United States Department of Veterans Affairs

Web Automated Reference Material System

 

M21-1MR

Part I Part II Part III Part IV Part V Part VI Part VII Part VIII Part IX Part X Part XI


Part 3. General Claims Process

Subpart I - Overview of Claims Processing and Structure of the Veterans Service Center

  Updated

Chapter 1 - Structure of the Veterans Service Center (VSC)

 8/5/11
Table of Contents 8/5/11

 

Chapter 2 - Pre-Discharge Claims

  
Table of Contents  10/26/11
Section A - General Information on Pre-Discharge Claims 10/26/11
Section B - Divison of Responsibilities for Processing Pre-Discharge Claims 10/26/11
Section C - Ancillary Claims and Miscellaneous Pre-Discharge Issues 8/15/11
Changes
10/24/05 11/6/07 5/26/09  8/5/11  8/15/11  10/26/11           

 

Subpart II - Initial Screening and Determining Veterans Status

Chapter 1 - Initial Screening Process

  
Table of Contents 3/30/12
Section A - Process Overview 10/11/11
Section B - Mail Management 3/27/13
Section C - Initial Screening Policies 9/30/10

 

Chapter 2 - Benefit Programs and Types of Claims

  
Table of Contents 1/22/13
Section A - Department of Veterans Affairs (VA) Benefit Programs 9/30/10
Section B - Original Disability Claims 1/22/13
Section C - Original Death Claims 10/11/11
Section D - Informal Claims 10/11/11
Section E - Reopened Claims 2/16/12
Section F - Claims for Increase 9/30/10
 

Chapter 3 - Folder Establishment

 4/19/05
   
Table of Contents 9/30/10
Section A - File Numbers 9/30/10
Section B - Folders and Charge Cards 10/11/11
Section C - Filing and Removal of Material 2/13/12

 

Chapter 4 - Files and Folder Control

  
   
Table of Contents 10/10/12
Section A - Folder Storage 10/10/12
Section B - Handling Mail 12/16/10
Section C - Delivery and Recharge of Folders 12/16/10
Section D - Lost Folders 10/5/05
Section E - Duplicate Claim (DUPC) Transactions 12/16/10
Section F - Segregated Folders and Deceased Veterans’ Claims Folders 12/16/10
Section G - Folder Maintenance 12/16/10
Section H - File Types (DUPC) Transactions 12/16/10
Section I - Folders Meeting the Criteria for Review by the United States Court of Appeals for Veterans Claims (CAVC) 12/16/10
Section J - Exhibits 12/16/10

 

Chapter 5 - Jurisdiction and Transfer

  
Table of Contents 9/2/10
Section A - Jurisdiction Over Claims Folders 9/2/10
Section B - Jurisdiction Over Deceased Veterans Claims Folders 9/2/10
Section C - Jurisdiction Over Education and Rehabilitation Claims 9/2/10
Section D - General Policies for Permanent Transfer 9/2/10
Section E - Permanent Transfer Out or Transfer In of Claims Folders 10/11/11
Section F - Temporary Transfer 9/2/10
Section G - Transfer of Folders Subject to Review by the United States Court of Appeals for Veterans Claims (CAVC) 9/2/10

 

Chapter 6 - Determining Veteran Status and Eligibility for Benefits

 3/30/12
Table of Contents 9/30/10

 

Chapter 7 - Referrals to the Rating Activity

 9/30/10
Table of Contents  9/30/10

 

Chapter 8 - First Notice of Death (FNOD) Processing

  
Table of Contents 7/29/11
Section A - General Policies for PNOD Processing 10/11/11
Section B - System Information 11/15/04
Section C - FNOD Claims Folders and Lightweight Folders 11/15/04
Section D - Interaction with the Records Management Center (RMC) 11/15/04
Section E - Verification of Service and Related Issues 6/10/09
Section F - Miscellaneous (FNOD) Issues 7/29/11

Changes
3/27/13  1/19/05 4/19/05 9/5/05 10/5/05 10/24/05 5/11/06 6/3/08 9/26/08 6/10/09
9/2/10  9/30/10  12/16/10  7/29/11  10/11/11  2/13/12  2/16/12  3/30/12  10/10/12  1/22/13 

 

Subpart III - General Development and Dependency Issues

  

Chapter 1 - Rules and Process

  
Table of Contents 2/13/12
Section A - Initial Considerations Regarding the Development Process 3/29/10
Section B - Evidence Requested from the Claimant 10/14/11
Section C - Requesting Evidence from Other Sources 2/13/12

 

Chapter 2 - Developing for Service Records

  
Table of Contents 10/2/12
Section A - General Information on Service Records 8/29/11
Section B - Service Record Migration 8/13/09
Section C - Beneficiary Identification and Records Locator Subsystem (BIRLS), Records Management Center (RCM) and the Service Treatment Record (STR) Folder 8/13/09
Section D - Requesting Information/Records Through the Personnel Information Exchange System (PIES) 10/2/12
Section E - Unique Claims and Situations that Require Special Handling 2/6/12
Section F - Merchant Marine Service Records 8/13/09
Section G - Prisoners of War (POW) Service Records 8/13/09
Section H - Record Exchanges between the Department of Veterans Affairs (VA) and the Service Departments 5/3/12
Section I - Control and Follow-up on Record Requests 8/16/12
Section J - Service Department Organzational Structures and service Record Address Codes 8/13/09
Section K - Other Contact and Reference Information 8/29/11

 

Chapter 3 - Information Requests to and from the Social Security Administration (SSA)

  
Table of Contents 8/17/09
Section A - Department of Veterans Affairs (VA) Requests for Information from the SSA 3/26/13
Section B - SSA Requests for Information from VA 8/17/09

 

Chapter 4 - Information Requests to or from Other Federal and State Agencies

 5/21/09
Table of Contents 5/21/09

 

Chapter 5 - Relationship and Dependency

  
Table of Contents 4/9/13
Section A - General Information on Relationship and Dependency 10/11/10
Section B - General Information on Establishing Marital Relationship 2/6/12
Section C - Establishing Common Law Marriages 10/11/10
Section D - Establishing Other Types of Marriages 10/11/10
Section E - Establishing Marital Relationship in Death Cases 8/29/11
Section F - Establishing Child relationship 5/3/12
Section G - Establishing relationship for a Biological Child, Adopted Child, and Stepchild 4/9/13
Section H - Marriage of a Child 10/11/10
Section I - Establishing Parental Relationship 10/11/10
Section J - Establishing Parental Dependency 10/11/10
Section K - Verification of Marital Status andd the Status of Dependents 9/26/11

 

Chapter 6 - School Attendance

  
Table of Contents 2/13/12
Section A -Notificationof Protential Entitlement and School Attendance Policies 2/13/12
Section B - Awards and Adjustments Based Upon School Attendance 2/13/12
Section C - Dependents' Educational Assistance (DEA) 10/5/10
Section D - Exhibits 10/5/10

 

Chapter 7 - EA Childs Permanent Incapacity for Self Support

 9/25/08
Table of Contents 8/13/07

Changes
3/26/13  4/9/13  8/13/07 11/26/07 9/25/08 5/21/09 8/13/09 8/17/09 3/25/10 3/29/10
6/28/10 10/5/10  10/11/10  11/16/10  4/4/11  8/8/11  8/29/11  8/29/11  9/26/11 

10/14/11 
2/6/12  2/6/12  2/13/12  2/13/13  5/3/12  5/3/12  5/3/12  8/17/12  8/16/12  10/2/12 

 

Subpart IV - General Rating Process

  

Chapter 1 - General Information on the rating Activity

 12/13/05
Table of Contents 12/13/05

 

Chapter 2 - Reviewing Claims

  
Table of Contents 
Section A - Preliminary Review of Claims 2/22/2012
Section B - Revision of Decisions 2/22/2012

 

Chapter 3 - Examinations

  
Table of Contents 8/3/11
Section A - Examination Request 12/3/12
Section B - Scheduling Examinations 8/3/11
Section C -Control of Examinations 8/3/09
Section D - Examination Reports 6/5/12
Section E - VA Medical Facilities 12/29/07

 

Chapter 4 - Rating Specific Disabilities

  
Table of Contents 8/3/11
Section A - Musculoskeletal Conditions 6/5/12
Section B - Conditions of the Organs of Special Sense 6/5/12
Section C -Infectious Diseases, Immune Disorders, and Nutritional Deficiencies 12/13/05
Section D - Respiratory Conditions 8/3/11
Section E - Cardiovascular System Conditions 8/3/09
Section F- Endocrine Conditions 12/29/07
Section G - Neurological Conditionals and Convulsive Disorders 6/5/12
Section H -Mental Disorders 6/5/12
Section I - Conditions of Other Body Systems 8/3/09

 

Chapter 5 - Evaluating Evidence and making a Decision

 5/7/12

Table of Contents 

 12/13/05

 

Chapter 6 - The Rating Decision

  
Table of Contents 8/3/11
Section A - Intermediate Rating Decisions and Deferred Issues 4/4/2011
Section B - Determining the Issues 8/3/11
Section C - Documenting the Decision 8/1/06
Section D - Codesheet Section 12/13/05
Section E - Coded Conclusion 12/13/05

 

Chapter 7 - Finalizing and Reviewing the Rating Decision

  
Table of Contents 8/3/11
Section A - Finalizing the Rating Decision 8/3/09
Section B - Reviewing the Rating Decision 8/3/11

 

Chapter 8 - Competency, Due Process and Protected Ratings

  
Table of Contents 8/3/09
Section A - Evaluating Competency 6/7/12
Section B - Proposed rating Decisions 6/7/12
Section C - Protected Ratings 12/13/05
Section D - Reductions in Awards 12/13/05
Section E - Other Due Process Concerns 6/7/12

Changes
12/13/05 8/1/06 6/20/08 12/29/07 8/3/09 7/14/10 4/4/11  8/3/11  5/7/12 
6/7/12  6/5/12  6/5/12  7/31/12  12/3/12           

 

Subpart V - General Authorization Issues and Claimant Notifications

  

Chapter 1 - Administration Decisions

  
Table of Contents 3/30/12
Section A - General Information 3/30/12
Section B - Statutory Bar to Benefits and Character of Discharge 2/23/12
Section C - Former Prisioner of War (POW) Status 11/14/11
Section D - Willful Misconduct and Line of Duty 11/14/11
Section E - Determinations of Insanity 11/14/11
Section F- Considering Eligibility When Homicide is Involved 11/14/11
Section G - Presumption of Death 11/14/11
Section H - Finding of Fact and Date of Death 11/14/11
Section I - Reversal of Prior Determinations and Administrative Errors 11/14/11

 

Chapter 2 - Decision Authorization and Notification

  
Table of Contents 3/14/13
Section A - Decision Authorization 6/4/12
Section B - Decision Notices 3/14/13

 

Chapter 3 - Apportionments

  
Table of Contents 5/3/12
Section A - Apportionment Process 3/28/11
Section B - Adjusting Apportioned Awards 5/3/12
Section C -Special Issues in Apportionment cases 3/28/11

 

Chapter 4 - Elections, Waivers, and Recoupments

  
Table of Contents 3/25/13
Section A - General Information on Elections 11/22/11
Section B - Recoupment of Readjustment, Separation, and Severance Pay 3/25/13
Section C - Waiver of Department of Veterans Affairs (VA) Benefits During Reserve Training of Guard Drill 3/25/13
Section D - Federal Employees' Compensation (FEC) 8/14/06
Section E - Two Parent Cases 11/22/11
Section F- Miscellaneous Election Issues 11/22/11

 

Chapter 5 - Military retirement Pay

  

Table of Contents 

 11/21/06
Section A - Elections and Waivers in Military Retirement Pay cases 8/29/11
Section B - Preparing and Adjusting Awards in Military Retirement Pay Cases 11/21/06
Section C - Coordinating Military retirement Pay Cases With retired Pay Centers and Service Departments 11/21/06
Section D - Reconciliation of Department of Veteran Affairs (VA), Department of Defense (DoD), and Department of Transportation (DoT) Records 11/21/06

 

Chapter 6 - Hospitalization at Department of Veterans Affairs (VA) Expense

  
Table of Contents 02/06/12
Section A - Information Exchange Between VA Regional Offices (ROs) and Medical Facilities 02/06/12
Section B - Adjustments Under 38 CFR 3.551 and 3.556 8/29/11
Section C - Adjusting Awards Involving Aid & Attendance (A&A) Allowance 8/29/11
Section D - Adjusting Compensating When a Veteran is Hospitalized in Excess of 21 Days 8/29/11
Section E - Institutional Awards Specific to Incompetent Veterans 8/29/11
Section F - Estate limitations 4/10/07
Section G -  Compensation and Pension Record Interchange (CAPRI) 02/06/12
Section H - Exhibits 4/10/07

 

Chapter 7 - Eligibility for Department of Veterans Affairs (VA) Medical and Dental Treatment

  
Table of Contents 5/26/09
Section A - Eligibility for Hospital, Nursing Home, Domiciliary, and Medical Care 8/29/11
Section B - Overview of Classes of Eligibility for Dental treatment 5/26/09
Section C - Processing Dental Claims 5/26/09

 

Chapter 8 - Incarceration

  
Table of Contents 5/6/13
Section A - General Information on the Payment of Benefits During Incarceration 5/21/09
Section B - Apportioning Benefits of an Incarcerated Veteran 5/6/13
Section C - Incarceration of a Dependent 5/21/09

 

Chapter 9 - Authorizing Awards for Incompetency and Fiduciary Cases

  
Table of Contents 5/6/13
Section A - General Information on Incompetency and Fiduciary Cases 7/26/07
Section B - Authorizing Awards for Incompentency Cases 5/6/13
Section C - Authorizing Awards for Fiduciary cases 2/23/11

Changes
5/6/13  5/6/13 6/6/06 8/14/06 11/21/06 1/12/07 5/26/09 4/10/07 4/12/07 5/14/07
7/26/07 11/13/08 3/26/09 2/23/11  3/28/11 4/4/11  4/21/11  7/29/11  8/5/11  8/29/11 
11/14/11  11/22/11  2/06/12  2/23/12  3/30/12  5/3/12  6/4/12  3/14/13  3/25/13  3/25/13 

 

 

 

Subpart VI - Special Authorization Issues

  

Chapter 1 - Central Office Guidance, Equitable Relief, and Other Requests

  
Table of Contents 08/03/11
Section A - Compensation and Pension (C&P) Service Guidance 08/03/11
Section B - Equitable Relief and Other Request 08/03/11

 

Chapter 2 - Processing Awards Involving Indebtedness

  
Table of Contents 8/14/06
Section A - Simultaneous Award Adjustments 8/14/06
Section B - Fiscal Authorization (FISA), 8/14/06
Section C - Debt Collection 8/14/06

 

Chapter 3 - Special Act and Foreign Resident Beneficiaries

  
Table of Contents 8/14/06
Section A - Jurisdiction 8/14/06
Section B - Awards in Foreign Resident Beneficiaries 8/14/06

 

Chapter 4 - Philippine Cases

  
Table of Contents 8/14/06
Section A - General Information on Philippine Cases 8/14/06
Section B - Eligibility for Benefits 8/14/06
Section C - Development of Philippine Cases 8/14/06
Section D - Awards and Payments 8/14/06
Section E - Unique Circumstances 8/14/06

 

Chapter 5 - Fraud and Forfeiture

  

Table of Contents 

 5/10/07
Section A - Fraud 5/10/07
Section B - Forfeiture Discontinuance Provisions 5/10/07

 

Chapter 6 - Contested Claims

  
Table of Contents 5/10/07
Section A - General Information on Contested Claims 5/10/07
Section B - Contested Claims Development 5/10/07
Section C - Authorization and Notification 5/10/07

 

Chapter 7 - Certifications for Special Purposes

 8/19/11
Table of Contents 02/03/11

 

 Chapter 8 - Miscellaneous Authorization Issues

 5/10/07
Table of Contents 5/10/07

Changes
8/14/06 5/10/07 12/29/08 02/03/11  08/03/11  8/19/11 

 

 


 

 


 

 

 

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