# Veterans Benefits Administration M21-1, Part III

**Department of Veterans Affairs Change 131**

# Washington, DC 20420 February 25, 2005

> Veterans Benefits Manual M21-1, Part III, "Authorization and Clerical
> Procedures," is changed as follows:

**Pages 4-i and 4 --ii and 4-I-1 and 4-I-3:** Remove these pages and
substitute pages 4-i and 4-ii and 4-I-1 and 4-I-3 attached.

Paragraph 4.01(2)(b)is revised to reflect the appropriate references.

**Page 4-I-9:** Remove this page and substitute page 4-I-9 attached.

Paragraph 4.02c is added to show that the Veterans Information Solution
(VIS) application enables VA regional office and medical center
employees to have access to electronic service member discharge data.

**Pages 4-IV-3 and 4-IV-4:** Remove these pages and substitute pages
4-IV-3 and 4-IV-4 attached.

Paragraph 4.24e(2) is revised to reflect that when submitting a PIES
request for Navy cases, code O43 is used, and that all other branches
require a dictated letter.

**Pages 4-IV-7 and 4-IV-8:** Remove these pages and substitute these
pages 4-IV-7 and 4-IV-8 attached.

Paragraphs 4.25f(2) and 4.25f(3) are revised to show that if a
dependent's inpatient and outpatient medical records are needed to
support the veteran's claim, then respectively, request codes C03 and
C04 are used to obtained the medical records.

Paragraph 4.26b(2) is amended to include a note stating that VAMC
personnel can access and view eligibility information via the Veterans
Information Solution (VIS) application.

**Pages 4-V-3 and 4-V-4:** Remove these pages and substitute these pages
4-V-3 and 4-V-4 attached.

Paragraph 4.28b is amended to show that follow-ups on requests that have
been pending 120 days at NPRC should no longer be sent, and that after
the initial 120 days, the liaison office will respond within 60 days.

**Pages 4-A-3 through 4-A-8:** Remove these pages and substitute these
pages 4-A-3 through 4-A-8 attached.

Addendum A is amended to show that address code 55 is to be used in
obtaining verification of in-service stressors and for disabilities
related to exposure to Agent Orange

**Pages 4-C-1 through 4-C-4:** Remove these pages and substitute these
pages 4-C-1 through 4-C-4 attached.

Addendum C is revised to show changes in the addresses and telephone
numbers for address codes 16, 21, 35 and 47; to include a purpose
statement for address codes 16, 17, 25, 35, and 47; to add address code
55, and the mailing address and telephone number for the U.S. Armed
Services Center for Unit Records Research.

**Pages 4-K-1 through 4-K-7:** Remove these pages and substitute these
pages 4-K-1 through 4-K-8 attached.

Addendum K is revised to update the reference for request code C01. It
is further revised to add PIES request codes C03, C04, O40, O41, O42 and
O43. The pages are renumbered.

**M21-1, Part III February 25, 2005**

**Change 131**

**Pages 4-O-1:** Remove this page and substitute page 4-O-1 attached.

Addendum O is revised to reflect editorial changes.

**Pages 5-i and 5-ii and 5-I-1 and 5-I-2:** Remove these pages and
substitute pages 5-i and 5-ii and 5-I-1 and 5-I-2 attached.

Paragraph 5.03c is revised to state that a request for Social Security
Administration medical records must also include a request for any
disability decisions in connection with the veteran's claim.

**Pages 5-II-1 through 5-II-2 and pages 5-II-9 through 5-II-22:** Remove
these pages and substitute pages 5-II-1 through 5-II-2 and pages 5-II-9
through 5-II-22 attached.

Paragraph 5.10c(1) note is revised to show that Code O43 will be used
for Navy only when submitting a PIES request for verification of Vietnam
service, and that all other branches will require a dictated letter.

Paragraph 5.14b(1) is revised to show consistency within the manual and
the CURR Stressor Verification Guide on the correct wording for Combat
Infantry Badge. This is a miscellaneous editorial correction to the
chapter.

Paragraph c(2)(a) is revised to delete the word "As" and replace it with
"At." This is a miscellaneous editorial change to the subchapter.

Paragraph 5.14c(3) is amended to show that when requesting confirmation
of in-service stressor(s), codes O40, O41 and O42 are to be used, unless
the stressor occurred during Marine Corps service, and the information
that must be included when submitting a PIES request. All Marine Corps
unit records for the Vietnam Era are currently viewable and searchable
through Virtual VA. Instructions for handling denials of service
connection for PTSD, based solely on the absence of a verifiable
stressor during Marine Corps service, are currently pending. Regional
offices should postpone denying service connection in these cases until
further notice.

Paragraph 5.14c(3) note is revised to show that only after additional
development has occurred, and if the information is still insufficient
to resubmit to CURR, can a station render a final decision. The word
"affect" is deleted and replaced with "effect." This is a miscellaneous
editorial correction to the chapter.

Paragraph 5.14c(3)(a) is updated to show the current mailing address for
the U.S Armed Services Center for Unit Records Research (CURR), the VA's
liaison officer telephone number, and when requesting verification of
in-service stressors, codes O40, O41 and O42 are to be used.

Paragraph 5.14c(3)(b) is revised to state that the new codes in PIES
will allow an end user to submit up to three requests for verification
of in-service stressors for each veteran.

Paragraph 5.14c(4) is amended to include a cross reference to
subparagraph 5.14c(3), and to state that a denial is improper, unless
the veteran has been informed of the basic information that is needed
for a CURR request, and the claims folder has been properly documented.

Paragraph 5.14 c(5) is changed to show a reference to the CURR Stressor
Verification Guide.

Subparagraphs 1 through 7 are added to show the procedures for properly
documenting the claims folder and the responsibilities of the CURR
coordinator. In subparagraph 6, the reference to Exhibit B-11, is a
memorandum that must be completed to document the findings, and to show
that all efforts have been exhausted in obtaining verification of
in-service stressor(s).

**February 25, 2005** **M21-1, Part III**

#  Change 131

**Page 5-B-1 through 5-B-15:** Remove these pages and substitute pages
5-B-1 through 5-B-15 attached.

The pagination of pages 5-B-2 through 5-B-15 is corrected.

Appendix B is amended to show the removal of Exhibit B-9. The
information displayed in Exhibit B-9 is now available through the Modern
Awards Processing-Development (MAP-D) application. The remaining
exhibits are renumbered.

Exhibits B-5, B-6, B-7, and B-8 are revised to update the term
Adjudication Officer to Veterans Service Center Manager.

Exhibit B-11 is the approved memorandum to be used in certifying the
steps taken to obtain verification of in-service stressor(s).

**Pages 9-I-1 and 9-I-2:** Remove these pages and substitute pages 9-I-1
and 9-I-2 attached.

A note is added to paragraph 9.01b(6) to state that, if information in
the claims folder indicates the claimant receives disability benefits
from the Social Security Administration (SSA), a copy of the SSA
decision determination should be requested, in addition to SSA medical
records or other evidence in SSA's possession that the claimant requests
be obtained.)

Paragraph 9.01c is revised to reflect that the initial follow-up request
for SSA medical evidence should be after 60 days and that the second and
subsequent follow-up requests should be 30 days apart. The paragraph is
also amended to state the requirement for a formal finding of Federal
record unavailability and to provide references to M21-1, Part III,
Chapter 4, Addendum O and M21-1MR, Part I, 1.C.5.f.

> By Direction of the Under Secretary for Benefits

Renée Szybala, Director

> Compensation and Pension Service

Distribution: RPC: 2068

FD: EX: ASO and AR (included in RPC 2068)

LOCAL REPRODUCTION AUTHORIZED

**February 25, 2005 M21-1, Part III**

Change 131

CHAPTER 4. REQUESTS FOR SERVICE RECORDS

**CONTENTS**

**SUBCHAPTER I. SERVICE RECORDS MIGRATION**

PARAGRAPH PAGE

4.01 Overview of Service Records Migration 4-I-1

4.02 Records Routinely Furnished 4-I-7

**SUBCHAPTER II. RECORDS MANAGEMENT CENTER (RMC) AND ASSOCIATED**

**RO PROCESSING**

4.03 VA Obtains Service Medical Records from the Military 4-II-1

4.04 RMC Workflow 4-II-2

4.05 BIRLS Information Showing SMR Folder Establishment 4-II-3

4.06 BIRLS Information Showing SMR Folder Received by the Regional
Office 4-II-4

4.07 Multiple SMRs 4-II-5

4.08 Request for Transfer of SMRs Required When NOD Folder Involved
4-II-5

4.09 Folder Transfer Restrictions 4-II-5

4.10 Claims Folders at RMC or an FRC 4-II-5

4.11 Informational Message for Claims Folder Establishment When SMR
Already Exists 4-II-5

4.12 CEST Processing 4-II-5

4.13 Special Problems With BIRLS Records 4-II-6

4.14 Original or a Photocopy of SMRs 4-II-6

4.15 RMC Liaison Established 4-II-6

4.16 Unassociated Service Medical Records 4-II-7

**SUBCHAPTER III. ROUTINE REQUESTS FOR SERVICE RECORDS**

4.17 General Procedure 4-III-1

4.18 Preparation of PIES Requests for Service Records 4-III-1

4.19 Protection of Records 4-III-1

4.20 Accessing Reports 4-III-2

4.21 RO Detail Report 4-III-3

**SUBCHAPTER IV. SPECIAL SITUATIONS AND ALTERNATE SOURCES OF RECORDS**

4.22 Surgeon General\'s Office (SGO) Extracts 4-IV-1

4.23 Fire-Related Cases 4-IV-2

4.24 Special Action Required to Obtain Specific Service Information
4-IV-3

4.25 Alternate Sources for Service and Medical Records 4-IV-6

4.26 Requests for Service Records from Medical Centers 4-IV-8

**SUBCHAPTER V. CONTROL AND FOLLOWUP PROCEDURES**

4.27 Routine Control and Followup Procedures 4-V-1

4.28 Special Followup by the Military Records Specialist 4-V-2

4.29 Procedure When Service Records Unavailable 4-V-5

**SUBCHAPTER VI. MERCHANT MARINE SERVICE**

4.30 Establishing Veteran Status Based on Merchant Marine Service 4-VI-1

**4-i**

**M21-1, Part III February 25, 2005**

**Change 131**

4.31 Service Record Requests for Merchant Seamen 4-VI-2

**SUBCHAPTER VII. EXCHANGE OF RECORDS WITH DISCHARGE REVIEW**

**BOARDS AND BOARDS FOR CORRECTION OF MILITARY RECORDS**

4.32 Exchange of Records Between VA and the U.S. Army Board for
Correction of Military

Records and the Army Discharge Review Board 4-VII-1

4.33 Exchange of Records Between VA and the U.S. Air Force Discharge
Review Board 4-VII-2

4.34 Exchange of Records Between VA and the Navy Board of Review and the
Board of

Correction of Naval Records 4-VII-3

**SUBCHAPTER VIII. SERVICE RECORDS FOR PRISONERS OF WAR (POWS)**

4.35 Requests for Prisoner of War Records 4-VIII-1

4.36 World War II Record Groups 4-VIII-1

4.37 Korean Conflict Record Groups 4-VIII-2

4.38 POW Records for Periods Other Than World War II and Korean Conflict
4-VIII-2

4.39 Action if Service Records Are Not Obtainable 4-VIII-2

**SUBCHAPTER IX. ADMISSION TO UNIFORMED SERVICES MEDICAL**

**FACILITIES**

4.40 Action on Receipt of VA Form 21-8358 4-IX-1

**SUBCHAPTER X. PROVIDING RECORDS TO SUPPORT MILITARY RESERVE**

**RECRUITING**

41. Providing Records to Air Force, Marine and Navy Reserve Recruiting
    Services 4-X-1

**SUBCHAPTER XI. REQUESTS BY DEFENSE MANPOWER DATA CENTER FOR**

**RETURN OF SMRS**

4.42 Procedures for Locating and Retrieving SMRs 4-XI-1

**ADDENDA**

A. Service Department or Records Center Address Codes 4-A-1

B. Service Number Series Guide 4-B-1

C. Service Request Addresses and Telephone Numbers 4-C-1

D. Addresses for National Archives to be Used to Obtain Logbooks 4-D-1

E. Marine Index Bureau Sample Pattern Letter to the Claimant 4-E-1

F. List of State Adjutants General 4-F-1

G. VA Regional Office & Associated Army Transition Point 4-G-1

H. Merchant Marine Letter for U.S. Army Transport Corps or Navy
Transportation Service 4-H-1

I. Development Letter for the U.S. Public Health Service 4-I-1

J. Development Letter for Records Expected to be in the Custody of the
Reserves or

National Guard 4-J-1

K. PIES Status and Request Codes 4-K-1

L. Determining the Discharge Status for PIES Requests 4-L-1

M. Organizational Structure for Complete Organizational Requests 4-M-1

N. Glossary 4-N-1

O. Formal Finding of Federal Records Unavailability 4-O-1

# 

**4-ii**

**February 25, 2005 M21-1, Part III**

######  Change 131

**CHAPTER 4. REQUESTS FOR SERVICE RECORDS**

**SUBCHAPTER I. SERVICE RECORDS MIGRATION**

**4.01 OVERVIEW OF SERVICE RECORDS MIGRATION**

a\. **General.** Where a veteran\'s service records end up following
separation is affected by a number of different agencies and may vary
depending on local conditions and workloads. Securing a veteran\'s
service records may require careful analysis on the part of the
individual doing the development. The following subparagraphs furnish a
*general* framework for understanding what happens to a veteran\'s
service records after separation from active duty. For specific
instructions and address codes, see Addendum A.

Note: A critical element in locating a veteran\'s service records is
knowing the type of separation. If the type of separation is
"Discharge," the veteran has no reserve obligation. If the type of
separation is "Release from Active Duty," the veteran is being
transferred to a reserve component to complete his/her military
obligation. This information is currently shown in item 23 of the DD214.
Additionally, the veteran\'s Reserve obligation termination date can be
found in Item 6 of DD 214, "Certificate of Release or Discharge from
Active Duty." Always use the current date when determining if there is a
remaining obligation when there is a need to request military service
records. When the obligation date is past, there is no reserve
obligation for purposes of requesting military service records.

b\. **National Personnel Records Center (NPRC)**

\(1\) The National Archives and Records Administration (NARA), an
independent agency separate from both VA and Department of Defense,
operates NPRC in St. Louis (address code 13). Most of the records needed
in connection with the adjudication of veterans\' claims will eventually
end up in NPRC except for the following service medical records:

\(a\) **Active Reservists' records**. These records are kept by the
personnel office of the Service Reserve Unit.

\(b\) **Inactive Reservists' Records**. These records are maintained by
the personnel office of the Branch of Service until the veteran is
activated for reserve duties at which time the records are sent to the
Reserve Unit\'s personnel office.

\(c\) **National Guards**. Records of veterans on National Guard duties
are maintained by the personnel office of the Service National Guard
Center where the veteran is serving.

\(d\) **Retirees' Records**. These records are maintained by the Branch
of Service that the veteran retired from. Upon the death of the veteran,
the records are sent to the National Personnel Records Center (NPRC).

\(e\) **Temporary Disability Retired Lists (TDRL)**. Records of veterans
on TDRL are kept by the personnel office of the Branch of Service. If
the veteran is subsequently retired due to permanent disability, these
records are sent to the National Personnel Records Center (NPRC).

\(f\) **General Officer**. All General Officer records are kept at the
Pentagon.

When there is no claim for VA benefits prepared prior to separation, the
dental and outpatient medical records are normally forwarded to the VA
Records Management Center (RMC) in St. Louis, MO.

Note*:* Although NARA operates NPRC, references in this chapter to \"the
service department\" include NPRC as it is one of the most important
repositories of service department records.

**4-I-1**

**M21-1, Part III February 25, 2005**

**Change 131**

\(2\) NPRC has three main types of veteran\'s records:

\(a\) **Individual Health and Service Records.** These records are
recorded in NPRC's database filed by the veteran\'s name, Social
Security number or service number.

\(b\) **Clinical Records.** Clinical records are filed by the military
hospital or other military medical facility which provided treatment.
The medical facility normally retires its records to NPRC when there has
been no treatment for two calendar years. Clinical records are filed by
hospital name or number, then chronologically by year of treatment, or
month and year of treatment. See paragraph 4.01i for more information on
the distinction between individual health records and clinical records.
Also see paragraph 4.25f for information on dependent medical records.

\(3\) NPRC has a Records Reconstruction Branch which uses unit records
and other alternative sources to reconstruct records which may have been
destroyed in the 1973 NPRC fire. See paragraph 4.23.

\(4\) The Personnel Information Exchange System (PIES) program is used
to request all service record requests for *all* address codes. The
submitted requests are electronically matched to NPRC's Registry
holdings at the end of each day. Currently, the requests for other than
Code 13 are printed at the RMC and forwarded directly to the appropriate
locations. The requests for NPRC are handled electronically by the VA
Liaison staff located at the NPRC. If the requester physically inserts
an address code, it overrides the computer mapping logic. The insertion
of an address code by the user should be limited to those situations
specifically provided for in later paragraphs.

c\. **Army Records**

\(1\) Records are assembled at the separation point. Every effort is
made to obtain the health and dental records for each separating
individual. Currently, the medical records are forwarded to the RMC if a
claim has not been filed. Enlisted members have an Official Military
Personnel Folder (OMPF) which is maintained at Ft. Benjamin Harrison
while the soldier is on active duty. The OMPF is stored in an optical
imaging format called the Permanent Electronic Records Management System
(PERMS). The field activity is responsible for seeing that information
from the field jacket, known as the Military Personnel Records Jacket
(MPRJ), is added to the OMPF in PERMS. When a member is released from
active duty, the maintenance of his/her PERMS record is transferred to
AR-PERSCOM. When the service member is discharged or retired, his/her
PERMS record is downloaded to a microfiche format and transferred, along
with any paper records that may still exist, to AR-PERSCOM for further
transfer to NPRC for storage. Exceptions:

> \(a\) All General Officer records are kept at the Pentagon.
>
> \(b\) If the veteran is in a specific Reserve or National Guard unit,
> the records are sent to that unit.

\(2\) When the veteran no longer has a Reserve obligation or any other
involvement with the Reserves or Guard, the records are forwarded to
NPRC.

\(3\) Addendum F provides a list of state Adjutants General. Because of
delays in forwarding records from one point to another, the records may
not be where they are supposed to be. It is also possible that the
records might never have left the separation center or treating facility
or that the records might be in the veteran\'s possession. If the
veteran had a terminated Reserve/Guard connection, the veteran\'s
records may still be at the Reserve/Guard unit. Develop to these
alternate locations if a primary request for records is unsuccessful.

**4-I-2**

**February 25, 2005 M21-1, Part III**

**Change 131**

> d\. **Navy Records**

\(1\) Service records are assembled at the separation point and
forwarded to the Naval Reserve Personnel Center (NRPC) in New Orleans
(address code 36). (Do not confuse \"NRPC\" with \"NPRC\".)

\(2\) Prior to January 31, 1994, NRPC received the medical and
nonmedical service records for each separating sailor. Beginning
*January 31, 1994,* NRPC receives nonmedical service records. The RMC
receives all medical records directly from military installations at
which the Navy veteran is separated if the member does not file a claim
at discharge. See Subchapter II for RMC processing. Subparagraphs (3)
through (7) below pertain to all service records but only SMRs for
veterans released *before* January 31, 1994.

\(3\) If the veteran is retired or discharged with no Reserve
obligation, the medical and dental records are held in New Orleans while
nonmedical service records are sent to the Naval Military Personnel
Command in Millington, TN (address code 31) for microfilming. After
approximately 12 months, the nonmedical service records are returned to
New Orleans (address code 36) where they are associated with the medical
records. Then the entire package is sent to NPRC (address code 13).

\(4\) If the veteran has a Reserve obligation but is not in an Active
Reserve unit, all service and medical records are maintained in New
Orleans (address code 36) until the Reserve obligation expires. When the
veteran no longer has a Reserve obligation, the nonmedical service
records are sent to Millington, TN (address code 31) for microfilming.
After approximately 12 months, the nonmedical service records are
returned to New Orleans (address code 36) where they are associated with
the medical records. Then the entire package is sent to NPRC (address
code 13).

\(5\) If the veteran is on TDRL (Temporary Disability Retired List), all
service and medical records remain in New Orleans (address code 36).
When the veteran is permanently retired or discharged, the records are
processed as described in subparagraph (3) above.

\(6\) If the veteran is in an Active Reserve unit, service records are
maintained by the unit. When the veteran leaves the Reserve unit,
service records go to New Orleans (address code 36) until the Reserve
obligation expires. At that time, the process described in subparagraph
4 above is completed.

\(7\) Addendum A shows the timeframes for sending requests to the
various address codes. Because of delays in forwarding records from one
point to another, the records may not be where they are supposed to be.
It is also possible that the records might never have left the
separation center or treating facility or that the records might be in
the veteran\'s possession. If the veteran was in a Naval Reserve unit,
the veteran\'s service records may still be at the Reserve unit.

**e. Air Force Records**

\(1\) Prior to May 1, 1994, records were assembled at the separation
point and a sort performed based on whether there was a Reserve
obligation or Reserve/Air National Guard connection. If there was no
Reserve obligation or Reserve/Air National Guard connection, the
veteran\'s records were sent to the USAF Military Personnel Center,
Randolph AFB, Texas (address code 22). The records were retained at
Randolph AFB for three to six months. Then they were forwarded to NPRC
(address code 13).

Note: Since May 1, 1994, code 22 received the medical and nonmedical
service records for each separating member. *Since* May 1, 1994**,**
code 22 receives nonmedical service records. The RMC receives all
medical records directly from installations at which the Air Force
veteran is separated *except* for those veterans assigned to a Selected
Reserve Unit. See Subchapter II for RMC processing. Subparagraphs (2)
and (4) through (6) below pertain to all service records but only SMRs
for veterans released *before* May 1, 1994.

**4-I-3**

**February 25, 2005 M21-1, Part III**

########  Change 131

service department. BIRLS indicates the existence of a VADS record with
a \"Y\" in the VADS field on the VID screen. See part II, paragraph
6.05e, on use of the BIRLS VID screen as evidence of service.

b\. **Return of Military Personnel and Medical Records on Loan to VA.**
Generally, military records will be retained in the veteran\'s claims
folder in the absence of a request for return of the records to the
service department. If a request by telephone or in writing for return
of the records is received, photocopy the records and promptly return
the originals to the requesting military element. Annotate the folder to
show where the original service records were sent and the date on which
they were sent and keep a copy of the request document from the military
if one was received. Photocopies of SMRs are acceptable for the Air
Force (SAF/MIBR) at Randolph Air Force Base in Texas in lieu of original
SMRs if the folder is being held because it is eligible for Court of
Appeals for Veterans Claims review. See also paragraph 4.14 and
Subchapter VII.

c\. **Veterans Information Solution (VIS) provides access to Electronic
Service Member Discharge Data.** The Veterans Information Solution (VIS)
is a web-based application that provides VA with access to information
from the Defense Enrollment Eligibility Registration System (DEERS). It
enables designated employees at regional offices and medical centers to
have electronic access to and obtain verification of veterans' discharge
data and disability information. These employees can use the application
for the following:

(1)To obtain verification of military service, especially to process
Benefits Delivery at Discharge (BDD) claims when the paper copy of the
discharge document (DD Form 214) is not readily available.

\(2\) To obtain eligibility information on Compensation and Pension data
such as service-connected disabilities, diagnostic codes, verification
of dependents and awards.

**Note**: If the information obtained from the VIS application indicates
a discrepancy in the information reported by the service member, then
proper development is required for verification of service.

**4-I-9**

**February 25, 2005 M21-1, Part III**

**Change 131**

Code M05. NA Form 13055, "Request for Information Needed to Reconstruct
Medical Data," should be completed by the veteran or claimant prior to
initiating the PIES request in order to facilitate searches of auxiliary
records. Occasionally, information required on NA Form 13055 is
available in the claims folder. In this case, do not delay submission of
a PIES request in order to have the NA Form 13055 completed. Enter the
appropriate information on the M05 request.

**(1) If the claimant fails to furnish an NA Form 13055 and the evidence
of record does not establish whether or not there is a legal bar,
disallow the claim for failure to prosecute and notify the claimant of
the reason for the disallowance. Furnish notice of procedural and
appellate rights.**

\(2\) If the claimant furnishes an obviously incomplete or inadequate NA
Form 13055 and there is insufficient information to complete the PIES
M05 request, disallow the claim without submitting the PIES request.
Fully advise the claimant of the reason for the disallowance and send
the claimant another NA Form 13055.

c\. **Alternate Sources--Development.** See paragraph 4.25 for alternate
sources of evidence that may be used in these cases. Where alternative
source of evidence is developed, the correspondence must avoid creating
the impression that the claimant would have obtained favorable action on
the claim had the records in existence at St. Louis not been destroyed
by fire.

**4.24 SPECIAL ACTION REQUIRED TO OBTAIN SPECIFIC SERVICE INFORMATION**

a\. **Pre-Formatted Request Codes.** Pre-formatted request codes have
been established for the most common PIES 3101 requests. These codes are
mapped to forward the request to the correct address code and to select
the proper record for retrieval at NPRC. These codes should be utilized
whenever possible. Review Addendum K for the current available request
codes. Where no record code will suffice, use the free text code O99.
Use of this code should be limited as it requires human intervention to
process.

> b\. **Classified Service Records**

\(1\) If a claimant alleges at any point that disability or death
occurred on active duty during classified or covert operations, request
the veteran's personnel records in addition to medical records.

\(2\) If the personnel and medical records considered together do not
provide a reasonable basis for a grant or denial of service connection,
advise the veteran that VA has secured all available service records and
invite the veteran to submit any additional evidence in his or her
possession that might support the claim. Suggest possible alternative
sources for the veteran to substantiate his or her claim such as
statements from members of the unit, contemporaneous letters home, and
contemporaneous statements to physicians. If no additional evidence is
forthcoming, adjudicate based on the evidence of record.

\(3\) VA does not have access to records that are still classified even
if they are relevant to a pending claim for disability or death
benefits.

c\. **Two Years Honorable Active Service.** If death occurs in service
and was not in line of duty or was due to willful misconduct, death
pension benefits may be payable, provided the serviceperson completed at
least 2 years honorable active service, one day of which was wartime
service, prior to death. See part IV, paragraph 11.04h and 38 CFR
3.1(d). Send a request for verification of 2 years honorable active
service to the service department using

**4-IV-3**

**M21-1, Part III February 25, 2005**

#### **Change 131**

request code O99 *only* if a claim for DIC or death pension is received
and it has been determined that death was not in line of duty or was the
result of willful misconduct.

> \(1\) In the free text section, enter the statement: "Please verify 2
> years honorable active service on enlistment prior to death."
>
> \(2\) Request verification of service using request code S01 for any
> prior period of service, if not already of record, to determine if
> qualifying service existed prior to the serviceperson's final
> enlistment.

d\. **Insanity.** If insanity is an issue (part IV, paragraph, 11.05),
develop the case by obtaining all service medical records that are in
any way pertinent. Obtain complete transcripts of any court-martial or
board proceedings that may be relevant. Use the free text request O99
and enter the following statement: "The issue of insanity has been
raised."

> e\. **Verifying Vietnam Service for Claims Involving Exposure to
> Herbicide Agents.**

\(1\) It may be necessary to determine if a veteran had "service in
Vietnam" in connection with claims based on exposure to herbicide
agents. A veteran must have actually served on land within the Republic
of Vietnam (RVN) to qualify for the presumption of exposure to
herbicides. 38 CFR Sec. 3.307(a)(6). The fact that a veteran has been
awarded the Vietnam Service Medal *does not* prove that he or she was
\"in country.\" Service members who were stationed on ships off shore,
or who flew missions over Vietnam, but never set foot in-country, were
sometimes awarded the Vietnam Service Medal. To verify service in RVN,
you should review the veteran\'s DD-214 to determine if it shows such
service (e.g., \"Foreign Service: Republic of Vietnam\"). If not, you
may need to obtain and review the veteran\'s other personnel records
(e.g., Department of the Army Form 20 or equivalent). (VAOPGCPREC 7-93.)

\(2\) If a veteran claims service connection for exposure to herbicide
agents, and alleges service on a ship in the waters offshore of Vietnam,
review the record for evidence that the ship was in the waters off
Vietnam and that the veteran's service involved duty or visitation on
land. If the veteran cannot produce evidence of this, request
verification from the service department. Contact the US Armed Services
Center for Unit Records Research (CURR) for verification only after the
veteran and service department have been unable to determine such
service. For Navy cases only, send a PIES request using request code
O43. For all other branches, send a dictated letter. See M21-1, Part
III, 5.14c(3)(a) for CURR's mailing address.

***Note:*** When contacting the service department or CURR for
verification of offshore duty, furnish the name and number of the ship
(e.g., USS Galveston (CLG 3)), and the specific dates (month, day, and
year) that the veteran alleges to have been in the waters offshore of
Vietnam.

f\. **Verification of Service of Affiants (Buddy Statements).** If it is
necessary to verify the evidence of an affiant who alleges personal
knowledge of certain occurrences while in active service with the
veteran, submit the PIES request with the original veteran's information
on Page 1 of the PIES request and the affiant's name and service
information on Page 2. Use request code O99 and state:

"Do the records of the department indicate that \[name of affiant\],
\[rank, organization and service number, if available\], was present
with his or her organization at or near \[place\] on or about \[date\]?
Do the records of \[name of hospital, vessel, dressing station, etc.\]
indicate that \[name of veteran\] \[rank and organization\] was
receiving treatment for \[disease or injury\] on or about \[date\]?"

**4-IV-4**

**February 25, 2005 M21-1, Part III**

#  Change 131

\(6\) Medical evidence from hospitals, clinics and private physicians by
which or by whom a veteran may have been treated, especially soon after
separation.

\(7\) Letters written during service.

\(8\) Photographs taken during service.

\(9\) Pharmacy prescription records.

\(10\) Insurance examinations.

d\. **Pay Grade for DIC.** See the procedures set forth in paragraph
2.14c with respect to development in DIC cases in those cases in which
pay grade is an issue. If the pay grade is of record on official
documents, use it for award action subject to later certification, if
necessary, by the Secretary of the service department concerned. See
Addendum A for address codes for pay grade information.

e\. **Prior VA Claim.** If there is any indication that a claim for VA
benefits has been previously filed, use BIRLS to the fullest extent in
an effort to locate the veteran\'s records. Other VA records available
to regional offices include:

\(1\) Station monthly microfilm pay tape.

\(2\) Philadelphia VA Regional Office and Insurance Center insurance
index files.

\(3\) VISTA at the medical center which services the veteran's place of
residence.

f\. **Dependents\' Records**

\(1\) Medical treatment records created by service departments for
treatment rendered to military dependents may be difficult to locate.
Records for dependents follow them from duty station to duty station. If
the dependent doesn\'t receive treatment for three years, the records
are retired even though the parent or spouse may still be in service in
the same place. They are retired to National Personnel Records Center
(NPRC). Records are sent to address code 75 (NPRC-CPR) for dependents of
Army and Air Force servicemembers and for dependents of Navy and Marine
Corps servicemembers who were treated at Army and Air Force facilities.
Records of dependents of Navy and Marine Corps servicemembers treated at
Navy or Marine Corps facilities are retired to address code 13
(NPRC-MPR).

\(2\) Dependents' inpatient and outpatient medical records are requested
when the veteran alleges treatment for a condition that is related to
his/her claim for a service-connected illness or injury.

\(3\) Use C03 to request dependents' inpatient medical records and C04
to request dependents' outpatient medical records. The request must
include the illness or injury for which treatment was administered, the
name of the sponsor, the sponsor's Social Security Number, and the
veteran's relationship to the sponsor. If treated as an inpatient, the
claimant *must* provide the year(s) of treatment and the full name of
the **last facility** at which treated. If treated as an outpatient, the
claimant *must* provide the last year of treatment and the full name of
the last facility at which treated. Occasionally, NPRC may request
additional information which must be supplied before it can conduct
further searches.

g\. **Servicepersons Married to Each Other.** Servicepersons married to
one another will each have individual military medical records under
their own SSN. If one is separated from active duty, the service medical
records (SMRs) for that individual will be transferred to the VA Records
Management Center (RMC). Records may then be created with that
individual as a dependent of the remaining serviceperson. If so, request
those records as described in subparagraph f(2).

**4-IV-7**

**M21-1, Part III February 25, 2005**

**Change 131**

\(1\) If the separated serviceperson enters a reserve unit, and remains
eligible for medical care as a dependent, the active duty medical record
will go to the RMC, and two \"new\" medical records will exist, one with
the reserve unit and the other as a dependent of the active duty member.
In this case development may be required through these separate sources.

\(2\) If the separated person is a retiree, he/she has independent
eligibility to medical care. Consequently, there will be a retiree
record created by the service department and the active duty SMRs are
sent to the RMC.

**4.26 REQUESTS FOR SERVICE RECORDS FROM MEDICAL CENTERS**

a\. **General.** It is VA policy that only regional offices request
service records. VA medical facilities will request RO assistance if
they need service verification, clinical records or other evidence from
the military.

b\. **Request from Medical Center Received**

\(1\) If service records are required by a VA medical center, it should
request the records through the regional office on VA Form 10-7131,
"Exchange of Beneficiary Information and Request for Administrative and
Adjudicative Action."

\(2\) If only verification of service is requested and no claims file
exists, create a BIRLS record using the BADD command. Request
verification of service via PIES request code S01. When verification is
received, update BIRLS and notify the originating medical facility.

**Note:** The Veterans Information Solution (VIS) application allows
designated employees at VA medical centers to have access to and view
electronic data such as verification of a veteran's service,
disabilities, diagnostic codes, dependents and awards. Before initiating
verification of service via PIES, check the VIS application to determine
if the requested information is available.

\(3\) If a request for service medical/dental records or character of
discharge determination is received from a VA medical center and no
claims file exists, establish a claims file. When the service records
are received, process any needed adjudication determinations and file
the documents in the claims folder. Notify the medical facility of the
determination. If the medical facility requests to review the records,
temporarily transfer the entire file to the medical center. Annotate the
COVERS transmittal: "File temporarily transferred per 10-7131 dated
\[MM/DD/YYYY\]. Return entire file when your action is complete.\"

**4-IV-8**

**February 25, 2005 M21-1, Part III**

#  Change 131

The Records Management Center will be responsible for providing these
changes to the Chief, Veterans Services Directorate (DARP-VS), Army
Reserve Personnel Command (AR-PERSCOM). A copy will also be sent to the
Compensation and Pension Service (212A) at VACO via e-mail to
VAVBAWAS/CO/212A.

*Note:* Each station may designate one alternate military records
specialist. References in this chapter to \"the military records
specialist\" include the alternate.

a\. **Criteria for Followup by Military Records Specialist**

\(1\) Handcarry the claims folder to the military records specialist for
further followup action if *all* of the following conditions have been
met:

\(a\) At least 60 days have elapsed from the date of an initial request,
*and*

\(b\) At least one followup request has been sent, *and*

\(c\) The control period on the followup has expired, *and*

\(d\) The response from the service department has been clearly
inadequate or nonexistent.

Note: If service records are needed in situations involving emergency
hospital admissions or disability claims of a very serious nature
(carcinoma, paraplegia, severe burns, etc.), identify the claims folder
at the development stage of adjudication. *Do not submit a PIES 3101.*
Instead, handcarry the claims folder to the military records specialist
for special handling procedures.

> \(2\) If the required records should be at AR-PERSCOM or NPRC, the
> military records specialist

will telephone the VA Liaison office (VALNO) at (314) 538-4278 or e-mail
VAVBASTL/RMC/LNO with the veteran's identifying information. If e-mail
is used, the request should be categorized as "high priority."

\(3\) If the required records should be at a location other than
AR-PERSCOM or NPRC, use Addendum C to determine the address code where
the records should be located and the applicable telephone number.
Special followup by the military records specialist normally consists of
one or more telephone calls to the appropriate address code. The
military records specialist should carefully document the telephone call
(date, person contacted, phone number, what was said, etc.).

> \(4\) The military records specialist should not initiate any fax or
> phone follow-ups without first

determining that the prior development was correct based on the
information in this chapter and other published directives from Central
Office. If the military records specialist determines that the prior
development was not correct (e.g., sent to wrong address code,
inadequate identifying information furnished), he or she should initiate
a new PIES 3101 request on VA Form 119.

b\. **Followup to NPRC.** No follow-ups on pending PIES 3101 requests
are appropriate since the status of individual requests are readily
available by accessing PIES. In addition, the military records
specialist should no longer send follow-ups on requests that have been
pending at the NPRC more than 120 days. The VA Liaison office maintains
a list of requests that have been pending for this amount of time and
dedicates resources to searching for the requested records on a daily
basis. After the initial 120 days, the liaison office will take
immediate action to reply within 60 days.

**EXAMPLE**: A negative final response from NPRC should be similar to
the following -- "The National Personnel Records Center has conducted an
extensive and thorough search of the records among our holdings. We were
unable to locate the records identified in your request. On the basis of
the request

**4-V-3**

**M21-1, Part III February 25, 2005**

**Change 131**

presented to NPRC, we have concluded that the records either do not
exist, that NPRC does not have them, or that further efforts to locate
them at NPRC would be futile."

c\. **Follow-up to AR-PERSCOM.** When a PIES request to address code 11
has been pending more than120 days without a response, the military
records specialist should e-mail VAVBASTL/RMC/LNO with the subject line
displaying "veteran's last name, first name, and claim number or Social
Security number." Explain this is a follow-up to a PIES request which
has been pending at AR-PERSCOM more than 120 days. The VA Liaison Office
(VALNO) will investigate and provide a status response.

d\. **Telephone Followup to Other Address Codes.** Telephone numbers for
records centers other than NPRC (code 13) and AR-PERSCOM (code 11) are
in Addendum C. If you are unable to get through on the listed numbers
because they are disconnected, or are referred to different numbers,
contact Compensation and Pension Service (212A) at VAVBAWAS/CO/212A with
this information.

e\. **Followup to Separation Points.** In some instances, the records
center which should have a veteran\'s records will indicate that the
desired records were never received from the separation point. If this
occurs and the veteran has been out of service long enough that the
records should have reached the

records center, ask the records center if it can furnish specific
information about a possible contact at the separation point. (Some
records centers have tracking systems that will reveal this
information.)

\(1\) If the records center is unable to furnish a telephone number to
call at the separation point, a number may be obtained from telephone
directories or from various publications such as the [U.S. Forces Travel
Guide]{.underline} which list addresses and phone numbers of military
facilities.

\(2\) Once a telephone number for the separation point has been
determined, use it in an attempt to locate the desired records.
Carefully document any information obtained from the separation point
and, if necessary, initiate further followup with the records center.

\(3\) *Do not* write to separation points (unless requested to do so by
the separation point as a followup to a telephone communication).
Separation points do not routinely respond to VA records requests and
the likelihood that a written request to a separation point will produce
results is slight.

\(4\) If the records center indicates that the veteran\'s records never
left the separation point and you cannot determine the location of the
separation point from evidence of record, ask the claimant to furnish
this information. Then contact that military facility to see if the
records are still there. For Navy veterans, occasionally the medical
records may be left on the last ship assigned. Contact the land based
office to request a search of the ship's medical record holdings.

f\. **Telephone Followup to Units.** A list of addresses and telephone
numbers for the State Adjutants General is provided in Addendum F. If
you are unable to get through on the listed numbers, contact
Compensation and Pension Service (212A) at VAVBAWAS/CO/212A. Local
telephone contact with Reserve units may also result in a list of
telephone numbers and contact points throughout the state. These lists
and contact points will be locally maintained.

g\. **Criteria for Requesting Central Office Assistance**

\(1\) If special followup by the military records specialist has been
unsuccessful, and there is evidence in the file or alleged by the
veteran of unusual circumstances which might indicate a reason why
records might not be in the normal records flow, contact Compensation
and Pension Service (212A) via e-mail to VAVBAWAS/CO/212A for
assistance. Examples of such circumstances are requests for records of
general or flag officers, allegations of classified information, etc.

4-V-4

**February 25, 2005 M21-1, Part III**

**Change 131**

**A. DEPARTMENT OF THE ARMY\--Continued**

**Address**

**Code**

7\. Retired pay 35

8\. SBP 17

9\. Service pay, allowance and allotment information on active duty
personnel 16

10\. Court-martial proceedings not in personnel records (request

must show date, type of court-martial and type of discharge 232

11\. National Guard Status Appropriate State

Adjutant General

12\. National Guard Officers/Warrant Officers 90

13\. Enlisted personnel separated from National Guard status 11

14\. Requests for verification of in-service stressors claimed by
veterans seeking 55

service connection for post-traumatic stress disorder and verification
of service

in Vietnam in connection with claims for disabilities related to
exposure to Agent Orange.

**B. DEPARTMENT OF THE NAVY**

1\. For Service, Traveltime, Pay Grade, Facts and Circumstances of Other
Than

Honorable Discharge including Board of Officers Proceedings--Officers

and Enlisted

a\. Separated by discharge, resignation, or retirement--no Reserve
obligation:

\(1\) Within 12 months 31

\(2\) Over 12 months 13

b\. Separated from active duty with Reserve obligation--not assigned to
a unit 36

(When Reserve obligation ends, records are sent to address code 31 for
12 months

and then on to address code 13.)

c\. Reservist assigned to Reserve unit separated before January 31, 1994
Unit of Assignment

d\. TDRL 36

e\. Placed on permanent disability retired list 13

2\. Medical and dental records only:

a\. Separated (before January 31, 1994) by discharge, resignation, or 13

retirement--no Reserve obligation :

**4-A-3**

**M21-1, Part III February 25, 2005**

**Change 131**

**B. DEPARTMENT OF THE NAVY\--Continued**

**Address**

**Code**

b\. Separated from active duty before January 31, 1994, with Reserve

obligation--not assigned to a unit 36

(Approximately 12 months after Reserve obligation ends,

records are transferred to address code 13.)

c\. Separated on or after January 31, 1994--separated for any reason--

> with or without a Reserve obligation RMC

d\. Reservist assigned to Reserve unit Unit of Assignment

e\. Remaining on TDRL status 36

f\. Deceased (not on active duty or inactive status)

\(1\) Within 12 months 36

\(2\) Over 12 months 13

3\. Reports of investigation of inservice injuries or deaths,
court-martial

proceedings not in personnel records (request must show date, type of
court-martial

and type of discharge), severance disabilities and investigation reports
232

4\. Retired pay 35

5\. Readjustment pay, severance pay, separation pay, allowance and

allotment information on active duty personnel 35 (Other)

6\. SBP 17

7\. Entrance and separation x-rays 75

8\. Inservice interim x-rays (films are retained 5 years beyond the

year of exposure, then destroyed)\* 85

9\. Medical Evaluation Board findings and Physical Evaluation Board
\*\*See below

> findings, periodic physical examinations for TDRL personnel including
>
> severance disability (not pay) information
>
> Naval Council of Personnel Boards
>
> Washington Navy Yard -- Records Section
>
> 720 Kennon St., SE, Room 309
>
> Washington, DC 20374-5023
>
> \*\*There is no current address code for this source.

\* Some inservice interim x-rays dated before 2/1/55 are still in
existence and may be requested from Address Code 75.

10\. Requests for verification of in-service stressors claimed by
veterans seeking 55

service connection for post-traumatic stress disorder and verification
of service

in Vietnam in connection with claims for disabilities related to
exposure to Agent Orange.

**4-A-4**

**February 25, 2005 M21-1, Part III**

**Change 131**

**C. DEPARTMENT OF THE AIR FORCE**

**Address**

**Code**

1\. For Service, Medical and Dental Records (separated before May 1,
1994),

Traveltime, Pay Grade; Facts and Circumstances on Other Than Honorable

Discharge to include Board of Officers Proceedings, Investigations and

Information Concerning All Courts-Martial; Reports of Investigation on

Inservice Injuries, Physical Evaluation Board Proceedings, Summary of

Proceedings of Summary, Special or General Courts-Martial:

a\. Officers (excluding General Officers) and enlisted personnel,

separated, retired, or deceased--no Reserve obligation

\(1\) Within 120 days (Active Duty) 22

\(2\) Within 120 days (Reserves and Air National Guard) 21

\(3\) Over 120 days (Active Duty, Air National Guard, and Reserves) 13

*Exception:* Requests for General Officers will be sent only to 22

b\. Separated from active duty with Reserve obligation and/or Reserve
status

\(1\) Not assigned to a unit 21

(When Reserve obligation ends, records are sent to address code 13.)

\(2\) Assigned to a Guard or Reserve unit--All Unit of Assignment

c\. Active duty--All 22

d\. TDRL--All 22

e\. SMRs for officers and enlisted separated for any reason on or after

May 1, 1994--not assigned to a Reserve/Guard unit RMC

2\. Readjustment pay, severance pay (not released from TDRL), separation
pay, allowance

and allotment information on personnel separated or deceased:

a\. Before 6-1-51 16

b\. On or after 6-1-51 25

(Records are destroyed 6 years and 3 months after separation or death of
member)

3\. Retired pay 35

4\. SBP 17

5\. Court-martial proceedings not in personnel record (request

must show date, type of court martial and type of discharge) 232

6\. Entrance and separation chest x-rays 75

**4-A-5**

**M21-1, Part III February 25, 2005**

######### Change 131

C.  **DEPARTMENT OF THE AIR FORCE -- Continued Address**

    **Code**

    7\. Inservice interim x-rays (retained 5 years beyond

    the date of exposure, then destroyed 85

    8.. . Requests for verification of in-service stressors claimed by
    veterans seeking 55

    service connection for post-traumatic stress disorder and
    verification of service

    in Vietnam in connection with claims for disabilities related to
    exposure to Agent Orange.

    **D. U.S. MARINE CORPS**

    1\. For Service, Medical and Dental Records (separated before May 1,
    1994),

    Traveltime, Pay Grade, Facts and Circumstances of Other Than
    Honorable

    Discharges including Board of Officers Proceedings:

    a\. Officers and Enlisted Personnel\--separated, retired or
    deceased\--no Reserve obligation.

    \(1\) Within 2 years 41

    \(2\) Over 2 years 13

    b\. Active Reservists Unit of Assignment

    c\. Separated from active duty with Reserve obligation but not
    assigned to unit. 42

    *Note:* Records are sent to code 42 from the separation point and
    remain there

    until the Reserve obligation terminates. Then the records go to code
    41 for 2 years.

    After 2 years (approximately), the records go to address code 13.

    2\. SMRs for officers and enlisted separated for any reason on or
    after

    May 1, 1994--with or without a Reserve obligation RMC

    3\. TDRL 41

    4\. Reports of investigation or inservice injuries or death,
    court-martial proceedings

    (request must show date, type of court-martial and type of
    discharge) 232

    5\. Retired pay 35

    6\. SBP 17

    7\. Readjustment pay, severance pay, separation pay, allowance and
    allotment information 47

    8\. Disability severance pay for:

    a\. Members discharged from active duty 45

    b\. Members discharged from TDRL 47

    9\. Inservice interim x-rays (retained 5 years beyond the year of
    exposure) 85

    10\. Entrance and separation x-rays 75

    **4-A-6**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

D.  **U.S. MARINE CORPS -- Continued**

**Address**

**Code**

11\. Medical Evaluation Board findings and Physical Evaluation Board
\*\*See below

findings, periodic physical examinations for TDRL personnel including

severance disability (not pay) information

Naval Council of Personnel Records

Washington Navy Yard -- Records Section

720 Kennon St., SE, Room 309

Washington, DC 20374-5023

\*\*There is no current address code for this source.

**E. U.S. COAST GUARD**

1\. For Service, Medical (including any disability for which disability
severance pay

is received) and Dental Records (separated before May 1, 1998),
Traveltime and

Pay Grade Data; Facts and Circumstances on Other Than Honorable
Discharge,

to Include Board of Officers Proceedings, Investigation and Information
Concerning

All Courts-Martial:

a\. Officers and Enlisted\--separated by discharge, retirement

or death\--no Reserve obligation

\(1\) Within 6 months 51

\(2\) Over 6 months 13

*Note:* If a member who is under the age of 60 retires from the Coast
Guard Reserve, records

will remain at code 51 until the individual reaches age 60.

b\. Separated from active duty with Reserve obligation 51

(When Reserve obligation ends, records are sent to address code 13 and
the

SMRs are sent to the RMC.)

c\. Medical records for members of active Reserves Unit of Assignment

d\. TDRL--All 51

2\. SMRs for officers and enlisted personnel separated on or after May
1, 1998 51

with no reserve obligation

3\. Reports of investigations of inservice injuries and deaths and

court-martial proceedings not in personnel records (request must show

date, type of court-martial, and type of discharge) 232

4\. Readjustment pay, severance pay, separation pay, service

pay, allowance and allotment information and retired pay:

a\. Within 6 months 51

b\. Over 6 months 13

**4-A-7**

**M21-1, Part III February 25, 2005**

**Change 131**

**Address**

**Code**

5\. Entrance and separation x-rays; inservice interim x-rays (retained 5
years beyond

the year of exposure, then destroyed) 85

6\. . Requests for verification of in-service stressors claimed by
veterans seeking 55

service connection for post-traumatic stress disorder and verification
of service

in Vietnam in connection with claims for disabilities related to
exposure to Agent Orange.

**F. U.S. MERCHANT MARINE**

1\. Served as civil servant with the U.S. Army Transport Service, later
redesignated U.S. Army Transportation Corps (service and medical
records) or with the Naval Transportation Service (service and medical
records), see paragraph 4.32c.

2\. Employed by the War Shipping Administration or Office of Defense
Transportation

or their agents, and documented by the U.S. Coast Guard or Department of
Commerce:

a\. For service, traveltime, pay grade and other statistical information
52

b\. For medical and dental records See par. 4.32b

**G. OTHER AGENCIES AND RECORD FACILITIES**

**1. PHS (PUBLIC HEALTH SERVICE)**

Service Information and Medical Records:

Commissioned Personnel Operations Division

Public Health Service

5600 Fishers Lane

Rockville, MD 20857

**2. NOAA (NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION) (formerly
Environmental Science Services Administration and Coast and Geodetic
Survey)**

Service information, pay data, and medical records:

Commissioned Personnel Center

National Oceanic and Atmospheric Administration

Room 12100

1315 East West Highway

Silver Spring, MD 20910

**3. REPUBLIC OF THE PHILIPPINES**

Service information and medical records for Members of the Philippine
Army ordered

into U.S. Army Forces and Philippine Guerrillas:

National Personnel Records Center

NRPMR-P

9700 Page Boulevard

St. Louis, MO 63132

**4-A-8**

**February 25, 2005 M21-1, Part III**

**Change 131**

**ADDENDUM C**

**SERVICE REQUEST ADDRESSES AND TELEPHONE NUMBERS**

[Address Code Mailing Address Telephone Number]{.underline}

10 National Archives and Records Administration (202) 501-5400

Washington, DC 20408

11 Commander (800) 318-5298

U.S. Army Reserve Personnel Command (AR-PERSCOM)

9700 Page Boulevard Fax (314) 592-1291

St. Louis, MO 63132-5200

13 National Personnel Records Center All branches (314) 538-2050\*

(Military Personnel Records) Fax (314) 538-4175

9700 Page Boulevard

St. Louis, MO 63132

\*This number should not be used by RO personnel to inquire about
records needed in conjunction with pending claims. The VALNO Number,
(314) 538-4278, should be used instead.

14 Commander (317) 510-3719

U.S. Army Enlisted Records & Evaluation Center

ATTN: (PCRE-FT)

8899 East 56^th^ Street

Fort Benjamin Harrison, IN 46249-5301

The Center also holds all service records of those enlisted men on the
Temporary Disability Retired List (TDRL) until a final determination is
made, sometimes years later. *Note:* TDRL Officers records are kept at:
Total Army Personnel Command, 200 Stovall, Alexandria, VA 22332-0400.

16 *For verification of status: active or discharged*

Defense Finance and Accounting Service (317) 510-2825

Indianapolis (317)-510-7583 (fax)

Army Military Pay Operations

Attn: Verifications -- Inquiries Team

8899 E. 56th St.

Indianapolis, IN 46249-0875

Purpose: To obtain severance pay/military benefits information on
service members who have been separated from the Army.

17 Defense Finance and Accounting Service (800) 321-1080

U.S. Military Annuitant Pay

P.O. Box 7131

London, KY 40742-7131

Purpose: To obtain pay information on retirees (living retired service
members) of all branches except Coast Guard, and their annuitants
(survivors of retired service persons who receive annuities).

**4-C-1**

**M21-1, Part III February 25, 2005**

**Change 131**

[Address Code Mailing Address Telephone Number]{.underline}

18 Commander (703) 325-4547

Total Army Personnel Command

ATTN: TAPC-MSR-S

200 Stovall St.

Alexandria, VA 22331-4000

For records of Army officers on Active duty and officers who are on TDRL
only.

21 Air Reserve Personnel Center (DSMR) (800) 525-0102

Denver, CO 80280-4600

22 HQ AFPC/DPSFCMP (210) 565-2450

550 C St. W.

Suite 19

Randolph Air Force Base, TX 78150

25 Department of Defense (Air Force) (303) 676-7335

DFAS--DE/PMJYB

6760 E. Irvington Place

Denver, CO 80279-8000

Purpose: To obtain severance pay/military benefits information on
service members who have been separated from the Air Force.

31 Bureau of Naval Personnel (901) 874-3070

PERS-324 MPC 312

5720 Integrity Drive

Millington, TN 38055-3130

35 Retired Pay

Army, Navy, Air Force, Marine Corps

Defense Finance & Accounting Service 1-800-321-1080

U.S. Military Retirement Pay

P.O. Box 7130

London, KY 40742-7130

For Navy Reserve, active duty, separation, severance pay

Defense Finance & Accounting Service (888) 332-7411 or (216) 522-5534

Cleveland -Navy 522-555, 522-5637 or

Military Pay Operations (216) 522-6924 (fax)

ATTN: Separations

1240 East Ninth St.

Cleveland, OH 44199

\*\*\*Use telephone number 522-5534 or 5535 for Reserve pay matters and
522-5637 for active duty/separation/severance pay matters.

Purpose: To obtain severance pay/military benefits information on
service members who have been separated from the Navy.

**4-C-2**

**February 25, 2005 M21-1, Part III**

**Change 131**

[**Address Code** **Mailing Address** **Telephone Number**]{.underline}

36 Naval Reserve Personnel Center (866) 250-4778

4400 Dauphine St.

New Orleans, LA 70149-7800

Note: The Center retains all service records of those veterans with
Reserve obligations (not assigned to units). The Center also holds all
service records of those veterans on the Temporary Disability Retired
List (TDRL) until a final determination is made, sometimes years later.

41 Commandant (703) 784-3920/3921

Headquarters United States Marine Corps

ATTN: MMSB-10 (medical only) 784-3926

2008 Elliott Rd.

Quantico, VA 22134-5030

Note 1: Requests for records other than medical and TDRL records: Use
telephone number 784-3920 for records ending with Social Security
Numbers 00 through 49. Use 784-3921 for records with Social Security
Numbers ending with 50 through 99.

*Note 2:* Requests for medical and TDRL records: Use Office Symbol
MMRB-16 in the address element and telephone number 784-3926.

42 Marine Corps Reserve Support Command (800) 255-5082 x. 3380

Central Records Section x. 3381

Kansas City, MO 64147-1207 x. 3396

45 Defense Finance & Accounting Service (Marines) (816) 926-7145

Kansas City Center (CETAR) Records Section -- SS2R

1500 East 95^th^ Street

Kansas City, MO 64197-0001

47 Defense Finance & Accounting Service (816) 926-7652

Marines

Kansas City Center

ATTN: PMMCF

1500 East 95^th^ Street

Kansas City, MO 64197-0001

Purpose: To obtain severance pay/military benefits information on
service members who have been separated from the Marine Corps.

51 Commander (202) 267-1621

U.S. Coast Guard Personnel Command (ADM-3)

2100 Second St. SW

Washington, DC 20593-0001

52 United States Coast Guard (202) 493-1022

National Maritime Center

Washington, DC 20593-0001

**4-C-3**

**M21-1, Part III February 25, 2005**

**Change 131**

**[Address Code Mailing Address Telephone]{.underline}**

55 U.S Armed Services Center for (703) 428-6915

Unit Records Research (CURR)

7701 Telegraph Road

Kingman Building, Room 2C08

Alexandria, VA 221353852

75 National Personnel Records Center (314) 538-5761

Civilian Personnel Records Fax: (314) 538-5719

111 Winnebago St. e-mail: [cpr.center@nara.gov]{.underline}

St. Louis, MO 63118-4126

85. Medical facility where X-rays were created; complete address must be
    used. These are retained for only 5 years before destruction. PIES
    cannot be used to make these requests, since an individual facility
    address cannot be entered in PIES. Generate a tailored letter
    providing complete identification of the veteran and the records
    requested.

90 Commander, Army National Guard (703) 607-7114

Personnel Center

ATTN: NGB-ARP-C

111 S. George Mason Drive

Arlington, VA 22204-1382

*Note:* They have records only for officers currently on active duty in
the National Guard and currently serving in the National Guard. They
suggest going through the state Adjutants General offices first.

232 Director (376/232) (314) 538-4550

VA Records Management Center

P.O. Box 5020

St. Louis, MO 63115

**4-C-4**

**February 25, 2005 M21-1, Part III**

**Change 131**

**ADDENDUM K**

**PIES Status and Request Codes**

Overall status codes (2 character code shown on the bottom of the PIES
3101 screen)

-   **CO---Complete---**All requested items for all parts of the 3101
    have a response and have been "closed out."

-   **IC---Incomplete---**Any of the individual 3101 requested items
    remain without a related response.

-   **DL---Deleted---**A 3101 request that has been deleted before it is
    printed at the NPRC/RMC (i.e., before the status code changes to IP
    -- In Process.

-   **MD---Marked for deletion---**A 3101 request needing to be deleted
    which could not be deleted by an RO employee because it has already
    been printed.

    **Branch of Service status codes (2 character code shown on the tab
    for Branch of Service on Page 2)**

-   **DK---Deleted---**A request in SU status that has been deleted by
    RO before it was printed at NPRC/RMC.

-   **FA---Forwarded as addressed** (*and* closed out in PIES)---3101s
    without pre-addressing and run against NPRC's Registry and are
    negative have been identified by logic incorporated into PIES to be
    sent to codes 11, 31, 36, 21, 22, 31, 42, and 51. *Also* includes
    all other 3101s addressed directly by the RO employee to any address
    code other than 13. *(The latter will not go against NPRC Registry,
    so an RO employee needs to be [certain]{.underline} that he/she is
    using the correct address code. It is best to let PIES do the
    addressing, otherwise.)*

-   **FR---Readdressed and forwarded** along with the record(s) to a
    service department for further response (*and* closed out in PIES)
    -- NPRC has completed its action, but the remainder of request must
    be completed by the Service Department.\*

-   **IP---In process---**3101s that have been received at NPRC/RMC and
    printed and are in the process of being worked *(i.e., record
    requested, in search process, or on caseworker's desk).*

-   **MD---Marked for Deletion---**When the Regional Office desires the
    3101 request to be canceled or "deleted" but it has already been
    changed to a status code IP (In Process), the request can be marked
    for deletion in PIES. An NPRC or RMC supervisor can change the MD
    status code to DL so that the case can be deleted from the PIES
    pending database.\* The RO employee can still go in and delete the
    request from his/her side. The system will "mark it for deletion" on
    the NPRC/RMC side.

-   **PO---Pending at NPRC---**Delayed for Organizational Records search
    *(i.e., morning reports, clinical records).*

-   **PP---Pending at NPRC---**Delayed for procurement of records or
    information from outside sources for records reconstruction
    purposes. *(Usually fire-related)*

-   **PR---Pending at RMC---**Delayed due to search process.

-   **PV**---**Pending at NPRC**---Delayed for verification search. The
    record is not in file (charged out) and a special search is being
    conducted to locate it.

-   **RP---Request printed** at NPRC/RMC.

-   **RS---Readdressed and sent to information provider** (*and* closed
    out in PIES)---3101s that are pre-addressed to code 13 (either by
    PIES logic or by the RO employee) but are NPRC Registry negatives.
    PIES will readdress these to one of the address codes listed under
    code FA.\*

-   **RT---Response provided and returned to RO** (*and* closed out in
    PIES) -- Case completed at NPRC/RMC. An NPRC/RMC caseworker has
    completed a response and entered this code. The completion of a case
    that involves multiple branches of service will be identified as
    complete by the system and the overall status code changed to "CO"
    when the last part is "signed off."

-   **SU---Submitted by RO---**This status appears when a 3101 request
    is submitted by the Regional Office but not yet printed by NPRC/RMC.
    The Regional Office can cancel a 3101 request while in this status
    without any involvement of NPRC/RMC.

\*These branch status codes will trigger the overall status code "CO
(Completed Overall) when there is only one branch of service involved
*or* if all branches of service requests are completed.

4-K-1

**M21-1, Part III February 25, 2005**

**Change 131**

**PIES PROGRAMMED REQUESTS FOR SELECTION**

REQUEST

**CODE CODE NARRATIVE WHEN TO USE**

**C01** CLINICAL RECORDS. FURNISH ACTIVE When inpatient clinical records
are needed

DUTY INPATIENT CLINICAL RECORDS because outpatient file does not contain
any

FOR \<ALLEGATION\>FROM or sufficient documentation about

\<MM/DD/YYYY\> TO \<MM/DD/YYYY\> AT hospitalization. See subparagraph
4.01i for

\<CLINIC/HOSPITAL NAME OR NUMBER\> existing clinical files.

**C02** MILITARY RETIREE OUTPATIENT. When post-separation treatment
files for

FURNISH RECORDS FOR \<ALLEGATION\> retirees are needed.

FROM \<MM/DD/YYYY\> TO \<MM/DD/YYYY\>

AT \<HOSPITAL NAME OR NUMBER\>.

**C03** INPATIENT DEPENDENT MEDICAL RECORDS When the claimant alleges
inpatient

FURNISH INPATIENT DEPENDENT MEDICAL treatment for a condition while a
dependent

RECORDS FOR \<\<ALLEGATION\>\> of a servicemember. The records are

\<\<HOSPITAL NAME OR NUMBER\>\> stored by month and year of treatment

\<\<FROM \<\<MM/DD/YYYY\>\>\<\< TO under the sponsor's name, SSN

\<\<MM/DD/YYYY\>\>\<\< SPONSOR'S NAME\>\> and/or SN, if applicable

\<\<SPONSOR'S SSN/SN\>\>

\<\<RELATIONSHIP TO SPONSOR\>\>

**C04** OUTPATIENT DEPENDENT MEDICAL When the claimant alleges
outpatient

> RECORDS FURNISH OUTPATIENT DEPENDENT treatment for a condition while a
> dependent RECORDS FOR \<\<ALLEGATION\>\> of a servicemember. The
> records are stored

\<\<CLINIC/HOSPITAL NAME OR NUMBER\>\> by year and last place of
treatment under

> \<\<DATE OF LAST YEAR TREATED AT THIS the sponsor's name, SSN and/or
> SN, if
>
> FACILITY -- MM/DD/YYYY\>\> applicable.

\<\<SPONSOR'S NAME\>\> SPONSOR'S SSN/SN\>\>

\<\<SPONSOR'S BRANCH OF SERVICE\>\>

> \<\<RELATIONSHIP TO SPONSOR\>\>

**M01** MEDICAL/DENTAL. FURNISH COMPLETE Outpatient medical and dental
records

MEDICAL/DENTAL RECORD \<SMRS\>. existing at NPRC will be furnished.

**M02** ENTRANCE PHYSICAL. FURNISH Use when the outpatient medical
records are

ENTRANCE PHYSICALS---CHECK negative and physical condition upon

MICROFICHE. enlistment is needed.

**M03** SEPARATION/RETIREMENT PHYSICAL. Use when the outpatient medical
records are

FURNISH SEPARATION/RETIREMENT negative and physical condition upon

PHYSICALS---CHECK MICROFICHE. discharge is needed. Remember that

beginning in the mid 1970s, discharge

physicals are not always performed.

**4-K-2**

**February 25, 2005 M21-1, Part III**

**Change 131**

**M04** SERVICE MEDICAL RECORDS NOT Use when there is no record of the
SMR at

LOCATED AT RMC. FURNISH COMPLETE the RMC on the BIRLS LOC screen, and
all

MEDICAL/DENTAL RECORDS IF ON FILE other possible locations have been
searched. AT YOUR LOCATION. Use ONLY when the SMR is supposed to be at
the RMC based on the dates found in

paragraph 4.01h(2).

**M05** MEDICAL/DENTAL & SGOS -- FURNISH Use this code for fire related
Army and Air

MEDICAL/DENTAL & SGOS (POTENTIAL Force veteran records. Secure
information

FIRE-RELATED CASE). IF NO MEDICAL/ from the claimant for the fill-ins
prior to

DENTAL RECORDS OR SGOS, PLEASE submitting a request. Insufficient

SEARCH SICK/MORNING REPORTS. information may result in a.

*(SUB-GRID REQUIRES COMPLETION)* negative finding 3101 responses from

SICK/MORNING REPORTS FOR NPRC beginning 5-18-90 automatically

\<COMPLETE ORGANIZATIONAL searched for SGOs prior to making the

ASSIGNMENT AND HOSPITAL, IF response. (*See Addendum L for*

APPLICABLE\> FROM \<MM/YYYY\> TO *complete organizational
descriptions.)*

\<MM/YYYY\> FOR REMARKS PERTAINING

TO \<ALLEGATION\>.

**M06** SGO. FURNISH ANY SGO RECORDS. Use this code when the claim
folder discloses the prior 3101 request was after 7-12-73 but before
5-18-90 and the response was that there were no records due to the fire
at NPRC. 3101 responses from NPRC

> beginning 5-18-90 automatically searched for SGOS prior to making the
> response.

**O01** ELIGIBILITY FOR COMPLETE Use this code when developing for

SEPARATION. FURNISH DATES OF information to prepare a conditional

ENLISTMENT, FURNISH TERMS OF discharge decision on an other than

ENLISTMENT AND REENLISTMENT; honorable separation.

DATES, TYPES, AND TERMS OF ANY

EXTENSIONS; AND DATES OF TIME LOST

AND REASON. (TO ASSIST IN

> DETERMINING ELIGIBILITY FOR
>
> COMPLETE SEPARATION)

**O02** MILITARY BENEFITS. FURNISH Use this code to request military
benefit

VERIFICATION OF MILITARY BENEFITS information from the Finance Center
when

> TYPE AND AMOUNT AND INCLUDE the veteran alleges receipt of a benefit
> but he
>
> DISABILITY, IF DISABILITY SEVERANCE benefit is not verified in type
> and/or amount.
>
> IS SHOWN. The Finance Center will provide the type, gross and net
> amounts. *The appropriate address code for the Finance Center from
> Appendix A must be inserted by the user.*
>
> 4-K-3

**M21-1, Part III February 25, 2005**

**Change 131**

**O03** SEVERANCE PAY. FURNISH Use this code to request severance pay

VERIFICATION OF SEVERANCE PAY VS. information from the Finance Center
when

> DISABILITY SEVERANCE PAY. the veteran alleges receipt of a severance
> pay but the type and amounts are not verified. The Finance Center will
> provide the type, gross and net amounts. *The appropriate address code
> for the Finance Center from appendix A must be inserted by the user.*

**O04** NET SEPARATION PAY. FURNISH TYPE Use this code to request
separation pay

> AND AMOUNT OF SEPARATION PAY. information from the Finance Center when
> the veteran alleges receipt of a separation pay but the type and
> amount are not verified. The Finance Center will provide the type,
> gross and net amounts. *The appropriate code for the Finance Center
> from appendix A must be inserted by the user.*

**O05** DATE OF BIRTH. FURNISH DATE OF BIRTH Use this code when
necessary to secure the

OR AGE AT TIME OF ENTRANCE ON date of birth or age of the veteran for
the

ACTIVE DUTY. decision on voided enlistments or for pension cases where
date of birth is not

verified for 38 CFR 3.208 purposes.

**O06** HOME ADDRESS. FURNISH LATEST HOME Use when address information
is necessary ADDRESS. to process the claim.

**O07** TRAVEL TIME. FURNISH NUMBER OF Use this code when the veteran's
length of

> DAYS OF TRAVEL TIME. service is insufficient to meet minimum duty time
> under 38 U.S.C. 106(c). Do not use if active duty is less than 80
> days. Also request travel time if veteran dies within 11 days of
> discharge. M21-1, Part III, Paragraph 2.08c.

**O08** REASON FOR SEPARATION. FURNISH Request reason for separation
when REASON FOR SEPARATION. IF veteran's length of service does not meet

SEPARATED FOR DISABILITY SHOW LOD minimum duty requirements under

AND DISEASE OR INJURY. 38 U.S.C. 106(c) for pension entitlement.

**O09** PREVIOUS VA FORMS 3101. FURNISH Use when trying to rebuild a
file when the

COPIES OF ANY PREVIOUSLY VERIFIED original file is missing and copies of
prior

VA FORMS 3101 (REBUILT FOLDERS) 3101s could be helpful.

**O10** FACTS AND CIRCUMSTANCES. FURNISH Use when character of
separation was other

FACTS AND CIRCUMSTANCES than under honorable conditions and

SURROUNDING DISCHARGE (ALL eligibility to VA benefits or services is

RECORDS). claimed.

**4-K-4**

**February 25, 2005 M21-1, Part III**

**Change 131**

**O11** MEDICAL/PHYSICAL EVALUATION Use when the rating assessment
and/or

BOARD. FURNISH MEDICAL/PHYSICAL evaluation requires the MED/PEB findings
EVALUATION BOARD PROCEEDINGS. or when the service medical records

> cannot be located and the veteran discharged
>
> for claims to be disability.

**O12** LINE OF DUTY. FURNISH LOD FOR Use when the circumstances
surrounding the

> \<(INCIDENT AND DATE)\>. injury or death appears to be under
> misconduct or suspicious conditions.

**O13** DISCHARGE UPGRADE INFORMATION. Use when the claimant indicates
the

FURNISH TYPE OF PROGRAM UPGRADE discharge was upgraded and the upgraded

WAS UNDER, DATE APPLIED FOR character may afford new entitlement.

UPGRADE, DATE DISCHARGE WAS

UPGRADED, CHARACTER OF DISCHARGE

BEFORE UPGRADE.

**O14** RADIATION RISK ACTIVITY. FURNISH Use to develop for radiation
exposure under

SERVICE PERSONNEL RECORDS TO 38 CFR 3.309(d).

CONFIRM RADIATION RISK.

**O15** RADIATION. FURNISH DD1141/RECORDS Use to request DD1141 for
processing cases

> OF EXPOSURE TO RADIATION. under 38 CFR 3.311(a)(2)(iii) due to
> occupational ionizing radiation claim.

**O16** ASBESTOS. FURNISH RECORDS OF Use when information of record is

EXPOSURE IN SERVICE OR JOBS VETERAN insufficient to determine exposure
to

PERFORMED. asbestos in service.

**O17** PAY GRADE. FURNISH HIGHEST PAY Use when needed to authorize
correct rate

GRADE HELD. of payment.

**O18** PERSONAL TRAUMA PTSD. FURNISH Use for personal trauma cases
where all

ENTIRE PERSONNEL FILE. personnel records are required to include

> Performance ratings. These records are several pages in size.

**O19** PTSD. FURNISH PAGES FROM THE Use to request copies of the
service

PERSONNEL FILE SHOWING UNIT OF personnel records that document

ASSIGNMENT, DATES OF ASSIGNMENT, awards, medals, decorations, military,

PARTICIPATION IN COMBAT occupational specialty campaigns,

OPERATIONS, WOUNDS IN ACTION, assignments, etc. It is not necessary to

AWARDS AND DECORATIONS AND identify the specific pages by number or

OFFICIAL TRAVEL OUTSIDE THE U.S. title.

**O20** MORNING REPORTS. SEARCH MORNING Use when evidence to support
alleged injury

REPORTS OF \<ORGANIZATION\> FROM or illness is not in service medical
records.

\<MM/DD/YYYY\> to \<MM/DD/YYYY\> FOR Insure that request includes
complete

REMARKS REGARDING \<IDENTIFIER\>. organizational assignment down to
company

(NOTE: MORNING REPORTS WERE RARELY level. *(See Addendum L for complete*

CREATED AFTER 1974.) *organizational descriptions.)*

> 4-K-5

M21-1, Part III February 25, 2005

**Change 131**

**O21** SEPARATION DOCUMENTS. FURNISH Use when a copy of the separation
document COPIES OF ANY SEPARATION is required for the authorization of
the VA

DOCUMENTS (DD214 OR EQUIVALENT). benefit. Rarely needed for compensation
or

pension benefits.

**O22** CONSCIENTIOUS OBJECTOR. FURNISH Use when appropriate to
determine

STATEMENT OF NATURE OF RELEASE AS eligibility for VA benefits.

CONSCIENTIOUS OBJECTOR, INDICATING

WHETHER BASED ON REFUSAL TO

PERFORM MILITARY SERVICE, REFUSAL

TO WEAR THE UNIFORM OR

NONCOMPLIANCE WITH LAWFUL ORDERS

OF COMPETENT MILITARY AUTHORITIES.

**O23** PHILIPPINE MILITARY SERVICE. FURNISH Use when appropriate to
determine

DETAILS OF MILITARY SERVICE IN THE eligibility for VA benefits.

PHILIPPINES.

**O24** PURPLE HEART. FURNISH VERIFICATION Use when necessary to verify
receipt of

OF RECEIPT OF PURPLE HEART, purple heart.

INCLUDING THE DATE AND DISABILITY

FOR WHICH AWARDED.

**O25** POW. FURNISH POW DATES AND CAMPS Use when needed for
establishment of

OF CONFINEMENT. entitlement as a prisoner of war.

**O26** MUSTARD GAS/LEWISITE. FURNISH ANY Use when needed for
establishment of

RECORDS OF EXPOSURE TO MUSTARD exposure to mustard gas/lewisite.

GAS/LEWISITE.

**O27** RESERVED Blank -- reserved for later use.

**O28** HIV. FURNISH RESULTS OF PRE- Use when needed to assess existence
of HIV

INDUCTION BLOOD SCREENING FOR HIV. at time of enlistment.

**O29** JAPAN. FURNISH ANY DOCUMENTS Use when needed to determine
veteran's

SHOWING ASSIGNMENT IN JAPAN participation in occupation of Japan for

BETWEEN 8-6-45 AND 7-1-1946. radiation exposure claim. *(See Addendum L*

VETERAN WAS ASSIGNED TO *for complete organizational descriptions.)*

\<COMPLETE ORGANIZATIONAL

ASSIGNMENT\>.

**O30** SOUTHWEST ASIA. FURNISH ACTIVE Use to verify service in
southwest Asia

DUTY DATES IN SOUTHWEST ASIA ON OR during Gulf War.

AFTER 8-2-90.

**O31** MEXICO. FURNISH PLACE OF SERVICE IN Use when verifying service
in Mexico

MEXICO FROM 5-9-1916 TO 4-5-1917. preceding the onset of World War I.

**O32** RUSSIA. FURNISH PLACE OF SERVICE IN Use when verifying service
in Russia

RUSSIA FROM 4-6-1917 TO 4-1-1920. following the end of World War I.

**4-K-6**

**February 25, 2005 M21-1, Part III**

**Change 131**

**O33** 90 DAYS. DID THE VETERAN HAVE 90 Use when verified service is
more than

DAYS OR MORE CREDITABLE ACTIVE 80 days but less than 90 days for pension

SERVICE (WHICH INCLUDES ONE OR purposes.

MORE DAYS WARTIME SERVICE

EXCLUSIVE OF FURLOUGH TIME AND

OTHER NON-CREDITABLE SERVICE)? IF

NOT, FURNISH TRAVEL TIME AND

> REASON FOR SEPARATION. COMPUTE
>
> AND FURNISH TRAVEL TIME IF THE
>
> VETERAN IS WITHIN 10 DAYS OF HAVING
>
> 90 DAYS CREDITABLE ACTIVE WARTIME
>
> SERVICE.

**O34** VIETNAM. FURNISH DATES OF SERVICE Use when claim for benefits
requires

IN VIETNAM. documentation of actual service in

Vietnam or waters adjacent thereto.

Usually associated with Agent Orange/

herbicide exposure claim.

**O35** RESERVED Blank -- reserved for later use.

**O36** HERBICIDES. FURNISH ANY DOCUMENTS Use when veteran claims
herbicide

SHOWING EXPOSURE TO HERBICIDES. exposure outside of Vietnam.

**O37** INSURANCE. FURNISH ALL DOCUMENTS For use by Philadelphia
Insurance Center

SHOWING DESIGNATION OF in processing claims.

BENEFICIARY. IF NO BENEFICIARY

DESIGNATIONS IN FILE, FURNISH ALL

DOCUMENTS LISTING DEPENDENTS.

**O40** PTSD STRESSOR 1 Use when verification of an in-service

THE INFORMATION PROVIDED IN THE stressor is required from the U.S

POP-UP GRIDS IS FURNISHED TO HELP IN Armed Forces Center for Unit
Records

IDENTIFYING OR RECONSTRUCTING Research (CURR) per M21-1, Part III, 5.14.

EVIDENCE TO SUPPORT A CLAIM FOR

SERVICE CONNECTION FOR PTSD.

**NOTE**: This request code cannot be used for USMC

Personnel. See M21-1, Part III, Chapter 5

**O41** PTSD STRESSOR 2 Use when verification of a second in-service

> THE INFORMATION PROVIDED IN THE stressor is required from the U.S.
>
> POP-UP GRIDS IS FURNISHED TO HELP IN Armed Forces Center for Records
>
> IDENTIFYING OR RECONSTRUCTING Unit Research (CURR)per M21-1, EVIDENCE
> TO SUPPORT A CLAIM FOR Part III, 5.14.
>
> SERVICE CONNECTION FOR PTSD.
>
> **NOTE**: This request code cannot be used for USMC
>
> Personnel. See M21-1, Part III, Chapter 5.
>
> 4-K-7

M21-1, Part III February 25, 2005

**Change 131**

**O42** PTSD STRESSOR 3 Use when verification of a third in-service

THE INFORMATION PROVIDED IN THE stressor is required from the U.S. Armed
POP-UP GRID IS FURNSIHED TO HELP IN Forces Center for Unit Records

IDENTIFYING OR RECONSRUCTING Research (CURR)per M21-1, Part III, 5.14.

EVIDENCE TO SUPPORT A CLAIM FOR

SERVICE CONNECTION FOR PTSD.

**NOTE**: This request code cannot be used for USMC

Personnel. See M21-1, Part III, Chapter 5.

**O43** AGENT ORANGE/RVN SERVICE Use when confirmation is required that
an

THE INFORMATION PROVIDED IN THE individual who served on a Navy vessel
off POP-UP GRIDS IS FURNISHED TO HELP IN the shores of Vietnam actually
spent

OBTAINING EVIDENCE TO SUPPORT A time within that country.

CLAIM FOR SERVICE CONNECTION FOR

> DISABILITIES RELATED TO EXPOSURE
>
> TO AGENT ORANGE IN VIETNAM.
>
> **NOTE**: Do not select this request code unless you
>
> have obtained a response from address code 13
>
> confirming the veteran may have had in-country
>
> service because he was onboard ships that were in the official waters
> of RVN.

**099** \<COMPOSED REQUEST ITEM\> Free text space

**S01** SERVICE. VERIFY ONLY THE UNVERIFIED Use when verification of
active duty is

PERIODS OF SERVICE SHOWN AND NAME, needed. If only service is active
duty for

SSN, SN, AS APPLICABLE. training, the response will indicate that

fact.

4-K-8

**February 25, 2005 M21-1, Part III**

**Change 131**

##### ADDENDUM O

## Sample: Formal Finding of Federal Records Unavailability

+---+---+---+---+----------------------------+---+---------------------------+
|   | # |   |   |                            | # |                           |
|   | # |   |   |                            | # |                           |
|   | # |   |   |                            | # |                           |
|   |   |   |   |                            | # |                           |
|   | D |   |   |                            |   |                           |
|   | e |   |   |                            | M |                           |
|   | p |   |   |                            | e |                           |
|   | a |   |   |                            | m |                           |
|   | r |   |   |                            | o |                           |
|   | t |   |   |                            | r |                           |
|   | m |   |   |                            | a |                           |
|   | e |   |   |                            | n |                           |
|   | n |   |   |                            | d |                           |
|   | t |   |   |                            | u |                           |
|   |   |   |   |                            | m |                           |
|   | o |   |   |                            |   |                           |
|   | f |   |   |                            |   |                           |
|   |   |   |   |                            |   |                           |
|   | V |   |   |                            |   |                           |
|   | e |   |   |                            |   |                           |
|   | t |   |   |                            |   |                           |
|   | e |   |   |                            |   |                           |
|   | r |   |   |                            |   |                           |
|   | a |   |   |                            |   |                           |
|   | n |   |   |                            |   |                           |
|   | s |   |   |                            |   |                           |
|   |   |   |   |                            |   |                           |
|   | A |   |   |                            |   |                           |
|   | f |   |   |                            |   |                           |
|   | f |   |   |                            |   |                           |
|   | a |   |   |                            |   |                           |
|   | i |   |   |                            |   |                           |
|   | r |   |   |                            |   |                           |
|   | s |   |   |                            |   |                           |
+---+---+---+---+----------------------------+---+---------------------------+
|   |   |   |   |                            |   |                           |
+---+---+---+---+----------------------------+---+---------------------------+
| D |   | D |   |                            |   |                           |
| a |   | e |   |                            |   |                           |
| t |   | c |   |                            |   |                           |
| e |   | e |   |                            |   |                           |
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+---+---+---+---+----------------------------+---+---------------------------+
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Signature/Position

**4-O-1**

# February 25, 2005 M21-1, Part III

#  Change 131

**CHAPTER 5. REQUESTS FOR MEDICAL/EMPLOYABILITY EVIDENCE**

**CONTENTS**

PARAGRAPH PAGE

####### SUBCHAPTER I. GENERAL COMPENSATION CLAIMS

5.01 Service Medical Records 5-I-1

5.02 Claims Based on Positive Tuberculin Reaction 5-I-1

5.03 Requests for Medical/Employment Evidence from Nonservice Sources
5-I-1

5.04 Requests for Evidence Regarding Acute Disabilities 5-I-3

5.05 Development of Chronic or Tropical Disease Claims 5-I-3

5.06 Development of Accidental Injuries 5-I-4

5.07 Prompt Submission to Rating Activity 5-I-4

5.08 Control of Evaluations Based on Individual Unemployability 5-I-4

5.09 Distribution of Examinations 5-I-5

####### SUBCHAPTER II. COMPENSATION CLAIMS FOR SPECIAL DISABILITIES

5.10 Claims Based on Exposure to Herbicides Containing Dioxin (2, 3, 7,
8

Tetrachlorodibenzo-p-dioxin) During Service in the Republic of Vietnam
5-II-1

5.11 Presumptive Service Connection Under 38 U.S.C. 1112 for Radiogenic
Diseases 5-II-2

5.12 Development of Ionizing Radiation Exposure (under 38 CFR 3.311)
5-II-3

5.13 Asbestos-Related Diseases 5-II-10

5.14 Post Traumatic Stress Disorder (PTSD) 5-II-10

5.15 Acquired Immune Deficiency Syndrome (AIDS) 5-II-16

5.16 Ex-Prisoner of War Cases 5-II-16

5.17 Development of Claims Based on Undiagnosed Illnesses of Gulf War
Veterans 5-II-18

5.18 Development for Exposure to Mustard Gas and Lewisite 5-II-20

####### SUBCHAPTER III. ORIGINAL DISABILITY PENSION CLAIMS

5.19 General 5-III-1

5.20 Medical Evidence of Probable Entitlement 5-III-1

5.21 Development as to Unemployability 5-III-2

5.22 Income and Net Worth 5-III-2

5.23 Development as to Veteran\'s Age 5-III-2

5.24 Development Regarding Willful Misconduct 5-III-2

5.25 Referral to Rating Activity 5-III-3

5.26 Distribution of Examinations 5-III-3

####### [APPENDIX A]{.smallcaps}

A-1 Acronyms and Forms Used in Chapter 5 5-A-1

####### APPENDIX B---EXHIBITS

B-1 Sample of Folder Flash 5-B-2

B-2 GW Checklist 5-B-3

B-3 Gulf War Undiagnosed Illness Standard Development Letter 5-B-4

B-4 Sample Paragraph Concerning Extension of Presumptive Period 5-B-6

**5-i**

**M21-1, Part III February 25, 2005**

**Change 131**

B-5 Letter of Notification if No Change after Readjudication 5-B-7

B-6 Sample Letter Asking GW Veterans with Pending Claims if They Want
Their Medical

Information Included in the Health Registry 5-B-8

B-7 Request for Lay Evidence 5-B-9

B-8 Follow-Up Request for Lay Evidence 5-B-11

B-9 Suggested Letter to Use to Request Participation or Radiation Dose
Information

from the Defense Threat Reduction Agency 5-B-13

B-10 Exposure to Nuclear Radiation and Department of Defense Secrecy
Agreements 5-B-14

B-11 Formal Finding of a Lack of Evidence to Verify Stressor 5-B-15

**5-ii**

**February 25, 2005 M21-1, Part III**

**Change 131**

**CHAPTER 5. REQUESTS FOR MEDICAL/EMPLOYABILITY EVIDENCE**

**SUBCHAPTER I. GENERAL COMPENSATION CLAIMS**

Note: VA has a duty to assist the claimant in obtaining evidence to
substantiate a claim. Procedures described in paragraph 1.02 are to be
followed when requesting all types of evidence.

Abbreviations, acronyms, etc., are used throughout the chapter. A
complete list is included as Appendix A.

**5.01 SERVICE MEDICAL RECORDS**

We must get all available service medical records. Ascertain the alleged
disabilities and any dental conditions from the claim, including the
dates and places of examination or treatment. Carefully review any
available service medical/dental records in the claims folder to find
records supporting the claimed disabilities. Submit requests for service
dental and medical records on the same Request for Information. If
possible, make the request for records using the Personnel Information
and Exchange System (PIES). Refer the service medical records to the
rating activity for review.

**5.02 CLAIMS BASED ON POSITIVE TUBERCULIN REACTION**

a\. **Positive Tuberculin Reaction is Sole Condition Claimed.** If VA
Form 21-526 is received claiming only a positive tuberculin reaction,
refer the claim to the rating activity for a determination as to whether
or not a disability is present (pt. IV, par. 23.05).

b\. **Other Disabilities Claimed.** If a VA Form 21-526 indicates that a
positive tuberculin reaction is claimed together with other
disabilities, complete any appropriate development required for the
other disabilities. Refer the file to the rating activity for rating of
all claimed disabilities.

c\. **Follow-Up Report.** As provided in part IV, paragraph 23.05, a VA
outpatient clinic or medical center will furnish a report of the
follow-up examination made on expiration of the 12-month period of
chemotherapy to discharged personnel who have had a tuberculin test
conversion from negative to positive during service. If this report or
any other evidence indicates the presence of tuberculous disease, take
appropriate rating action. Give due regard to establishment of service
connection by way of presumption under 38 CFR 3.307 (par. 5.05d).

**5.03 REQUESTS FOR MEDICAL/EMPLOYMENT EVIDENCE FROM NONSERVICE
SOURCES**

Request any treatment records that the claimant has identified and that
are relevant to the disposition of the claim. Advise the non-VA
institution, physician, etc., that VA cannot pay for the information
requested. Establish a 60-day control for receipt of the records. If no
response is received, follow the duty to assist procedures in par. 1.02.
If the custodian of the records does not respond to the request, send a
follow up request and establish a 30-day control for receipt of the
records.

a\. **Requesting Medical Information from Non-VA Sources.** Treatment
reports from non-VA sources will not ordinarily be furnished without a
current authorization by the claimant or, if the patient is incompetent,
fiduciary or next of kin. Send the VA Form 21-4142 to the claimant (or
fiduciary or next of kin) if not already of record. When evidence is
requested, simultaneously notify the claimant that the request is made,
but that he or she is ultimately responsible for seeing that the records
are provided. The records may be requested from the claimant via the 203
screen (HOSPITAL/DOCTOR REPORT).

**5-I-1**

**M21-1, Part III February 25, 2005**

**Change 131**

\(1\) **Authorization for Release of Information.** A reproduction of
the \"Certification and Authorization for Release of Information\"
section of VA Form 21-526 dated within 1 year of its being completed
will generally be accepted as sufficient authority to release
confidential medical information. If this authorization for release is
not acceptable to the medical provider, send VA Form 21-4142,
"Authorization for Release of Information," or the release provided by
the record holder, to the claimant via a BDN development or a locally
generated letter.

\(2\) **Request to Non-VA Institution for Hospital Report.** Send FL
21-121 (original and one copy) with an authorization to obtain a report
from a non-VA hospital.

\(3\) **Request to Civilian Physician.** Send FL 21-104 (original and
one copy) with an authorization to obtain a report from an attending
physician.

\(4\) **Request to Persons Who Know Facts about Veteran\'s Sickness,
Disease or Injury.** Send FL 21-53 to each person listed on the
veteran\'s VA Form 21-526.

\(5\) **Action on Expiration of Control Date.** Concurrently request
reports from both the medical facility or physician and the claimant. If
the report or statement is not received from the institution, physician
or person having knowledge of the claimed condition after two attempts,
forward the claims file to the rating board for rating or to direct
further development.

b\. **Requesting Medical Information from VA Institution**

\(1\) **AMIE/CARPI Request or Use of VA Form 10-7131.** If the veteran
is a patient at a VA medical center or at a non-VA hospital as a VA
beneficiary, and an AMIE/CAPRI request or VA Form 10-7131 admission
notice has been received, indicate on the request what reports and
hospital summaries are required. If requested via AMIE/CAPRI, progress
notes or hospital summaries can be requested by range. If a veteran's
records are not on AMIE/CAPRI, they can be requested electronically via
the VA Form 10-7131. See part IV, paragraph 18.01. Establish necessary
controls to ensure the timely return of the requested reports.

\(a\) If an admission notice has not been received, request that
information from the medical facility via AMIE/CAPRI.

\(b\) Similarly, if the veteran has been treated at a VA outpatient
clinic and a summary of that treatment is needed, request that report
via AMIE/CAPRI.

\(2\) **Follow-Up Requests.** VA must continue to send follow-up
requests until we are reasonably certain that the records requested do
not exist or until we determine that further efforts would be futile.
This applies to all SMRs, Federal records, including VA and SSA. Change
the suspense date accordingly.

c\. **Requesting Medical/Employment Information from Social Security
Administration.** If a veteran is claiming an increased evaluation for
service-connected conditions or nonservice-connected pension and there
is indication that he or she has claimed or is receiving disability
benefits from the Social Security Administration (SSA), request copies
of the medical records on which the SSA decision was based. In addition,
request copies of the SSA disability decision documents. The
availability of these documents will further assist with the processing
of the veteran's claim for benefits. See paragraph 9.01 for instructions
on making this request.

d\. **Requesting Vocational Rehabilitation Records.** If a veteran is
claiming \"individual

unemployability\" and Chapter 31 training was either not found to be
medically feasible or discontinued, include the vocational
rehabilitation records when forwarding the claims folder to the rating
activity.

**5-I-2**

**February 25, 2005 M21-1, Part III**

**Change 131**

# SUBCHAPTER II. COMPENSATION CLAIMS FOR SPECIAL DISABILITIES

**5.10 CLAIMS BASED ON EXPOSURE TO HERBICIDES CONTAINING DIOXIN (2, 3,
7, 8**

##### TETRACHLORODIBENZO-P-DIOXIN) DURING SERVICE IN THE REPUBLIC OF VIETNAM

a\. **General.** When initially corresponding with a veteran claiming
disability resulting from exposure to herbicides while in the Republic
of Vietnam, inform him or her of the availability of hospital
examination and treatment. Inform the veteran that if he or she has
already had the herbicide examination or been treated for herbicide
exposure, he or she should submit a copy of the examination or treatment
report or submit the name of the VA facility performing the examination
or treatment so that the regional office may obtain a copy of the
examination report.

b\. **No Specific Disability Claimed.** If the veteran alleges herbicide
exposure but claims no disability, inform the veteran that mere exposure
is not a disability. Tell the veteran to specify the disabilities
resulting from herbicide exposure and to submit medical evidence of the
earliest manifestations of symptoms together with evidence of continuity
of treatment. Process as a denial without a rating decision and take the
end product at that point.

c\. **Presumption of Service Connection.** The Agent Orange Act of 1991
(Public Law 102-4) establishes a presumption of service connection for
veterans with service in Vietnam during the Vietnam era who subsequently
develop, to a degree of 10% or more, Hodgkin's disease, multiple
myeloma, non-Hodgkin\'s lymphoma (NHL), acute and subacute peripheral
neuropathy, porphyria cutanea tarda, prostate cancer, respiratory
cancers (cancers of the lung, bronchus, larynx or trachea), soft-tissue
sarcoma or chloracne or other acneiform disease consistent with
chloracne, diabetes mellitus (type 2), and chronic lymphocytic leukemia.
Public Law 104-275 provided that effective January 1, 1997, the
applicable service dates for purposes of the presumption of exposure to
herbicides are from January 9, 1962, to May 7, 1975. Qualifying skin
conditions must have become manifest to a degree of 10% or more within 1
year of the last date of service within the Republic of Vietnam. Even a
few hours in Vietnam during the Vietnam era may be sufficient to service
connect subsequently developed presumptive conditions based on exposure
to herbicides.

***Note*: Under 38 CFR 3.313, service in Vietnam together with the
development of NHL after service is sufficient to establish service
connection for that disease. It does not have to be at least 10%
disabling. The term \"service in Vietnam\" includes service in the
waters offshore, or service in other locations if the conditions of
service involved duty or visitation in Vietnam. There is no requirement
for a specified length of service, duty or visitation in Vietnam under
38 CFR 3.313.**

\(1\) **Development.** If the claimant alleges Vietnam service, review
the DD Form 214 or other evidence in file to confirm such service. If
necessary, develop with the service department and ask the claimant to
submit evidence to show Vietnam service or to obtain confirming buddy
statements. The claim cannot be denied based on a lack of verification
of Vietnam service until the claimant has had 60 days to respond to the
request and the 30-day follow-up period exhausted. Additionally, if
Federal records were requested, continue to follow-up *until* the
requested records are received or a formal response is received that the
records are unavailable.

***Note:*** Contact the US Armed Services Center for Unit Records
Research (CURR) for verification of Vietnam service if the veteran and
the service department have been unable to determine such service by
submitting a PIES request under code O43 for Navy only. For all other
branches, send a dictated letter. See M21-1, Part III, 5.14c(3)(a) for
CURR's mailing address.

d\. **Birth Defects.**

***(1)** Spina Bifida**: Claims for benefits for a child suffering from
spina bifida and other birth defects are discussed in M21-1MR, Part VI,
Chapter 18. ***

> ***(2) Claims for additional benefits by women Vietnam veterans due to
> certain birth defects of a natural child have been authorized under PL
> 106-419. Please refer to FL 00-90 for processing claims of this
> type.***

**5-II-1**

**M21-1, Part III February 25, 2005**

**Change 131**

\(3\) The law limits the birth defects for which we may pay benefits.
Claims for benefits from birth defects resulting from a familial
disorder, a birth-related injury, or a fetal or neonatal infirmity with
well-established causes, should be denied as not authorized by law.

**5.11 PRESUMPTIVE SERVICE CONNECTION UNDER 38 U.S.C. 1112 FOR
RADIOGENIC DISEASES**

a\. **General.** Several radiogenic diseases are subject to presumptive
service connection in both live and death cases under PL 100-321. This
law became effective May 1, 1988. The only radiation risk activities
which can be considered for presumptive service connection are
participation in atmospheric nuclear weapons testing, post-war
occupation of Hiroshima or Nagasaki, and internment as a POW in Japan.
Prior to August 14, 1991, the presumption applied only to veterans
exposed to ionizing radiation while on active duty. However, PL 102-86,
enacted on that date, extended the presumption to include persons
exposed while on active duty for training or inactive duty for training.
A specified disease which became manifest in a radiation-exposed veteran
is considered to have been incurred or aggravated during the veteran\'s
service.

b\. **Diseases Specific to Radiation-Exposed Veterans.** There are two
sets of radiogenic conditions

with separate development paths. Conditions considered presumptive under
38 CFR 3.309 are considered service-connected for any veteran who
participated in a radiation activity (38 CFR 3.309(d)(3)(ii)) while
serving on active duty, active duty for training, or inactive duty for
training. Service connection for other radiogenic conditions can also be
granted but require development for a reconstructed dose estimate. Those
conditions are in 38 CFR 3.311.

c\. **Development**

\(1\) Before undertaking development of a claim, the following criteria
must be met:

\(a\) One of the presumptive radiogenic diseases listed above must be
shown to exist by medical evidence.

\(b\) It must be alleged the disability was the result of participation
in a radiation-risk activity.

\(2\) If one of the above criteria is not met, no further development
under this law is warranted. In such cases, consider the claim as any
other claim for direct service connection under 38 CFR 3.303 or 38 CFR
3.311. The denial of benefits under all applicable laws and regulations,
if warranted, will be accomplished by a rating decision.

\(3\) The Department of Defense is the source of information concerning
the veteran\'s participation in radiation-risk activity. As with a claim
for direct service connection, requests for verification of U.S.
atmospheric nuclear weapons test participation, occupational force
involvement or internment as a POW in Japan subject to the same
conditions as occupational forces are to be sent to: Defense Threat
Reduction Agency (DTRA) at the following address: Attn: TDND-NTPR 8725
John J. Kingman Rd., Mail Stop 6201 Ft. Belvoir, VA 22060-6201. NTPR
identifies the Nuclear Test Personnel Review Program. Verification
requests pertaining to *non-U.S.* test participation should be processed
in accordance with paragraph 5.12e below.

\(4\) A sample development letter is shown as Exhibit B-9. Development
letters to DTRA must contain the following information:

\(a\) Veteran\'s and claimant\'s names.

\(b\) Veteran\'s military service number.

(c) Veteran\'s Social Security number.

**5-II-2**

**February 25, 2005 M21-1, Part III**

**Change 131**

g\. **Referral to Central Office**

\(1\) If the three requirements of the initial review have been
satisfied and development has been completed, including the receipt of
the response from the DoD, refer the claim to the Compensation and
Pension Service, Policy Staff (211), for review. Include a cover letter
briefly summarizing the following information:

\(a\) Pertinent service information.

\(b\) The circumstances, including dates of veteran\'s exposure.

\(c\) A description of the disease claimed, including the specific cell
type and stage, if known, and when first manifested.

\(d\) Veteran\'s age at time of exposure.

\(e\) Dose assessment as given by DTRA, applicable Service organization,
or Under Secretary for Health as specified in 38 C.F.R.
3.311(a)(2)(iii).

\(f\) Time lapse between exposure and onset of disease.

\(g\) Gender, pertinent family history and employment history.

\(h\) Veteran\'s history of exposure to known carcinogens or radiation
prior to and after service, including smoking history and, if claiming
skin cancer, exposure to sun.

\(i\) Any other information relevant to determining the cause of the
disease.

\(2\) The Compensation and Pension Service will request a medical
opinion from the Under Secretary for Health. Referral to an outside
consultant is also possible. See 38 CFR 3.311(c) and (d).

\(a\) The regional office will notify the claimant of the referral to
Central Office.

\(b\) The regional office and the claimant will be notified if the
referral is made to the Under Secretary for Health.

\(3\) The Compensation and Pension Service will furnish an opinion to
the regional office directing either allowance or denial of the claim.
The written response of both VHA and an outside consultant (if
solicited) will also be transmitted to the regional office.

h\. **Expunging Classified Military Data.** Veterans seeking benefits in
connection with exposure to nuclear radiation are authorized (see
Exhibit B-10) to divulge to VA the name, location of their command,
duties performed, dates of service, and related information necessary to
validate exposure to nuclear radiation. This authorization does not
relieve veterans of responsibility for continuing to protect specific
technical information that could contribute to the development of a
weapon of mass destruction or the application of nuclear technology.
Information relative to military bases where nuclear weapons may be
located within the continental United States is classified
\"Confidential.\" Locations past or present outside the continental
United States are classified \"Secret\" or \"Top Secret.\" The fact that
a veteran inadvertently revealed such information in an application for
benefits should not be compounded by further release within or outside
VA in any manner.

\(1\) Any classified data will be cut out (rather than obliterated) from
such records or statements.

\(2\) A VA Form 119 prepared for the claims file and signed by the
Veterans Service Center Manager or supervisory designee not lower than
the Assistant Veterans Service Center Manager will cite the kind of
evidence removed and the reason for doing so, and summarize or restate
any other obliterated facts or statements not referring to specific
military bases where nuclear exposure allegedly occurred

**5-II-9**

**M21-1, Part III February 25, 2005**

**Change 131**

i\. **Subsequent Review.** A claim for compensation based on radiation
exposure as a consequence of service with the occupation forces of
Hiroshima or Nagasaki, Japan, or in connection with nuclear testing that
was denied prior to enactment of Public Law 98-542, "The Veterans\'
Dioxin and Radiation Exposure Compensation Standards Act," on October
24, 1984, must receive a complete, new review if the claim is
subsequently reopened. New and material evidence need not be submitted
to reopen these claims. Handle this type of claim as if it were an
initial ionizing radiation claim. Refer to subparagraph b for proper
action to be taken.

**5.13 ASBESTOS-RELATED DISEASES**

a\. **General.** Many people with asbestos-related diseases have only
recently come to medical attention because the latent period varies from
10 to 45 or more years between first exposure and development of
disease. In addition, exposure to asbestos may be brief (as little as a
month or two) or indirect (bystander disease).

b\. **Responsibility.** The rating activity is responsible for
determining whether or not military records demonstrate evidence of
asbestos exposure in service and ensuring that development is
accomplished to determine if there is pre-service and post-service
evidence of occupational or other asbestos exposure.

**5.14 POST-TRAUMATIC STRESS DISORDER (PTSD)**

a\. **Post-Traumatic Stress Disorder.** Service connection for
post-traumatic stress disorder (PTSD)

requires medical evidence diagnosing the condition in accordance with 38
CFR 4.125(a); a link, established by medical evidence, between current
symptoms and an in-service stressor; and credible evidence that the
claimed in-service stressor occurred. (38 CFR 3.304(f))

b\. **Evidence of a Stressor in Service.** Obtain all available evidence
from the service department showing that the veteran served where the
stressful event occurred. Also obtain evidence supporting the veteran's
description of the event.

\(1\) **Combat Stressors.** The following individual decorations are
examples of decorations which

may serve as evidence that the veteran engaged in combat:

-   Air Force Cross

-   Air Medal with \"V\" Device

-   Army Commendation Medal with \"V\" Device

-   Bronze Star Medal with \"V\" Device

-   Combat Action Ribbon

-   Combat Aircrew Insignia

-   Combat Infantry Badge

-   Combat Medical Badge

-   Distinguished Flying Cross

-   Distinguished Service Cross

-   Joint Service Commendation Medal with \"V\" Device

-   Medal of Honor

-   Navy Commendation Medal with \"V\" Device

-   Navy Cross

-   Purple Heart

-   Silver Star

    **5-II-10**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

    If the evidence established that the veteran engaged in combat with
    the enemy and the claimed stressor is related to that combat, in the
    absence of clear and convincing evidence to the contrary, and
    provided that the claimed stressor is consistent with the
    circumstances, conditions, or hardships of the veteran's service,
    the veteran's testimony alone establishes the occurrence of the
    claimed in-service stressor. (38 CFR 3.304(f) and 38 U.S.C. 1154(b))

    \(2\) **Non-Combat Stressors.** PTSD may result from a non-combat
    stressor, such as a plane crash, ship sinking, explosion, rape or
    assault, duty on a burn ward or in a graves registration unit.

    \(3\) **POW Status.** If the evidence establishes that the veteran
    was a prisoner-of-war under the provisions of 38 CFR 3.1(y) and the
    claimed stressor is related to that prisoner-of-war experience, in
    the absence of clear and convincing evidence to the contrary, and
    provided that the claimed stressor is consistent with the
    circumstances, conditions, or hardships of the veteran's service,
    the veteran's testimony alone establishes the occurrence of the
    claimed in-service stressor. (38 CFR 3.304(f) and 38 U.S.C. 1154(b))

    c\. **Development**

    \(1\) If the veteran indicates pertinent treatment in a VA facility,
    Vet Center, or elsewhere, request

    hospital report(s) and clinical records.

    \(2\) If the evidence does not establish that the veteran was
    engaged in combat with the enemy, or the evidence does establish
    this but the claimed stressor is not related to that combat, then
    credible supporting evidence is required to establish that a
    stressor occurred. (38 CFR 3.304(f)) In cases where available
    records do not contain this, develop for this evidence as follows:

    \(a\) Request specific details of the in-service stressful
    incident(s): date(s), place(s), unit of assignment at the time of
    the event(s), description of the event(s), medal(s) or citation(s)
    received as a result of the event(s), and, if appropriate, name(s)
    and other identifying information concerning any other individuals
    involved in the event(s). At a minimum, the claim must indicate the
    location and approximate time (a 2-month specific date range) of the
    stressful event(s) in question, and the unit of assignment at the
    time the stressful event occurred. Inform the veteran that this
    information is necessary to obtain supportive evidence of the
    stressful event(s) and that failure to respond or an incomplete
    response may result in denial of the claim.

    **Note**: Do not ask the veteran for specific details in any case in
    which there is credible supporting evidence that the claimed
    in-service stressor occurred.

    \(b\) Use only one of these codes at a time in PIES. Use O19 for
    simple PTSD claims and O18 for personal trauma. Do *not* use the
    free text and list all of the information mentioned in the manual.
    The response team at NPRC knows which pages to send for simple PTSD
    cases. In personal trauma cases, they will send copies of
    everything. *There should be no occasion where both O18 and O19 are
    used. If the claim is for both personal trauma and PTSD, the use of
    code O18 will include pages that would have been sent in response to
    code O19.* In either event, no additional instructions need to be
    added to the PIES request.

-   **ARMY:** "Personnel Qualification Record," DA Form 2-1. The form is
    used for both Officers and Enlisted personnel, and first came into
    use in January 1973. Prior to that, DA Form 20 and DA Form 66 were
    used.

-   **NAVY**: Enlisted record of \"Transfer and Receipts\" (p 12), pages
    32 and 33. Enlisted record of \"Administrative Remarks\" (p. 4-9,
    13), page 34. Officer record, NAVPERS 1301/51, \"Officer Data
    Card,\" page 35. DD214 and enlistment contracts are usually
    included.

    **5-II-11**

    **M21-1, Part III February 25, 2005**

    **Change 131**

-   **AIR FORCE**: "Airman Military Record," AF Form 7, Enlisted, pages
    36 through 39. Officer Military Record (AF Form 11), pages 39
    and 40. Performance Reports for both Officer and Enlisted.

-   **MARINE CORPS:** Enlistment contracts, discharge papers, MABMC-11
    (discharge order) and service records usually provided Pages 3, 5-6,
    8-9, 12-13, and 17 included.

-   **COAST GUARD:** Enlisted Record, \"Endorsement on Order Sheet\"
    (DOT Form CG 3312B). Officer Record, \"Service Records Card,\" CG
    3301, CG 3303 and CG 3305, pages 3, 5, 6-7. DD214 and enlistment
    contract.

    \(3\) If medical evidence establishes a valid diagnosis of PTSD, and
    development is complete in every respect but for confirmation of the
    in-service stressor, contact the U.S. Armed Services Center for Unit
    Records Research (CURR) through PIES, using request codes O40, O41,
    O42 (unless the stressor occurred during Marine Corps service. All
    Marine Corps unit records for the Vietnam Era are currently viewable
    and searchable through Virtual VA. Unit records for the Korean
    Conflict will be available shortly. Instructions for handling
    denials of service connection for PTSD, based solely on the absence
    of a verifiable stressor during Marine Corps service, are currently
    pending. Regional offices should postpone denying service connection
    in these cases until further notice). Requests to that office must
    include the following:

-   Adequate identifying information, to include the claimant's full
    name and social security number, and

-   A description of the claimed stressor(s).

-   Month and year during which the stressful event occurred (CURR will
    research records dated 30 days before the date provided and 30 days
    after.),

-   The veteran's unit of assignment at the time of the stressful event,

-   The geographic location where the stressful event took place,

-   Information from pertinent administrative records such as Form 20
    and 2-1 (Army), DA Form 66, AF Form 7 and 11 (Air Force), and all
    pages of NAVMC 118 (Navy). This information will be used in
    completing the PIES request to CURR.

    Additional information identified by CURR as helpful in conducting
    research includes:

-   Medals or citations received by the veteran,

-   Names of other soldiers or sailors involved in the stressful
    incident

    As of October 11, 2000, Field Station Directors appointed CURR
    coordinators for each respective VA regional office. The CURR
    coordinator should be the primary point of contact for all
    CURR-related issues and should

-   perform periodic reviews of all outgoing research requests

-   ensure the validity of the requests

-   notify CURR when a research request has become unnecessary, e.g.,
    other evidence was received that verifies a stressor, the claim was
    withdrawn, etc.

-   monitor the CURR stressor verification database (located on the VBA
    intranet website at [vbaw.vba.va.gov/bl/20/opai]{.underline} ) for
    status of stressor verification requests.

-   forward inquiries regarding CURR issues to the VACO CURR e-mailbox
    at VAVBAWAS/CO/CURR

    ***Note:*** Any research requests identified as inadequate or
    incomplete will be returned to the regional office with an
    explanation of the deficiencies identified. Any additional
    development should be undertaken prior to resubmission of the
    request to CURR. Stations may, at their discretion, render a final
    decision on cases if they determine that the information needed to
    conduct the research is unobtainable. The file should be documented
    to this effect.

    \(a\) For all services *except* the Marine Corps, submit a PIES
    request under request code O40, O41 or O42. If the Marine Corps case
    is one where the veteran was assigned to a Navy ship, send a letter
    to: U.S. Armed Services Center for Unit Records Research (CURR),
    7701 Telegraph Road, Kingman Building, Room 2C08, Alexandria, VA
    22315-3852. The VA's liaison officer telephone number is (703)
    428-6915. If necessary, you may also contact the

    **5-II-12**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

    Coast Guard at: Commander, Military Personnel Command, MPC-S-3, 2100
    Second St. SW, Washington, DC 20593-0001. Requests for Marine Corps
    records are temporarily on hold pending further instructions.

    \(b\) The first stressor is entered under code O40, the second under
    code O41, and the third under code O42. A request should *not* be
    sent until a valid diagnosis of PTSD is of record.

    \(4\) If sufficient evidence is already of record to grant service
    connection for a claimed condition, do so. If not, *but* there is a
    confirmed diagnosis of PTSD, and the claimant has provided the
    essential information necessary for researching the stressor (for
    the information required, see Part III, 5.14c(3)), send an inquiry
    to CURR. A denial solely because of an unconfirmed stressor is
    improper unless:

```{=html}
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-   the veteran has been properly notified and has failed to provide the
    basic information CURR requires to conduct research, and

-   the CURR coordinator has properly documented the claims folder
    according to the procedures noted.

\(5\) Occasionally, CURR will request a more specific description of the
stressor in question. Additional development action must be taken to
obtain the information in order for CURR to conduct meaningful research.
In some cases, the station's coordinator can initiate a report of
contact with the veteran in order to obtain the additional information
that is needed to identify the in-service stressor. For more detailed
information on stressor development and the additional evidence that may
be required to conduct research, access the CURR Stressor Verification
Guide at:
[http://152.124.238.193/bl/21/publicat/Letters/TrngLtrs/TL04-02A.doc]{.underline}.
Failure by the veteran to respond substantively to the request for
information will be grounds to deny the claim based on an unconfirmed
stressor. If the claim is denied for failure to respond, documentation
must be of record indicating the attempts that were made by the CURR
coordinator to obtain the information. Listed below are procedures for
properly documenting the claims folder and the responsibilities of the
CURR coordinator when stressor information cannot be obtained from the
veteran:

(1) Although VA will do all it can to assist the claimant in
    establishing entitlement to benefits, and to make a

    thorough and complete effort to get all the evidence required, the
    ultimate responsibility for furnishing the evidence needed to
    perfect the claim rests with the veteran.

(2) If information is requested from the veteran and the information
    submitted is not sufficient, send a follow-up letter to the veteran
    explaining the necessity of the specific details of his/her
    stressful event, as well as an explanation as to why the response
    was not sufficient. Allow an additional 30 days for the veteran's
    response.

(3) If there is no response to the follow-up letter, or the veteran
    responds with information that is still

    insufficient, the CURR Coordinator should review the requests for
    information, any applicable military records in the claims folder,
    and any other evidence of record to ensure that the information
    available is not sufficient. The CURR Coordinator will make a formal
    finding regarding the lack of sufficient information in the claims
    file to request verification of the stressful event(s) and document
    the efforts made to secure the evidence.

(4) If the information is requested from the veteran and no response is
    received, send a follow-up letter

    requesting the details of the stressful event as outlined in
    paragraph 5.14 c (3). Allow an additional 30 days for the veteran's
    response.

(5) If there is no response to the follow-up letter, the CURR
    Coordinator should review the requests for

    information, any applicable military records in the claims folder
    and any other evidence of record to ensure that the information
    available is insufficient. The CURR Coordinator will make a formal
    finding regarding the lack of sufficient information in the claims
    file to request verification of the stressful event(s) and document
    the efforts made to secure the evidence.

    **5-II-13**

    **M21-1, Part III February 25, 2005**

    **Change 131**

(6) In both cases, the finding should establish that all the procedures
    have been properly followed; evidence

of written and telephonic efforts to obtain the records are in the file;
all efforts to obtain the needed information have been exhausted;
further efforts are futile; and that based on these facts, the
information required to verify the stressful events is unavailable. The
finding should detail the actions taken to obtain the required
information. Prepare the findings on a separate page to be filed in the
claims folder. (See Exhibit B-11 of this chapter) Final approval rests
with the Veterans Service Center Manager (VSCM) or his/her designee.

\(7\) After the finding is signed, the veteran will be contacted
telephonically. Fully advise the claimant of the determination and give
the claimant 10 days to furnish the evidence. The veteran should be
advised of the lack of evidence required to verify the stressful events
and the requirement that he/she submit any relevant documents/evidence
in his/her possession. Further advise the claimant that a decision will
be made based on the evidence of record if the requested evidence is not
received within 10 days from the date of the conversation. Document the
results of the telephone contact on VA Form 119. If telephone contact
cannot be made, provide written notification of this information to the
claimant. The 10-day time limit for reply will be based on the date of
this letter.

d\. **PTSD Claims Based on Personal Assault**

\(1\) Veterans claiming service connection for disability due to an
in-service personal assault face unique problems documenting their
claims. Personal assault is an event of human design that threatens or
inflicts harm. Examples of this are rape, physical assault, domestic
battering, robbery, mugging, and stalking. Although these incidents are
most often thought of as involving female veterans, male veterans may
also be involved. Care must be taken to tailor development for a male or
female veteran. These incidents are often violent and may lead to the
development of PTSD secondary to personal assault.

\(2\) Because assault is an extremely personal and sensitive issue, many
incidents of personal assault are not officially reported, and victims
of this type of in-service trauma may find it difficult to produce
evidence to support the occurrence of the stressor. Therefore,
alternative evidence must be sought.

\(3\) To service connect PTSD, there must be credible evidence to
support the veteran's assertion that the stressful event occurred. This
does not mean that the evidence actually proves that the incident
occurred, rather that there be at least an approximate balance of
positive and negative evidence that it occurred.

\(4\) Review the claim and all attached documents. Develop for SMRs and
MPRJ information as needed.

\(a\) Service records not normally requested may be needed to develop
this type of claim. Responses to the development letter requesting
details concerning the personal assault may identify additional
information sources. These include:

-   A rape crisis center or center for domestic abuse,

-   A counseling facility,

-   A health clinic,

-   Family members or roommates,

-   A faculty member,

-   Civilian police reports,

-   Medical reports from civilian physicians or caregivers who may have
    treated the veteran either immediately following the incident or
    sometime later,

-   A chaplain or clergy,

-   Fellow service persons, or

-   Personal diaries or journals.

    **5-II-14**

# February 25, 2005 M21-1, Part III {#february-25-2005-m21-1-part-iii-1 .unnumbered}

#  Change 131 {#change-131-8 .unnumbered}

Obtain any reports from the military police, shore patrol, provost
marshal\'s office, or other military law enforcement. Development may
include phone, fax, e-mail, or correspondence as long as documented in
the file.

\(5\) Identifying possible sources of alternative evidence will require
that you ask the veteran for information concerning the incident. This
should be done as compassionately as possible in order to avoid further
traumatization. The PTSD stressor development letter used by regional
offices to solicit details concerning a combat stressful incident is
inappropriate for this type of PTSD claim. Select the personal assault
option from the PTSD Special Issue screen in MAP-D for this type of
claim.

\(6\) Rating Veterans Service Representatives (RVSRs) must carefully
evaluate all the available evidence. If the military record contains no
documentation that a personal assault occurred, alternative evidence
might still establish an in-service stressful incident. Behavior changes
that occurred at the time of the incident may indicate the occurrence of
an in-service stressor. Examples of behavior changes that might indicate
a stressor are (but are not limited to):

-   Visits to a medical or counseling clinic or dispensary without a
    specific diagnosis or specific ailment;

-   Sudden requests that the veteran's military occupational series or
    duty assignment be changed without other justification

-   Lay statements indicating increased use or abuse of leave without an
    apparent reason such as family obligations or family illness

-   Changes in performance and performance evaluations

-   Lay statements describing episodes of depression, panic attacks or
    anxiety but no identifiable reasons for the episodes;

-   Increased or decreased use of prescription medications;

-   Increased use of over-the-counter medications

-   Evidence of substance abuse such as alcohol or drugs

-   Increased disregard for military or civilian authority

-   Obsessive behavior such as overeating or undereating

-   Pregnancy tests around the time of the incident

-   Increased interest in tests for HIV or sexually transmitted diseases

-   Unexplained economic or social behavior changes

-   Treatment for physical injuries around the time of the claimed
    trauma but not reported as a result of the trauma, or

-   Breakup of a primary relationship.

    \(7\) In personal assault claims, secondary evidence may need
    interpretation by a clinician, especially if it involves behavior
    changes. Evidence that documents such behavior changes may require
    interpretation in relationship to the medical diagnosis by a
    neuropsychiatric physician.

    **5-II-15**

    **M21-1, Part III February 25, 2005\
    Change 131**

    **5.15 ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS).** AIDS is defined
    by the Centers for Disease Control as \"a disease at least
    moderately predictive of a defect in cell-mediated immunity
    occurring in a person with no known cause for diminished resistance
    to that disease.\" AIDS is caused by human immunodeficiency virus
    (HIV).

    a\. **Testing Procedures.** The most commonly used lab test for AIDS
    is the HIV antibody test. Two antibody tests are available: the
    screening ELISA test and the confirmatory Western Blot.

    b\. **Development**

    \(1\) If service medical records are not on file, request them. The
    veteran may submit current records of treatment by a private
    physician or hospital. If the veteran indicates treatment at a VA
    medical center or outpatient clinic, request those records.

    \(2\) If a substantially complete claim exists, send the claim to
    the rating activity.

    **5.16 EX-PRISONER OF WAR CASES.** See chapter 4 to request service
    records for ex-prisoners of war (ex-POWs). If service records cannot
    be obtained, follow the procedures listed below.

    a\. **Action Required**

    \(1\) Accept a veteran\'s statement regarding disabilities incurred
    as a POW unless inconsistent with other evidence. Supporting
    statements from other comrades constitute medical evidence.
    Discrepancies or deficiencies in the evidence require development.

    \(2\) If neither the service medical records received regarding
    examination immediately after POW confinement nor other service
    medical records support the alleged disabilities in the claim, ask
    the veteran to submit additional evidence. Use a locally generated
    letter along the following lines:

    "Since you were a prisoner of war and your service medical records
    do not clearly disclose all the disabilities you claim, any
    additional evidence you may be able to furnish will assist us in
    making a decision in your case."

    "For your claimed \[specify conditions\], it would be helpful to
    submit statements from fellow prisoners of war, servicepersons,
    veterans, doctors or other persons who had personal knowledge of the
    above disabilities in service or shortly thereafter, stating the
    dates and places of their observations and the circumstances under
    which these observations were made. Statements of comrades must
    contain their name, rank, service number and organization."

    \"If the evidence is not received within 60 days, your claim will be
    considered on the available evidence, if any, in your folder, unless
    you request an extension of time. If you do not intend to or cannot
    submit any statements, notify us promptly so we do not unnecessarily
    delay action.\"

    b\. **Employability Information.** If the employment information
    submitted with a claim is incomplete, and individual unemployability
    will be an issue for consideration by the rating activity, develop
    under paragraph 5.21 simultaneously with development for service
    medical records (par. 5.01) and medical evidence from nonservice
    sources (par. 5.03). If medical evidence is in file, develop for
    employment history as above, and immediately refer the claim to the
    rating activity.

    **5-II-16**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

    c\. **Civilian Employees, Pacific Naval Air Bases, Who Actively
    Participated in the Defense of Wake Island.** These individuals are
    considered to have served on active duty from December 8, 1941,
    until approximately October 1, 1945. From December 23, 1941 until
    approximately October 1, 1945, they are classified as being POWs.

    \(1\) **DD Forms 214.** The remarks section of the DD Form 214 for
    these individuals will contain:

    \(a\) The name of the group.

    \(b\) A statement of the time period the individual was held as a
    POW.

    \(c\) A statement indicating there are no medical or dental records
    for the time the individual was a POW.

    \(2\) **Medical Record Requests.** Requests for medical records
    should *not* be submitted to the service department in these cases.
    Available records, if any, can be obtained from the Office of
    Workers\' Compensation Programs---Branch of Special Claims, P.O. Box
    37117, Washington, DC 20013. Make requests by locally generated
    letter.

    \(3\) **Prohibition Against Concurrent Benefits.** Defenders of Wake
    are entitled to Federal Employees

    Compensation Act (FECA) benefits. An election between FECA benefits
    and VA benefits is required. On receipt of a claim for VA benefits,
    follow the procedures in part IV, chapter 20.

    d\. **Certain Peacetime Veterans May Be Granted Ex-POW Status.**
    Only VA has authority to determine ex-POW status if detention or
    internment occurred during peacetime or if detention or internment
    during wartime was by allied governments, *e.g.*, the Soviet Union
    in World War II, or neutral governments, *e.g*., Switzerland or
    Sweden in World War II, their agents, or by hostile governments or
    forces. An administrative decision is required. See part IV, chapter
    11.

    \(1\) If a veteran claims ex-POW status but has provided no
    verification and verification is not available in the claims folder,
    make a PIES request to the appropriate service department. The
    information requested from the service department will depend on the
    type of status claimed. At the same time the information is
    requested from the service department, undertake development with
    the veteran to request any information needed.

    \(a\) If the veteran claims status as a peacetime ex-POW, request
    the facts and circumstances of detention or internment. Describe the
    information required in the ADDITIONAL INFORMATION REQUESTED field
    (circumstances of detention, dates and places of internment,
    detaining power and supporting documents). Where possible, provide
    dates of internment as given by the veteran to serve as guidelines
    for the service department. Do *not* request certification of ex-POW
    status.

    \(b\) If the veteran alleges detention during wartime, request the
    circumstances of detention, the dates and places of internment and
    the detaining power. The facts and circumstances of detention are
    needed only if the detaining power was an allied or neutral power or
    its agent, or a hostile force, or if the certification of the
    service department legitimately may be questioned, requiring an
    administrative decision by the regional office. Use PIES to request
    the information.

    **5-II-17**

    **M21-1, Part III February 25, 2005**

    **Change 131**

    \(2\) If the response indicates that no records may be released
    because they are classified or if the response is inadequate,
    contact the Compensation and Pension Service, Policy Staff (211),
    at (202) 273-7210.

    e\. **Questions.** Any questions on POW issues may be directed to VA
    Central Office, Veterans Services Staff (216B).

    **5.17 DEVELOPMENT OF CLAIMS BASED ON UNDIAGNOSED ILLNESSES OF GULF
    WAR**

    **VETERANS**

    a\. **General.** When a claim is received from a Gulf War veteran
    alleging either a disability resulting

    from exposure to environmental hazards or an undiagnosed illness
    (e.g., fatigue, headache, muscle aches, memory loss or other
    conditions listed in 38 CFR 3.317(b)), the regional office should
    put a flash on the outside of the claims folder as shown in exhibit
    B.1. A checklist shown in exhibit B.2 is designed to be completed as
    each step in the development process is accomplished, to ensure that
    all needed development is completed.

    b\. **Development**. Ensure that the development letter in exhibit
    B.3 has been sent to the claimant and that a copy of the letter is
    in the claims file, or that an equivalent request has been made by
    telephone, fax, etc., for any new claim received. The regional
    office will not make a decision on these claims unless the
    development letter or evidence of an equivalent request by another
    method is of record.

    \(1\) The letter issued as an attachment to All-Station Letter 96-73
    is still acceptable as an initial

    development letter, if it is already of record. However, any
    follow-up development letter that may be needed requires inclusion
    of the exact wording of paragraph 1 in exhibit B.4.

    \(2\) Document development by telephone by means of VA Form 119. See
    paragraph 11.18.

    \(3\) If the veteran has a power of attorney, a copy of the VA Form
    119 will be sent to the veteran's

    representative in the same manner as copies of development letters.

    c\. **Service Department Records.** In addition to service medical
    records, request the following

    records whenever possible.

    \(1\) If the veteran furnishes information on the application about
    specific inpatient treatment, request clinical records
    *simultaneously* with the service medical records. In addition,
    request the dates of service and confirm active duty dates in the
    Southwest Asia theater of operations during the Gulf War (beginning

    August 2, 1990) if this information is not already established by
    the evidence of record.

    \(2\) If confirmation of Southwest Asia theater duty is not received
    following usual service department

    requests and the veteran is---or was at the time of service in
    Southwest Asia---a member of a Reserve or National Guard unit, call
    the veteran's Reserve or National Guard unit to ask for this
    information. Document the call.

    d\. **Types of Evidence.**

    \(1\) **Medical Evidence.** Request reports for all private and VA
    medical treatment that is indicated by the veteran, both during and
    after service. This includes statements from doctors, hospitals,
    laboratories, medical facilities, mental health clinics, X-rays,
    physical therapy records, etc.

    **5-II-18**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

    \(2\) **GW Registry Exam.** If a veteran has submitted a VA From
    21-526 which does not include the question asking the veteran if he
    or she wants medical or other information included in the Gulf
    Health Registry, the regional office must send a letter to the
    veteran providing the opportunity to have his or her medical or
    other records included in the registry. The text of the letter is
    included in exhibit B.6. If the veteran indicates that the GW
    Registry examination has been conducted, request the examination
    report from the appropriate medical facility.

    \(3\) **Lay Evidence.** If the veteran alleges that a disability
    began after military service, request evidence to establish that
    fact. If the disability claimed is an undiagnosed condition, the
    evidence may be either medical evidence or nonmedical indications
    that can be independently observed or verified.

    \(a\) Nonmedical indications include---but are not limited to---such
    events as time lost from work, evidence that a veteran has sought
    medical treatment for his or her symptoms, and evidence affirming
    changes in the veteran's appearance, physical abilities, and mental
    or emotional attitude. Lay statements may be especially important in
    cases where an undiagnosed illness is manifested solely by the
    symptoms which the veteran reports and which might not be verifiable
    by medical examination.

    \(b\) Lay evidence from a person making a statement from personal
    observation or experience is credible if the person was in a
    position to know the facts attested to, if the statement is
    sufficiently specific to address the facts, and if the evidence is
    not contradicted by evidence of record which is more credible.
    Provisions of 38 CFR 3.317 state that the nonmedical indicators must
    be *capable* of independent verification. This means that if we were
    to seek verification from an independent source, it would be
    possible to obtain that verification.

    \(c\) On occasion, the lay statement may request clarification.
    Generally, however, unless there is reason to doubt the credibility
    of evidence, do not develop for corroboration.

    \(d\) See exhibits B.7 and B.8 for use in developing lay evidence.

    e\. **Medical Examination Needed.** When an undiagnosed illness is
    claimed, a thorough medical examination report is essential to rule
    out known diagnoses and provide---where possible---an accurate
    picture of disability for rating purposes. Specialist examinations
    will be ordered as appropriate (e.g., pulmonary function studies
    when breathing problems are claimed; neurological evaluation for
    headaches; psychiatric/neuropsychiatric examinations for memory loss
    or fatigue). If multiple joint or muscle pain is alleged, ask the
    veteran to identify specific areas affected. When nonspecific
    complaints are presented, the examiner must address these issues.

    \(1\) Are there clinical, objective indicators for the following
    symptoms:

    \(a\) fatigue \_\_\_\_\_\_\_\_\_ Yes \_\_\_\_\_\_\_\_\_\_ No

    \(b\) joint pain \_\_\_\_\_\_\_\_\_ Yes \_\_\_\_\_\_\_\_\_\_ No

    \(c\) \[List all alleged symptoms.\]

    \(2\) Are any of the aforementioned symptoms attributable to a
    "known" clinical diagnosis? Please specify.

    f\. **No Residual Disability.** A claim based on exposure only, with
    no residual disability claimed as a result of that exposure, will
    require clarification. Inform the claimant that he or she must
    identify a specific disability, as exposure in and of itself is not
    a disability. If a specific condition is subsequently claimed, fully
    develop as an environmental hazard or undiagnosed illness claim.

    **5-II-19**

    **M21-1, Part III February 25, 2005**

# Change 131 {#change-131-9 .unnumbered}

g\. **Notification Letters.** All GW environmental hazard or undiagnosed
illness notification letters (grant or disallowance) must include a
reference to the regulation that authorizes compensation for
disabilities due to undiagnosed illness lasting six months or longer,
and medically unexplained chronic multi-symptom illnesses (such as
chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome)
that began either during active service in the Southwest Asia theater of
operations or at any time through September 30, 2011. See exhibits B.4
and B.5. Exhibit B.5 contains a notification letter to be sent if there
is no change following readjudication of a GW environmental hazard or
undiagnosed illness claim.

**5.18 DEVELOPMENT FOR EXPOSURE TO MUSTARD GAS AND LEWISITE**

a\. **General.** 38 CFR 3.316 authorizes service connection for veterans
who underwent *any* full-body exposure to mustard gas or lewisite during
military service. Service connection may be granted for the following
conditions: chronic conjunctivitis, keratitis, corneal opacities, scar
formation, nasopharyngeal cancer, lung cancer (except mesothelioma), or
squamous cell carcinoma of the skin based on full-body exposure to
nitrogen or sulfur mustard during active military service. Service
connection may also be granted for a chronic form of laryngitis,
bronchitis, emphysema, asthma, or chronic obstructive pulmonary disease
based on full-body exposure to nitrogen or sulfur mustard or lewisite
during active military service, and acute nonlymphocytic leukemia based
on exposure to nitrogen mustard during active military service. Included
are veterans:

\(1\) Exposed during field or chamber testing;

\(2\) Exposed under battlefield conditions in World War I;

\(3\) Present at the German air raid on the harbor of Bari, Italy, in
World War II;

\(4\) Engaged in manufacturing and handling vesicant (blistering) agents
during their military service.

b\. **Development**

\(1\) Development for evidence of full-body exposure to mustard gas or
lewisite is necessary *only* if the

veteran claims exposure and has a mustard gas induced condition.

\(2\) Compensation claims based on exposure under battlefield conditions
during WWI or other types of exposure, may show evidence in service
medical records of the acute effects of mustard gas or lewisite
exposure. Delayed effects of exposure may appear even though no acute
effects were noted in service. It is also possible that the veteran may
have been exposed to nonservice-related causative conditions or events.

c\. **Chemical Exposure Database**. The Defense Manpower Data Center
(DMDC) maintains a database containing information on Army and Navy
persons who may have been exposed during World War II to mustard gas and
lewisite during testing programs, production, storage or transportation.
Written inquiries may be submitted to:

Ms. Shirley Martin

Defense Manpower Data Center

1600 Wilson Boulevard, Suite 400

Arlington, Virginia 22209

\(703\) 696-7403

**5-II-20**

**February 25, 2005 M21-1, Part III**

**Change 131**

Inquiries should contain the following information:

-   Full name of veteran

-   Service number

-   Social Security number

-   Number of exposures

-   Month and year of exposure(s)

-   Location of exposure(s)

-   Full organizational designation at the time of exposure(s)

-   Type of activity: basic training, test or experiment, school, etc.

-   Description of events involved in the exposure. *This is very
    important since names are not always available and exposure
    verification is determined based on comparison of the description
    and dates against test reports*. Include length of time exposed,
    procedures followed before, during and after the actual exposure,
    effect of the exposure and whether medical treatment was given

-   Copy of any pertinent documentation the veteran may possess
    including names of other individuals, Special Orders, TDY orders,
    etc.

    ***Note:*** Be advised that copies of the database cannot be
    requested by the regional offices. Individual exposure inquiries
    must be addressed by DMDC.

    d\. **Navy Development**

    \(1\) From 1942 to 1945, the NRL conducted a program to test and
    evaluate protective clothing and applications (ointments, powders,
    etc.) for use against war gases. The tests involved Navy enlisted
    volunteers from the Out-Going Unit (OGU) at the Naval Training
    Station at Bainbridge, Maryland. Naval records show that much of the
    testing of the protective clothing and equipment was performed using
    sulfur mustard gas. The records also show that some lewisite and
    nitrogen mustard were used.

    \(2\) Development for NRL Testing

    \(a\) Before writing to NRL, ensure that the veteran served in the
    Navy and received training at Bainbridge Naval Training Station,
    Bainbridge, Maryland. Development can include asking for a copy of
    orders to or from NRL, copies of morning report entries, buddy
    statements from others who participated at the same time, etc. NRL
    does not have custody of any records related to veterans who
    participated in tests conducted at other sites in the United States
    or elsewhere (e.g., Great Lakes, Illinois, and Hart Island, New
    York, etc.).

    \(b\) The Naval Branch at the NPRC in St. Louis will review
    veteran\'s records and, if information concerning the testing is
    found, will provide it to the regional office. This office may be
    reached at (314) 538-4166.

    \(c\) If no information is found in the veteran\'s file, the
    requester will be referred to:

    Naval Research Laboratory

    Attn: Code 1230, Public Affairs Branch

    Washington, DC 20375-5000

    \(3\) Other Navy Testing. Develop information about chemical testing
    by the Navy at sites other than NRL through the NPRC.

    **5-II-21**

    **M21-1, Part III February 25, 2005\
    Change 131**

    e\. **Army Development**

    \(1\) The Army conducted research into the effects of chemical
    warfare on individuals for several years prior to WWII through 1975.
    Projects included the use of mustard gases and other types of
    chemicals.

    \(2\) Prior to the early 1950s, information about a person\'s
    participation in any kind of testing by the Army was placed in the
    individual\'s service medical records. These records are stored at
    the NPRC and can be obtained by a PIES request.

    \(3\) Since the 1950s, the records on testing for \"medical
    volunteers\" have been compiled in different formats and stored in a
    number of locations. Some are on microfiche, or on magnetic tape, or
    remain on paper. Simultaneous development to NPRC and to the listed
    address should be taken. Include a cross- reference on each request.

    \(4\) For testing which occurred *prior to 1955* send the request
    to:

    Commander

    U.S. Army Chemical and Biological Defense Agency

    Attn: AMSCB-CIH/E5183

    5101 Hadley Rd.

    Aberdeen Proving Ground, MD 21010-5423

    For testing from *1955 to 1975,* send the request to:

    Headquarters

    Army Medical Research and Materiel Command

    Attn: SGS

    Fort Detrick

    Frederick, MD 21702-5012

    \(5\) The test information may not be maintained under the
    participant\'s name and verification may only be determined based on
    the comparison of the description and dates against the reports.
    Therefore, in addition to the veteran\'s name, include as much
    information as possible. The request should contain as much of the
    following information as possible:

-   The name served under if different from current name.

-   Service number

-   Social Security number, if available.

-   The date of the alleged exposure (month and year).

-   Location of the alleged exposure

-   The unit to which the veteran was assigned at time of alleged
    exposure

-   Claimant's statement in support of claim describing the event, and a
    copy of the DD 214, WD AGO Form 100, Form 20, and any supporting
    information \[i.e., names of other servicemen, a copy of a special
    order,

    TDY orders, or a copy of a proficiency certificate (such as one from
    a Unit Gas Officer or a Chemical Warfare School)

-   Copy of any service medical records which may indicate vapor burns
    and/or exposure to H or L (mustard agent or Lewisite)

-   Documentation pertaining to exposure from medical and personnel
    files provided by NPRC.

    **5-II-22**

    **February 25, 2005 M21-1, Part III**

    **Change 131**

#  Appendix B {#appendix-b .unnumbered}

Appendix B provides letters to be used for developing information
relating to Gulf War claims; for use in requesting evidence from the
service department relating to personal assault claims; a memorandum for
certifying that all efforts have been exhausted in obtaining
verification of in-service stressors, sample letters for use in
requesting evidence from the Defense Threat Reduction Agency; and, a DoD
letter authorizing release of classified information. (See Exhibits B-1
through B-11.)

**5-B-1**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

**Exhibit B-1**

### Sample of Folder Flash {#sample-of-folder-flash .unnumbered}

The following represents a sample of the folder flash which may be used
on Gulf War environmental hazard or undiagnosed illness cases. Create
the flashes on white paper using the wording shown here, with lettering
large enough to indicate prominently the nature of the claim.

GULF WAR

ENVIRONMENTAL

HAZARD OR

UNDIAGNOSED

ILLNESS CLAIM

VARO \[Insert RO name and number.\]

**5-B-2**

**February 25, 2005** **M21-1, Part III**

**Change 131**

**Appendix B**

**Exhibit B-2**

**[GW CHECKLIST]{.underline}**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 1. Environmental hazard or claim for an
undiagnosed illness or** **medically unexplained chronic multi-symptom
illness (such as chronic fatigue syndrome, fibromyalgia, and irritable
bowel syndrome) is of record.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 2. Service in SWA
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ to \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is
verified.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 3. Other service
\_\_\_\_\_\_\_\_\_\_\_\_ to \_\_\_\_\_\_\_\_\_\_\_\_ is verified.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 4. Standard development letter has been
sent. (See Exhibit A.3.)**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 5. SMRs for all periods of service are
of record, or documentation is of record that**

**they are not available.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 6. Adequate VA examination is of
record.**

**a. All issues (including those raised on GW Registry exam)
addressed.**

**b. Additional medical evidence obtained if shown on exam.**

**c. Additional lay evidence requested if shown on exam.**

**d. All recommended tests completed.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 7. GW Registry exam is in file (if
conducted).**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 8. Treatment records from VA have been
received.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 9. Treatment records from private
sources have been requested (with appropriate**

**followup).**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 10. All lay evidence has been
requested.**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 11. Other conditions claimed have been
fully developed (e.g., PTSD, exposure,**

**disability pension, etc.).**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 12. Due process time (60 days) has been
allowed and response has/has not been**

**received. \[Circle one.\]**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 13. Date of claim
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \[Enter date of receipt of claim for
environmental**

**hazard or undiagnosed illness.\]**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\[Initials\] \[Date\]**

**5-B-3**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

**Exhibit B-3**

**Gulf War Undiagnosed Illness Standard Development Letter**

\[Following Publication in the *Federal Register* of the Regulation
Extending the Presumptive Period\]

Dear :

We've received your claim for disability benefits based on Gulf War
service. We may be able to pay benefits if an undiagnosed illness or a
medically unexplained chronic multi-symptom illness (such as chronic
fatigue syndrome, fibromyalgia, and irritable bowel syndrome)

-   began EITHER during active service in the Southwest Asia theater of
    operations OR at any time through September 30, 2011, and

-   has lasted for six months or longer.

**WHAT WE NEED**

We need more information before we can continue work on your claim. *We
can use both medical and nonmedical evidence.*

**MEDICAL EVIDENCE**

1\. Any medical evidence you have from the time you began active duty in
the Gulf War area. These are

Things like your complete service medical records or anything else you
have showing medical treatment while in the Gulf area.

2\. Any medical evidence you have from the time you left the Gulf. This
includes reports or statements from

doctors, hospitals, laboratories, medical facilities, or mental health
clinics, X-rays, physical therapy records, and so on.

3\. Medical statements should show dates of examination, findings, and
diagnoses. Doctors' statements

should also state when the doctor first noticed your disabilities, how
they appeared, and how long they lasted.

4\. If you have participated in a Gulf Health Registry Examination,
please let us know when the examination

took place and which VA Medical Center conducted the examination.

**NONMEDICAL EVIDENCE**

1\. Any evidence which is written or can be verified. Things which can
help us with your claim include records or reports of:

a\. time lost from work;

b\. changes in your physical appearance;

c\. changes in your physical abilities;

d\. changes in your mental or emotional attitude.

2\. We can also use statements from persons who knew you during the Gulf
War or after your military service.

**5-B-4**

**February 25, 2005** **M21-1, Part III**

**Change 131**

**Appendix B**

**Exhibit B-3 - continued**

a\. This person should have personal knowledge of your disabilities.
Each person should submit a

> statement on the enclosed VA Form titled "Statement in Support of
> Claim" or a letter with the following statement above the signature:
>
> I hereby certify that the information I have given is true to the best
> of my knowledge and belief.

b\. The person's name and complete address must be clearly shown.
Identify the statement with your

> name and VA file number.

c\. The statement should describe exactly what the person observed and
mention specific dates and

> places.

d\. A person on active duty at the time should include his or her
service number and military unit.

**WHAT YOU SHOULD DO NEXT**

Please send this information to the address at the top of this letter as
soon as you can, preferably within 60 days. If you wish, you may visit
our office with the evidence. The sooner we receive what we need, the
sooner we will be able to decide your claim.

If we don't hear from you within one year from the date of this letter,
we can only begin payment of benefits from the date we get your
response.

**IF YOU HAVE ANY QUESTIONS**

If you have any questions about this letter or any VA benefits, call our
toll-free Gulf Information Helpline at 1-800-PGW-VETS.

> Sincerely yours,
>
> \[Signature Block of Veterans Service Center Manager\]

Enclosure: VA Form 21-4138

> **5-B-5**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

**Exhibit B-4**

**\[Sample Paragraphs Concerning Extension of Presumptive Period**

Paragraph 1 \[For Use in Supplemental Developmental Letter\]

**IMPORTANT NOTE**

A regulation has authorized compensation for disabilities due to
undiagnosed illness or for medically unexplained chronic multi-symptom
illnesses (such as chronic fatigue syndrome, fibromyalgia, and irritable
bowel syndrome) lasting six months or longer that began either during
active service in the Southwest Asia theater of operations or at any
time through September 30, 2011. If you have, or develop, disabilities
that you believe may entitle you to compensation under the new
regulation, please contact the nearest VA regional office for
information on how to file a new claim.

Paragraph 2 \[For Use in Notification Letter---Either Grant or
Disallowance\]

This decision was made under a regulation that authorizes compensation
for disabilities due to undiagnosed illness or for medically unexplained
chronic multi-symptom illnesses (such as chronic fatigue syndrome,
fibromyalgia, and irritable bowel syndrome) lasting six months or longer
that began either during active service in the Southwest Asia theater of
operations or at any time through September 30, 2011. If you have, or
develop, disabilities that you believe may entitle you to compensation
under the new regulation, please contact the nearest VA regional office
for information on how to file a new claim.

**5-B-6**

**February 25, 2005 M21-1, Part III**

**Change 131**

**Appendix B**

**Exhibit B-5**

**Letter of Notification if No Change after Readjudication**

Dear :

We have completed a review of your claim for disability benefits based
on Gulf War service. The purpose of our review was to ensure that all
evidence pertaining to your claim for disability benefits was complete
and had been fully considered in reaching a decision on your claim.

Service connection for \_\_\_\_\_\_\_\_\_\_\_\_ was denied because
\_\_\_\_\_\_\_\_\_\_\_\_. The evidence we considered in that decision
included:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. Our
letter of \_\_\_\_\_\_\_\_\_\_\_\_ told you about that decision,
including all the evidence considered at that time.

Review of your file shows that all the evidence listed above was fully
considered. There is no information to show that there is any additional
evidence available for us to consider. Therefore, our prior decision is
unchanged and service connection for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
remains denied.

This decision was made under a new regulation that authorizes
compensation for disabilities due to undiagnosed illness lasting six
months or longer that began either during active service in the
Southwest Asia theater of operations or at any time through September
30, 2011. If you have, or develop, disabilities that you believe may
entitle you to compensation under the new regulations, please contact
the nearest VA regional office for information on how to file a new
claim.

If you believe our decision is not correct, please see that attached
notice of procedural or appeal rights.

Sincerely yours,

\[Signature Block of Veterans Service Center Manager\]

Enclosure: Appeal Notice

> **5-B-7**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

**Exhibit B-6**

**Sample Letter Asking GW Veterans with Pending Claims if They Want
Their Medical Information**

**Included in the Health Registry**

Public Law 102-584 requires the Department of Veterans Affairs (VA) to
establish and maintain a registry of veterans who served in the
Southwest Asia theater of operations during the Gulf War. This registry
will be used as a basis for research on the health consequences of
military service in the Southwest Asia theater.

If you served in the Southwest Asia theater of operations, your name
will be automatically included in the registry. VA will also include
relevant medical or other information about you, but we need your
permission to do so. The information in the registry will be shared only
with the Department of Defense and others as provided by law, for
example, the National Academy of Sciences for research purposes.

Periodically, VA will inform you of significant developments in research
on the health consequences of military service in the Southwest Asia
theater.

If you want relevant medical and other records included in the registry,
please let us know. If you do not want your records included in the
registry, you do not have to do anything.

> Sincerely yours,
>
> \[Signature Block of Veterans Service Center Manager\]

**5-B-8**

**February 25, 2005 M21-1, Part III**

**Change 131**

**Appendix B**

**Exhibit B-7**

**Request for Lay Evidence**

(For Use in Development for Lay Evidence in PGW Claim---Initial Request)

Dear XXXX:

The above veteran currently has a claim for Department of Veterans
Affairs (VA) disability benefits pending in this office. He has reported
that you may have personal knowledge which may help support his (her)
claim.

**What We Need**

In order to assist the veteran with his (her) claim, we are asking that
you furnish the following information:

A. Please describe exactly what you observed, giving dates and places.
(Be sure to include specific month,

day and year.) If you are in an occupation which would qualify you as an
expert witness, e.g., medical doctor, nurse, etc., please include this
information. Your statement should describe factual events or conditions
which you witnessed or know with reasonable certainty occurred.

B. Include information based on your personal knowledge and your
observations of the level of severity and the duration.

C. Please provide information concerning your relationship to the
veteran which enabled you to make your observations.

D. If you were on active duty at the time, please include your former
rank, organization and service serial number.

**What You Should Do Next**

We are enclosing VA Form 21-4138 for your convenience in replying. This
form includes the statement that you are certifying the information to
be true to the best of your knowledge and belief. If you choose not to
use this form, please include this certification on whatever document is
submitted.

**When We Need The Requested Information**

This evidence should be furnished as soon as possible, preferably within
60 days. The sooner we receive what we need, the sooner we'll be able to
determine the veteran's entitlement to benefits.

It may expedite the veteran's claim is you would fax the report to us.
Our fax number is (XXX) XXX-XXXX. If you do fax this evidence, please
clearly write the veteran's name and VA claim number on each page. The
veteran's VA claim number is located at the top of this letter above the
veteran's name.

> **5-B-9**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

**Exhibit B-7 - continued**

**If You Have Questions**

If you have any questions, call us toll-free by dialing 1-800-827-1000.
Our TDD number for the hearing impaired is 1-800-829-4833. *If you call,
please have this letter with you.*

*Please show the veteran's full name and VA file number on all
correspondence or evidence submitted.*

> Sincerely yours,
>
> \[Signature Block of Veterans Service Center Manager\]

Enclosure

**5-B-10**

**February 25, 2005 M21-1, Part III**

**Change 131**

**Appendix B**

**Exhibit B-8**

**Follow-up Request for Lay Evidence**

(For Use if Additional Information Is Needed to Clarify Response to
Initial Request)

Dear XXXX:

The above veteran currently has a claim for Department of Veterans
Affairs (VA) disability benefits pending in this office. Thank you for
providing us with your \[Insert date\] lay statement; however, we need
the following additional information.

**What We Need**

In order to assist the veteran with is claim, we are asking that you
furnish the following additional information:

\[The following are 5 optional paragraphs. Select the paragraph or
paragraphs needed.}

> \(1\) List all symptoms/conditions that you have observed.
>
> \(2\) The specific month, day and year that you first noticed each
> condition/symptom.
>
> \(3\) Length of time each condition/symptom was observed.
>
> \(4\) Frequency of each condition/symptom observed (i.e., 1, 2, 3
> times a day, week, month, etc.)
>
> \(5\) Result or impact of each condition/symptom observed on the
> veteran (i.e., did he (she) take medicines or seek medical help, and
> if so, how often; did he(she) miss work or school, and if so, how
> often; did it affect relationships with family and friends, and if so,
> describe in detail).

**What You Should Do Next**

We are enclosing VA Form 21-4138 for your convenience in replying. This
form includes the statement that you are certifying the information to
be true to the best of your knowledge and belief. If you choose not to
use this form, please include this certification on whatever document is
submitted.

**When We Need The Requested Information**

This evidence should be furnished as soon as possible, preferably within
60 days. The sooner we receive what we need, the sooner we'll be able to
determine the veteran's entitlement to benefits.

It may expedite the veteran's claim if you would fax the report to us.
Our fax number is (XXX) XXX-XXXX. If you do fax the evidence, please
clearly write the veteran's name and VA claim number on each page. The
veteran's VA claim number is located at the top of this letter above the
veteran's name.

> **5-B-11**

# M21-1, Part III February 25, 2005

# Change 131

**Appendix B**

**Exhibit B-8 - continued**

**If You Have Questions**

If you have any questions, call us toll-free by dialing 1-800-827-1000.
Our TDD number for the hearing impaired is 1-800-829-4833. *If you call,
please have this letter with you.*

*Please show the veteran's full name and VA file number on all
correspondence or evidence submitted.*

> Sincerely yours,
>
> \[Signature Block of Veterans Service Center Manager\]

Enclosure

**5-B-12**

**February 25, 2005 M21-1, Part III**

**Change 131**

#  Appendix B

**Exhibit B-9**

**SUGGESTED LETTER TO USE TO REQUEST PARTICIPATION OR RADIATION DOSE
INFORMATION FROM THE DEFENSE THREAT REDUCTION AGENCY**

Defense Threat Reduction Agency 00/21

Attn: TDND/NTPR C 12 345 679

8725 John J. Kingman Rd., Mail Stop 6201 JONES, John A.

Ft Belvoir, VA 22060-6201

Dear Sir/Madam:

We have received a claim for service connection under provisions of 38
C.F.R. 3.309 for conditions allegedly due to radiation risk activity.

Veteran's identifying information:

> Full name: John A. Jones
>
> VA Claim No: C 12 345 679
>
> Social Security No: 234 56 7890
>
> Branch of Service: Navy
>
> Assigned Unit: USS SEVERN (AO-61)

The veteran, Mr. Jones, participated in OPERATION CROSSROADS (ABLE &
BAKER) FROM July 7, 1946, to August 24, 1946. His duties and activities
included COOK.

The alleged radiogenic disease is SKIN CANCER \[specific site of lesion
must be included\]. A copy of the claimant's statement is enclosed.

The claimant's name and address is:

> John A. Jones
>
> 793 Smith St.
>
> Hometown, CA 92027
>
> Telephone:

Please verify the veteran's participation in the radiation risk activity
described above and provide the associated radiation dose. If no
individual radiation dose record is available, please provide a dose
reconstruction for his unit.

Please send your reply to \[give regional office address, as shown
below\]:

> Department of Veterans Affairs
>
> Regional Office
>
> 2022 Camino Del Rio North
>
> San Diego, CA 92108

Your assistance in this matter is appreciated.

> Sincerely yours,
>
> \[Name and Title of Veterans Service Center Manager\]
>
> **5-B-13**

**M21-1, Part III February 25, 2005**

**Change 131**

**Appendix B**

# Exhibit B-10

# Exposure to Nuclear Radiation and Department of Defense Secrecy Agreement

**THE SECRETARY OF DEFENSE**

**WASHINGTON THE DISTRICT OF COLUMBIA**

**13 FEB 1996**

**MEMORANDUM FOR SECRETARIES OF THE MILITARY DEPARTMENTS**

> **CHAIRMAN OF THE JOINT CHIEFS OF STAFF**
>
> **UNDER SECRETAIRES OF DEFENSE**
>
> **DIRECTOR, DEFENSE RESEARCH AND ENGINEERING**
>
> **ASSISTANT SECRETARIES OF DEFENSE**
>
> **GENERAL COUNSEL OF THE DEPARTMENT OF DEFENSE**
>
> **INSPECTOR GENERAL OF THE DEPARTMENT OF DEFENSE**
>
> **DIRECTOR, OPERATIONAL TEST AND EVALUATION**
>
> **ASSISTANTS TO THE SECRETARY OF DEFENSE**
>
> **DIRECTOR, ADMINISTRATION AND MANAGEMENT**
>
> **DIRECTORS OF THE DEFENSE AGENCIES**

**SUBJECT: Exposure to Nuclear Radiation and Secrecy Agreements**

**Inquiries continue to be received regarding the appropriate action
that should be taken to release veterans from secrecy obligations so
they may justify medical treatment for conditions allegedly arising from
exposure to nuclear radiation. Congressman Bill Richardson has
specifically requested a public statement be issued announcing personnel
are relieved of any security obligation they may have incurred in
connection with their military involvement in nuclear testing to
establish the validity of a service-connected disability.**

**In the interest of fairness to the many veterans who have so honorably
served our country, in coordination with the Department of Energy, I
hereby authorize veterans seeking to establish a medical disability in
connection with exposure to nuclear radiation to divulge to the
Department of Veterans Affairs the name and location of their command,
duties performed, dates of service, and related information necessary to
validate exposure to nuclear radiation. This authorization does not
relieve veterans of responsibility for continuing to protect specific
technical information that could contribute to the development of a
weapon of mass destruction or the application of nuclear technology.**

**/s/**

**William J. Perry**

**Cc: Honorable Bill Richardson**

**U.S. House of Representatives**

**Secretary of Energy**

**Secretary of Veterans Affairs**

**5-B-14**

# February 25, 2005 M21-1, Part III

> **Change 131**

#  Appendix B

#  Exhibit B-11

## Sample: Formal finding of a lack of evidence to verify stressors

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+---+---+---+---+----------------------------+---+---------------------------+

Signature/Position

**5-B-15**

**February 25, 2005 M21-1, Part III**

**Change 131**

**CHAPTER 9. INFORMATION REQUESTS TO OR FROM OTHER**

**FEDERAL AND STATE AGENCIES**

**SUBCHAPTER I. SOCIAL SECURITY ADMINISTRATION (SSA) REQUESTS**

**9.01 REQUESTS FOR INFORMATION**

a\. **General.** Except as provided in paragraph 9.05 and part IV,
paragraph 33.04, if information is needed from SSA in connection with
adjudication of a claim, request it as shown below. Note that the
correct routing of a request for SSA disability records depends on the
individual's age. If the person is younger than age 55, FAX the request
to the Office of Disability Operations in Baltimore. If the person is
age 55 or older, FAX the request to the National Records Center (NRC) in
Kansas City. If the person resides at a foreign address, mail the
request to the Division of International Operations, P.O. Box 17769,
Baltimore, MD 21235-7769.

\(1\) **Requests to Office of Disability Operations (ODO) (for persons
under age 55).** Send a FAX to (410) 298-7954 (see ADDENDUM A).

\(2\) **Requests to Nations Records Center (for persons 55 years old and
older).** Send a FAX to (816) 257-5106 (see ADDENDUM B).

\(a\) A request should be on VA letterhead and should include the
information shown in paragraph (2)b below. The requestor's name,
telephone number and FAX number are required information so that SSA has
a VA point of contact. Do not transmit a FAX cover sheet with the
request.

\(b\) Keep the original FAX in the claim file. Annotate the FAX with the
date it was transmitted to SSA. The date will be needed for any
follow-up FAX.

b\. **Information to Be Included in Requests.** In all requests for
information, include as much of the following data as is available:

\(1\) Name and address of the claimant.

\(2\) Name of the wage earner.

\(3\) Name of wage earner\'s parents.

\(4\) Wage earner\'s SSN.

\(5\) Date, age, and place of birth of wage earner, if known.

\(6\) Exact nature of the information desired. (**Note:** If information
in the claims folder indicates that the claimant either receives SS
disability benefits or has been denied such benefits, request a copy of
the SSA decision, in addition to the SSA medical records. If the
claimant asks VA to obtain other evidence in SSA's possession, request
it as well.)

\(7\) Purpose for which the requested information is to be used.

\(8\) The requester\'s name, telephone and FAX numbers.

c\. **Follow-up on Requests for SSA Medical Records.** Do not follow up
on requests for records from SSA before 60 days have elapsed from the
date of the original request. Second and subsequent follow-up requests
must be 30 days apart. Prepare a formal finding of Federal record
unavailability if the SSA records custodian reports that the requested
records do not exist or are not available. See Chapter 4, Addendum O
(sample of a formal finding of unavailability memorandum) and M21-1MR,
Part I, 1.C.5.f.

**9-I-1**

**M21-1, Part III February 25, 2005**

**Change 131**

\(1\) **Follow-up on Requests to Division of Disability Operations (for
persons under age 55).** If the original request to the Division of
Disability Operations (par. 9.01a(1) above) was sent via FAX, the
follow-up should be sent

via FAX to (410) 298-7954. Use the sample form in Addendum A to this
chapter. If the original request to the Division of Disability
Operations was sent by mail, all follow-ups must be sent via mail also.

\(2\) **Follow-ups on Requests to National Records Center (for persons
55 years old and older).** If no reply has been received within 10
working days, FAX a follow-up request to (816) 257-5106.

d\. **Filing Social Security Records.** Handle all information furnished
to VA from SSA records under this paragraph in accordance with the
provisions of 38 CFR 1.521.

e\. **Verification of Amount of Social Security Monthly Payments.** All
tax contribution records are maintained by SSA in its Baltimore office.
Benefit payment records are maintained in the regional Program Service
Centers. Use Federal On-line Query (FOLQ) to verify the amount of the
monthly benefit.

\(1\) **Federal On-Line Query (FOLQ)**

\(a\) FOLQ is a read-only-specific real-time query developed by SSA for
states and other agencies to obtain certain SSA data. This system
provides the following information:

-   Verification of SS numbers,

-   Title II, Retirement, Survivors, and Disability Insurance data,

-   Title XVI, Supplemental Security Income data, and

-   A limited payment history file.

Access to FOLQ will enable VBA to assist veterans and dependents by
providing instant verification of the information on applications and
post entitlement reviews, such as EVR processing.

\(b\) **Access FOLQ through SHARE**. FOLQ requires the VA file number,
claimant's name, claimant\'s SSN, date of birth, and reason for inquiry
for each individual for whom information is needed. A response is
immediate, in "real time."

\(c\) **FOLQ User Guide.** This guide is found and maintained on the VBA
Intranet at the following address:
http://152.124.238.193/bl/21/publicat/Users/SSA/index.htm.

\(2\) **Combined SSA Check to a Surviving Spouse and Children.** Under
SSA procedures, a surviving spouse may continue to receive Social
Security benefit checks in his or her own name but, because of earnings,
one or more of these checks will be for the benefit of the child or
children in custody. If the VA award is based on combined earnings and
Social Security benefits and the amount of the adjusted Social Security
benefit is questionable, obtain verification of the Social Security
rates paid for the surviving spouse\'s benefit as follows:

\(a\) Establish a control to dispatch VA Form 21-8086, "Request for
Benefit Data," on or after May 15 of the year following the year of
reported income change to the appropriate PSC listed in subparagraph
9.02a.

\(b\) After dispatching the form, maintain a 60-day control. Follow up
by sending another VA Form 21-8086 marked \"Second Request\" to SSA at
the expiration of that period.

f\. **Combined SSA Check to Veteran and Spouse.** SSA may issue a
combined check to a husband and wife although the benefit payment is
based on the employment of only one spouse, if both the wage earner and
spouse reside at the same address, neither is incompetent, neither
voices any objection to the combination and no other reason exists
making the combination undesirable, e.g., entitlement by the dependent
spouse to old-age insurance (Social Security) benefits on his or her own
account. A certificate of award is sent to each containing a statement
as to the benefit rates payable to each.

\(1\) Consider only the amount of the combined check that represents the
veteran\'s part as his or her income.

**9-I-2**