a Restricted Access Claims Center (RACC) has jurisdiction over an incompetent beneficiary’s claim. The definition of the “appointment” and “certification” are essentially the same for the purposes of this section. (The “certification” is the signature on the VA Form 21-555, Certificate of Legal Capacity to Receive and Disburse Benefits.) References: For more information on IDES, see M21-1, Part III, Subpart i, 2.D RACCs, see M21-1, Part III, Subpart ii, 4.A.4, or terms associated with incompetency and fiduciary cases, see the , and . b. Requesting Appointment of a Fiduciary for Insurance Proceeds Request the appointment of a fiduciary for the purpose of paying VA insurance proceeds, despite the existence of a or potential payee not otherwise requiring fiduciary hub certification. Example: A fiduciary must be certified for a minor child entitled to insurance payments, regardless of any payment of pension or Dependency and Indemnity Compensation (DIC) benefits under . Reference: For more information on VA insurance proceeds, see M21-1, Part III, Subpart vi, 8.6.f. c. Preparing VA Form to Request the Appointment of a Fiduciary Prepare and submit VA Form 21-592 to a fiduciary hub using Virtual VA. Follow the steps in the table below when preparing and submitting VA Form 21-592. Step Action 1 Open Virtual VA. the VA claim number in the QUICK FIND field. Depress the (keyboard) key. 2 When the electronic claims folder (eFolder) opens, click the INSERT FORMS button. Illustration: 3 From the dropdown list, located on the top, left side of the screen, select VA Form 21-592. 4
14B RELATIONSHIP Enter the relationship between the beneficiary and the individual listed in Item 14A. 14C TELEPHONE NUMBER (If of record) Enter the telephone number of the individual listed in Item 14A. 15A NAME AND ADDRESS OF PERSON HAVING CUSTODY OF MINOR OR INCOMPETENT (If different from Item 14A) If different from the information in item 14A, enter the name and address of the individual having custody of the incompetent beneficiary, or child. If Item 15A requires an entry, the following items must also be completed 15B, RELATIONSHIP, and 15C, TELEPHONE NUMBER. If Item 15A does not require an entry, go to Item 16A. 15B RELATIONSHIP Enter the relationship between the beneficiary and the individual named in Item 15A. 15C TELEPHONE NUMBER (If of record) Enter the telephone number of the individual named in Item 15A. 16A AMOUNT OF BENEFITS ENTITLED TO BUT UNPAID TO DATE Enter the amount of VA benefits the beneficiary is entitled to but is unpaid to date. Important: If no entitlement exists, enter 0.00 in the item field. 16B MONTHLY PAYMENTS/EFFECTIVE DATES the monthly amount of VA benefits the beneficiary receives and the effective date(s). Notes: If there are two or more children entitled to equal shares, show only the total monthly payment for all children and the effective date. When, as in awards of DIC, the total amount payable for all the children is not or will not be equally divided among them, show the amount payable to each child.
17 AMOUNTS IN PFOP, IF KNOWN, AND AMOUNTS WITHHELD UNDER 38 CFR 3.557 If the beneficiary is a Veteran, the amount of any funds in his/her Personal Funds of Patients (PFOP) account. the field blank if no funds exist in the PFOP account, or the beneficiary is not a Veteran. Important: Amounts withheld under 38 CFR 3.557 were withheld due to an estate limitation law that was repealed effective December 27, 2001. VA has since rescinded 38 CFR 3.557. However, it has not yet updated Item 17 of VAForm 21-592. 18 REMARKS As applicable, enter additional information for the fiduciary hub, and/or appropriate indicators to alert the fiduciary hub that the beneficiary might be a danger to himself/herself or others. 19 NAMES AND LOCATIONS OF PHYSICIANS OR HOSPITALS Enter the names and addresses of the physicians or hospitals that generated medical information VA used to rate the beneficiary incompetent. 20 DATE OF EXAMINATION Enter the date of the medical examination VA used to rate the beneficiary incompetent. 21 DIAGNOSES Enter the beneficiary’s medical diagnosis, specifically as it relates to his or her mental condition. 22 DATE OF RATING OF INCOMPETENCY Enter the date of VA’s rating of incompetence. 23 NAME AND ADDRESS OF PERSON, RECOGNIZED ATTORNEY, SERVICE REPRESENTATIVE OR COOPERATING AGENCY PROSECUTING CLAIM OR CORRESPONDING IN BEHALF OF MINOR OR INCOMPETENT the identity of the beneficiary’s power of attorney, or other legal representative recognized by VA.
If the minor or incompetent beneficiary resides in ... Then the fiduciary hub of jurisdiction is ... Florida Georgia North Carolina, or Carolina Columbia Fiduciary Hub P.O. Box 9367 Columbia, SC 29209-9998 1-888-407-0144, #1 VA e-mail: VAVBACMS/RO/FIDUCIARY/PROMULGATION Connecticut Delaware Indiana Maryland Massachusetts Michigan New Hampshire New Jersey New York Ohio Pennsylvania Rhode Island Vermont, or any foreign country except the Caribbean, Mexico, and Central and South America Indianapolis Fiduciary Hub P.O. Box 441480 Indianapolis, IN 46244 1-888-407-0144, #2 VA e-mail: VAVBAIND/RO/FIDUCIARY/PROMULGATION Kansas Nebraska North Dakota Oklahoma South Dakota Texas the Caribbean Mexico, or Central and South America Lincoln Fiduciary Hub P.O. Box 5444 Lincoln, NE 68505-5444 1-888-407-0144, #3 VA e-mail: VAVBALIN/RO/FIDUCIARY/PROMULGATION Alabama Kentucky Mississippi Virginia Tennessee Washington, DC West Virginia, or Puerto Rico Louisville Fiduciary Hub P.O. Box 3487 Louisville, KY 40201 1-888-407-0144, #4 VA e-mail: VAVBALOU/RO/FIDUCIARY/PROMULGATION
Republic of the Philippines Manila Fiduciary Hub 1501 Boulevard Pasay City, PI 1302 VA e-mail: VAVBAMPI/RO/F&FE Arkansas Illinois Iowa Louisiana Minnesota Missouri, or Wisconsin Milwaukee Fiduciary Hub P.O. Box 14975 Milwaukee, WI 53214-0975 1-888-407-0144, #5 VA e-mail: VAVBAMIW/RO/FIDUCIARY/PROMULGATION Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington, or Wyoming Salt Lake City Fiduciary Hub P.O. Box 58086 Salt Lake City, UT 84158 1-888-407-0144, #6 VA e-mail: VAVBASLC/RO/FIDUCIARY/PROMULGATION f. Referring Status Inquiries After Sending VA Form sending VA Form 21-592 to the fiduciary hub of jurisdiction, refer inquiries regarding the status of the corresponding case to the same fiduciary hub. It is the responsibility of fiduciary hubs to respond to such inquiries. g. Requesting a Temporary Fiduciary While a Determination of Incompetence Is Being Made or Appealed Fiduciary hubs have authority under to appoint a temporary fiduciary to protect the VA benefit payments of a beneficiary while a determination of competency is being made or appealed. VA may appoint a temporary fiduciary only when there is clear evidence the beneficiary’s VA funds are being misused, or the beneficiary is unable or unwilling to use the funds for urgent needs. Note: The authorization activity of fiduciary hubs is responsible for processing requests for temporary fiduciaries, but there are exceptions when ROs bear the responsibility for requesting a temporary fiduciary.
appoints a new, permanent fiduciary, or determines direct payment should be made before the expiration of the temporary fiduciary appointment ask finance activity to terminate the 63C deduction, and amend the claimant’s award to pay the new fiduciary or the beneficiary, and restore the full rate of payment and any withheld benefits (except the amount paid to the temporary fiduciary). appoints a new, permanent fiduciary, or determines direct payment should be made after the expiration of the temporary fiduciary appointment amend the claimant’s award to restore the previously withheld benefits (except the amount paid to the temporary fiduciary). j. Example: Processing an Award for Appointment of a Temporary Fiduciary The following example describes a procedure that provides for payment to a temporary fiduciary, and control for adjustment of a beneficiary’s award after the appointment of the temporary fiduciary expires. Scenario: VA was paying a gross monthly rate of $900 to a beneficiary’s fiduciary. A fiduciary hub’s authorization activity receives a VA Form 21-555 on March 25 that reflects the appointment of a temporary fiduciary and requests the payment of $200 per month to the temporary fiduciary, pending appointment of a new, permanent fiduciary. The authorization activity asks finance activity to establish a 63C deduction code with a balance of $800 ($200 per month not to exceed four months). The authorization activity prepares an amended award on April 5 that reflects the Veteran’s name and address in the payee field and a payment status of supervised direct pay. Results: The withholds $700 using a withholding code 1 and pays $200 effective April 1. The award includes a future rate line that eliminates the withholding and pays the full $900 effective August 1. Each month the deduction code 63C causes the $200 payment to be captured and applied toward reducing the 63C balance. The finance activity releases a payment of $200 to the temporary fiduciary designated on the VA Form 21-555.