**August 15, 2002 M21-1, Part II**

**Change 44**

**CHAPTER 1. CLAIMS ESTABLISHMENT AND MAIL MANAGEMENT**

**CONTENTS**

PARAGRAPH PAGE

**SUBCHAPTER I. CLAIMS ESTABLISHMENT**

1.01 General 1-I-1

1.02 The BDN Computer System 1-I-1

1.03 Basic Principles for Establishing BDN Controls 1-I-1

1.04 BDN Commands 1-I-1

1.05 Initial Claims Establishment (CEST) Procedures 1-I-2

1.06 Computer Master Record Controls 1-I-3

**SUBCHAPTER II. MAIL MANAGEMENT**

1.07 **Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004** 1-II-1

1.08 **Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004** 1-II-1

1.09 **Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004** 1-II-2

**February 5, 2004 M21-1, Part II**

**Change 54**

**CHAPTER 1. CLAIMS ESTABLISHMENT AND MAIL MANAGEMENT**

**SUBCHAPTER I. CLAIMS ESTABLISHMENT**

**1.01 GENERAL**

This chapter provides procedures concerning workflow control,
instructions for establishing automated controls and directives for mail
management within the service center.

**1.02 THE BDN COMPUTER SYSTEM**

The primary tool used in the adjudication process is the Benefits
Delivery Network (BDN). This system also facilitates workflow control.
Use the BDN system to control all issues unless otherwise directed in
this manual. Establish an automated control on all claims or issues
within 7 calendar days of receipt in the division. The date of claim for
claims establishment purposes is the earliest date the claim was
actually received by a VA facility (e.g., a VA medical center or another
regional office (RO) if the claim was first received there before being
forwarded to the RO establishing the pending issue). Maintain the
control until final action is taken on the claim or issue. The following
procedures are premised on a good working knowledge of the BDN system.
For additional information about this system, consult the lessons
available using part V of this manual.

**1.03 BASIC PRINCIPLES FOR ESTABLISHING BDN CONTROLS**

a\. Use the following procedures to establish and maintain controls on
all pending claims or issues. Establish a pending issue as part of the
initial action taken in connection with the claim or issue.
(**EXCEPTION:** In death cases, DO NOT assign a new file number for the
purpose of maintaining BDN control until the minimum information
required by paragraph 5.12 is of record.) Control establishment includes
identification of the end product involved, the type of control needed
and the applicable control period. The establishment process also
includes a review of any already-existing BDN system pending issue
controls for the same file number to ensure that the claim is not
related to an existing controlled issue.

b\. The claims establishment process enables the operator to set up a
pending issue to hold the claim data entered. This data is stored in the
\"Pending Issue File\" (PIF). This process also provides for automatic
work measurement and controls. Authorization of the completed action
clears the pending issue out of the PIF and automatically generates end
product credit.

**1.04 BDN COMMANDS**

a\. A BDN pending issue can be established by using one of the commands
below.

\(1\) **CEST\--Claims Establishment.** The CEST command is used to
establish a PIF control for a pending claim or appeal. CEST processing
accesses the BIRLS record to obtain the veteran\'s service data for all
original or reopened transactions (cases with either a terminated master
record or no master record at Hines) and when specifically requested on
the \"Ready\" screen. A BIRLS record can be established under this
command if none exists.

\(2\) **CDAT\--Claims Data Entry.** When an active master record exists,
this command may be used to establish an issue. Upon completion of the
101 screen, processing will return to the original command.

\(3\) **CADJ\--Claims Adjudication.** When an active master record
exists, this command may be used to establish a pending issue. Upon
completion of the 101 screen, processing returns to the original
command.

b\. Master record types are discussed in part V, chapter 2. Additional
data on the establishment process may be found in part V, chapter 16.

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**M21-1, Part II February 5, 2004**

**Change 54**

**1.05 INITIAL CLAIMS ESTABLISHMENT (CEST) PROCEDURES**

Initial claims establishment requires completion of the \"Ready\"
screen, the \"Veterans Identification Data\" (VID) screen and the
\"Claims Establishment\" screen (101). The \"Presidential Memorial
Certificate\" (PMC) screen may also be completed in death cases (see
par. 1.05e). Some claims may require completion of more than one BIRLS
screen.

**a. Completion of the Ready Screen.** The minimum required entries on
the \"Ready\" screen for the CEST command are: command, operator\'s
password, payee number, end product code, benefit type, stub name of
veteran or beneficiary and the file number, Social Security number,
service number; or insurance number.

\(1\) Benefit types are abbreviated for BDN purposes. Use \"CPL\" for a
veteran\'s disability claim (compensation or pension) or apportionment
claims against the veteran. Use \"CPD\" for a claim based on a deceased
veteran\'s service (DIC, death pension, death compensation or burial
benefits). Codes for vocational rehabilitation or education benefit
claims are designated by program of participation: CH30, CH31, CH32,
CH35, 1606, 901 or 903 as appropriate.

\(2\) Always enter the applicable end product code (e.g., 110, 120, 130,
etc., or 116, 126, etc. for foreign cases established at the Pittsburgh
RO, White River Junction VAM&ROC, or Houston RO). Sequential numbering
of issues is inappropriate since the last digits are assigned for
specific use as shown below. If the operator enters a basic end product
and one already exists, the message \"DUPLICATE ISSUE EXISTS\--INCREMENT
EPC UNLESS 700 SERIES START NEW COMMAND WITH PA2 KEY\" will be
displayed. When the current issue is not part of existing issues, the
operator must determine the next end product increment and enter it with
all other required entries on the \"Ready\" screen. See M21-4, appendix
C, for further information regarding end products.

\(3\) Third-digit modifiers two (2) through five (5) and (8) pertain to
the specific pending issue claimed. The third-digit modifier nine (9) is
required for all pending issues of veterans who served in the Southwest
Asia Theater of Operations during the Gulf War. This data is used to set
indicators in the C&P Master and BIRLS records. To avoid removing an
existing indicator, it is important that all issues established for
these veterans contain the end product modifier \"9.\" When any other
third-digit modifier described in paragraph (3) above also applies, the
\"9\" will be used.

[MODIFIER USE]{.underline}

0 : General

1 : Increment

2 : Radiation issues (EP 010, 110, 020, or 140)

3 : POW Status (EP 010, 110, 020, or 140)

4 : Post Traumatic Stress Disorder (EP 010, 110, 020, or 140)

5 : Agent Orange Exposure (EP 010, 110, 020, or 140)

6 : Foreign case (for ROs 311, 362, 405 only)

7 : Foreign case (for ROs 311, 362, 405 only)

8 : Personal Trauma case

9 : All issues (Southwest Asia Theater of Operations during the Gulf
War)

\(4\) If access is attempted on a record and the message \"UNAUTHORIZED
ACCESS SENSITIVE FILE\" is displayed, the operator should immediately
notify his or her supervisor. Processing or access to that record must
be accomplished by an operator with the appropriate security level. See
M23-1, part V, for detailed information on secured records. See
paragraph 3.04 re security for employee and other classes of restricted
access records.

b.  **Completion of the BIRLS screens.** Upon successful completion of
    the \"Ready\" screen, a BIRLS \"Veteran

Identification Data\" (VID) screen will be displayed when appropriate.
(See part V, par. 16.02f.)

# I-1-2

**June 23, 1998 M21-1, Part II**

**Change 33**

\(1\) Compare the information displayed with the current claim or issue
to ensure the record displayed is that of the veteran on whose service
the claim is based. If the displayed record is not the correct record,
terminate processing by entering \"END\" in the \"NEXT SCREEN\" field.
If the displayed record is correct, review all data for accuracy and
completeness. Correct any erroneous data and enter missing data.

\(2\) Determine if a claims folder already exists. If it does not, note
the message at the bottom of the \"VID\" screen directing the
establishment of a folder under the file number displayed. A print of
the screen is automatically generated. If a folder already exists and it
is not located on station, use the \"LOC\" screen to request transfer.
(For CH35 cases, transfer should be requested using the \"BID\" screen.)

\(3\) When the benefit type is CPD and the BIRLS record does not contain
a date of death, the \"VID\" screen will be displayed in the \"Notice of
Death\" (FNOD) format. This allows for entry of the date of death and
other death-related entries without the need for a separate FNOD entry.

\(4\) When the last required BIRLS screen has been completed, enter
\"UPD\" in the \"NEXT SCREEN\" field. The 101 screen will then be
displayed.

**c. Completion of the Pending Issue Control Establishment Screen.**
Detailed instructions on the completion of this screen can be found in
part V, chapter 16.

**d. Completion of the Presidential Memorial Certificate Screen.** The
\"Presidential Memorial Certificate\" (PMC) screen is displayed during
CEST processing of an initial death claim. To avoid issuing more than
one PMC, complete the screen only if entering the date of death. If the
date of death is already in the BIRLS record at the time a CEST is done,
assume that the PMC was already sent. PMC eligibility is discussed in
paragraph 5.25.

\(1\) When the veteran\'s name as displayed from the BIRLS record in the
top left hand portion of the PMC screen is incorrect, enter the correct
name in the field \"CORRECT VETERAN NAME\" to the right.

\(2\) Enter the title, name, address and relationship of the person who
is to receive the PMC in the bottom portion of the screen. Accuracy is
essential as it is the source used to prepare the certificate.

\(3\) If a PMC cannot be issued because of incomplete or inaccurate
information or no certificate should be sent at this time, enter \"END\"
in the \"NEXT SCREEN\" field.

**1.06 COMPUTER MASTER RECORD CONTROLS**

**a. General.** Computer control can be established and maintained only
if there is a master record existing. A maximum of nine segments can be
maintained in the master record.

\(1\) **Computer-Generated Diaries.** Certain future diary controls are
generated by the system. These include diaries for generation of
Eligibility Verification Reports, dependency verification notices, etc.

\(2\) **Controls Established by Adjudication.** Adjudication may
establish diary controls by the use of specific diary reason codes. Such
controls may be entered on the 220 Screen\--\"Future Date Diary
Control,\" the 301 Screen\--\"Rating Data\" or the 401
Screen\--\"Special Conditions.\"

\(3\) **Selection of Control Dates.** The computer reviews diary
controls only during end-of-month processing. At that time, the
designated month and year of each diary control is examined and those
matching the current month and year are selected. For example, EOM
January 97 selects cases with diary

**1-I-3**

**M21-1, Part II June 23, 1998**

**Change 33**

control dates of 0197. The appropriate notices will be generated for
delivery by the first week of February 97. (For EVR selection controls,
cases are selected during EOM processing the month preceding the diary
date.) This should be kept in mind when establishing diary controls. The
date entered should normally be the month prior to that in which
followup or review action is required.

**b. The 220 Screen\--**\"**Future Date Diary Control**\" **and the DIAR
Command.** Future date controls can be established, changed or canceled
by use of the 220 screen. When award action is required, establishment
of diary controls can be accomplished by entries on the 301 and 401
screens. (See part V, chapter 5.)

\(1\) **Ready Screen.** Access the 220 screen by entering the command
\"DIAR,\" password, file number, payee number, benefit and stub name on
the \"Ready\" screen.

\(2\) **Establishment.** Upon successful entry of the \"Ready\" screen,
the 220 screen will be displayed. Any diaries currently stored in the
master record will be displayed. To establish a new diary control, enter
an X in the \"ADD\" field with the appropriate month, year and reason.
The date entered must be at least two months in the future but cannot
exceed the time shown in the following chart.

DIARY REASON CODES MAXIMUM CONTROL LIMITS

01\--Future Physical Exam 5 years

02\--Generated Individual Unemployability Review, M21-1, III, 5.08 2
years

03\--Helpless Child Review, M21-1, IV, 15.06 5 years

04\--NSC TB\--38 CFR 3.342 6 months

10\--Review for \$1500 limitation\--38 CFR 3.557 5 years

11\--Reduction\--38 CFR 3.551(B) 6 months

12\--Restore Rate\--38 CFR 3.556(D) 6 months

13\--Disappearance 7-Year Review 7 years

20\--Helpless Child Reaches Majority, M21-1, IV, 17.03 3 years

21\--Verify School Attendance 1 year

22\--Verify Income or Dependency 3 years

24\--Dependency Review\--Issue VA Form 21-0537 or VA Form 21-0538 3
years

25\--Control for Return of VA Form 21-0537 or VA Form 21-0538 3 months

27\--Reservist Requires Drill Pay Days 6 months

30\--Local Regional Office Special Use \[Specify in \"Remarks\"\] 15
years

32\--Expiration of Employability Control, M21-1, III, 5.08b(3) 19 years

35\--Hospital Adjustments for NSC Pensioners\--38 CFR 3.551 and 3.556
Generated

38\--Review Future Examination Control, for Use in Cases with No Master
Record Generated

41\--EVR Selection Control, M21-1, IV, 29.01b(5) 1 year

\(3\) **Cancellation.** When an existing diary control is no longer
needed, access the 220 screen and enter an X in the \"DELETE\" field.

\(4\) **Changing an Existing Diary Control.** When it is necessary to
change the date of an existing diary control, you must delete the
existing control and reestablish it using the corrected future date.
Enter an X in the \"DELETE\" field of the existing diary. Then enter an
X in the \"ADD\" field with the appropriate month, year and reason code.

**1-I-4**

**July 1, 2004 M21-1, Part II**

**Change 56**

**SUBCHAPTER II. MAIL MANAGEMENT**

**1.07 Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004**

**1.08 Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004**

**1.09 Rescinded per M21-1MR, Part III, Subpart ii dated November 15,
2004**

**NOTE: Pages 1-II-2 through 1-II-3 have been removed per M21-1MR, Part
III, Subpart ii dated November 15, 2004**

**1-II-1**