age 100.
Reference:  For more information on evidence required to change or correct existing vital information about a beneficiary, see M21-1, Part II, Subpart iii, 3.B.

2.  Processing EP 130 Generated to Initiate the Review of a Running Award to a 100-Year-Old Beneficiary

Introduction

  
This topic contains information on processing EP 130 generated to initiate the review of a running award to a 100-year-old beneficiary, including

Change Date

   October 11, 2022

XIV.3.2.a.  First Step in Processing EP 130 for 100-Year Review

  
Following establishment of EP 130, referenced in M21-1, Part XIV, 3.1.b, attempt to make the verifications described in M21-1, Part XIV, 3.1.a, using data in Social Security Administration (SSA) records, which users may access through the Federal Online Query System (FOLQ) in Share or the Veterans Benefits Management System.
 
References:  For more information on the actions to take when the attempt to access data in SSA records through FOLQ is

XIV.3.2.b.  Actions to Take When the Attempt to Access Data in SSA Records Is Successful

  
Use the table below to determine the actions to take on EP 130 referenced in M21-1, Part XIV, 3.1.b, when the attempt to access data in SSA records through FOLQ is successful.
 
If SSA records show …
Then …
updated vital information, such as DOB, Social Security number (SSN), and so forth
  • update any erroneous data element(s) in the appropriate VA systems, and
  • clear EP 130.
Reference:  For more information on evidence required to change or correct existing vital information about a beneficiary, see M21-1, Part II, Subpart iii, 3.B.
  • the beneficiary is not alive, and
  • the award is not in suspense due to the Death Master File (DMF) match
  • discontinue the award under EP 130, based on the date of death shown in SSA records, and
  • furnish contemporaneous notice of the action taken.
Note:  A Veteran’s award should be discontinued using the FIRST NOTICE OF DEATH (FNOD) command.  Follow the procedures in M21-1, Part XI, Subpart i, 1.B.2.a and M21-1, Part XI, Subpart i, 1.A.  The FNOD will clear any pending EPs.
  • the beneficiary is not alive, and
  • the award is in suspense due to the DMF match
follow the procedures in M21-1, Part XIV, 2.B.
  • the beneficiary is alive, and
  • no changes are needed to vital information
clear EP 130.
 
Important:  If the beneficiary is receiving pension or survivor benefits, review to ensure Social Security income is properly counted as listed on the row below and establish an EP 150 when necessary.
the beneficiary receives Social Security benefits
verify that any Social Security benefits are being properly counted on any award of income-dependent VA benefits.
  • If the income is being properly counted,
    • clear EP 150, and
    • take no further action.
  • If the income is not properly counted, and a corresponding adjustment to the beneficiary’s award
    • would not result in a reduction of benefits, make the award adjustment under EP 150, or
    • would result in a reduction of benefits,
      • clear EP 150
      • establish EP 600, and
      • furnish a notice of proposed adverse action for an adjustment based on the rate and effective date of the Social Security benefits.
Note:  If additional information is needed before proposing an adjustment, undertake development under EP 150.
 
Reference:  For more information on providing a notice of proposed adverse action, see M21-1, Part X, Subpart ii, 3.B.
 
Reference:  For more information on EPs, see M21-4, Appendix B.

XIV.3.2.c.  Actions to Take When the Attempt to Access Data in SSA Records Is Unsuccessful

  
Use the table below to determine the actions to take on the EP 130 referenced in M21-1, Part XIV, 3.1.b, when the attempt to access data in SSA records through FOLQ is unsuccessful.
 
Step
Action
1
Does a review of the claims folder reveal a name, SSN, or DOB that differs from the name, SSN, or DOB in the corporate record?
  • If yes,
    • update the system using the name, SSN, and/or DOB identified in the claims folder
    • make another attempt to access data in the beneficiary’s SSA records through FOLQ, and
    • go to the next step.
  • If no, (claims folder did not reveal any changes), go to
    • Step 3 if the beneficiary is receiving compensation, or
    • Step 4 if the beneficiary is receiving pension or survivor benefits.
2
Was the attempt to access data in the beneficiary’s SSA records through FOLQ successful?
  • If yes,
  • If no, go to
    • Step 3 if the beneficiary is receiving compensation, or
    • Step 4 if the beneficiary receiving pension or survivor benefits.
3
  • Add the Potential Under/Overpayment special issue if the beneficiary is receiving disability compensation, and
  • go to the next step.
Reference:  For more information on the purpose of the Potential Under/Overpayment special issue, see M21-1, Part II, Subpart i, 2.D.3.a.
4
  • Attempt to contact the beneficiary by telephone, requesting confirmation of the individual’s
    • name
    • SSN, and
    • DOB.
  • Advise the beneficiary that
    • this information is required, and
    • failure to provide the information will result in a termination of payments.
Note:  Follow the instructions in M21-1, Part III, Subpart i, 2.D.1.e, when obtaining information from a beneficiary by telephone.
5
Was information required to successfully access data in the beneficiary’s SSA records through FOLQ obtained from the beneficiary?
  • If yes,
  • If no, write to the beneficiary,
    • explaining that the information provided did not match SSA records
    • asking for a statement from SSA showing the beneficiary’s
      • SSN, and
      • DOB, and
    • allow 60 days for a response.
6
If, after 60 days from the date of the written request, the beneficiary fails to provide the information required to successfully access SSA records through FOLQ,
  • clear EP 130
  • establish EP 600, 100-Year Review for compensation or PMC 100-Year Review for pension and survivor beneficiaries, and
  • send a notice of proposed adverse action proposing to terminate benefits from the date of inception under the provisions of 38 CFR 3.652(a)(1).
 

XIV.3.2.d.  Handling Cases of Fraud

  
If there is an indication that someone is or was fraudulently receiving the benefits of a deceased beneficiary, follow the procedures in M21-1, Part X, Subpart iv, 3.A.

XIV.3.2.e.  When the Beneficiary Has No SSN and Verification Is Not Available Through FOLQ

  
Review the claims folder for a written certified statement stating the beneficiary was not assigned an SSN per M21-1, Part II, Subpart iii, 1.B.1.b.
 
Follow the table below for action to take to verify the beneficiary information.
 
If there is …
Then …
a written statement
follow the procedures in the M21-1, Part XIV, 2.B.2.b to determine if beneficiary is still alive.
 
Note:  Clear EP 130 if the beneficiary is alive and continued entitlement exists.  Update any vital information needed prior to clearing the EP.  No further action is necessary.
  • a written statement but the beneficiary could not be confirmed alive, or
  • no written statement
follow Step 6 of M21-1, Part XIV, 3.2.c, to propose adverse action and advise the beneficiary to
  • furnish a statement that clearly identifies them as the living beneficiary, and
  • provides an SSN or furnishes a statement per M21-1, Part II, Subpart iii, 1.B.1.b (if not previously of record).