## Section E. Miscellaneous EVR Issues

#### Overview

+------------+---------------------------------------------------------+
| #          | > This section contains the following topics:           |
| #### In th |                                                         |
| is Section |                                                         |
+------------+---------------------------------------------------------+

  ------------ ---------------------------------------------- ------------
  Topic        Topic Name                                     See Page

  35           EVR Transactions                               7-E-2

  36           EVR Letters                                    7-E-5

  37           EVR End Product (EP) Issues                    7-E-7

  38           Exhibit 1: Sample EVR Continuation Letter      7-E-10

  39           Exhibit 2: Sample EVR Due Process Letter--VA   7-E-11
               Form 21-8782                                   
  ------------ ---------------------------------------------- ------------

#### 35. EVR Transactions

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on Eligibility        |
| troduction | > Verification Report (EVR) transactions, including     |
|            |                                                         |
|            | -   amended award transaction 13Q                       |
|            |                                                         |
|            | -   clear control transaction 45                        |
|            |                                                         |
|            | -   notice of receipt of transaction 47                 |
|            |                                                         |
|            | -   notice of receipt transaction 47I                   |
|            |                                                         |
|            | -   notice of receipt transaction 48, and               |
|            |                                                         |
|            | -   accepted transaction 49.                            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 21, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a.   | > Transaction 13Q is the same as a regular amended      |
|  Amended A | > award (TR 13C) except that an entry was made in the   |
| ward Trans | > Eligibility Verification Report (EVR) field on the    |
| action 13Q | > 306 screen.                                           |
|            | >                                                       |
|            | > Use transaction 13Q if an account under EVR control   |
|            | > must be adjusted. This transaction clears a code 42   |
|            | > or 43 diary and resumes from EVR, regular or dual     |
|            | > suspense.                                             |
|            | >                                                       |
|            | > ***Note***: A case is under EVR control when there is |
|            | > a reason code 42 or 43 diary on the M12 screen.       |
|            | >                                                       |
|            | > ***Reference***: For more information on EVR          |
|            | > transactions, see [M21-1, Part V,                     |
|            | > 15.04](htt                                            |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part5/ch15.doc). |
+------------+---------------------------------------------------------+

Continued on next page

35\. EVR Transactions, Continued

+------------+---------------------------------------------------------+
| ##### b    | > Transaction 45 removes a master record 42 or 43 diary |
| . Clear Co | > and resumes benefits if the account is in EVR         |
| ntrol Tran | > suspense.                                             |
| saction 45 | >                                                       |
|            | > Do not use transaction 45 if the award needs to be    |
|            | > changed. If an adjustment is required, process a      |
|            | > transaction 13Q.                                      |
|            | >                                                       |
|            | > To process a transaction 45                           |
|            |                                                         |
|            | -   use the resume payment on a suspended award (RESU)  |
|            |     command, and                                        |
|            |                                                         |
|            | -   enter a "*Y*" in the TR 45 field on the 406 screen. |
|            |                                                         |
|            |     > ***Note***: If an award is put into regular       |
|            |     > suspense by processing a SUSP transaction, or if  |
|            |     > it is put into dual suspense by processing a SUSP |
|            |     > transaction after the case is already in EVR      |
|            |     > suspense, a TR 45 will not resume payments.       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > This transaction is generated when an EVR is referred |
| ### c. Not | > to a Veterans Service Representative (VSR) after      |
| ice of Rec | > processing on the E02 screen. Both operator referrals |
| eipt Trans | > and system referrals generate transaction 47.         |
| action 47  |                                                         |
| {#c.-notic | > Transaction 47                                        |
| e-of-recei |                                                         |
| pt-transac | -   removes any master record code 42 or 43 diary       |
| tion-47 .u |                                                         |
| nnumbered} | -   resumes benefits if the account is in EVR suspense, |
|            |     and                                                 |
|            |                                                         |
|            | -   creates an end product (EP) 155 pending issue file  |
|            |     (PIF).                                              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > When an EVR is coded as incomplete on the E02 screen, |
| # d. Notic | > transaction 47I                                       |
| e of Recei |                                                         |
| pt Transac | -   replaces a code 42 diary with a code 43 diary, and  |
| tion 47I { |                                                         |
| #d.-notice | -   extends the EVR suspense date by two months.        |
| -of-receip |                                                         |
| t-transact |     > ***Important***: Transaction 47I does not lift    |
| ion-47i .u |     > suspense, create an EP 155, or change any other   |
| nnumbered} |     > diary.                                            |
+------------+---------------------------------------------------------+

Continued on next page

35\. EVR Transactions, Continued

+------------+---------------------------------------------------------+
| ##         | > When entries coded onto the E02 screen indicate a     |
| ### e. Not | > possible overpayment, transaction 48 refers the EVR   |
| ice of Rec | > and creates an EP 155 PIF.                            |
| eipt Trans |                                                         |
| action 48  | > ***Important***: Transaction 48 neither suspends nor  |
| {#e.-notic | > lifts suspense.                                       |
| e-of-recei |                                                         |
| pt-transac |                                                         |
| tion-48 .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > When the entries coded onto the E02 screen pass all   |
| # f. Accep | > edits, transaction 49                                 |
| ted Transa |                                                         |
| ction 49 { | -   updates the master record income segment            |
| #f.-accept |                                                         |
| ed-transac | -   lifts EVR suspense, and                             |
| tion-49 .u |                                                         |
| nnumbered} | -   clears a code 42 or 43 diary.                       |
|            |                                                         |
|            |     > ***Important***: Transaction 49 does not resume   |
|            |     > from dual or regular suspense.                    |
+------------+---------------------------------------------------------+

#### 36. EVR Letters {#evr-letters .unnumbered}

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on EVR letters. It    |
| troduction | > includes information on                               |
|            |                                                         |
|            | -   continuation letters                                |
|            |                                                         |
|            | -   amended award letters                               |
|            |                                                         |
|            | -   due process letters, and                            |
|            |                                                         |
|            | -   termination letters.                                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 21, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a.   | > An accepted transaction 49 or clear control           |
|  Continuat | > transaction 45 generates a continuation letter from   |
| ion Letter | > the central system.                                   |
| s {#a.-con |                                                         |
| tinuation- | > The system issues continuation letters with power of  |
| letters .u | > attorney (POA) copies but without drop file copies.   |
| nnumbered} | > Continuation letters cannot be suppressed.            |
|            |                                                         |
|            | > ***Reference***: For a sample EVR continuation        |
|            | > letter, see M21-1MR, Part V, Subpart iii, 7.E.38.     |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. A | > When an amended award transaction 13Q generates an    |
| mended Awa | > amended award letter from the Benefits Delivery       |
| rd Letters | > Network (BDN) letter file, follow the guidelines      |
|  {#b.-amen | > below.                                                |
| ded-award- |                                                         |
| letters .u | -   Suppress this letter on the 501 screen if a         |
| nnumbered} |     locally-generated letter is required.               |
|            |                                                         |
|            | -   Complete the OVERPAYMENT PARAGRAPH field on the 501 |
|            |     screen for 13Q awards that create overpayments.     |
|            |                                                         |
|            | -   Enter finance action to collect accounts receivable |
|            |     (FISA) data during Claims Automated Authorization   |
|            |     (CAUT) processing, if a 13Q award increases         |
|            |     benefits and a debt exists.                         |
+------------+---------------------------------------------------------+

Continued on next page

36\. EVR Letters, Continued

+------------+---------------------------------------------------------+
| #####      | > The Hines Information Technology Center (ITC) sends   |
| c. Due Pro | > due process letters to payees upon processing of the  |
| cess Lette | > suspense transactions during each month's updating    |
| rs {#c.-du | > cycles for the maturing reason code 42 and 43         |
| e-process- | > diaries.                                              |
| letters .u |                                                         |
| nnumbered} | > The central system at the Hines ITC also prepares a   |
|            | > POA copy of the letter.                               |
|            |                                                         |
|            | > ***Reference***: For an example of *VA Form 21-8782,  |
|            | > EVR Due Process Letter*, see M21-1MR, Part V, Subpart |
|            | > iii, 7.E.39.                                          |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A stop-pay transaction, in conjunction with the       |
| d. Termina | > appropriate 209 screen entry, generates a letter when |
| tion Lette | > termination is required for failure to submit an EVR. |
| rs {#d.-te |                                                         |
| rmination- | > ***Note***: A stop-pay transaction alone will not     |
| letters .u | > generate a letter.                                    |
| nnumbered} |                                                         |
|            | > If terminating an award for excessive income, prepare |
|            | > a locally-generated letter or an amended award.       |
|            |                                                         |
|            | > ***Note***: If a Benefits Delivery Network (BDN)      |
|            | > letter cannot be generated, a Department of Veterans  |
|            | > Affairs regional office (VARO) will use a local       |
|            | > notification letter. This letter must have a "cc" to  |
|            | > the POA of record in the Beneficiary Identification   |
|            | > and Records Locator Subsystem (BIRLS).                |
+------------+---------------------------------------------------------+

#### 37. EVR End Product (EP) Issues {#evr-end-product-ep-issues .unnumbered}

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on EVR end product    |
| troduction | > (EP) issues. It includes information on               |
|            |                                                         |
|            | -   EP 050                                              |
|            |                                                         |
|            | -   EP 155                                              |
|            |                                                         |
|            | -   multiple issues under EP 155                        |
|            |                                                         |
|            | -   multiple issues for different EPs                   |
|            |                                                         |
|            | -   pending issue control period                        |
|            |                                                         |
|            | -   updated income information not affecting rate, and  |
|            |                                                         |
|            | -   action to take if other EPs are pending when the    |
|            |     EVR is received.                                    |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 21, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a. E | > EP 050 is credited automatically for any EVR          |
| P 050 {#a. | > successfully processed to completion on the E02       |
| -ep-050 .u | > Screen.                                               |
| nnumbered} |                                                         |
|            | > ***Note***: Insert the EVR and the E02 screen print   |
|            | > into the electronic claims folder (e-file) in Virtual |
|            | > VA.                                                   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. E | > A single EP 155 is in order for all income issues     |
| P 155 {#b. | > raised by an EVR that is referred for action.         |
| -ep-155 .u |                                                         |
| nnumbered} | > When a case is referred for action from the E02       |
|            | > screen, the EP 155 is established automatically.      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Follow the guidelines below when dealing with EP 155  |
| # c. Multi | > issues.                                               |
| ple Issues |                                                         |
|  Under EP  | -   If the payee reports the existence of a dependent   |
| 155 {#c.-m |     whose income would reduce the payee's rate of       |
| ultiple-is |     pension, or for whom no income information is of    |
| sues-under |     record, develop under EP 155.                       |
| -ep-155 .u |                                                         |
| nnumbered} | -   If income must be developed and the payee also      |
|            |     reports the existence of a dependent whose income   |
|            |     would not reduce the rate of pension or claims      |
|            |     special monthly pension, develop both issues under  |
|            |     EP 155.                                             |
|            |                                                         |
|            | -   If the two issues are resolved at different times,  |
|            |     take two EPs. If both issues are resolved at the    |
|            |     same time, take a single EP 155.                    |
+------------+---------------------------------------------------------+

Continued on next page

37\. EVR End Product (EP) Issues, Continued

+------------+---------------------------------------------------------+
| ####       | > When the EVR furnishes sufficient income information  |
| # d. Multi | > to permit the EVR to be processed to completion but   |
| ple Issues | > the EVR raises a separate issue, (such as a dependent |
|  for Diffe | > whose income will not reduce rate, special monthly    |
| rent EPs { | > pension), take the EP 155 when the transaction 45 or  |
| #d.-multip | > 13Q is processed.                                     |
| le-issues- |                                                         |
| for-differ | > Use the table below when multiple issues and          |
| ent-eps .u | > different EPs are involved.                           |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+----------------------------------+-----------------------------------+
| If a beneficiary ...             | Then ...                          |
+----------------------------------+-----------------------------------+
| reports a dependent              | develop for the dependent under   |
|                                  | EP 137.                           |
| -   without income, or           |                                   |
|                                  |                                   |
| -   without enough income to     |                                   |
|     reduce the benefit rate      |                                   |
+----------------------------------+-----------------------------------+
| -   answers "*YES"* to "*Are you | if entitlement to A&A benefits    |
|     a patient in a nursing       | can be established under [38 CFR  |
|     home*?" and                  | 3.351(c)(                         |
|                                  | 2)](http://www.warms.vba.va.gov/r |
| -   does or does not             | egs/38CFR/BOOKB/PART3/S3_351.DOC) |
|     specifically claim Aid and   | based on the beneficiary's status |
|     Attendance (A&A) benefits    | as a nursing home patient         |
|                                  |                                   |
| ***Reference***: For more        | -   award A&A benefits under the  |
| information on handling          |     pending EP 155, and           |
| potential entitlement to A&A,    |                                   |
| see                              | -   PCLR EP 027 or 127, as        |
|                                  |     appropriate.                  |
| -   M21-1MR, Part V, Subpart     |                                   |
|     iii, 7.C.24.b, and           | if entitlement to A&A benefits    |
|                                  | cannot be established based on    |
| -   M21-1MR, Part V, Subpart     | nursing home patient status,      |
|     iii, 7.C.27.a.               | develop for evidence needed to    |
|                                  | establish entitlement under EP    |
|                                  | 027 or 127, as appropriate.       |
+----------------------------------+-----------------------------------+

+------------+---------------------------------------------------------+
| ##### e    | > If evidence is requested in connection with EVR       |
| . Pending  | > processing, leave the issue pending for at least 60   |
| Issue Cont | > days unless a response is received sooner.            |
| rol Period |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Process a transaction 13C if the EVR was cleared and  |
| # f. Updat | > EP 050 or 155 was taken, but receipt of new income    |
| ed Income  | > information requires updating the master record       |
| Informatio | > income segment only.                                  |
| n Not Affe | >                                                       |
| cting Rate | > Take a separate EP 157 for the 13C transaction.       |
+------------+---------------------------------------------------------+

Continued on next page

37\. EVR End Product (EP) Issues, Continued

+------------+---------------------------------------------------------+
| ##### g.   | > Do not combine EP credit for processing an EVR with   |
| Action to  | > credit for other issues pending at the time the EVR   |
| Take If Ot | > is received. This applies even when the non-EVR issue |
| her EPs Ar | > is income-related.                                    |
| e Pending  | >                                                       |
| When EVR I | > ***Example***: If an EP 154 established for an Income |
| s Received | > Verification Match (IVM) worksheet is pending when an |
|            | > EVR for the same payee is received                    |
|            |                                                         |
|            | -   leave the EP 154 pending until the IVM issue is     |
|            |     resolved, and                                       |
|            |                                                         |
|            | -   process the EVR under a separate EP 050 or 155, as  |
|            |     appropriate.                                        |
+------------+---------------------------------------------------------+

#### 38. Exhibit 1: Sample EVR Continuation Letter

+------------+---------------------------------------------------------+
| ##### In   | > This exhibit contains a sample EVR continuation       |
| troduction | > letter.                                               |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 21, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         |                                                         |
| ### a. EVR |                                                         |
|  Continuat |                                                         |
| ion Letter |                                                         |
+------------+---------------------------------------------------------+

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#### 39. Exhibit 2: Sample EVR Due Process Letter--VA Form 21-8782

+------------+---------------------------------------------------------+
| ##### In   | > This exhibit contains a sample *EVR Due Process       |
| troduction | > Letter--VA Form 21-8782*.                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 21, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          |                                                         |
| #### a. EV |                                                         |
| R Due Proc |                                                         |
| ess Letter |                                                         |
+------------+---------------------------------------------------------+

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