Updated Nov 27, 2023
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 |
November 27, 2023
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XIV.4.C.1.b. Overview of the Match |
The table below provides an overview of the match.
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XIV.4.C.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 with claim labels listed in M21-1, Part XIV, 4.A.1.d.
Reference: For information on FTI eligible EP claims, see the FTI-GUI User Guide.
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XIV.4.C.1.e. PAA Worksheets |
Hines ITC will produce worksheets and upload them with the secured category description of IRS/SSA – Verification within the secured FFR 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 PAA worksheets, see M21-1, Part XIV, 4.C.4.
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XIV.4.C.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 December 16, 2020, due to a PAA. A review of the record shows that a second EP 154, established October 5, 2019, is due to an income verification match (IVM). Cancel the EP that was established December 16, 2020, and work the PAA and the IVM under the EP established October 5, 2019.
Reference: For more information on when a fiduciary may verify FTI, see M21-1, Part XIV, 4.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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XIV.4.C.2.c. Compression Letter |
Beginning in fiscal year 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 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 XIV, 4.D.
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XIV.4.C.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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XIV.4.C.2.e. Effective Date of Proposed Action for the Compressed Letter |
For the purposes of the compressed letter, VA will
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 XIV, 4.C.3.d and e.
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XIV.4.C.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. Use the table below to determine the VA form(s) Hines ITC mailed to the beneficiary.
Exception: Beneficiaries of Parents’ Dependency and Indemnity Compensation (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, including |
Change Date |
January 18, 2022
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XIV.4.C.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, see M21-1, Part XIV, 4.C.3.d.
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XIV.4.C.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, see M21-1, Part XIV, 4.C.3.d.
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XIV.4.C.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 store FTI created for PAA in the secured FFR folder. Documents that contain FTI can be viewed via the FTI DOCUMENTS tab in VBMS.
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XIV.4.C.3.d. Example 1: Final Award Actions |
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, of being 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, if the Veteran
Reference: For more information on decision notification requirements, see M21-1, Part VI, Subpart i, 1.B.1.b.
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4. PAA Worksheet
Introduction |
This topic contains information on the PAA worksheet, including
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Change Date |
April 2, 2020
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XIV.4.C.4.a. PAA Worksheet Data |
PAA worksheets may contain the following:
References: For information on
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XIV.4.C.4.b. PAA Worksheet Data Definitions |
The table 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 XIV, 4.C.4.c.
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XIV.4.C.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 follow the steps in the table below to determine how long the income should be counted.
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XIV.4.C.4.d. PAA Worksheet- IRS SOURCE Field Reads Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, Etc. |
Follow the steps in the table below when the IRS SOURCE field reads Distributions from Pensions, Annuities, Retirement or Profit-sharing Plans, IRAs, Insurance Contracts, Etc.
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XIV.4.C.4.e. Sample PAA Worksheet (Page One) |
Below is a sample of the first page of a PAA worksheet.
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XIV.4.C.4.f. Sample PAA Worksheet (Additional Pages) |
Below is a sample of an additional page of a PAA worksheet.
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