Products...As-Is...Business Line...Compensation
Compensation
The major functions within this business line are the seven items denoted surrounding "VBA" (the agency responsible for carrying out these actions): Eligibility Determination, Appeals, Customer Service, Program Management, Program Integrity, Outreach, and Account Maintenance. This diagram shows the major stakeholders and some of the relationships between those stakeholders, the agency, and its denoted functions.
Scroll down for descriptions of objects shown in this diagram. Clicking over a function name can directly bring up related process diagrams and activity descriptions.
| Links to Z11 (listed alphabetically) | |
|---|---|
| Name | Description |
| Account Information |
Vocational Rehabilitation and Employment Services (Master Record)
Specific information related to a veteran’s account with a VA program, which is used to support the delivery of services to the veteran and management of the overall program. Information will include: name (identity) of the veteran (to link to personal data); contact address (for the purpose of contacting the veteran for Chapter 31 related benefits); case/account number; name (identity) of beneficiary; veteran contact history; eligibility determination information; and benefit information. |
| Agency Funding Requests |
Budget proposals and other forms of requests for funding that VA sends to Congress and other funding approval bodies. |
| Agency Reports |
Standard and ad-hoc reports about VA operations that are prepared and submitted to external organizations and oversight groups. |
| Appeals |
Formal requests for reconsideration of eligibility for benefits and services administered by the Department of Veterans Affairs. |
| Compensation |
Enterprise financial and monetary output products intended for program beneficiaries, service partners, and other entities outside the VA organization. |
| Entitlement Information |
Information relating to the applicant’s entitlement. This information includes the number of months of original entitlement and the number of months of remaining entitlement. |
| Information on Veterans and Beneficiaries |
Demographic and personal information provided by veterans and other program beneficiaries that are part of VA’s information resource. |
| Legislation and Executive Orders |
Laws and Executive Orders that either define or limit the scope of VA activities, products and services.
|
| Military Service Information |
Information about a military person provided by the Department of Defense that are part of VA’s information resource. |
| Official Government Guidance |
Government circulars and other official guidance from external organizations that affect VA’s operations. |
| Program Information |
Information about programs administered or implemented by VA . |
| Public Opinion |
Feedback from the general public regarding the operations of the VA or ideas about any of the products and services that VA provides. |
| Requests for VA Actions |
Information contained in requests for VA action coming from sources external to VA . |
| VA Program Funds |
Monetary resource products from external sources for use in funding VA programs. |
| Links to Z12 (listed alphabetically) | |
|---|---|
| Name | Description |
| Account Maintenance |
This function includes activities associated with account maintenance and payment of supplemental claims. |
| Appeals |
This function includes activities associated with claimant appeals. Claimants have the right to appeal VA's decisions. |
| Customer Service |
The function performed by Compensation Service as it provides program and claim information to program participants and others seeking information about the compensation program. |
| Eligibility Determination |
This function focuses on the receipt, evaluation, and first payment for all original claims. |
| Outreach |
Title 38 requires VA to inform veterans, service personnel, reservist, dependents, and other eligible persons about all VA benefits he/she may be eligible to receive. The Outreach program is designed to provide this information, as well as any changes to this information, through many different mediums. These include briefings to service personnel before and upon separation, mail outs, web sites, etc. |
| Program Integrity |
Program integrity is primarily the detection and prevention of fraud by claimants and staff in claims processing. There is a responsibility for reviewing internal controls to ensure accountability against fraud. |
| Program Management |
Planning, leading, organizing, and monitoring various compensation benefit programs. |
| Links to Z14 (listed alphabetically) | |
|---|---|
| Name | Description |
| Department of Defense |
An executive department of the U.S. Government consisting of the Secretary of Defense and his office, the War Council, the Joint Chiefs of Staff, Joint Staff and joint agencies, as well as the Departments of the Army, the Navy, and the Air Force. It is headed by the Secretary of Defense.
|
| Dependents |
Qualifying dependents for VA benefit purposes who may be a veteran’s spouse or child (natural child, adopted child, or stepchild). A veteran’s mother or father may also be considered a dependent generally if there is financial need and he or she is otherwise entitled.
|
| Government Policy Makers (Owners) |
A category of VA stakeholders. Stakeholders falling under this category possess the authority to create and enforce major government policies and regulations that affect the Department of Veterans Affairs.
|
| Ineligible Beneficiaries |
Discharged military persons and members of their families who, for various reasons, are not entitled to certain VA benefits and services at a particular point in time. |
| Program Beneficiaries (Customers) |
A category of VA stakeholders. This group of stakeholders is composed of people who are directly served by the VA.
|
| Public |
A category of V A stakeholders. Stakeholders falling under this category possess the power to elect people who hold public offices, the ability to pay government taxes, and assist government in other ways.
|
| Survivors |
Surviving spouse and children of a deceased veteran.
|
| Veterans |
A person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable. |
| Veterans Benefits Administration (VBA) |
The VBA is one of the three Administrations under the VA. VBA provides benefits and services to the veteran population through 58 VA regional offices. Some of the benefits and services provided by VBA to veterans and their dependents include compensation and pension, education, loan guaranty, and insurance. |
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Account Maintenance |
This function includes activities associated with account maintenance and payment of supplemental claims. |
| Appeals |
This function includes activities associated with claimant appeals. Claimants have the right to appeal VA's decisions. |
| Customer Service |
The function performed by Compensation Service as it provides program and claim information to program participants and others seeking information about the compensation program. |
| Eligibility Determination |
This function focuses on the receipt, evaluation, and first payment for all original claims. |
| Outreach |
Title 38 requires VA to inform veterans, service personnel, reservist, dependents, and other eligible persons about all VA benefits he/she may be eligible to receive. The Outreach program is designed to provide this information, as well as any changes to this information, through many different mediums. These include briefings to service personnel before and upon separation, mail outs, web sites, etc. |
| Program Integrity |
Program integrity is primarily the detection and prevention of fraud by claimants and staff in claims processing. There is a responsibility for reviewing internal controls to ensure accountability against fraud. |
| Program Management |
Planning, leading, organizing, and monitoring various compensation benefit programs. |
Eligibility Determination

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Create Pending Issues File |
Create pending issues file (CEST) for veterans and populate it with information available in the Beneficiary Identification and Resource Locator System (BIRLS). |
| Establish Facts of Service |
Review the veteran's military service information and verify key data that indicate eligibility for veteran compensation. |
| Establish Service Connection of Disability |
The Rating board makes a decision on service connection of the disability. |
| Formalize Compensation Award |
Case goes to veteran’s service representative to create award based on case-specific circumstances. Letter of notification is sent to veteran and his/her representative.
|
| Process Incoming Compensation Claims |
Veteran applies for compensation benefits via mail, in person, or online. VA acknowledges receipt of compensation claims/applications. Send application to the Records Management Center (RMC). Personnel Information Exchange System (Pies) request to archived information. |
| Receive Service Data from DOD |
Receive and record incoming military service data from the Deptartment of Defense. DOD provides service member data at start of service (creates Beneficiary Identification and Resource Locator System (BIRLS) record). DOD sends form DD214 to the VA Office in Austin, TX when separation occurs. |
| Verify Veterans Disabilities |
Conduct physical examination and compile other medical records of veterans applying for disability compensation. |
Appeals

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Decide Appeal Cases |
Board of Veterans Appeals (BVA) receives case, also reviews and issues decision, including DRO action, using entire claims file (sustain, reverse, remand). |
| Receive Notices of Disagreements (NODs) |
Receive, review and record formal appeals from veterans and their family members. |
| Recommend Action on the Appeal |
Decision Review Officer (DRO) performs review and issues new decision, at Regional Office. |
| Route and Track NODs |
Board of Veteran’s Appeals and Regional Office (RO) track case after NOD received. |
Customer Service

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Assist Veterans in Obtaining State-level Benefits |
Coordination with States on State-level benefits for disabled veterans.
|
| Respond to Called-in Requests and Inquiries |
Support for incoming 800 calls to regional offices |
| Respond to Requests and Inquiries Coming in via Email and Websit |
Send email responses to Incoming emails from Consumer Affairs and Regional Office websites. |
| Serve Walk-In Customers |
Provide assistance and service to veterans and their family members who visit the VA Regional Offices and other VA sites. |
Program Management

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Coordinate with Program Partners |
Perform inter-department Liaison (DOD, SSA, DOJ, other countries, and cooperation with Census on veteran issues. |
| Evaluate Program Performance |
Conduct physical folder review, implement quality assurance programs, conduct station surveys on Regional Office operations, conduct customer surveys, and perform recommendation tracking on Inspector General (IG)/GAO/other actions. |
| Prepare Program Reports |
Prepare Systematic and Technical Accuracy Report (STAR). (Get a better definition for this process.)
|
| Train Program Personnel |
Implement employee training and development programs. |
| Update Program Plans & Budgets |
Develop plans and budgets, analyze BIRLS information, and provide financial cost inputs to legislation. (Need to clarify the last sub-process.) |
Program Integrity

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Check Veteran Accounts in Matching Programs |
Check other agency records on veteran financial status, and for possible duplication of benefits with IRS (financial), Department of Defense (on reserve activity), and with SSA (on death notices.) |
| Perform Code 18 Review |
TBD |
| Perform Criminal Record Checks |
Perform prison and fugitive felons matching. Search for possible criminal records. |
| Perform Data Integrity Audits |
Perform data integrity on regional office activities. |
| Verify True Addresses of Beneficiaries |
Address checking with postal records.
|
| Verify True Medical Status of Beneficiaries |
Routine Futures: scheduling exams for cases for which improvement is expected. |
Outreach

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Brief New Veterans on VA Benefits and Assistance Programs |
Conduct Transition Assistance Program (TAP), Disability TAP (DTAP) briefings right after separation from military service. |
| Reach Out to Special Veteran Populations |
This process of the compensation program provides specific outreach to individual veterans, e.g., Agent Orange, Gulf War, other special categories. VA representatives who attend public/veterans group events also perform in-person outreach.
|
| Send VA Benefits Information to Veterans |
Termination from active duty triggers mailing of Veterans Assistance Discharge System (VADS) package – For all VA benefits. Initial mailings are done through VADS and initial outreach is performed under the "Veterans Right to Know Act.” This process provides general information via various media for the benefit of new and old veterans. |
Account Maintenance

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Process Requests for Increased Disability Compensation |
|
| Track Changes in Dependency Status |
Gather up-to-date information about veteran dependents relevant to compensation claims.
|
| Update Compensation Remittance Information |
Keep payment information such as name, address, and Electronic Fund Transfer (EFT) information up-to-date. |
Process Requests for Increased Disability Compensation

Reference(s):
| Links to Z22 (listed alphabetically) | |
|---|---|
| Name | Description |
| Develop Claims |
TBD |
| Perform Rating Board Reviews |
The Rating Board reviews requests for increased disability compensation. |
| Recalculate Compensation Awards |
Determine the updated compensation amount based on the recalculations by the Veterans Service Representative (VSR). |
| Send Decision Notifications |
Send a formal notice to the veteran of the decision on compensation benefit changes. |


