# Veterans Benefits Administration M21-1, Part IV

**Department of Veterans Affairs Change 224**

**Washington, DC 20420 December 19, 2005**

Veterans Benefits Manual M21-1, Part IV, "Authorization Procedures," is
changed as follows:

**Pages 29-II-1 and 29-II-2:** Remove these pages and substitute pages
29-II-1 and 29-II-2 attached.

Paragraph 29.02b(2) is revised to show that only one witness of a
signature by mark on an EVR is necessary, provided that witness is an
accredited agent, attorney, or service organization representative.

Subparagraphs 29.02b(3)(h) and (i) are revised to show that, except as
provided in subparagraphs 29.02b(3)(a) through (g), if a payee leaves
any block on an EVR blank, the EVR is considered incomplete and must be
returned to the payee for completion.

By Direction of the Under Secretary for Benefits

Renée Szybala, Director

> Compensation and Pension Service

Distribution: RPC: 2068

FD: EX: ASO and AR (included in RPC 2068)

LOCAL REPRODUCTION AUTHORIZED

# December 19, 2005 M21-1, Part IV

## Change 224

**SUBCHAPTER II. INITIAL STAGE EVR PROCESSING**

**29.02 INITIAL STAGE REVIEW OF EVRS**

a\. **Overview**

\(1\) EVR processing may be performed in two stages. An initial review
may be conducted by an employee who is not an adjudicator. This employee
may be able to process the EVR through to completion. More involved
cases are referred to an adjudicator for final processing. This
subchapter is intended primarily for the employee conducting the initial
stage review of an EVR. Subchapter III contains instructions for
adjudicators. Also, see part V, paragraph 15.02.

\(2\) The E01 and E02 Screens are used by the person conducting the
initial stage review to show that a beneficiary\'s EVR was received and
to code the EVR eligibility information furnished by the beneficiary
into the system. If the EVR is fully completed and the information from
the EVR passes all edits, the E02 Screen generates a transaction 45 or
49 which clears the EVR control and allows continued payments for
another year. However, the person conducting the initial review may,
either based on judgment or a system-generated message, return the EVR
to the beneficiary or refer the EVR to an adjudicator.

b\. **EVRs Returned to Beneficiaries After Coding \"Incomplete\" on E02
Screen**

\(1\) **No Signature on EVR.** If the EVR is unsigned, it is incomplete.
Return it to the payee for signature.

\(2\) **EVR Signed by Mark.** An EVR signed by mark (X) or thumbprint is
acceptable only if the mark or thumbprint is accompanied by a separate
sheet of paper containing the following statement: \"I hereby certify
that the information on this form is true and correct to the best of my
knowledge and belief.\" The mark or thumbprint of the claimant must also
appear below the certification statement along with the signatures,
legible names and addresses of two witnesses. The signature (with
legible name and address) of one witness is acceptable if the witness is
identified as a VA employee or notary public, or an accredited agent,
attorney, or service organization representative. Any signature by mark
or thumbprint not properly witnessed under this subparagraph is not
acceptable and the EVR must be returned as incomplete.

\(3\) **Blocks on EVR Blank**

\(a\) The following blocks on EVR forms do not have to be completed by
the beneficiary: Medical Expenses, Education Expenses, and Veteran\'s
Social Security Number (unless the veteran is the payee).

\(b\) The net worth block does not have to be completed if the
beneficiary is a child in receipt of Old Law pension.

\(c\) The Family Maintenance (Hardship) Expenses block does not have to
be completed unless a child income hardship deduction is being allowed.
Do not return the EVR for failure to complete this block. If an entry is
required, the system will refer the EVR to Adjudication.

\(d\) If a beneficiary answers NO to \"Are you a patient in a nursing
home?\" the other blocks pertaining to nursing home status may be blank.

\(e\) If the beneficiary answers NO to \"Did any income change/increase
during the past 12 months?\" the blocks describing the income change may
be left blank.

\(f\) If the EVR has multiple \"other\" income blocks and the claimant
writes \"NONE\" or \"0\" in the first \"other\" income block, the
remaining \"other\" income blocks may be left blank. However, if the
claimant

**29-II-1**

# M21-1, Part IV December 19, 2005

**Change 224**

enters an amount greater than \$0 in the first \"other\" income block
and leaves the remaining \"other\" blocks blank, the EVR is incomplete.

\(g\) School status blocks do not have to be completed for children
under the age of 18.

\(h\) Except as provided under 29.02b (3)(a) through (g), if any of the
blocks on the EVR are left blank, the EVR is incomplete. Return the EVR
to the payee after coding the E02 Screen to show that an incomplete EVR
was received.

\(i\) Except as provided under 29.02b(3)(a) through (g), the absence of
a positive response to any question on the EVR may not be interpreted as
\"none\" or \"not applicable.\"

\(j\) Any unambiguous entry on an EVR, e.g., \"none,\" \"0,\" \"n/a,\"
is acceptable. Lining through the block is also an acceptable way of
indicating \"none.\" Treat any indefinite entry such as \"?\" or
\"unknown\" as no response and return the EVR to the payee after coding
the E02 Screen to show an incomplete EVR was received.

\(4\) **E02 Screen Entry for Returned Cases.** If an incomplete EVR is
to be returned to the claimant, enter \"X\" in the INCOMPLETE field on
the E02 Screen and press the ENTER key. This will generate a print for
drop file and a 47I transaction. The 47I extends the EVR due date for
two months to give the payee time to complete the EVR properly before
the account goes into EVR suspense. See paragraph 29.01d(2).

\(5\) **Returning Incomplete EVRs.** VA Form 21-4174b, Request to
Complete and Return Your Eligibility Verification Report, may be used to
return incomplete EVR forms. Check incomplete items on the EVR in red
ink. Ambiguous entries should be circled in red ink. If there is a need
to communicate additional information to the payee, use a form letter or
locally generated letter. In some instances, it may be helpful to
highlight pertinent parts of an EVR instruction sheet, VA Form 21-0510,
and send it to the beneficiary with the returned EVR. If a form letter
or locally generated letter is used to return the EVR, attach a copy of
the letter to the tear sheet print for drop file in the claims folder.
If VA Form 21-4174b is used to return the EVR, annotate the print
\"Returned via VA Form 21-4174b.\" It is not necessary to retain a
photocopy of the returned EVR for file.

c\. **EVRs to Be Referred to Adjudication without Prior Coding on
E01/E02 Screens.**

\(1\) **EVR Completely Blank.** If an EVR is received which is blank and
unsigned, refer it to Adjudication without coding on the E01/E02
Screens. The adjudicator will review the master record and claims file
to determine if the payee has died or changed addresses. If there is no
indication that the payee has died, remail the EVR to the last address
of record. Annotate the file to reflect the date the EVR was remailed
and the address to which it was remailed. If the EVR is returned a
second time with no entries, file it down and let the account go into
EVR suspense.

\(2\) **Whereabouts Unknown.** If a blank EVR is returned because the
payee\'s whereabouts is unknown, immediately refer the EVR to an
adjudicator. Do not process the EVR on the E01/E02 Screens. The
adjudicator will review the master record and claims folder to determine
if the payee has died or changed addresses. If there is no indication
that the payee has died, remail the EVR to the last address of record.
Annotate the file to reflect the date the EVR was remailed and the
address to which it was remailed. If the EVR is returned a second time
with no entries, file it down and let the account go into EVR suspense.

d\. **EVRs to Be Referred to Adjudication After Coding on E01/E02
Screens.** Refer the following EVRs to Adjudication by making an entry
in the REFER EVR: ADJUD field on the E02 screen:

(1) **Payee Deceased.** Refer any EVR showing the payee as deceased to
    Adjudication.

**29-II-2**