What this means
m21-4:7.12 explains purpose of QRT iqrs. In plain terms, the official guidance says a review of the individual’s work is intended as a performance measure to ascertain the quality element in that individual’s performance standard. It also addresses the standard of review for QRT IQRs is to ensure accurate completions of the quality checklist used for RVSR and VSR IQRs.
How this may help with a claim
Use m21-4:7.12 as an internal VA audit trail for purpose of QRT iqrs, not as a promise of a particular result. Compare the actions recorded in your claim file or decision notice with this source-specific detail: A review of the individual’s work is intended as a performance measure to ascertain the quality element in that individual’s performance standard. The standard of review for QRT IQRs is to ensure accurate completions of the quality checklist used for RVSR and VSR IQRs. If the record does not show the expected action, identify the missing step precisely when asking VA or an accredited representative to review the file.
What to review in your file
- Check the file against this official condition: A QRT IQR is intended to provide an evaluation of an individual QRS’s work product to determine if the minimal standard for correctness has been met.
- Confirm that the record or notice addresses this source point: A QRS performing a QRT IQR will select either AGREE or DISAGREE with the initial review performed.
- Document how this stated step or exception applies: QRT Performance Errors are required when correcting question responses to reflect the appropriate answer for a task because it is important to ensure RVSRs and VSRs receive credit for work completed correctly or to ensure the employees do not receive undue credit for work not applicable to the transaction(s) under review.
Important limits
m21-4:7.12 is primarily internal workflow guidance about purpose of QRT iqrs. It can help identify what VA was expected to document, but it does not by itself create a claimant deadline, a freestanding entitlement, or a guaranteed remedy. The source also states: A review of the individual’s work is intended as a performance measure to ascertain the quality element in that individual’s performance standard. No error is present. The AQRS incorrectly cited a Task 9 Error on the VSR.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Purpose of QRT IQRs
- m21-4:7.12
- Purpose QRT IQRs
- IQRs
- purpose IQRs
- review criteria IQRs
- standard review IQRs
- recording method IQRs
Original VA guidance
The official VA text of this section
12. QRT IQRs
Introduction
This topic contains information about QRT IQRs, including
- purpose of QRT IQRs
- review criteria for QRT IQRs
- standard of review for QRT IQRs
- recording method for QRT IQRs, and
- QRT IQR-final review level and QRT coach responsibilities.
Change Date
October 29, 2020
7.12.a. Purpose of QRT IQRs
A review of the individual’s work is intended as a performance measure to ascertain the quality element in that individual’s performance standard.
A QRT IQR is intended to provide an evaluation of an individual QRS’s work product to determine if the minimal standard for correctness has been met.
QRT IQRs are the review of five randomly selected cases per month (on average) for the QRS. This review determines the employee’s individual quality level as part of the employee’s overall performance evaluation.
The intent of the performance standard is to obtain an average of five per month over the entire FY for each employee to assess the quality element in the standard.
7.12.b. Review Criteria for QRT IQRs
QRSs are responsible for performing IQRs identified by QMS on other QRSs. QRT IQRs, with cited errors, will be routed via QMS to a QRT coach for peer review. These reviews will consist of a random selection of work based on the amount set forth in the national performance standards. The selection of actions, while random, will reflect an appropriate mix of work performed by the employee throughout the month (i.e. not from a single day or single week).
7.12.c. Standard of Review for QRT IQRs
The standard of review for QRT IQRs is to ensure accurate completions of the quality checklist used for RVSR and VSR IQRs. The QRT IQR will encompass a thorough assessment of the QRS’s completed checklist in its entirety to ensure that the minimum standard for review has been met on the initial quality review.
The minimum standard includes proper selection of yes, no, and N/A on the checklist task questions.
- The minimum standard for review is to ensure all
- no responses on the checklist rise to the level of a CUE or a clear violation of current regulations or directives
- yes responses on the checklist account for the proper actions implicitly or explicitly taken by the RVSR or VSR for the transaction(s) under review, and
- N/A responses on the checklist do not apply to the transaction(s) under review.
- Selecting the proper checklist responses to reflect the appropriate answer for each task is important to ensure the RVSR or VSR receives credit for work completed correctly or ensuring the employee does not receive undue credit for work not applicable to the transaction under review.
Important:
- A QRS performing a QRT IQR will select either AGREE or DISAGREE with the initial review performed. If an error is found on the initial review, to include only changing a task question from yes to N/A or N/A to yes, the reviewer performing the QRT IQR will identify the task question(s) in error in the comment box along with a complete error narrative.
- QRT Performance Errors are required when correcting question responses to reflect the appropriate answer for a task because it is important to ensure RVSRs and VSRs receive credit for work completed correctly or to ensure the employees do not receive undue credit for work not applicable to the transaction(s) under review.
Example 1: A Rating QRS (RQRS) is completing a review on the rating decision complete transaction. The previous RQRS marked the review correct. The RQRS conducting the QRT IQR determined that the denial for service-connected (SC) death was incorrect because the RVSR missed a condition on the death certificate that the Veteran was SC for. The RQRS will DISAGREE with the initial review and will include the following sample narrative in the comment box:
Error for incorrect denial of DIC. The RQRS failed to cite a Task 6 error of the RVSR.
Example 2: An Authorization QRS (AQRS) is completing a review on the generating an award transaction. The previous AQRS marked a Task 9 error because the award did not include a cost of living adjustment (COLA) withholding based on the COLA causing a decrease in pension. The AQRS conducting the QRT IQR determined that a withholding was not required as the COLA caused the pension rate to remain the same. The AQRS will DISAGREE with the initial review and will include the following sample narrative in the comment box:
No error is present. The AQRS incorrectly cited a Task 9 Error on the VSR.
7.12.d. Recording Method for QRT IQRs
An IQR on a QRS is identified as QRTIQR in the REVIEW LEVEL column in the MY REVIEWS view, which can be accessed by clicking on the REVIEWS LANDING PAGE tab. Whether the IQR selected is for a QRS can also be identified by reviewing the REVIEW DETAIL screen. If QMS selects an IQR for a QRS, the QRT PERFORMANCE REVIEW box is checked on the REVIEW DETAIL screen.
To open the review, click on the REVIEW NAME column, which will open the REVIEW DETAIL screen. To see additional information, select the REVIEW SUMMARY button from the REVIEW DETAIL screen.
Follow the steps in the table below to record a QRT IQR.
Scroll sideways to see the full table.
| Step | Action |
|---|---|
| 1 | Select the PERFORM REVIEW button on the REVIEW DETAIL screen. |
| 2 | Scroll down to CLAIM REVIEW – INITIAL REVIEW PROCESS which will display the recorded review to include any errors cited and error citation box. |
| 3 | After completing a review of the QRS’s review, scroll down to the SUBSEQUENT REVIEWER DECISION section, which includes the MY COMMENTS, AGREE, and DISAGREE. |
| 4 | The reviewer will complete the MY COMMENTS box and select either the AGREE or DISAGREE button depending on the outcome of the case. If DISAGREE is selected, the reviewer provides the error narrative with the task question(s) form the associated quality review checklist. |
Notes:
- A comment is required regardless of whether the AGREE or DISAGREE button is selected.
- If the reviewer agrees with the QRS’s initial review, the reviewer will input a comment, select the AGREE button, and click SUBMIT. Once the QRS selects SUBMIT, the review is complete.
- If the reviewer disagrees with the QRS’s initial review, the checklist completed during the initial review will require modification and/or correction. When the DISAGREE button is selected, the reviewer is returned to the initial REVIEW PAGE that contains the claim information with the error citations and comments provided by the initial reviewer. The QRT IQR reviewer will cite any additional errors found, correct any of the errors called on the initial review, and/or correct any responses to the task question(s). After correcting the corresponding checklist, the reviewer selects the REVIEW SUMMARY button. The reviewer will also notate the error that was cited or that should have been cited from the applicable checklist, along with any changes to task question responses. Once the review checklist is updated and the error narrative is input in the comment box, the reviewer will select SUBMIT REVIEW button and the review is complete.
Reference: For more information on QRT IQR routing rules and procedures, see the QMS User Guide in the QRT SharePoint site.
7.12.e. QRT IQR-FINAL Review Level and QRT Coach Responsibilities
QRT IQRs with cited errors will be routed via QMS to a QRT coach for peer review.
All QRT IQRs that result in a Disagree are routed to the QRTIQRFinal review level. This level is directed to a QRT coach for their determination on the outcome of the review. The coach performs the review using the same steps listed above.
Important: If the coach is agreeing with the changes to the review made by the last individual that reviewed the case, this indicates the QRTIQRFinal individual is approving the changes and the disagreement indicated by the QRTIQR reviewer. A disagreement at the QRTIQRFinal level is used if the coach does not agree with the subsequent reviewer’s determination.