X.iv.3.B.2.b. Process for Forfeiture of Benefits Based on Fraud or Treasonable Acts | | The table below describes the stages in the process for handling forfeiture of benefits when VA receives evidence of qualifying fraud or treasonable acts.| Stage | Description |
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| 1 | The authorization activity suspends any current payments effective the date in the LAST PAID DATE field on the AWARD INFORMATION tab in Share in any case where there is a current award of gratuitous benefits. | | 2 | The development activity collects, or develops for, any additional evidence needed that | | 3 | The development and/or authorization activity- evaluates the evidence (which includes determining its credibility), and
- prepares an administrative
- proposed forfeiture decision if the evidence presented indicates forfeiture, or
- non-forfeiture determination if the evidence does not meet the standard for forfeiture.
The decision must address the standard, as applicable, for forfeiture forImportant: The court has held in Del Rosario v. Peake, 22 Vet. App. 399, 404 (2009), that forfeiture is supported only if the underlying conduct is shown beyond a reasonable doubt. If a proposed forfeiture decision is issued, it must include- the specific charges against the person
- a detailed statement of the evidence supporting the charges, subject to regulatory limitations on disclosure of information
- citation and discussion of the applicable statute(s), and
- the right to
- submit a statement or evidence within 60 days, either to rebut the charges or to explain the person’s position, and
- a hearing within 60 days, with representation by counsel of the person’s own choosing, but that fees for representation are limited in accordance with 38 U.S.C. 5904(c) and that no expenses incurred by a claimant, counsel or witness will be paid by VA.
| | 4 | The development and/or authorization activity submits the proposed forfeiture decision or non-forfeiture decision to- an authorizer for concurrence, and
- the Veterans Service Center Manager (VSCM) or designee for approval.
| | 5 | The VSCM or designee approves or rejects the decision. | | 6 | The development and/or authorization activity- refers the claims folder and decision to District Counsel, and
- establishes a suspense date to trigger the review of the status of the District Counsel referral.
Contact District Counsel if there are any questions about submission procedures. | | 7 | District Counsel considers the claim and takes appropriate action.| If District Counsel ... | Then they will ... |
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| approves of a proposed forfeiture decision | - furnish the claimant with due process as provided in 38 CFR 3.905, and
- reassign the case to the RACC for any additional work that may be required, such as filing evidence received or scheduling a hearing during the due process period.
Go to Stage 8. | | agrees with a non-forfeiture determination | - reassign the case to the RACC with a memorandum setting forth the basis for the decision, and
- the authorization activity will provide notice to the Veteran of the non-forfeiture decision.
Disregard the remaining stages in this table. | disagrees with the decision made by the RACC – whether that is a - proposed decision finding forfeiture criteria are met, or
- a non-forfeiture decision
| - reassign the case to the RACC with a memorandum setting forth the basis for the decision, and
- the RACC will take corrective action.
Go to Stage 3. |
| | 8 | At the end of the 60-day due process period following proposed forfeiture, refer the case back to District Counsel. District Counsel must consider any additional evidence (including any hearing testimony) and argument. | If District Counsel ... | Then they will ... |
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| still recommends forfeiture | reassign the case to the RACC with a memorandum setting forth that determination.Go to Stage 9. | | no longer recommends forfeiture | - reassign the case to the RACC with a memorandum setting forth the basis for the decision, and
- at the RACC
- the development activity must prepare a non-forfeiture determination
- the decision must be approved by the VSCM or designee, and
- the authorization activity will provide notice to the Veteran of the non-forfeiture decision.
Disregard the remaining stages in this table. |
| | 9 | The development and/or authorization activity- prepares a final administrative decision finding forfeiture based on fraud or treasonable acts, and
- submits the decision to
- an authorizerfor concurrence, and
- the VSCM or designee for approval
| | 10 | The authorization activity refers the claims folder and final decision to District Counsel to determine whether or not it will submit the case to Compensation Service or Pension and Fiduciary (P&F) Service for consideration of forfeiture. | | 11 | District Counsel determines whether or not it will submit the case to Compensation Service or P&F Service for consideration of forfeiture.- If District Counsel decides to submit the case to Compensation Service or P&F Service, the process continues with Stage 1 of the process described in M21-1, Part X, Subpart iv, 3.B.2.c.
- If District Counsel decides not to submit the case to Compensation Service or P&F Service,
- it reassigns the case to the RACC with a memorandum setting forth the basis for the decision, and
- the RACC will prepare and issue a non-forfeiture determination.
| References: For more information on |