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- simultaneous award adjustments, single legal transactions, and award adjustments stemming from related factual circumstances, see M21-1, Part VI, Subpart iii, 2.A.1, and
- correcting a clear and unmistakable error in a rating decision, see M21-1, Part X, Subpart ii, 5.C.
| Step | Action |
|---|
| 1 | Establish an EP 600.Important: - Select the appropriate EP 600 administrative error claim label from M21-4, Appendix C.
- 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 13.
Reference: For more information on determining whether to attribute the erroneous payment of benefits to administrative error, see M21-1, Part VI, Subpart i, 2.B.3.b. | | 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- calculating the total amount of benefits VA erroneously paid a beneficiary, see the notes under the table in M21-1, Part VI, Subpart i, 2.B.3.h, and
- preparing administrative decisions, see
| | 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 | Does the case involve compensation benefits?- If yes, go to the next step.
- If no, go to Step 11.
| | 10 | To improve oversight and accountability of administrative errors for compensation benefits, designated reviewers must log each administrative error in the Administrative Error Tracker. The designated approver described in M21-1, Part VI, Subpart i, 2.B.3.h, must follow the steps in the table below to log the administrative error in the Administrative Error Tracker.Important: Tracker entries must be logged as soon as administrative error determinations are approved to ensure timely visibility and corrective action. Regional office approvers are responsible for all entries documenting errors totaling $39,999 or less.| Step | Action |
|---|
| 1 | Enter the benefit claim identification number in the BCID field. | | 2 | Select the appropriate office that identified the error from the BUSINESS OFFICE drop-down menu. | | 3 | Select the appropriate office that caused the error from the REGIONAL OFFICE IN ERROR drop-down menu. | | 4 | - Select the appropriate category from the ERROR CATEGORY drop-down menu, and
- enter the amount of the administrative error in the AMOUNT field.
| | 5 | Enter a narrative description of the error in the ERROR DESCRIPTION field. | | 6 | Select SUBMIT. | Note: All entry fields identified above are required. | | 11 | 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 13.
- 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. | | 12 | 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. | | 13 | 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 aVA Form 21-674 is submitted showing the child remained in school beyond August 2, 2016. |
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