Nashville, TN 37203 If the claims folder is completely Exception: beneficiary’s paperless, notify the Program Review Staff by e-mail (VAVBAWAS/CO/214B) that an administrative decision requiring approval is available in the eFolder. beneficiary’s 4 Did the Program Review Staff approve the administrative decision? If send the beneficiary notice of the proposed adverse yes, action according to instructions in . Sixty-five days after mailing the notice, take the actions described in or , whichever applies. If take the corrective action(s) prescribed by the Program no, Review Staff. Continued on next page , Continued d. Actions to Follow the steps in the table below if a beneficiary does respond to the not Take If a notice of proposed adverse action referenced in and with the submission of Beneficiary Does Not new evidence within 60 days of the date of the notice of proposed adverse Respond to the action, or Notice of a request for a hearing within 30 days of the date of the notice of proposed Proposed adverse action. Adverse Action Step Action 1 Adjust the award so the reduction or discontinuation beneficiary’s takes effect the first of the month following the month for which VA last paid the beneficiary. VA may create an overpayment in a Rationale: not beneficiary’s account when adjusting his/her award to correct an administrative error. The actual payment of VA benefits is always one month in Note: arrears. For example, benefits due a beneficiary for the month of October are deposited in the account at the end of beneficiary’s October or the beginning of November. Using this example, “the first of the month following the month for which VA last paid benefits to the be November 1. beneficiary” would
Nashville, TN 37203 Exception: If the beneficiary’s claims folder is completely paperless, notify the Program Review Staff by e-mail (VAVBAWAS/CO/214B) that an administrative decision requiring approval is available in the beneficiary’s eFolder. 4 Did the Program Review Staff approve the administrative decision? If yes, send the beneficiary notice of the proposed adverse action according to instructions in . Sixty-five days after mailing the notice, take the actions described in or , whichever applies. If no, take the corrective action(s) prescribed by the Program Review Staff. Continued on next page , Continued d. Actions to Take If a Beneficiary Does Not Respond to the Notice of Proposed Adverse Action Follow the steps in the table below if a beneficiary does not respond to the notice of proposed adverse action referenced in and with the submission of new evidence within 60 days of the date of the notice of proposed adverse action, or a request for a hearing within 30 days of the date of the notice of proposed adverse action. Step Action 1 Adjust the beneficiary’s award so the reduction or discontinuation takes effect the first of the month following the month for which VA last paid the beneficiary. Rationale: VA may not create an overpayment in a beneficiary’s account when adjusting his/her award to correct an administrative error. Note: The actual payment of VA benefits is always one month in arrears. For example, benefits due a beneficiary for the month of October are deposited in the beneficiary’s account at the end of October or the beginning of November. Using this example, “the first of the month following the month for which VA last paid benefits to the beneficiary” would be November 1.