October 2015. Burial Automation ◦ Upon the processing of a First Notice of Death (FNOD), if the Veteran was in receipt of Comp/Pension benefits, VA.

Pension Management Center

VARO Philadelphia

October 2015

Burial Automation

◦ Upon the processing of a First Notice of Death (FNOD), if the Veteran was in receipt of Comp/Pension benefits, VA will automate either the $300 basic NSC burial allowance or the $2000 basic SC burial allowance.

◦ Does not mean claimants will no longer file… Does not automate transportation, plot allowance, or additional NSC burial for VAMC deaths.

Recent Pension Rule Changes

Burial Automation

◦ Receipts/itemized funeral bills no longer required.

◦ Funeral Homes are no longer proper claimant for claims received on or after July 7th 2014 (except for unclaimed Veterans)

◦ “First to File” – VA no longer dividing burial payments. Benefit paid to the first person who files and is found entitled.

◦ If automated payment is made to the surviving spouse, and we receive an application from another eligible claimant for additional benefits, if it is determined they paid the expenses, the additional benefits can be paid.

- VA will pay the first living person to file a claim of those listed below:

(1) The veteran's surviving spouse; (2) The survivor of a legal union between

the deceased veteran and the survivor; (3) The veteran's children, regardless of age; (4) The veteran's parents or the surviving

parent (5) The executor or administrator of the

deceased veteran's estate.

WHO SHOULD FILE A BURIAL CLAIM

VII.1.A.4.a. Time Limits for Filing a Burial Claim

Claims for nonservice-connected (NSC) burial allowance must be filed within two years of the date of permanent burial or cremation of the Veteran.

There is no time limit for applying for the

service-connected (SC) death burial allowance VA hospitalization burial allowance plot or interment burial allowance, and transportation reimbursement.

Per this change, there is now no time limit to file a claim for an NSC burial based on VA hospital death, or to file a claim for the plot allowance. Basically the only time limit now is for normal NSC burials.

HUB promulgation Teams

◦ Fiduciary HUBS will now do:

Final findings of incompetency

Release withheld funds.

Recent Pension Rule Changes

PMC Processing Team FunctionAction(s) When a claim is reviewed by a RVSR and there is a Rating Decision that

proposes Incompetency, the Veterans Service Representative (VSR) or designee will perform the following:

VSR or designee prepares Pre-Incompetency  letter (date and release) and scans the letter in VVA◦ Adding the necessary paragraph to send correspondence to the Fiduciary Hub have

jurisdiction RVSR or VSR or designee conducts the Brady Bill Phone and documents

the phone call on a report of contact uploaded to Virtual VA  

VSR or designee establishes a one-month diary using the, “Local Regional Office – Special  use “ with remarks – “Incomp Due Process”

VSR or designee prepares Email notification to the appropriate Fiduciary Hub regarding the proposed incompetency.  (Individual Email sent to each Fid Hub)

The VSR or designee will upload a copy of the Email correspondence sent to the Fiduciary Hub to Virtual VA for confirmation purpose that notification of the proposed incompetency was sent to the Fiduciary Hub having jurisdiction over the claim action.

Fiduciary Hubs: Issue a final incompetency rating, unless

the beneficiary requests a hearing or submits additional evidence challenging the proposed incompetency rating.

Prepare the 21-592 and schedule Field Examinations with the proposed fiduciary and the beneficiary.

Authorize payment of monthly benefits and/or withheld retroactive benefits to the fiduciary.

IRS and SSA will provide VA with application income information for pension applicants.

PMC will use this information to verify the income of applicants for original Veterans and survivors pension claims.

In the future upfront verification will be expanded to include additional pension end products.

Upfront Verification of Income

Reduce the potential for fraud and vulnerability to abuse.

Reduce or eliminate improper payments caused by the failure to verify a claimants income at the time the PMC determines entitlement to benefits.

Prevent complex, time-consuming, and untimely income verification matching and due process procedures required to suspend or terminate an award.

Reduce debt management workload.

Benefits of Upfront Verification

Coming In the Near Future

Final Rule at www.regulations.gov AO73

Net Worth Limits and Asset Transfers

Upfront Verification of Net Worth

Nursing Home, Assisted Living Facility(ALF), Independent(Residential)Living Facility(ILF-RLF).

$90.00 Medicaid Nursing Home Rate

When can ILF Room and Board fees be considered Medical Expenses.

Activities of Daily Living(ADLs)

Care Facilities

Must Have A&A or Housebound Rating for Fees to be considered Medical Expenses.

Must have a Statement from Caregiver detailing services and the fees they charge.

If caregiver is a family member, need proof of payment to show they are actually employed in this capacity

In Home Care Givers

Some DIC Payments Now Automated◦ 100% S/C for 10 years or more◦ IU for 10 years or more

and have a dependent spouse on their award

SBP and Non-Concurrent Payments

VAF 21-534EZ VA Obligated to Address the Claimant’s Entitlement to DIC, Survivor’s Pension and Accrued Benefits.

DIC

Criteria for a substantially complete Pension Application for benefits

Claimant’s name and relationship to the Veteran, if applicable Sufficient service information for the Department of Veterans Affairs (VA) to verify

the Veteran’s service, if applicable Benefit claimed Disability(ies) on which the claim for benefits is based (Exposure to certain

agents such as Agent Orange or anthrax, with no corresponding disability or symptomatology, is not a disability for VA purposes.)

Signature of the claimant or other legally authorized individual (M21-1, III.ii.1.A.3b), and

Statement of income for non-service-connected (NSC) disability pension, death pension or Parents’ Dependency and Indemnity Compensation (DIC), if claimed.

If the claimant submits any income or net worth information, but does not complete all blocks, we will obtain the missing information. The application is considered substantially complete. The EP will remain pending while development is undertaken.

For pension claims:VA encourages the use of the VA Form 21-527EZ; however, the VA Form 21-526 and VA Form 21-527 are also acceptable for pension claims.

For DIC and survivor benefits:VA encourages the use of the VA Form 21-534EZ; however, the VA Form 21-534 and VA Form 21-535 are also acceptable for DIC and survivor benefits.

Components of “Standard Claims and Appeals Form” Rule

How to submit an intent to file

An intent to file may be received from the claimant or his/her representative:

Electronically via eBenefits or the Stakeholder Enterprise Portal,

Over the phone with a VA National Call Center or other public contact representative or

On the paper VA Form 21-0966, which may be mailed, faxed or delivered in person.

Components of “Standard Claims and Appeals Form” Rule

Scanning Contractor for Claims and Responses to Development:

Department of Veterans AffairsPension Intake CenterATTN: Philadelphia Pension CenterPO Box 5206Janesville, WI 53547-5206

Not FTI or IVM Responses

Will be scanned into VBMS

Address to SMS Portal

FAX Number to PMC:215-842-4410

Claims uploaded to VVA.

Special Inquiry Phone Queue:215-381-3762

VSO E-mail Addresses:[email protected]

Special PO Box:PO Box 42910

Philadelphia, PA 19101

Special Fax Number:215-842-4410

Special Access to:Philadelphia PMC Advocacy Team

Fiduciary Hub(888) 407-0144