VII.i.1.B.4.b. Processing an EP 130 That Was Generated Because a Veteran Failed to Return VA Form 21-0538 | | The table below contains instructions for processing an EP 130 that was generated because a Veteran failed to return a VA Form 21-0538. Important: Only the status of those dependents named on the enclosure that accompanies VA Form 21-0538 is subject to verification.| Step | Action |
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| 1 | Review the claims folder and mail portal to determine whether the Veteran submitted the form and VA personnel failed to cancel the corresponding diary. Important:- As indicated in M21-1, Part VII, Subpart i, 1.B.2.b, a Veteran may verify the status of dependent(s) by telephone instead of submitting VA Form 21-0538. If a VA Form 27-0820 is of record that confirms a Veteran verified the status of dependent(s) by telephone, treat the VA Form 27-0820 as a completed VA Form 21-0538.
- Treat as a completed VA Form 21-0538 a VA Form 21-686c that meets the following criteria.
- VA must have received the form no earlier than one year before the date of the EP 130.
- The form must account for all of the dependents named on the enclosure that accompanies VA Form 21-0538.
- VA Form 21-686c must have been
- personally signed by the Veteran (or VA-designated fiduciary), or
- completed by a VA employee who documents that the information was received from the Veteran (or VA-designated beneficiary).
Notes:- VA considers as “personally signed” a VA Form 21-686c that a Veteran submits to VA electronically through the means described in M21-1, Part II, Subpart iii, 4 or M21-1, Part VII, Subpart i, 1.D.
- Do not treat as a completed VA Form 21-0538 a VA Form 21-686c completed on a Veteran’s behalf under the provisions of M21-1, Part VII, Subpart i, 1.A.4.j
- by anyone other than a VA employee, or
- when it is not clearly documented that the VA employee spoke directly with the Veteran to gather information for completion of VA Form 21-686c.
| | 2 | Is the VA Form 21-0538 of record?- If yes,
- cancel the corresponding EP, and
- go to the next step.
- If no, go to Step 4.
| | 3 | Was the form already processed?- If yes,
- ensure any necessary award adjustments were made
- create a permanent, Veteran-level note that indicates no adjustments were required based on the previously submitted VA Form 21-0538
- clear EP 330, and
- take no further action.
- If no,
- follow the instructions in M21-1, Part VII, Subpart i, 1.B.2.c, and
- disregard the remaining steps in this table.
Note: If the form was already processed and EP 692 and/or 130 are pending, these EPs should be cancelled. When the EP 692 or 130 were automatically cleared, the RO may still clear EP 330 after reviewing the case and adding the annotation above. If the EP 692 or 130 were manually cleared by an RO or the dependency contractor (RO 372), then no EP credit is warranted. | | 4 | - Confirm EP 130, Dependency Verification - 0538 is established.
- Add the Potential Under/Overpayment special issue.
| | 5 | Attempt to contact the Veteran by telephone. | | 6 | Was telephone contact made with the Veteran?- If yes, go to the next step.
- If no, go to Step 9.
Important: Document unsuccessful attempts to contact the Veteran by telephone as a permanent note in VBMS.Reference: For more information on adding notes in VBMS, see the VBMS Core User Guide. | | 7 | Ask the Veteran to provide the same information VA Form 21-0538 requires. | | 8 | Follow the instructions in the table below. | If the Veteran … | Then … |
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- provided the same information VA Form 21-0538 requires, and
- reported no change in the status of dependent(s)
| - record the information on VA Form 27-0820
- treat the VA Form 27-0820 as a completed VA Form 21-0538
- inform the Veteran (while on the telephone) that benefits will continue at the current rate
- clear the EP 130, and
- disregard the remaining steps in this table.
| - provided the same information VA Form 21-0538 requires, and
- reported changes in the status of dependent(s)
| | | did not provide the same information VA Form 21-0538 requires | - document the conversation with the Veteran on VA Form 27-0820, and
- go to the next step.
| Important: - If a Veteran provides the same information VA Form 21-0538 requires exceptfor the date of an event that necessitates removal of a dependent(s) from the Veteran’s award,
- disregard the remaining steps in this table, and
- follow the instructions in the table in M21-1, Part VII, Subpart i, 1.B.3.d.
- If the Veteran is unable to provide (by telephone) all of the information VA Form 21-0538 requires, allow the Veteran until the end of the next business day to provide the missing information (by telephone). If the Veteran provides the missing information by the end of the next business day, go to Step 22. Otherwise, go to the next step.
| | 9 | Clear the pending EP 130. | | 10 | - Establish EP 600 with a suspense date that is 65 days from the date of the notice of proposed adverse action discussed in the next step.
- Add the Potential Under/Overpayment special issue.
| | 11 | Prepare and send to the Veteran a notice of proposed adverse action that- informs the Veteran VA plans to reduce benefits effective the first of the month following the date the Veteran last verified the status of the dependent(s) in question due to failure to return a completed VA Form 21-0538, and
- advises the Veteran the proposed reduction could result in the creation of an overpayment that VA may require the Veteran to repay.
Notes: - If a Veteran failed to verify the status of a spouse, propose to remove from the Veteran’s award the spouse and any stepchildren of whom the spouse is the biological or adoptive parent. Take this action even if the stepchildren were not on the Veteran’s award as of the date VA sent VA Form 21-0538 to the Veteran for completion.
- It is unnecessary, in this step, for claims processors to determine the actual date the Veteran last verified the status of dependent(s) and the rate to which VA will reduce the Veteran’s award if it takes the proposed action. Claims processors may wait until the action described in Step 19 of this table is taken to make these determinations. (Claims processors may simply state in the notice of proposed adverse action VA proposes to reduce your benefits effective the first of the month following the date you last verified the status of your dependent(s) without providing the actual date and proposed rate).
References: For more information on | | 12 | Did VA receive the form within the additional 65-day period?- If yes,
- cancel the EP 330 referenced in M21-1, Part VII, Subpart i, 1.B.2.a or b, if pending, and
- go to Step 22.
- If no, go to the next step.
Exceptions: The table below describes exceptions to the instructions in this step.| If VA … | Then … |
|---|
- did not receive the form, and
- has already removed from the Veteran's award all of the dependents or the only dependent whose status the Veteran must verify (because, for example, the dependent child(ren) turned 18 or stopped attending school shortly after VA issued the form)
| go to Step 19. | | received the form, but the Veteran did not sign it or the form is otherwise incomplete | - cancel the EP 330 referenced in M21-1, Part VII, Subpart i, 1.B.2.a, if pending
- disregard the remaining steps in this table, and
- follow the instructions in M21-1, Part VII, Subpart i, 1.B.4.c.
Exception: If the form is complete except for the date of the event (such as death, divorce or adoption) that necessitates removal of a dependent(s) from the Veteran’s award,- disregard the remaining steps in this table, and
- follow the instructions in M21-1, Part VII, Subpart i, 1.B.4.d.
| Important: Treat as a completed VA Form 21-0538 a VA Form 21-686c that a Veteran personally signs and returns to VA in response to the notice of proposed adverse action referenced in Step 11. | | 13 | Remove from the Veteran’s award the dependent(s) whose status the Veteran failed to verify. Important: Remove the dependent(s) from the Veteran’s award effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS. | | 14 | Briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen. | | 15 | Prepare and send to the Veteran a decision notice that informs the Veteran of the following: - VA has removed from the award the dependent(s) whose status the Veteran failed to verify, effective the date in the LAST PAID DATE field on the CURRENT AND HISTORICAL AWARD INFORMATION page in VBMS, and
- VA will remove from the award the same dependent(s) from an earlier effective date (the first of the month following the date the Veteran last verified the status of the dependent(s), as proposed in the notice of proposed adverse action referenced in Step 11) if the Veteran does not provide verification within 90 days.
| | 16 | Establish a diary under diary code 30, Local Regional Office Special Use, that expires the month after a 90-day period that begins on the current date. Reference: For more information on establishing diaries see the- VBMS Core User Guide, and
- VBMS Awards User Guide.
| | 17 | Go to the next step when the earlier of the following occurs:- the Veteran verifies the status of the dependent(s), or
- the diary established in Step 16 expires.
Note: Expiration of the diary established in Step 16 triggers the generation of an 810 work item labeled 631 Diary Due Date/Reason/Legend. | | 18 | Follow the instructions in the table below. | If the Veteran … | Then … |
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| returned VA Form 21-0538 or verified the status of the dependent(s) through other acceptable means | - cancel the EP 330 referenced in M21-1, Part VII, Subpart i, 1.B.2.a or b, if pending
- clear the diary established in Step 16 (if it has not yet expired)
- establish EP 130, using the date VA received verification as the date of claim, and
- go to Step 22.
| | has not yet verified the status of the dependents | - establish EP 130, using the date of the 810 work item referenced in Step 17 as the date of claim
- add the Potential Under/Overpayment special issue, and
- go to the next step.
|
| | 19 | Remove the dependent(s) whose status the Veteran failed to verify effective the first of the month following the date the Veteran last verified the status of the dependent(s) in question. Notes: - ROs must be prudent in management of pending diaries. If an RO were to clear the diary established in Step 16 for a reason other than that specified in Step 18, removal of the Veteran’s dependents from the proper effective date might never occur.
- To determine the date a Veteran last verified the status of a dependent(s), search the claims folder for the most recent communication with the Veteran that provides such verification.
Examples: The date a Veteran last verified the status of a dependent(s) could be- the date VA last received a VA Form 21-686c or other form listed in M21-1, Part II, Subpart iii, 1.A.1.a, that shows the status of the dependent(s), or
- the date of the last documented telephone conversation with the Veteran regarding the status of the dependent(s).
| | 20 | Briefly explain the basis for the reduction in the OTHER PRINT REMARKS field on the PRINT REMARKS screen. | | 21 | - Notify the Veteran of the action taken in Step 19.
- Disregard the remaining step in this table.
| | 22 | Follow the instructions in the table below. | If the Veteran reports … | And … | Then … |
|---|
| no change in the status of dependent(s) | VA has not reduced the Veteran’s benefits due to failure to return VA Form 21-0538 | - notify the Veteran that benefits will continue at the current rate, and
- clear any associated EP(s) that remains pending.
| | VA has reduced the Veteran’s benefits due to failure to return VA Form 21-0538 | - restore the payment of additional compensation for the dependent(s) the Veteran verified, effective the date VA previously reduced benefits because the Veteran failed to return the form, and
- notify the Veteran of the action taken.
Important: Follow the guidance in M21-1, Part VI, Subpart ii, 4.B.2.a when the Veteran is in receipt of military retired pay. | | a change in the status of a dependent(s) that necessitates removal of the dependent(s) from the Veteran’s award | --- | follow the instructions in M21-1, Part VII, Subpart i, 1.B.3.b. |
| Notes: Reference: For more information on notifying a Veteran of a decision VA made and/or an action VA took, see M21-1, Part VI, Subpart i, 1.B. |