### Section E. Reopened Claims

#### Overview

+------------+---------------------------------------------------------+
| #          | > This section contains the following topics:           |
| #### In th |                                                         |
| is Section |                                                         |
+------------+---------------------------------------------------------+

  ------------ ---------------------------------------------- ------------
  Topic        Topic Name                                     See Page

  19           Reopened Claims: The Importance of New and     2-E-2
               Material Evidence and Definition of Terms      

  20           Handling Claims to Reopen                      2-E-4

  21           Handling Newly Received Evidence               2-E-6

  22           Determining an Effective Date and Handling a   2-E-9
               Denial                                         
  ------------ ---------------------------------------------- ------------

#### 19. Reopened Claims: The Importance of New and Material Evidence and Definition of Terms 

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on definitions of     |
| troduction | > terms relating to reopened claims for service         |
|            | > connection. It includes information on                |
|            |                                                         |
|            | -   the importance of new and material evidence for     |
|            |     reopening a claim for service connection, and       |
|            |                                                         |
|            | -   definitions of the terms                            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   reopened claim                                      |
|            |                                                         |
|            | -   evidence                                            |
|            |                                                         |
|            | -   new evidence, and                                   |
|            |                                                         |
|            | -   material evidence.                                  |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a.   | > New and material evidence is required before the      |
|  Importanc | > Department of Veterans Affairs (VA) will reconsider a |
| e of New a | > finally denied claim for service connection for a     |
| nd Materia | > particular disability.                                |
| l Evidence |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A ***reopened claim*** is any claim for service       |
|  b. Defini | > connection, received after a finally denied claim,    |
| tion: Reop | > which VA must reconsider because the evidence it      |
| ened Claim | > presents is new and material. A finally denied claim  |
|            | > means that at least one year has elapsed since the    |
|            | > letter was sent notifying the claimant of the         |
|            | > decision to deny the benefit sought.                  |
|            | >                                                       |
|            | > ***Note***: The term "reopened" does not apply to     |
|            | > pension, increased ratings, or individual             |
|            | > unemployability. Those claims involve the review of   |
|            | > new evidence based on new applications, rather than   |
|            | > reconsideration of prior decisions. For this reason,  |
|            | > they are "new" claims.                                |
|            | >                                                       |
|            | > ***Reference***: For more information on reopened     |
|            | > claims, see [38 CFR                                   |
|            | > 3.160(e)](http://w                                    |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_160.DOC). |
+------------+---------------------------------------------------------+

Continued on next page

19\. Reopened Claims: The Importance of New and Material Evidence and
Definition of Terms, Continued

+------------+---------------------------------------------------------+
| ##### c.   | > ***Evidence*** is any means by which an alleged       |
| Definition | > matter of fact is established or disproved.           |
| : Evidence | >                                                       |
|            | > ***Examples***: Examples of evidence include the      |
|            | > following:                                            |
|            |                                                         |
|            | -   testimony, to include                               |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   statements                                          |
|            |                                                         |
|            | -   contentions, and                                    |
|            |                                                         |
|            | -   arguments                                           |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   documentary proof                                   |
|            |                                                         |
|            | -   medical examinations or reports, and                |
|            |                                                         |
|            | -   other material not previously considered.           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > ***New evidence*** is evidence not previously of      |
| d. Definit | > record.                                               |
| ions: New  | >                                                       |
| Evidence a | > ***Material evidence***                               |
| nd Materia |                                                         |
| l Evidence | -   is relevant and relates to an unestablished fact    |
|            |     necessary to substantiate the claim, and            |
|            |                                                         |
|            | -   has a legitimate influence or bearing on the        |
|            |     decision in the case.                               |
|            |                                                         |
|            | > ***Note***: The provisions of [38 CFR                 |
|            | > 3.105(b)](http://                                     |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_105.DOC) |
|            | > do not apply if a decision is changed because of the  |
|            | > receipt of new and material evidence.                 |
|            | >                                                       |
|            | > ***Reference***: For more information on material     |
|            | > evidence, see [38 CFR                                 |
|            | > 3.156](http://w                                       |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_156.DOC). |
+------------+---------------------------------------------------------+

#### 20. Handling Claims to Reopen

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on handling claims to |
| troduction | > reopen a finally denied claim. It includes            |
|            | > information on                                        |
|            |                                                         |
|            | -   the general policy for screening newly received     |
|            |     material                                            |
|            |                                                         |
|            | -   previously filed claims                             |
|            |                                                         |
|            | -   handling correspondence                             |
|            |                                                         |
|            | -   identifying duplicate claims, and                   |
|            |                                                         |
|            | -   handling duplicate claims.                          |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > November 15, 2004                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Carefully screen all newly received material to       |
| #### a. Ge | > determine whether authorization or the rating         |
| neral Poli | > activity is responsible for making a new decision.    |
| cy on Scre |                                                         |
| ening Newl |                                                         |
| y Received |                                                         |
|  Material  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > If a claimant has already filed *VA Form 21-526,      |
| ### b. Pre | > Veteran's Application for Compensation or Pension,*   |
| viously Fi | > he/she does *not* need to file another formal claim.  |
| led Claims | >                                                       |
|            | > However, *VA Form 21-526* may be used as the best     |
|            | > means of obtaining all the necessary information in   |
|            | > some claims for increase or reconsideration.          |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Correspondence from a claimant asking for             |
| ### c. Han | > reconsideration for service connection is a *claim to |
| dling Corr | > reopen*.                                              |
| espondence | >                                                       |
|            | > Upon receipt of correspondence from a claimant asking |
|            | > for reconsideration                                   |
|            |                                                         |
|            | -   establish a control under [M21-1MR, Part III,       |
|            |     Subpart ii,                                         |
|            |     1](../pt03_sp02_ch01_secA.xml#III.ii.1.A), and      |
|            |                                                         |
|            | -   refer the claim for necessary development.          |
|            |                                                         |
|            | > ***Note***: Effective dates are governed by [38 CFR   |
|            | > 3.400(q)](http://w                                    |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_400.DOC). |
+------------+---------------------------------------------------------+

Continued on next page

20\. Handling Claims to Reopen, Continued

+------------+---------------------------------------------------------+
| ##### d    | > Consider a claim a *duplicate claim* if the           |
| . Identify | > application                                           |
| ing Duplic |                                                         |
| ate Claims | -   is based on the same conditions for which a prior   |
|            |     claim for service connection was denied, and        |
|            |                                                         |
|            | -   does not furnish new and material evidence.         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Upon receipt of a duplicate claim                     |
| # e. Handl |                                                         |
| ing Duplic | -   establish a pending issue control, and              |
| ate Claims |                                                         |
|            | -   inform the claimant that he/she must submit new and |
|            |     material evidence in order to have the claim        |
|            |     reconsidered.                                       |
+------------+---------------------------------------------------------+

#### 21. Handling Newly Received Evidence

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on handling newly     |
| troduction | > received evidence. It includes information on         |
|            |                                                         |
|            | -   referring medical evidence                          |
|            |                                                         |
|            | -   actions to take if the claimant submits duplicate   |
|            |     medical evidence                                    |
|            |                                                         |
|            | -   handling                                            |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   supplemental service records                        |
|            |                                                         |
|            | -   hospital reports                                    |
|            |                                                         |
|            | -   claimant statements, and                            |
|            |                                                         |
|            | -   affidavits and statements                           |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   descriptions of symptoms                            |
|            |                                                         |
|            | -   handling correspondence from a former prisoner of   |
|            |     war (POW), and                                      |
|            |                                                         |
|            | -   handling information from a veteran with a          |
|            |     psychiatric disability.                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 19, 2005                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Refer medical evidence to the rating activity if      |
|  a. Referr |                                                         |
| ing Medica | -   it is *not* a duplication of evidence already in    |
| l Evidence |     file, or                                            |
|            |                                                         |
|            | -   there is a question as to whether reconsideration   |
|            |     by the rating activity is warranted.                |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > If the claimant submits duplicate medical records or  |
|  b. Action | > reports, or any other duplicate evidence              |
| s to Take  |                                                         |
| If the Cla | -   date-stamp each page of the material to show the    |
| imant Subm |     date of receipt by VA, and                          |
| its Duplic |                                                         |
| ate Medica | -   return all the materials to the claimant with a     |
| l Evidence |     cover letter that                                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   advises him/her that the submitted material is a    |
|            |     duplicate of material already in the folder, and    |
|            |                                                         |
|            | -   summarizes what material is being returned.         |
|            |                                                         |
|            | > ***Sample Language***: "*Enclosed are eight pages of  |
|            | > medical evidence submitted by you that were received  |
|            | > by VA on 3/29/93. The evidence, covering your         |
|            | > hospitalization at General Hospital for the period    |
|            | > 6/17/72 to 6/23/72, is a duplicate of evidence        |
|            | > already in file, and has, therefore, already been     |
|            | > considered*."                                         |
+------------+---------------------------------------------------------+

Continued on next page

21\. Handling Newly Received Evidence, Continued

+------------+---------------------------------------------------------+
| ##### c    | > Refer all supplemental service medical records to the |
| . Suppleme | > rating activity for review and consideration.         |
| ntal Servi |                                                         |
| ce Records |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Promptly forward VA hospital reports to the rating    |
|  d. Hospit | > activity.                                             |
| al Reports | >                                                       |
|            | > ***Reference***: For more information about hospital  |
|            | > reports, see                                          |
|            |                                                         |
|            | -   M21-1MR, Part III, Subpart v, 6.A.2 (TBD) or        |
|            |     [M21-1, Part IV,                                    |
|            |     18.02](htt                                          |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part4/ch18.doc), |
|            |     and                                                 |
|            |                                                         |
|            | -   M21-1MR, Part III, Subpart v, 6. A.4 (TBD) or       |
|            |     [M21-1, Part IV,                                    |
|            |     18.05](htt                                          |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part4/ch18.doc). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Refer statements from claimants to the rating         |
| #### e. Re | > activity.                                             |
| ferral of  | >                                                       |
| Statements | > The rating activity will decide whether or not the    |
|            | > statements constitute new and material evidence.      |
|            | >                                                       |
|            | > ***Reference***: For more information, see [38 CFR    |
|            | > 3.156](http://w                                       |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_156.DOC). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > Use the table below to determine how to handle        |
| # f. Affid | > affidavits and statements submitted by or on behalf   |
| avits and  | > of a veteran.                                         |
| Statements |                                                         |
+------------+---------------------------------------------------------+

+------------------------+---------------------------------------------+
| If the affidavits or   | Then ...                                    |
| statements ...         |                                             |
+------------------------+---------------------------------------------+
| relate to a rating     | refer the material to the rating activity   |
| issue                  | for review and necessary action.            |
+------------------------+---------------------------------------------+
| do *not* furnish a     | fully inform the veteran and his/her        |
| basis for              | representative as to                        |
| reconsideration        |                                             |
|                        | -   why the evidence is deficient           |
|                        |                                             |
|                        | -   the specific type of evidence that is   |
|                        |     required, and                           |
|                        |                                             |
|                        | -   the right to appeal.                    |
|                        |                                             |
|                        | ***Reference***: For more information about |
|                        | certification requirements, see M21-1MR,    |
|                        | Part III, Subpart iii, 1.B.6 (TBD) or       |
|                        | [M21-1, Part III,                           |
|                        | 1.07](http://www.warm                       |
|                        | s.vba.va.gov/admin21/m21_1/part3/ch01.doc). |
+------------------------+---------------------------------------------+

Continued on next page

21\. Handling Newly Received Evidence, Continued

+------------+---------------------------------------------------------+
| ###        | > A claimant's own statement, covering in sufficient    |
| ## g. Desc | > detail a condition that is within his/her ability to  |
| riptions o | > describe, such as his/her own symptoms, may to that   |
| f Symptoms | > extent constitute evidence.                           |
|            | >                                                       |
|            | > ***Rationale***:                                      |
|            |                                                         |
|            | -   While such statements have self-serving aspects,    |
|            |     the claimant is often the most qualified source to  |
|            |     describe the circumstances of the disabling effects |
|            |     of the disease or injury.                           |
|            |                                                         |
|            | -   If such statements are new and material and of      |
|            |     sufficient probative value, they may serve as a     |
|            |     basis for ordering a VA examination.                |
|            |                                                         |
|            | > ***Reference***: For more information about VA        |
|            | > examinations, see M21-1MR, Part III, Subpart iv,      |
|            | > 3.A.11 (TBD) or [M21-1, Part VI,                      |
|            | > 1.01c](htt                                            |
|            | p://www.warms.vba.va.gov/admin21/m21_1/part6/ch01.doc). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### h. H | > Use the table below to determine how to proceed if a  |
| andling Co | > former prisoner of war (POW) expresses                |
| rresponden | > dissatisfaction with a rating within one year of      |
| ce from a  | > notification.                                         |
| Former POW |                                                         |
+------------+---------------------------------------------------------+

+---------------------+------------------------------------------------+
| If a POW protocol   | Then ...                                       |
| examination is ...  |                                                |
+---------------------+------------------------------------------------+
| > *not* of record   | refer the case to the predetermination team to |
|                     | request a POW protocol examination.            |
|                     |                                                |
|                     | ***Reference***: For more information about VA |
|                     | examinations, see M21-1MR, Part III, Subpart   |
|                     | iv, 3.A.6 and M21-1MR, Part III, Subpart iv,   |
|                     | 3.A.7 (TBD) or [M21-1, Part VI,                |
|                     | 1.02c](http://www.w                            |
|                     | arms.vba.va.gov/admin21/m21_1/part6/ch01.doc). |
+---------------------+------------------------------------------------+
| > of record         | -   consider the statement from the veteran a  |
|                     |     Notice of Disagreement (NOD), and          |
|                     |                                                |
|                     | -   forward the file to the appeals team.      |
|                     |                                                |
|                     | ***Reference***: For more information about    |
|                     | appeals, see [M21-1MR, Part I,                 |
|                     | 5](http://vb                                   |
|                     | aw.vba.va.gov/bl/21/M21-1MR/m21-1mr_main.htm). |
+---------------------+------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### i    | > If you receive information indicating that a veteran  |
| . Veterans | > with a 100 percent psychiatric disability evaluation  |
|  With a Ps | > is employed, submit the information to the rating     |
| ychiatric  | > activity.                                             |
| Disability |                                                         |
+------------+---------------------------------------------------------+

#### 22. Determining an Effective Date and Handling a Denial

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on determining        |
| troduction | > effective dates and handling denials of claims to     |
|            | > reopen. It includes information on                    |
|            |                                                         |
|            | -   the date of receipt of a claimant's statement as an |
|            |     effective date, and                                 |
|            |                                                         |
|            | -   denying a claim when no new and material evidence   |
|            |     is provided.                                        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### Ch   | > November 15, 2004                                     |
| ange Date  |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > The date of receipt of statements from the claimant   |
| #### a. Da | > that are held to be new and material evidence may     |
| te of Rece | > constitute an effective date for increased benefits   |
| ipt of a C | > under [38 CFR                                         |
| laimant's  | > 3.400(q)](http://w                                    |
| Statement  | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_400.DOC). |
| as an Effe |                                                         |
| ctive Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. D | > If the claimant submits evidence that is *not* *both* |
| enying a C | > new and material, send a denial letter indicating     |
| laim When  |                                                         |
| No New and | -   that VA does *not* consider the claim reopened, and |
|  Material  |                                                         |
| Evidence I | -   the reasons why the evidence is not new and         |
| s Provided |     material.                                           |
|            |                                                         |
|            | > ***Note***: Letters to claimants should *not* refer   |
|            | > to a claim as "reopened" unless a claimant submits    |
|            | > new and material evidence. Otherwise, it is a "claim  |
|            | > *to* reopen."                                         |
+------------+---------------------------------------------------------+