What this means
m21-4:7.13 explains purpose of iprs. In plain terms, the official guidance says an IPR is a non-punitive review designed to correct deficiencies throughout the claims process prior to promulgation. IPRs will reduce errors at certain touches or places in the claim process where high error categories exist. It also addresses detailed results of IPRs should be maintained as this information should be used to identify potential training needs of an individual employee or group of employees.
How this may help with a claim
Use m21-4:7.13 as an internal VA audit trail for purpose of iprs, not as a promise of a particular result. Compare the actions recorded in your claim file or decision notice with this source-specific detail: An IPR is a non-punitive review designed to correct deficiencies throughout the claims process prior to promulgation. Detailed results of IPRs should be maintained as this information should be used to identify potential training needs of an individual employee or group of employees. 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: Immediate feedback will be provided to employees so that prompt corrective action can be taken when deficiencies are identified. This feedback will be provided on a PMC IPR checklist.
- Confirm that the record or notice addresses this source point: identify errors and be returned for correction before the case proceeds to the next stage.
- Document how this stated step or exception applies: The following EPs are excluded from IPRs: 135, 154, 330, 400, 330, and 800 series work items and all matching program EPs.
Important limits
m21-4:7.13 is primarily internal workflow guidance about purpose of iprs. 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: An IPR is a non-punitive review designed to correct deficiencies throughout the claims process prior to promulgation. Example: A PMC has 4 RQRSs and 6 AQRSs for a total of 10 QRSs. The PMC is required to complete 200 IPRs per month.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Purpose of IPRs
- m21-4:7.13
- Purpose IPRs
- using IPRs training tool
- quantity selection IPRs
- documenting IPRs conducted
- checklist.
- 7.13.a. Purpose IPRs
Original VA guidance
The official VA text of this section
13. IPRs
Introduction
This topic contains information about IPRs, including
- purpose of IPRs
- IPR EPs
- using IPRs as a training tool
- quantity and selection of IPRs
- documenting IPRs conducted, and
- PMC IPR checklist.
Change Date
October 29, 2020
7.13.a. Purpose of IPRs
An IPR is a non-punitive review designed to correct deficiencies throughout the claims process prior to promulgation. IPRs will reduce errors at certain touches or places in the claim process where high error categories exist. PMC cases will only require a one-touch IPR. A one touch IPR is designed to provide feedback on corrective actions without the need for multiple actions through the lifespan of the claim. In time, the results of these IPRs should significantly improve quality and timeliness, as offices systematically review claims during key touches and phases of the claim.
Immediate feedback will be provided to employees so that prompt corrective action can be taken when deficiencies are identified. This feedback will be provided on a PMC IPR checklist. The PMC IPR checklist details the deficiency and provides citations explaining the deficiency. It is strongly encouraged that face-to-face discussions provide guidance to reinforce the correct action.
IPRs will
- allow the PMC to identify errors early in the claims process
- place an emphasis on getting the case right
- improve the employee’s understanding of why these errors occur and how to prevent the errors in the future by giving immediate feedback, and
- identify errors and be returned for correction before the case proceeds to the next stage.
Important:
- These reviews will not be used for individual performance management purposes, but may be used for training purposes.
- IPRs will not be simultaneously completed on the same case for which an employee’s IQR is being performed.
- This process should be viewed as on-the-job training and will provide employees with an opportunity to develop a mentoring relationship with the QRS.
7.13.b. IPR EPs
EPs included for IPR reviews include
- 029
- 120 series
- 130 (DIC and apportionment only)
- 190 series
- 150 series (unreimbursed medical expenses and reopened claims only)
- 140
- 160 series (SC death only)
- 165
- 180 series
- 290 (character of discharge)
- 600 (not to include competency determination) and ad-hoc assessments of matching program, and
- 930.
Note: The following EPs are excluded from IPRs: 135, 154, 330, 400, 330, and 800 series work items and all matching program EPs. These work products will be assessed through required ad-hoc reviews and systematic analyses of operations annually.
7.13.c. Using IPRs as a Training Tool
Detailed results of IPRs should be maintained as this information should be used to identify potential training needs of an individual employee or group of employees.
Although IPRs are intended to be non-punitive, if it is noticed that an employee continues to make the same type of errors, then the information should be shared with the QRT supervisor, and employee’s coach. Management would then make a decision as to whether or not there is a need for increased IQRs to address a potential performance issue.
7.13.d. Quantity and Selection of IPRs
The number of IPRs completed per PMC should be no less than an average of 20 IPRs per QRS per month.
Example: A PMC has 4 RQRSs and 6 AQRSs for a total of 10 QRSs. The PMC is required to complete 200 IPRs per month.
Because logistics vary, PMCs should monitor error trends from IPRs to determine a proper balance of IPR volume for each EP category. PMC cases will only require a one-touch IPR. A one-touch IPR is designed to provide feedback on corrective actions without the need for multiple review actions throughout the lifespan of a claim.
7.13.e. Documenting IPRs Conducted
The QRSs assigned to conduct IPRs will coordinate the identification and review of cases using the designated PMC IPR checklist and provide immediate feedback to the employee. If other deficiencies outside the specific IPR checklist are noted during the review, the deficiencies should be identified and corrected. All IPRs should be entered, captured, and recorded.
7.13.f. PMC IPR Checklist
The checklist below is the IPR checklist to be used by PMCs.