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M21-1MR Part 3. General Claims Process

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

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

Chapter 2 - Pre-Discharge Claims

  • Table of Contents- Updated 7/14/14
  • Section A - General Information on Pre-Discharge Claims - Updated 9/16/14
  • Section B - Divison of Responsibilities for Processing Benefits Delivery at Discharge (BDD) and Quick Start Claims- Updated 7/14/14
  • Section C - Ancillary Claims and Miscellaneous Pre-Discharge Issues - Updated 8/15/13
  • Section D - Integrated Disability Evaluation System (IDES) - 3/26/14

Chapter 3 - Fully Developed Claim (FDC) Program 

Changes

Subpart II - Initial Screening and Determining Veterans Status

Chapter 1 - Initial Screening Process

Chapter 2 - Benefit Programs and Types of Claims

  • Table of Contents- Updated 11/13/14
  • Section A - Department of Veterans Affairs (VA) Benefit Programs - Updated 11/13/14
  • Section B - Original Disability Claims - Updated 7/11/14
  • Section C - Original Death Claims - Updated 4/7/14
  • Section D - Informal Claims - Updated 10/9/14
  • Section E - Reopened Claims - Updated 9/16/14
  • Section F - Claims for Increase - Updated 9/30/10
  • Section G - Claims for Reconsideration Updated 11/13/14

Chapter 3 - Folder Establishment

Chapter 4 - Files and Folder Control

  • Table of Contents- Updated 8/21/14
  • Section A - Folder Storage - Updated 10/10/12
  • Section B - Handling Mail - Updated 12/16/10
  • Section C - Delivery and Recharge of Folders - Updated 12/16/10
  • Section D - Lost Folders - Updated 10/5/05
  • Section E - Duplicate Claim (DUPC) Transactions - Updated 12/16/10
  • Section F - Segregated Folders and Deceased Veterans’ Claims Folders - Updated 8/22/14
  • Section G - Folder Maintenance - Updated 08/21/14
  • Section H - File Types - Updated 12/16/10
  • Section I - Folders Meeting the Criteria for Review by the United States Court of Appeals for Veterans Claims (CAVC) - Updated 5/28/14
  • Section J - Exhibits - Updated 12/16/10

Chapter 5 - Jurisdiction and Transfer

  • Table of Contents- Updated 9/19/14
  • Section A - Jurisdiction Over Claims Folders - Updated 9/22/14
  • Section B - Jurisdiction Over Deceased Veterans Claims Folders - Updated 9/22/14
  • Section C - Jurisdiction Over Education and Rehabilitation Claims - Updated 9/2/10
  • Section D - General Policies for Permanent Transfer - Updated 9/19/14
  • Section E - Permanent Transfer Out or Transfer In of Claims Folders - Updated 10/11/11
  • Section F - Temporary Transfer - Updated 9/2/10
  • Section G - Transfer of Folders Subject to Review by the United States Court of Appeals for Veterans Claims (CAVC) - Updated 8/6/14

Chapter 6 - Determining Veteran Status and Eligibility for Benefits

Chapter 7 - Referrals to the Rating Activity

Chapter 8 - First Notice of Death (FNOD) Processing

  • Table of Contents - Updated 9/22/14
  • Section A - General Policies for PNOD Processing - Updated 9/22/14
  • Section B - System Information - Updated 11/15/04
  • Section C - FNOD Claims Folders and Lightweight Folders - Updated 11/15/04
  • Section D - Interaction with the Records Management Center (RMC) - Updated 11/15/04
  • Section E - Verification of Service and Related Issues - Updated 6/10/09
  • Section F - Miscellaneous (FNOD) Issues - Updated 8/21/14

Changes

Subpart III - General Development and Dependency Issues

Chapter 1 - Rules and Process

  • Table of Contents- Updated 9/16/14
  • Section A - Initial Considerations Regarding the Development Process - Updated 5/27/14
  • Section B - Evidence Requested from the Claimant - Updated 10/14/11
  • Section C - Requesting Evidence from Other Sources - Updated 9/16/14

Chapter 2 - Developing for Service Records

  • Table of Contents- Updated 10/21/14
  • Section A - General Information on Service Records - Updated 8/21/14
  • Section B - Service Record Migration - Updated 8/21/14
  • Section C - Beneficiary Identification and Records Locator Subsystem (BIRLS), Records Management Center (RCM) and the Service Treatment Record (STR) Folder - Updated 10/21/14
  • Section D - Requesting Information/Records Through the Personnel Information Exchange System (PIES) - Updated 9/19/14
  • Section E - Unique Claims and Situations that Require Special Handling - Updated 1/23/14
  • Section F - Merchant Marine Service Records - Updated 12/27/13
  • Section G - Prisoners of War (POW) Service Records - Updated 8/13/09
  • Section H - Record Exchanges between the Department of Veterans Affairs (VA) and the Service Departments - Updated 9/19/14
  • Section I - Control and Follow-up on Record Requests - Updated 9/19/14
  • Section J - Service Department Organzational Structures and service Record Address Codes - Updated 8/13/09
  • Section K - Other Contact and Reference Information - Updated 8/29/11

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

  • Table of Contents - Updated 6/17/14
  • Section A - Department of Veterans Affairs (VA) Requests for Information from the SSA - Updated 6/17/14
  • Section B - SSA Requests for Information from VA - Updated 5/28/14

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

  • Table of Contents - Updated 5/21/09
  • Chapter 4 - Information Requests to or from Other Federal and State Agencies - Updated 9/19/14

Chapter 5 - Relationship and Dependency

  • Table of Contents- Updated 9/23/14
  • Section A - General Information on Relationship and Dependency - Updated 10/11/10
  • Section B - General Information on Establishing Marital Relationship - Updated 2/6/12
  • Section C - Establishing Common Law Marriages - Updated 9/19/14
  • Section D - Establishing Other Types of Marriages - Updated 10/11/10
  • Section E - Establishing Marital Relationship in Death Cases - Updated 9/23/14
  • Section F - Establishing a Child's Age and Relationship and Adjusting Awards for Dependents - Updated 9/23/14
  • Section G - Establishing relationship for a Biological Child, Adopted Child, and Stepchild - Updated 9/19/14
  • Section H - Marriage of a Child - Updated 10/11/10
  • Section I - Establishing Parental Relationship - Updated 10/11/10
  • Section J - Establishing Parental Dependency - Updated 10/11/10
  • Section K - Verification of Marital Status and the Status of Dependents - Updated 9/19/14

Chapter 6 - School Attendance

  • Table of Contents - Updated 10/15/14
  • Section A - Notification of Potential Entitlement and School Attendance Policies - Updated 6/19/12
  • Section B - Awards and Adjustments Based Upon School Attendance - Updated 10/15/14
  • Section C - Dependents' Educational Assistance (DEA) - Updated 10/5/10
  • Section D - Exhibits - Updated 10/5/10

Chapter 7 - EA Childs Permanent Incapacity for Self Support

Changes

Subpart IV - General Rating Process

Chapter 1 - General Information on the Rating Activity

Chapter 2 - Reviewing Claims

Chapter 3 - Examinations

Chapter 4 - Rating Specific Disabilities

  • Table of Contents- Updated 9/23/14
  • Section A - Musculoskeletal Conditions - Updated 10/9/14
  • Section B - Conditions of the Organs of Special Sense - Updated 1/10/14
  • Section C - Infectious Diseases, Immune Disorders, and Nutritional Deficiencies - Updated 12/13/05
  • Section D - Respiratory Conditions - Updated 9/23/14
  • Section E - Cardiovascular System Conditions - Updated 9/22/14
  • Section F- Endocrine Conditions - Updated 12/29/07
  • Section G - Neurological Conditionals and Convulsive Disorders - Updated 6/5/12
  • Section H -Mental Disorders - Updated 6/5/12
  • Section I - Conditions of Other Body Systems - Updated 9/23/14

Chapter 5 - Evaluating Evidence and making a Decision

Chapter 6 - The Rating Decision

  • Table of Contents- Updated 10/9/14
  • Section A - Intermediate Rating Decisions and Deferred Issues - Updated 4/4/2011
  • Section B - Determining the Issues - Updated 8/3/11
  • Section C - Documenting the Decision - Updated 8/1/06
  • Section D - Codesheet Section - Updated 10/9/14
  • Section E - Coded Conclusion - Updated 12/13/05

Chapter 7 - Finalizing and Reviewing the Rating Decision

Chapter 8 - Competency, Due Process and Protected Ratings

Changes

Subpart V - General Authorization Issues and Claimant Notifications

Chapter 1 - Administration Decisions

  • Table of Contents- Updated 9/22/14
  • Section A - General Information - Updated 9/22/14
  • Section B - Statutory Bar to Benefits and Character of Discharge - Updated 8/21/14
  • Section C - Former Prisioner of War (POW) Status - Updated 11/14/11
  • Section D - Willful Misconduct and Line of Duty - Updated 6/19/14
  • Section E - Determinations of Insanity - Updated 11/14/11
  • Section F - Considering Eligibility When Homicide is Involved - Updated 11/14/11 
  • Section G - Presumption of Death - Updated 11/14/11
  • Section H - Finding of Fact and Date of Death - Updated 11/14/11
  • Section I - Reversal of Prior Determinations and Administrative Errors - Updated 6/19/14

Chapter 2 - Decision Authorization and Notification

Chapter 3 - Apportionments

Chapter 4 - Elections, Waivers, and Recoupments

  • Table of Contents- Updated 9/22/14
  • Section A - General Information on Elections - Updated 9/22/14
  • Section B - Recoupment of Readjustment, Separation, and Severance Pay - Updated 9/23/14
  • Section C - Adjusting Department of Veterans Affairs (VA) Benefits Based on a Veteran's Receipt of Active Service Pay - Updated 3/25/13
  • Section D - Federal Employees' Compensation (FEC) - Updated 8/14/06
  • Section E - Two Parent Cases - Updated 11/22/11
  • Section F - Miscellaneous Election Issues - Updated 11/22/11

Chapter 5 - Military Retirement Pay

  • Table of Contents- Updated 11/21/06
  • Section A - Elections and Waivers in Military Retirement Pay Cases - Updated 8/29/11
  • Section B - Preparing and Adjusting Awards in Military Retirement Pay Cases - Updated 11/21/06
  • Section C - Coordinating Military retirement Pay Cases With retired Pay Centers and Service Departments - Updated 7/10/14
  • Section D - Reconciliation of Department of Veteran Affairs (VA), Department of Defense (DoD), and Department of Transportation (DoT) Records - Updated 11/21/06

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

  • Table of Contents- Updated 8/22/14
  • Section A - Information Exchange Between VA Regional Offices (ROs) and Medical Facilities - Updated 8/22/14
  • Section B - Adjustments Under 38 CFR 3.551 and 3.556 - Updated 8/29/11
  • Section C - Adjusting Awards Involving Aid & Attendance (A&A) Allowance - Updated 7/9/14
  • Section D - Adjusting Compensating When a Veteran is Hospitalized in Excess of 21 Days - Updated 8/29/11
  • Section E - Institutional Awards Specific to Incompetent Veterans - Updated 8/29/11
  • Section F - Estate limitations - Updated 4/10/07
  • Section G - Compensation and Pension Record Interchange (CAPRI) - Updated 8/22/14

 

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

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

Chapter 8 - Incarceration

  • Table of Contents- Updated 9/16/14
  • Section A - General Information on the Payment of Benefits During Incarceration - Updated 5/21/09
  • Section B - Apportioning Benefits of an Incarcerated Veteran - Updated 9/16/14
  • Section C - Incarceration of a Dependent - Updated 5/21/09

Chapter 9 - Authorizing Awards for Incompetency and Fiduciary Cases

  • Table of Contents- Updated 9/16/14
  • Section A - General Information on Incompetency and Fiduciary Cases - Updated 7/26/07
  • Section B - Authorizing Awards for Incompentency Cases - Updated 9/16/14
  • Section C - Authorizing Awards for Fiduciary Cases - Updated 2/23/11

Changes

Subpart VI - Special Authorization Issues

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

  • Table of Contents- Updated 9/22/14
  • Section A - Compensation and Pension (C&P) Service Guidance - Updated 9/22/14
  • Section B - Equitable Relief and Other Request - Updated 11/13/14

Chapter 2 - Processing Awards Involving Indebtedness

Chapter 3 - Special Act and Foreign Resident Beneficiaries

Chapter 4 - Philippine Cases

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

Chapter 5 - Fraud and Forfeiture

Chapter 6 - Contested Claims

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

Chapter 7 - Certifications for Special Purposes

Chapter 8 - Miscellaneous Authorization Issues

Changes

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