## Section C. Processing Dental Claims

#### Overview

+------------+---------------------------------------------------------+
| ##         | > This section contains the following topics:           |
| ### In thi |                                                         |
| s Section  |                                                         |
+------------+---------------------------------------------------------+

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

  17           Receipt and Processing of *VA Form 10-7131,    7-C-2
               Exchange of Beneficiary Information and        
               Request for Administrative and Adjudicative    
               Action*                                        

  18           Completing *VA Form 10-7131* for Missing Teeth 7-C-7

  19           Referring Dental Disability Claims to the      7-C-9
               Rating Activity                                

  20           Processing *VA Form 10-7131* for Former        7-C-10
               Prisoners of War (POWs) and Totally Disabled   
               Service-Connected (SC) Veterans                

  21           Disposition of *VA Form 10-7131* Requests and  7-C-11
               Handling Notices of Disagreement               
               (NODs)/Appeals                                 
  ------------ ---------------------------------------------- ------------

#### 17. Receipt and Processing of *VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action*

+------------+---------------------------------------------------------+
| #####      | > This topic contains information on procedures for     |
| Introducti | > processing *VA Form 10-7131, Exchange of Beneficiary  |
| on {#intro | > Information and Request for Administrative and        |
| duction .u | > Adjudicative Action*, for dental outpatient           |
| nnumbered} | > treatment. It includes information on                 |
|            |                                                         |
|            | -   the responsibilities of the treating VA facility    |
|            |                                                         |
|            | -   procedures for processing *VA Form 10-7131*         |
|            |                                                         |
|            | -   verification of former prisoner of war (POW) status |
|            |                                                         |
|            | -   determining the character of discharge, and         |
|            |                                                         |
|            | -   procedures for review and development.              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 12, 2007                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > The treating VA facility initiates *VA Form 10-7131,  |
| a. Respons | > Exchange of Beneficiary Information and Request for   |
| ibilities  | > Administrative and Adjudicative Action* upon          |
| of the Tre | > determining that a claim for dental treatment         |
| ating VA F | > involves                                              |
| acility {# |                                                         |
| a.-respons | -   Class I dental care                                 |
| ibilities- |                                                         |
| of-the-tre | -   Class II dental treatment, including                |
| ating-va-f |                                                         |
| acility .u | ```{=html}                                              |
| nnumbered} | <!-- -->                                                |
|            | ```                                                     |
|            | -   IIa                                                 |
|            |                                                         |
|            | -   IIb, and                                            |
|            |                                                         |
|            | -   IIc, or                                             |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   Class IV dental treatment.                          |
|            |                                                         |
|            |     > Generally, this determination is done promptly    |
|            |     > upon receipt of an outpatient treatment claim and |
|            |     > prior to a Department of Veterans Affairs (VA)    |
|            |     > examination.                                      |
|            |                                                         |
|            |     > ***Reference***: For a description of dental      |
|            |     > classes, see M21-1MR, Part III, Subpart v, 7.B).  |
+------------+---------------------------------------------------------+

Continued on next page

17\. Receipt and Processing of *VA Form 10-7131, Exchange of Beneficiary
Information and Request for Administrative and Adjudicative Action*,
Continued

+------------+---------------------------------------------------------+
| a\.        | > The treating facility personnel also complete any     |
| Respon     | > development required to establish dates and places of |
| sibilities | > treatment. The following documents are provided by    |
| of the     | > the treating facility, except in referrals of Class   |
| Treating   | > II(c) or Class IV cases:                              |
| VA         |                                                         |
| Facility   | -   *VA Form 10-7131, Exchange of Beneficiary           |
| (          |     Information and Request for Administrative and      |
| continued) |     Adjudicative Action*                                |
|            |                                                         |
|            | -   a copy of *VA Form 10-10, Application for Medical   |
|            |     Benefits*, and                                      |
|            |                                                         |
|            | -   copies of any additional statements showing dates   |
|            |     and places of treatment.                            |
|            |                                                         |
|            | > ***Note***: Claims for missing teeth should not be    |
|            | > referred for adjudication unless exercise of          |
|            | > professional judgment alone cannot establish          |
|            | > entitlement after VA examination. In such cases, a    |
|            | > copy of the VA examination should also be submitted   |
|            | > along with *VA Form 10-7131, Exchange of Beneficiary  |
|            | > Information and Request for Administrative and        |
|            | > Adjudicative Action* with the annotation "*Claim for  |
|            | > missing teeth under [38 CFR                           |
|            | > 17.161(f)](http://www.                                |
|            | warms.vba.va.gov/Regs/38CFR/BookI/Part17/s17_161.doc)*" |
|            | > in Part I, Item 6 of the form.                        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. P | > The basic procedures for processing *VA Form 10-7131, |
| rocedures  | > Exchange of Beneficiary Information and Request for   |
| for Proces | > Administrative and Adjudicative Action* for dental    |
| sing VA Fo | > outpatient treatment are the same as those provided   |
| rm 10-7131 | > in M21-1MR, Part III, Subpart v, 7.A.2.               |
|  {#b.-proc |                                                         |
| edures-for |                                                         |
| -processin |                                                         |
| g-va-form- |                                                         |
| 10-7131 .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > When the request involves verification of former      |
| # c. Verif | > prisoner of war (POW) status or total                 |
| ication of | > service-connected (SC) disabilities, the request      |
|  Former PO | > appears in the "Remarks" section of Part II of *VA    |
| W Status { | > Form 10-7131* as follows:                             |
| #c.-verifi |                                                         |
| cation-of- | -   "*Dental Eligibility -- POW, [38 U.S.C.             |
| former-pow |     1712(a)(1)(F)](http://assembler.law.cornell.edu/us  |
| -status .u | code/html/uscode38/usc_sec_38_00001712----000-.html),*" |
| nnumbered} |     or                                                  |
|            |                                                         |
|            | -   "*Dental Eligibility -- Total Disability, [38       |
|            |     U.S.C.                                              |
|            |     1712(a)(1)(G)](http://assembler.law.cornell.edu/us  |
|            | code/html/uscode38/usc_sec_38_00001712----000-.html)*." |
|            |                                                         |
|            | > Information on verification of the veteran's POW      |
|            | > status or total SC disabilities should appear in the  |
|            | > claims file. If verification of POW status is not     |
|            | > available, request verification using the Personnel   |
|            | > Information Exchange System (PIES) and request code   |
|            | > 025.                                                  |
+------------+---------------------------------------------------------+

Continued on next page

17\. Receipt and Processing of *VA Form 10-7131, Exchange of Beneficiary
Information and Request for Administrative and Adjudicative Action*,
Continued

+------------+---------------------------------------------------------+
| c\.        | > ***References***:                                     |
| Ve         |                                                         |
| rification | -   For more information on processing *VA Form         |
| of Former  |     10-7131, Exchange of Beneficiary Information and    |
| POW Status |     Request for Administrative and Adjudicative         |
| (          |     Action,* for POWs, see M21-1MR, Part III, Subpart   |
| continued) |     v, 7.C.20.                                          |
|            |                                                         |
|            | -   For information on using PIES, see the *PIES User   |
|            |     Guide*.                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > When a request involves determining the character of  |
| # d. Deter | > the veteran's discharge                               |
| mining the |                                                         |
|  Character | -   follow the procedures in M21-1MR, Part III, Subpart |
|  of Discha |     v, 7.A.3, and                                       |
| rge {#d.-d |                                                         |
| etermining | -   for more information, see M21-1MR, Part III,        |
| -the-chara |     Subpart v, 1.B.                                     |
| cter-of-di |                                                         |
| scharge .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > Follow the steps in the table below when *VA Form     |
| ### e. Pro | > 10-7131, Exchange of Beneficiary Information and      |
| cedures fo | > Request for Administrative and Adjudicative Action,*  |
| r Review a | > is received requesting adjudication on a dental       |
| nd Develop | > claim.                                                |
| ment {#e.- |                                                         |
| procedures |                                                         |
| -for-revie |                                                         |
| w-and-deve |                                                         |
| lopment .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

  -------- --------------------------------------------------------------
  Step     Action

  1        Review the request to ensure the claim is based on one or more
           of the dental outpatient classifications discussed in M21-1MR,
           Part III, Subpart v, 7.B.
  -------- --------------------------------------------------------------

Continued on next page

17\. Receipt and Processing of *VA Form 10-7131, Exchange of Beneficiary
Information and Request for Administrative and Adjudicative Action*,
Continued

  -----------------------------------------------------------------------
  e\. Procedures for Review and Development (continued)

  -----------------------------------------------------------------------

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 2     | Determine if the dental claim is for *one* of the following  |
|       | circumstances:                                               |
|       |                                                              |
|       | -   treatment of an SC compensable dental disability or      |
|       |     condition                                                |
|       |                                                              |
|       | -   an SC non-compensable dental condition or disability     |
|       |     resulting from combat wounds or service trauma           |
|       |                                                              |
|       | -   treatment of a veteran with POW status                   |
|       |                                                              |
|       | -   treatment based on the veteran's combined schedular      |
|       |     evaluation of 100 percent (not [Paragraphs               |
|       |     28](ht                                                   |
|       | tp://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_28.DOC), |
|       |     [29](ht                                                  |
|       | tp://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_29.DOC), |
|       |     or                                                       |
|       |     [30](ht                                                  |
|       | tp://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_30.DOC)) |
|       |     or eligibility to the 100-percent rate on the basis of   |
|       |     individual unemployability, or                           |
|       |                                                              |
|       | -   the veteran had teeth extracted while in military        |
|       |     service (per [38 CFR                                     |
|       |     17.161](http:/                                           |
|       | /www.warms.vba.va.gov/Regs/38CFR/BookI/Part17/s17_161.doc)), |
|       |     provided that                                            |
|       |                                                              |
|       | ```{=html}                                                   |
|       | <!-- -->                                                     |
|       | ```                                                          |
|       | -   the claim is made within 90 days of discharge or release |
|       |     from active duty, or within 90 days after date of        |
|       |     correction of a disqualifying discharge or release       |
|       |                                                              |
|       | -   service did not consist entirely of active or inactive   |
|       |     duty for training, and                                   |
|       |                                                              |
|       | -   exercise of professional judgment alone cannot establish |
|       |     entitlement.                                             |
|       |                                                              |
|       | ***Note***: "Schedular evaluation of 100 percent" means that |
|       | the veteran's SC disabilities combine to an evaluation of    |
|       | 100 percent. "Not par. 28, 29, or 30" means that this does   |
|       | not apply to cases in which the 100 percent evaluation is    |
|       | granted on a *temporary basis* due to surgical or            |
|       | hospitalized treatment for an SC disability.                 |
+-------+--------------------------------------------------------------+

Continued on next page

17\. Receipt and Processing of *VA Form 10-7131, Exchange of Beneficiary
Information and Request for Administrative and Adjudicative Action*,
Continued

  -----------------------------------------------------------------------
  e\. Procedures for Review and Development (continued)

  -----------------------------------------------------------------------

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 3     | Does the claim meet one or more of the criteria outlined in  |
|       | Step 2?                                                      |
|       |                                                              |
|       | -   If *yes*, go to Step 4.                                  |
|       |                                                              |
|       | -   If *no*, return *VA Form 10-7131* to the medical         |
|       |     facility with Part II, "Remarks," annotated to state     |
|       |     "*Improper referral because \[\_\_\_\_\_\_\_\_\].        |
|       |     Authorization action is not required*."                  |
+-------+--------------------------------------------------------------+
| 4     | If clinical records for the alleged treatment are            |
|       |                                                              |
|       | -   *on* file, complete *VA Form 10-7131*                    |
|       |                                                              |
|       | -   *not on* file, initiate a PIES request to obtain service |
|       |     dental records.                                          |
|       |                                                              |
|       | ***Reference***: For information on completing *VA Form      |
|       | 10-7131, Exchange of Beneficiary Information and Request for |
|       | Administrative and Adjudicative Action,* for missing teeth,  |
|       | see M21-1MR, Part III, Subpart v, 7.C.18.                    |
+-------+--------------------------------------------------------------+

#### 18. Completing *VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action,* for Missing Teeth

+------------+---------------------------------------------------------+
| ##### Int  | > This topic contains information on completing *VA     |
| roduction  | > Form 10-7131, Exchange of Beneficiary Information and |
|            | > Request for Administrative and Adjudicative Action,*  |
|            | > for missing teeth. It includes information on         |
|            |                                                         |
|            | -   the responsibility of authorization personnel, and  |
|            |                                                         |
|            | -   procedures for completing *VA Form 10-7131,         |
|            |     Exchange of Beneficiary Information and Request for |
|            |     Administrative and Adjudicative Action*.            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 12, 2007                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a. R | > If service dental records are received in a claim     |
| esponsibil | > under [38 CFR                                         |
| ity of Aut | > 17.160](http://ww                                     |
| horization | w.warms.vba.va.gov/Regs/38CFR/BookI/Part17/s17_160.doc) |
|  Personnel | > for missing teeth, authorization personnel have the   |
|  {#a.-resp | > primary responsibility for                            |
| onsibility |                                                         |
| -of-author | -   reviewing the service dental records, and           |
| ization-pe |                                                         |
| rsonnel .u | -   furnishing a prompt response to the request.        |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > Use the table below to take the appropriate actions   |
|  b. Proced | > when completing *VA Form 10-7131, Exchange of         |
| ures for C | > Beneficiary Information and Request for               |
| ompleting  | > Administrative and Adjudicative Action*, based on the |
| *VA Form 1 | > evidence contained in the service records.            |
| 0-7131, Ex |                                                         |
| change of  |                                                         |
| Beneficiar |                                                         |
| y Informat |                                                         |
| ion and Re |                                                         |
| quest for  |                                                         |
| Administra |                                                         |
| tive and A |                                                         |
| djudicativ |                                                         |
| e Action*  |                                                         |
| {#b.-proce |                                                         |
| dures-for- |                                                         |
| completing |                                                         |
| -va-form-1 |                                                         |
| 0-7131-exc |                                                         |
| hange-of-b |                                                         |
| eneficiary |                                                         |
| -informati |                                                         |
| on-and-req |                                                         |
| uest-for-a |                                                         |
| dministrat |                                                         |
| ive-and-ad |                                                         |
| judicative |                                                         |
| -action .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+-----------------------------+----------------------------------------+
| If service dental records   | Then ...                               |
| contain ...                 |                                        |
+-----------------------------+----------------------------------------+
| a panoramic x-ray taken at  | -   return the x-ray with *VA Form     |
| induction                   |     10-7131*, and                      |
|                             |                                        |
|                             | -   annotate *VA Form 10-7131*, Part   |
|                             |     II, "Remarks," to indicate the     |
|                             |     x-ray is attached.                 |
+-----------------------------+----------------------------------------+

Continued on next page

18\. Completing *VA Form 10-7131, Exchange of Beneficiary Information
and Request for Administrative and Adjudicative Action,* for Missing
Teeth, Continued

  -----------------------------------------------------------------------
  b\. Procedures for Completing *VA Form 10-7131, Exchange of Beneficiary
  Information and Request for Administrative and Adjudicative Action*
  (continued)

  -----------------------------------------------------------------------

+-----------------------------+----------------------------------------+
| If service dental records   | Then ...                               |
| contain ...                 |                                        |
+-----------------------------+----------------------------------------+
| -   a complete dental       | annotate *VA Form 10-7131*, Part II,   |
|     examination taken at    | "Remarks," to show whether or not any  |
|     induction, and          | teeth were missing at induction.       |
|                             |                                        |
| -   the induction dental    | ***Example***: "Teeth #5 and #12       |
|     examination is          | missing at induction."                 |
|     *definite*              |                                        |
|                             | ***Reference***: For various tooth     |
|                             | numbering methods, see M21-1MR, Part   |
|                             | IX, Subpart ii, 2.2.n.                 |
+-----------------------------+----------------------------------------+
| -   a complete dental       | -   if the veteran was examined within |
|     examination taken at    |     60 days after induction, accept    |
|     induction, and          |     the first examination after        |
|                             |     induction as an induction          |
| -   the notation on the     |     examination, or                    |
|     induction dental        |                                        |
|     examination is          | -   if the veteran was *not* examined  |
|     *indefinite,* such as   |     within 60 days after induction,    |
|                             |     annotate *VA Form 10-7131*, Part   |
| ```{=html}                  |     II, "Remarks" as to why a          |
| <!-- -->                    |     statement of missing teeth cannot  |
| ```                         |     be provided.                       |
| -   "*acceptable*"          |                                        |
|                             |                                        |
| -   "*undisqualifying*," or |                                        |
|                             |                                        |
| -   "*not examined*"        |                                        |
+-----------------------------+----------------------------------------+
| records of dental treatment | -   review the records for indication  |
|                             |     of extractions, and                |
|                             |                                        |
|                             | -   annotate *VA Form 10-7131*, Part   |
|                             |     II, "Remarks," to show, by number, |
|                             |     any teeth extracted in service.    |
|                             |                                        |
|                             | ***Note***: If a tooth is identified   |
|                             | as missing at induction, but treatment |
|                             | records show its extraction, show the  |
|                             | tooth as extracted in service and do   |
|                             | not show it as missing at induction.   |
+-----------------------------+----------------------------------------+

#### 19. Referring Dental Disability Claims to the Rating Activity 

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on referring dental   |
| troduction | > disability claims to the rating activity. It includes |
|            | > information on                                        |
|            |                                                         |
|            | -   referring *VA Form 10-7131, Exchange of Beneficiary |
|            |     Information and Request for Administrative and      |
|            |     Adjudicative Action,* to the rating activity, and   |
|            |                                                         |
|            | -   using photostatic copies of Naval dental            |
|            |     examinations.                                       |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 12, 2007                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > In addition to the normal referral for rating         |
| # a. Refer | > required when *VA Form 21-526*, *Veteran's            |
| ral of *VA | > Application for Compensation or Pension*, is filed as |
|  Form 10-7 | > a claim for a compensable dental disability, rating   |
| 131, Excha | > action is also required for the proper disposition of |
| nge of Ben | > *VA Form 10-7131, Exchange of Beneficiary Information |
| eficiary I | > and Request for Administrative and Adjudicative       |
| nformation | > Action,* on a claim for dental treatment for          |
|  and Reque |                                                         |
| st for Adm | -   service-related non-compensable dental disabilities |
| inistrativ |     or conditions resulting from combat wounds or       |
| e and Adju |     service trauma                                      |
| dicative A |                                                         |
| ction,* to | -   SC non-compensable dental disabilities if the       |
|  the Ratin |     veteran was a POW                                   |
| g activity |                                                         |
|  {#a.-refe | -   SC non-compensable dental disabilities if           |
| rral-of-va |     additional pathology developed after 180 days of    |
| -form-10-7 |     active service, for conditions noted upon entry, or |
| 131-exchan |                                                         |
| ge-of-bene | -   dental treatment under [38 CFR                      |
| ficiary-in |     17.161](http://ww                                   |
| formation- | w.warms.vba.va.gov/Regs/38CFR/BookI/Part17/s17_161.doc) |
| and-reques |     for teeth extracted in service if service records   |
| t-for-admi |     do not identify teeth missing at induction or as    |
| nistrative |     extracted in service.                               |
| -and-adjud |                                                         |
| icative-ac | > ***Reference***: For more information on ratings for  |
| tion-to-th | > dental treatment, see M21-1MR, Part IX, Subpart ii,   |
| e-rating-a | > 2.                                                    |
| ctivity .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > If the veteran served prior to 1953, photostatic      |
| # b. Using | > copies of Naval dental examinations are generally not |
|  Photostat | > usable for rating purposes since red and blue         |
| ic Copies  | > markings were used on the originals. These markings   |
| of Naval D | > cannot be distinguished from each other on            |
| ental Exam | > photocopies.                                          |
| inations { |                                                         |
| #b.-using- | > In these cases, do not refer the folder to the rating |
| photostati | > activity until the originals are obtained.            |
| c-copies-o |                                                         |
| f-naval-de | > ***Reference***: For more information on Naval dental |
| ntal-exami | > records, see M21-1MR, Part IX, Subpart ii, 2.2.l.     |
| nations .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

#### 20. Processing *VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action,* for Former Prisoners of War (POWs) and Totally Disabled Service-Connected (SC) Veterans

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on processing VA Form |
| troduction | > 10-7131.                                              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 12, 2007                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > When processing *VA Form 10-7131, Exchange of         |
| ## a. Proc | > Beneficiary Information and Request for               |
| edure for  | > Administrative and Adjudicative Action*, follow the   |
| Processing | > procedure in the table below for claims filed under   |
|  *VA Form  | > [38 U.S.C. 1712(a)(1)(F) and                          |
| 10-7131, E | > (G)](http://assembler.law.cornell.edu                 |
| xchange of | /uscode/html/uscode38/usc_sec_38_00001712----000-.html) |
|  Beneficia | > for ex-POWs and totally disabled SC veterans.         |
| ry Informa |                                                         |
| tion and R |                                                         |
| equest for |                                                         |
|  Administr |                                                         |
| ative and  |                                                         |
| Adjudicati |                                                         |
| ve Action* |                                                         |
|  {#a.-proc |                                                         |
| edure-for- |                                                         |
| processing |                                                         |
| -va-form-1 |                                                         |
| 0-7131-exc |                                                         |
| hange-of-b |                                                         |
| eneficiary |                                                         |
| -informati |                                                         |
| on-and-req |                                                         |
| uest-for-a |                                                         |
| dministrat |                                                         |
| ive-and-ad |                                                         |
| judicative |                                                         |
| -action .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 1     | If records establish that a veteran was a POW for 90 days or |
|       | more, indicate in the response "*POW-90 days or more*."      |
+-------+--------------------------------------------------------------+
| 2     | Annotate the "Remarks" section of Part II, with "*Veteran    |
|       | 100 percent service-connected*" if a rating decision         |
|       | establishes the existence of an SC disability with combined  |
|       | schedular evaluation of                                      |
|       |                                                              |
|       | -   100 percent, or                                          |
|       |                                                              |
|       | -   eligibility to 100-percent rate based on individual      |
|       |     unemployability.                                         |
|       |                                                              |
|       |     > ***Note***: Permanency of total SC disabilities is not |
|       |     > required.                                              |
+-------+--------------------------------------------------------------+
| 3     | Notify the requesting healthcare facility of eligibility     |
|       | with a completed *VA Form 10-7131* if                        |
|       |                                                              |
|       | -   notice was furnished that the veteran did not meet       |
|       |     eligibility requirements, and                            |
|       |                                                              |
|       | -   it is later established by rating or service department  |
|       |     determination that the veteran now meets those           |
|       |     requirements.                                            |
+-------+--------------------------------------------------------------+

#### 21. Disposition of *VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action,* Requests Handling Notices of Disagreement (NODs)/Appeals

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on                    |
| troduction |                                                         |
|            | -   disposing of a *VA Form 10-7131, Exchange of        |
|            |     Beneficiary Information and Request for             |
|            |     Administrative and Adjudicative Action,* after a    |
|            |     dental rating decision, and                         |
|            |                                                         |
|            | -   handling a                                          |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   notice of disagreement (NOD), or                    |
|            |                                                         |
|            | -   certification of an appeal.                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > April 12, 2007                                        |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > After a dental rating decision has been made, staple  |
| a. Disposi | > a copy of the dental rating to the original *VA Form  |
| tion of VA | > 10-7131, Exchange of Beneficiary Information and      |
|  Form 10-7 | > Request for Administrative and Adjudicative Action,*  |
| 131 Reques | > request and return it to the originating office.      |
| t After a  |                                                         |
| Dental Rat | > ***Important***: Do *not* furnish notice of the       |
| ing Decisi | > decision directly to the veteran. The Chief Dental    |
| on {#a.-di | > Officer notifies the claimant of the final decision.  |
| sposition- |                                                         |
| of-va-form | > ***Note***: The rating decision should be prepared in |
| -10-7131-r | > accordance with the RBA 2000 User's Guide. The        |
| equest-aft | > historic manually prepared rating, *VA Form 21-546b*, |
| er-a-denta | > is obsolete and should not be used.                   |
| l-rating-d |                                                         |
| ecision .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > If a notice of disagreement (NOD) is received, the    |
| ### b. Not | > Veterans Service Center (VSC) is responsible for      |
| ice of Dis | > preparing a statement of the case if service          |
| agreement  | > connection is at issue, including such issues as      |
| (NOD) {#b. |                                                         |
| -notice-of | -   service trauma                                      |
| -disagreem |                                                         |
| ent-nod .u | -   POW status                                          |
| nnumbered} |                                                         |
|            | -   combat wounds, or                                   |
|            |                                                         |
|            | -   compensable evaluation.                             |
|            |                                                         |
|            |     > ***Reference***: For more information about a     |
|            |     > NOD, see M21-1MR, Part I, 5.B.                    |
+------------+---------------------------------------------------------+

Continued on next page

21\. Disposition of VA Form 10-7131, Exchange of Beneficiary Information
and Request for Administrative and Adjudicative Action, Requests
Handling Notices of Disagreement (NODs)/Appeals, Continued

+------------+---------------------------------------------------------+
| ##### c. C | > Follow the steps in the table below when              |
| ertificati | > certification of an appeal is in order.               |
| on of an A |                                                         |
| ppeal {#c. |                                                         |
| -certifica |                                                         |
| tion-of-an |                                                         |
| -appeal .u |                                                         |
| nnumbered} |                                                         |
+------------+---------------------------------------------------------+

+-------+--------------------------------------------------------------+
| Step  | Action                                                       |
+-------+--------------------------------------------------------------+
| 1     | Are there dental treatment or examination records in the     |
|       | claims folder?                                               |
|       |                                                              |
|       | -   If *yes*, forward the dental treatment records with the  |
|       |     claims folder for appellate consideration to the Board   |
|       |     of Veterans Appeals (BVA) in all claims for service      |
|       |     connection for dental disabilities.                      |
|       |                                                              |
|       | -   If *no*, send a statement to that effect to the BVA      |
|       |     along with the claims folder.                            |
+-------+--------------------------------------------------------------+
| 2     | Along with the records forwarded for appellate               |
|       | consideration, include the                                   |
|       |                                                              |
|       | -   application for dental treatment, and                    |
|       |                                                              |
|       | -   determination denying the benefits or additional benefit |
|       |     sought in the appeal.                                    |
+-------+--------------------------------------------------------------+

+-----------------------------------------------------------------------+
| > ***Reference***: For more information on the Board of Veterans      |
| > Appeals, see M21-1MR, Part I, 5.G.                                  |
+-----------------------------------------------------------------------+