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Caseflow is a web application that enables the tracking and processing of appealed claims at the Board of Veterans' Appeals.
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EP routing for legacy and AMA #6903

Closed lpciferri closed 5 years ago

lpciferri commented 6 years ago

Caseflow Dispatch currently creates EPs (when they can) and routes them to particular ROs for Board grants and partial grants depending on if there are special issues or not. There are quite a few special issues that require emails to be sent, because the AOJs adjusting the claim do not use VBMS - these are most commonly other business lines like VHA, NCA, Fiduciary, etc.

We want to know if this routing should be updated for AMA appeals, and correct it for legacy appeals as well.

AMA

Open questions:

Appeals without Special Issues

Appeals with Special Issues

Comp & Pen --> Creating VBMS EPs

Special Issue Name Routing logic for Board Grants
Incarcerated Veterans Caseflow relies on there being an Incarcerated Flash on the Veteran. NWQ sees this flash and routes accordingly.
Non-rating issue Use Board Grant Non-Rating EP codes for comp and pen
Private Attorney or Agent Caseflow relies on there being Private Attorney - Fee PayablePrivate Attorney - No Fee Payable Flash
Radiation 323-Jackson Radiation
- Contention Special Issue: Radiation Radiogenic Disability Confirmed
Rice Compliance Routed the same as normal Board Grant EPs (via NWQ to DROCs)
Spina Bifida Routed the same as normal Board Grant EPs (via NWQ to DROCs)
Vocational Rehab Separate Benefit Type, task created for Voc Rehab business line in Caseflow
Restricted Access Caseflow relies on there being a Restricted Access flash for routing
Contaminated Water at Camp LeJeune 327-Louisville CLCW
- Contention Special Issue: Environmental Hazard - Camp Lejeune – Louisville
Foreign claim - compensation claims, dual claims, appeals 311-Pittsburgh Foreign
- Flash: Foreign Claim (this should already be there for the Veteran)
Mustard Gas Caseflow relies on the Mustard Gas flash
U.S. Territory claim - American Samoa, Guam, Northern Caseflow relies on NWQ looking at the Veteran's zip code
Mariana Islands (Rota, Saipan & Tinian) Caseflow relies on NWQ looking at the Veteran's zip code
U.S. Territory claim - Philippines Caseflow relies on NWQ looking at the Veteran's zip code
U.S. Territory claim - Puerto Rico and Virgin Islands Caseflow relies on NWQ looking at the Veteran's zip code
Foreign pension, DIC - Mexico, Central and South America, Caribbean using PMC EPs + labels, Caseflow relies on NWQ looking at the Veteran's zip code
Foreign pension, DIC - all other foreign countries using PMC EPs + labels, Caseflow relies on NWQ looking at the Veteran's zip code
Pension - United States using PMC EPs + labels, going through NWQ Station 499
DIC - death, or accrued benefits - United States using PMC EPs, going through NWQ Station 499

Note:

Non-Comp & Pen --> Creating Caseflow tasks

Special Issue Name Routing
Education - GI Bill, dependents educational assistance Create Caseflow task in Education
Home Loan Guaranty Create Caseflow task
Insurance Create Caseflow task
National Cemetery Administration Create Caseflow task
VAMC Create Caseflow task
Waiver of Overpayment ???
Scholarship, transfer of entitlement Create Caseflow task for education

Legacy

Appeals without special issues

Appeals with special issues

Tier 1: Create EPs at ROJ

Legacy

Special Issue Name Create EP? Specific RO or Original RO - station of jurisdiction VBMS RO key RO location
Hearing - including travel board & video conference Yes Original RO - station of jurisdiction varies varies
Incarcerated Veterans Yes Original RO - station of jurisdiction varies varies
Manlincon Compliance Yes Original RO - station of jurisdiction varies varies
Non-rating issue Yes Original RO - station of jurisdiction varies varies
Private Attorney or Agent Yes Original RO - station of jurisdiction varies varies
Radiation Yes Original RO - station of jurisdiction varies varies
Rice Compliance Yes Original RO - station of jurisdiction varies varies
Spina Bifida Yes Original RO - station of jurisdiction varies varies
Vocational Rehab Yes Original RO - station of jurisdiction varies varies

Tier 2: Create EP at specialized RO

Special Issue Name Create EP? Specific RO or Original RO - station of jurisdiction VBMS RO key RO location
Contaminated Water at Camp LeJeune Yes Specific RO 327 Louisville, KY
Foreign claim - compensation claims, dual claims, appeals Yes Specific RO 311 Pittsburgh, PA
Mustard Gas Yes Specific RO 351 Muskogee, OK
U.S. Territory claim - American Samoa, Guam, Northern Yes Specific RO 459 Honolulu, HI
Mariana Islands (Rota, Saipan & Tinian) Yes Specific RO 459 Honolulu, HI
U.S. Territory claim - Philippines Yes Specific RO 358 Manila, Philippines
U.S. Territory claim - Puerto Rico and Virgin Islands Yes Specific RO 355 San Juan, Puerto Rico

Tier 3: No EP in VBMS

Special Issue Name Create EP? Who/RO (VACOLS RO code) Email address
DIC - death, or accrued benefits - United States No PMC: RO81 - Philadelphia PMC, RO82 - Milwaukee PMC, or RO83 - St. Paul PMC depending on region See PMC jurisdiction list
Education - GI Bill, dependents educational assistance No RO91 - Buffalo Education Center, RO93 - Muskogee Education Center, or RO94 - St. Louis Education Center, depending on region, see education jurisdiction See Education jurisdiction list
Foreign pension, DIC - Mexico, Central and South America, Caribbean No RO83 - St. Paul PMC AppealsPMC.VAVBASPL@va.gov, Hillary.Hernandez@va.gov
Foreign pension, DIC - all other foreign countries No PMC: RO81 - Philadelphia PMC, RO82 - Milwaukee PMC, or RO83 - St. Paul PMC depending on region See PMC jurisdiction list
Home Loan Guaranty No RO88 - Atlanta HLG Center jennifer.Tillery@va.gov
Insurance No RO80 - Philadelphia Insurance Center nancy.encarnado@va.gov
National Cemetery Administration No RO98 - NCA richard.byersII@va.gov
Pension - United States No PMC: RO81 - Philadelphia PMC, RO82 - Milwaukee PMC, or RO83 - St. Paul PMC depending on region See PMC jurisdiction list
VAMC No RO99 - VHA CO Travis.Richardson@va.gov'
Waiver of Overpayment No RO84 - Philadlephia COWC, RO85 - Milwaukee COWC, or RO86 - St. Paul COWC See COWC jurisdiction list
Scholarship, transfer of entitlement No RO91 - Buffalo Education Center, RO93 - Muskogee Education Center, or RO94 - St. Louis Education Center, depending on region, see education jurisdiction See Education jurisdiction list

EPs

AMA

EP Claim Label
030BGR Board Grant Rating
030BGNR Board Grant Non-Rating
040BDE Board DTA Error
040BDEIMO Board DTA Error with IMO
030BGRPMC PMC Board Grant Rating
030BGNRPMC PMC Board Grant Non-Rating
040BDEIMOPMC PMC Board DTA Error - w/IMO
040BDEPMC PMC Board DTA Error

Legacy

EP Claim Label
070BVAGR BVA Grant (070)
070BVAGRARC ARC BVA Grant
070BVAGRPMC PMC BVA Grant (070)
070RMND 070RMND
070RMNDARC ARC Remand (070)
070RMNDPMC PMC Remand (070)
070RMNDBVAG Remand with BVA Grant (070)
070RMBVAGARC ARC Remand with BVA Grant
070RMBVAGPMC PMC Remand with BVA Grant

Notes/tracking from update process

This is the original spreadsheet sent to AMO: EP routing and claim adjustment questions_09052018.xlsx

Questions asked to AMO

lpciferri commented 6 years ago

Response from AMO:

EP routing and claim adjustment questions_09072018 (002) AMO Edits.xlsx

lpciferri commented 6 years ago

EDU RO POCs

See below. Please note that the POCs have changed.

RO91

Buffalo Education Center

307

RO91

Sharon.Judson@va.govmailto:Sharon.Judson@va.gov

edu.vbamus@va.govmailto:edu.vbamus@va.gov

RO93

Muskogee Education Center

351

RO93

dawn.arnold@va.govmailto:dawn.arnold@va.gov

edu.vbamus@va.govmailto:edu.vbamus@va.gov

RO94

St. Louis Education Center

331

RO94

Kristy.Scott@va.govmailto:Kristy.Scott@va.gov

edu.vbamus@va.govmailto:edu.vbamus@va.gov

lpciferri commented 6 years ago

Asked some questions 10/25:

  1. Do all end products for AMA appeal grants without special issues continue to be routed to AMO? Legacy appeals?

    • Original answer - AMA Grants go to DROCs. Legacy grants continue to go to ARC.
    • Follow-ups:
      • What are the DROCs and their associated VBMS station numbers? (DC, Seattle, and?)
        • DC, Seattle, and St. Petersburg, FL
        • station numbers TBD? Dayna
      • TBD How are grants distributed among DROCs? Equally?
        • has to be talked out by the Ops team - need to talk with Dayna, John Shriver, Mike Edsall** action

  2. Let’s say the remand reason was duty to assist error for service treatment records and a medical examination - would two DTA EPs be created, or just one?

    • ultimately want 1 end product if related to the same issue. 1 DTA error EP
    • IMO EP takes precedence should be established, and list other DTA errors

Need to follow-up with @shanear on theses -

  1. Is our special issues VBMS EP or non-VBMS routing methodology still correct for legacy appeals?
    • Original answer - Mirror routing rules for legacy appeals for routing for AMA. Anything that would go for priority routing remains with the station. NWQ does Routing rules- Josh Will- NWQ routes once they are picked
    • Follow-ups:
      • Can you clarify how we can mirror legacy routing rules for AMA while also satisfying NWQ routing?
    • Note:
      • it sounds to me like they want to create them in station 499, and NWQ would distribute to the DROCs based on claim label + capacity/routing rules. but i sort of doubt NWQ will actually be ready for that. maybe she forgot that we don't create these EPs in the NWQ. it also might be fruitful to reach out to josh (joshua.will@va.gov) directly if you can't get a clear answer.
  2. How should AMA appeal grants with special issues be routed?
    • Original answer - according to NWQ routing

Already answered questions:

  1. Are any more special issues no longer relevant under AMA?
    • Original answer - No
  2. What special issues are not relevant to Compensation appeals (and are therefore not eligible for RAMP appeals pilot)?
lpciferri commented 6 years ago

You can find finance POCs herehttps://vbaw.vba.va.gov/orm/fin/field_poc.asp.

330 COWC Chairperson John Guion john.guion@va.gov

331 COWC Chairperson Elmer Linzie elmer.linzie@va.gov

lpciferri commented 5 years ago

Below is the list of attributes applied to a special mission claim to properly identify and route.

311-Pittsburgh Foreign

323-Jackson Radiation

327-Louisville CLCW

335-St. Paul RACC (Restricted Access Claim Center)

Further discussion will be needed with the AMO on how to identify Appeals for IDES claims as currently IDES claims for the VSC are identified using the below claim labels.

Respectfully Joshua Will Supervisory Lead Management Analyst National Work Queue, Department of Veterans Affairs

lpciferri commented 5 years ago

From Dayna Ribnikar, AMO Ops, 11/6:

AMA Board Grant EPs will be routed to DROCs SeaTac and St. Petersburg – DC will not receive these cases. Distribution of such cases will occur via NWQ and will be based on capacity at St. Pete and SeaTac.

Station Numbers are: SeaTac – 346 St. Petersburg – 317

We would like to create new station numbers for DROCs SeaTac and St. Petersburg but for now we are using the codes of the existing RO.

Essentially, yes – EPs will be created via Caseflow Intake and each night NWQ will recall all newly created EPs into 499. From there, based on the rules we set up and the priorities dictated, NWQ will distribute cases daily to SeaTac and St. Pete.

lpciferri commented 5 years ago

@aroltsch - next step is for @shanear and I to meet with Josh Will from NWQ to hammer out the details we don't know above for AMA appeal EP routing.

shanear commented 5 years ago

Josh and Laila are going to chat about the need to establish claims in the the station of jurisdiction. Sounds like they are leaning towards no, which would be nice and simplify things.

We need to send a list of the unaccounted for legacy special issues to Josh, he's willing to have a meeting about how to handle them.

shanear commented 5 years ago

got a message from Josh will that his team is still investigating this

shanear commented 5 years ago

We got a response from Josh!

Type of claim Flash Board Grants will Route to Comments Implication for Caseflow
Incarcerated Veterans Incarceration None Please let us know which station(s) you would like the claims routed to. We currently route these claims to specific stations for non-rating claims and can mirror those stations for appeals.  
Private Attorney/Agent Private Attorney - Fee PayablePrivate Attorney - No Fee Payable Local RO We currently route these claims to specific stations for rating and non-rating claims, which route to the local RO, and can mirror those stations for appeals.
Mustard Gas Mustard Gas Muskogee RO Please let us know if you want to change current routing  
U.S. Territory claim - American Samoa, Guam, Northern Mariana Islands (Rota, Saipan & Tinian) None required Honolulu RO We use country/zip codes from the Veteran’s address.  Please let us know if you want to mirror rating and non-rating and route to RO459- Honolulu  None required
U.S. Territory claim – Philippines None required Manilla RO We use country/zip codes from the Veteran’s address.  Please let us know if you want to change current routing  
U.S. Territory claim - Puerto Rico and Virgin Islands None required San Juan (RAMP claims are currently going to St Petersburg as requested by OPS until San Juan gets training) We use state codes from the Veteran’s address.  Please let us know if you want to change current routing  
Foreign pension, DIC - Mexico, Central and South America, Caribbean None required PMCs We use country codes from the Veteran’s address.  Existing claim labels:
EP682 PMC-Reviews – Rating Involved 2
EP683 PMC-Reviews – Rating Involved 3
Would route to PMC unless you want them routed differently.
Additionally, if you will be creating new claim labels please let us know*		  
Foreign pension, DIC - all other foreign countries None required PMCs  
lpciferri commented 5 years ago

@shanear action items

Ask AMO:

Ask Nate/Josh:

@laurjpeterson will craft an email with the overarching plan to send to AMO after we get a few more questions answered.

shanear commented 5 years ago

Are VBMS flashes on Veterans or on EPs?

Veteran. Confirmed with nate.

Is there any way to look back on a claim and it's associated contention to find a Contention Special Issue? e.g. 323-Jackson Radiation - Special Issue: Radiation Radiogenic Disability Confirmed

Capturing this in a seperate issue: https://github.com/department-of-veterans-affairs/appeals-design-research/issues/1098