What this means
m21-4:7.15 explains an overview of claims processing performed by automation. In plain terms, the official guidance says the PMCs currently uses Pension Optimization Initiative (POI) and Pension Automation (PA) to automate claims. VA pension decisions that can be completed by either of these automation processes include It also addresses PA, specifically, has the ability to establish the EPs and process and generate the appropriate notification letter (when applicable) for the following claims
How this may help with a claim
Use m21-4:7.15 as an internal VA audit trail for an overview of claims processing performed by automation, not as a promise of a particular result. Compare the actions recorded in your claim file or decision notice with this source-specific detail: The PMCs currently uses Pension Optimization Initiative (POI) and Pension Automation (PA) to automate claims. PA, specifically, has the ability to establish the EPs and process and generate the appropriate notification letter (when applicable) for the following claims 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: PA, specifically, has the ability to establish the EPs and process and generate the appropriate notification letter (when applicable) for the following claims
- Confirm that the record or notice addresses this source point: PA Q&O uses an Automation Quality Program (AQP) checklist when performing quality reviews. The quality checklists as constructed do not comply with the limited actions automation performed during the automated claims process.
- Document how this stated step or exception applies: The PMCs currently uses Pension Optimization Initiative (POI) and Pension Automation (PA) to automate claims. VA pension decisions that can be completed by either of these automation processes include
Important limits
m21-4:7.15 is primarily internal workflow guidance about an overview of claims processing performed by automation. 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: The PMCs currently uses Pension Optimization Initiative (POI) and Pension Automation (PA) to automate claims. For Quality Assurance purposes, the automation teams perform monthly quality reviews in QMS.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- An Overview of Claims Processing Performed by Automation
- m21-4:7.15
- Claims Processing Performed
- Automation
- Claims Processing Automation
- claims processing performed automation
- quality reviews performed
- pension automation quality checklist.
Original VA guidance
The official VA text of this section
15. Overview of Claims Processing by Automation
Introduction
This topic contains information on claims processing by automation, including
- an overview of claims processing performed by automation
- procedures for quality reviews performed, and
- pension automation quality checklist.
Change Date
May 29, 2026
7.15.a. An Overview of Claims Processing Performed by Automation
The PMCs currently uses Pension Optimization Initiative (POI) and Pension Automation (PA) to automate claims. VA pension decisions that can be completed by either of these automation processes include
- pension (grants and denials)
- DIC (grants and denials)
- rating decisions on service-connected death and special monthly pension, and
- burial benefits (including service-connected or non-service-connected grants and denials, State cemetery plots, and transportation benefits).
PA, specifically, has the ability to establish the EPs and process and generate the appropriate notification letter (when applicable) for the following claims
- DIC claims, grants, and denials (EP 140s), and
- burial claims to include service-connected and non-service-connected approvals or denials, State cemetery plots, and transportation benefits (EP 160s).
While POI processes and authorize pension and SMP claims.
7.15.b. Procedures for Quality Reviews Performed
For Quality Assurance purposes, the automation teams perform monthly quality reviews in QMS. The Pension Automation Quality & Oversight Team (PA Q&O) also performs Targeted Performance Reviews (TPRs) frequently.
7.15.c. Pension Automation Quality Checklist
PA Q&O uses an Automation Quality Program (AQP) checklist when performing quality reviews. The quality checklists as constructed do not comply with the limited actions automation performed during the automated claims process. There are several development transactions that are completed by the field.
Reference: For more information on the checklist, see, M21-4, Chapter 7, Appendix F.