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[House Report 106-781]
[From the U.S. Government Publishing Office]

106th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     106-781

======================================================================

 
                 VETERANS CLAIMS ASSISTANCE ACT OF 2000

                                _______
                                

 July 24, 2000.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

   Mr. Stump, from the Committee on Veterans' Affairs, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 4864]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Veterans' Affairs, to whom was referred the 
bill (H.R. 4864) to amend title 38, United States Code, to 
reaffirm and clarify the duty of the Secretary of Veterans 
Affairs to assist claimants for benefits under laws 
administered by the Secretary, and for other purposes, having 
considered the same, report favorably thereon with an amendment 
and recommend that the bill as amended do pass.
  The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veterans Claims Assistance Act of 
2000''.

SEC. 2. CLARIFICATION OF DEFINITION OF ``CLAIMANT'' FOR PURPOSES OF 
                    VETERANS LAWS.

  (a) In General.--Chapter 51 of title 38, United States Code, is 
amended by inserting before section 5101 the following new section:

``Sec. 5100. Definition of `claimant'

  ``For purposes of this chapter, the term `claimant' means any 
individual applying for, or submitting a claim for, any benefit under 
the laws administered by the Secretary.''.
  (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting before the item relating to 
section 5101 the following new item:

``5100. Definition of `claimant'.''.

SEC. 3. ASSISTANCE TO CLAIMANTS.

  (a) Reaffirmation and Clarification of Duty To Assist.--Chapter 51 of 
title 38, United States Code, is amended by striking sections 5102 and 
5103 and inserting the following:

``Sec. 5102. Applications: forms furnished upon request; notice to 
                    claimants of incomplete applications

  ``(a) Furnishing Forms.--Upon request made in person or in writing by 
any person claiming or applying for a benefit under the laws 
administered by the Secretary, the Secretary shall furnish such person, 
free of all expense, all such printed instructions and forms as may be 
necessary in establishing such claim.
  ``(b) Incomplete Applications.--If a claimant's application for a 
benefit under the laws administered by the Secretary is incomplete, the 
Secretary shall notify the claimant and the claimant's representative, 
if any, of the information necessary to complete the application. The 
Secretary shall notify each claimant of any additional information and 
medical and lay evidence necessary to substantiate the claim. As part 
of such notice, the Secretary shall indicate which portion of such 
evidence, if any, is to be provided by the claimant and which portion 
of such evidence, if any, the Secretary will attempt to obtain on 
behalf of the claimant.
  ``(c) Time Limitation.--In the case of evidence that the claimant is 
notified is to be provided by the claimant, if such evidence is not 
received by the Secretary within one year from the date of such 
notification, no benefits may be paid or furnished by reason of such 
application.
  ``(d) Inapplicability to Certain Benefits.--This section shall not 
apply to any application or claim for Government life insurance 
benefits.

``Sec. 5103. Applications: Duty to assist claimants

  ``(a) Duty To Assist.--The Secretary shall make reasonable efforts to 
assist in obtaining evidence necessary to establish a claimant's 
eligibility for a benefit under a law administered by the Secretary. 
However, the Secretary may decide a claim without providing assistance 
under this subsection when no reasonable possibility exists that such 
assistance will aid in the establishment of eligibility for the benefit 
sought.
  ``(b) Assistance in Obtaining Records.--(1) As part of the assistance 
provided under subsection (a), the Secretary shall make reasonable 
efforts to obtain relevant records that the claimant adequately 
identifies to the Secretary and authorizes the Secretary to obtain.
  ``(2) Whenever the Secretary, after making such reasonable efforts, 
is unable to obtain all of the records sought, the Secretary shall 
inform the claimant that the Secretary is unable to obtain such 
records. Such a notice shall--
          ``(A) specifically identify the records the Secretary is 
        unable to obtain;
          ``(B) briefly explain the efforts that the Secretary made to 
        obtain those records;
          ``(C) describe any further actions to be taken by the 
        Secretary with respect to the claim; and
          ``(D) request the claimant, if the claimant intends to 
        attempt to obtain such records independently, to so notify the 
        Secretary within a time period to be specified in the notice.
  ``(c) Obtaining Records for Compensation Claims.--In the case of a 
claim by a veteran for disability compensation, the assistance provided 
by the Secretary under subsection (a) shall include obtaining the 
following records if relevant to the veteran's claim:
          ``(1) The claimant's existing service medical records and, if 
        the claimant has furnished information sufficient to locate 
        such records, other relevant service records.
          ``(2) Existing records of relevant medical treatment or 
        examination of the veteran at Department health-care facilities 
        or at the expense of the Department, if the claimant has 
        furnished information sufficient to locate such records.
          ``(3) Information as described in section 5106 of this title.
  ``(d) Medical Examinations for Compensation Claims.--In the case of a 
claim by a veteran for disability compensation, the assistance provided 
by the Secretary under subsection (a) shall include providing a medical 
examination, or obtaining a medical opinion, when the evidence of 
record before the Secretary--
          ``(1) establishes that--
                  ``(A) the claimant has--
                          ``(i) a current disability;
                          ``(ii) current symptoms of a disease that may 
                        not be characterized by symptoms for extended 
                        periods of time; or
                          ``(iii) persistent or recurrent symptoms of 
                        disability following discharge or release from 
                        active military, naval, or air service; and
                  ``(B) there was an event, injury, or disease (or 
                combination of events, injuries, or diseases) during 
                the claimant's active military, naval, or air service 
                capable of causing or aggravating the claimant's 
                current disability or symptoms, but
          ``(2) is insufficient to establish service-connection of the 
        current disability or symptoms.
  ``(e) Regulations.--The Secretary shall prescribe regulations to 
carry out this section. Such regulations shall include provisions for--
          ``(1) specifying the evidence necessary under subsection (a) 
        to establish a claimant's eligibility for a benefit under a law 
        administered by the Secretary; and
          ``(2) determining under subsections (b) and (c) what records 
        are relevant to a claim.
  ``(f) Rule With Respect to Disallowed Claims.--Nothing in this 
section shall be construed to require the Secretary to reopen a claim 
that has been disallowed except when new and material evidence is 
presented or secured, as described in section 5108 of this title.
  ``(g) Other Assistance Not Precluded.--Nothing in this section shall 
be construed as precluding the Secretary from providing such other 
assistance to a claimant as the Secretary considers appropriate.''.
  (b) Reenactment of Rule for Claimant's Lacking a Mailing Address.--
Chapter 51 of such title is amended by adding at the end the following 
new section:

``Sec. 5126. Benefits not to be denied based on lack of mailing address

  ``Benefits under laws administered by the Secretary may not be denied 
a claimant on the basis that the claimant does not have a mailing 
address.''.
  (c) Clerical Amendments.--The table of sections at the beginning of 
chapter 51 of such title is amended--
          (1) by striking the items relating to sections 5102 and 5103 
        and inserting the following:

``5102. Applications: forms furnished upon request; notice to claimants 
of incomplete applications.
``5103. Applications: duty to assist claimants.'';

        and
          (2) by adding at the end the following new item:

``5126. Benefits not to be denied based on lack of mailing address.''.

SEC. 4. BURDEN OF PROOF.

  (a) Repeal of ``Well-Grounded Claim'' Rule.--Section 5107 of title 
38, United States Code, is amended to read as follows:

``Sec. 5107. Burden of proof; benefit of the doubt

  ``(a) Burden of Proof.--Except when otherwise provided by this title 
or by the Secretary in accordance with the provisions of this title, a 
claimant shall have the burden of proving entitlement to benefits.
  ``(b) Benefit of the Doubt.--The Secretary shall consider all 
evidence and material of record in a case before the Department with 
respect to benefits under laws administered by the Secretary and shall 
give the claimant the benefit of the doubt when there is an approximate 
balance of positive and negative evidence regarding any issue material 
to the determination of the matter.''.

SEC. 5. PROHIBITION OF CHARGES FOR RECORDS FURNISHED BY OTHER FEDERAL 
                    DEPARTMENTS AND AGENCIES.

  Section 5106 of title 38, United States Code, is amended by adding at 
the end the following new sentence: ``No charge may be imposed by the 
head of any such department or agency for providing such 
information.''.

SEC. 6. EFFECTIVE DATE.

  (a) In General.--Except as specifically provided otherwise, the 
provisions of section 5107 of title 38, United States Code, as amended 
by section 4 of this Act, apply to any claim--
          (1) filed on or after the date of the enactment of this Act; 
        or
          (2) filed before the date of the enactment of this Act and 
        not final as of the date of the enactment of this Act.
  (b) Rule for Claims the Denial of Which Became Final After the Court 
of Appeals for Veterans Claims Decision in the Morton Case.--(1) In the 
case of any claim for benefits--
          (A) the denial of which became final during the period 
        beginning on July 14, 1999, and ending on the date of the 
        enactment of this Act; and
          (B) which was denied or dismissed by the Secretary of 
        Veterans Affairs or a court because the claim was not well 
        grounded (as that term was used in section 5107(a) of title 38, 
        United States Code, as in effect during that period),
the Secretary of Veterans Affairs shall, upon the request of the 
claimant, or on the Secretary's own motion, order the claim 
readjudicated under chapter 51 of such title, as amended by this Act, 
as if such denial or dismissal had not been made.
  (2) A claim may not be readjudicated under this subsection unless the 
request is filed or the motion made not later than two years after the 
date of the enactment of this Act.
  (3) In the absence of a timely request of a claimant, nothing in this 
Act shall be construed as establishing a duty on the part of the 
Secretary of Veterans Affairs to locate and readjudicate claims 
described in this subsection.

                              Introduction

    On July 17, 2000, the Chairman and Ranking Member of the 
Veterans' Affairs Committee, the Honorable Bob Stump and the 
Honorable Lane Evans, along with the Chairman and Ranking 
Member of the Subcommittee on Benefits, the Honorable Jack 
Quinn and the Honorable Bob Filner, introduced H.R. 4864 to 
amend title 38, United States Code, to reaffirm and clarify the 
duty of the Secretary of Veterans Affairs to assist claimants 
for benefits under laws administered by the Secretary, and for 
other purposes.
    On March 23, 2000, the Subcommittee on Benefits held a 
hearing on the subject of ``well-grounded'' claims and H.R. 
3193, the Duty to Assist Veterans Act of 1999, introduced by 
the Honorable Lane Evans and others. Witnesses testifying 
included: Mr. Richard Schneider, Non Commissioned Officers 
Association; Mr. Leonard Selfon, Esq., Vietnam Veterans of 
America; Mr. Rick Surratt, Disabled American Veterans; Mr. 
Carroll Williams, The American Legion; Mr. Geoff Hopkins, 
Paralyzed Veterans of America; Mr. John McNeill, Veterans of 
Foreign Wars of the United States; and Honorable Joseph 
Thompson, Under Secretary for Benefits, Veterans Benefits 
Administration.
    Mr. Joseph Thompson testified about VA's role in assisting 
veterans filing claims for benefits and the Department's 
proposed rules, as a result of the Morton v. West decision, 
relevant to the concept of well-grounded claims and VA's 
statutory duty to assist claimants in the claim process. The 
veterans service organization witnesses adamantly opposed VA's 
regulations, and testified that VA did not have the authority 
to make the changes proposed in regulation.

                      Summary of the Reported Bill

    H.R. 4864, as amended, would:
    1.  LAuthorize the Secretary of Veterans Affairs to assist 
a claimant in obtaining evidence to establish entitlement to a 
benefit.
    2.  LEliminate the requirement that a claimant submit a 
``well-grounded'' claim before the Secretary can assist in 
obtaining evidence. (In the context of claims for service-
connected disability benefits, a ``well-grounded'' claim is one 
that has evidence of in-service injury or disease, a diagnosis 
of a current disability or disease, and a medical opinion that 
the current disability or disease is related to the in-service 
injury or disease).
    3.  LFor most kinds of claims, require the Secretary to 
make reasonable efforts to obtain relevant records that the 
claimant identifies and authorizes the Secretary to obtain.
    4.  LFor service-connected disability compensation claims, 
require the Secretary to (a) obtain existing service medical 
records and other Department treatment records, (b) obtain 
relevant records in the control of federal agencies, and (c) 
provide a medical examination if the Secretary finds that the 
veteran has a current disability or symptoms and there is 
evidence to suggest that it may be related to an event, injury, 
or disease which took place in service.
    5.  LDefine a ``claimant'' who would be eligible to receive 
assistance from the Secretary as any person seeking veterans' 
benefits.
    6.  LRequire other Federal agencies to furnish relevant 
records to the Department at no cost to the claimant.
    7.  LPermit veterans who had claims denied or dismissed 
after the Court of Appeals for Veterans Claims decision in 
Morton v. West to request review of those claims within a two 
year period following enactment.

                       Background and Discussion

    As the Committee has noted, the Department of Veterans 
Affairs' system for deciding benefits claims ``is unlike any 
other adjudicative process. It is specifically designed to be 
claimant friendly. It is non-adversarial; therefore, the VA 
must provide a substantial amount of assistance to a veteran 
seeking benefits.''\1\ This assistance includes requesting 
service records, medical records, and other pertinent documents 
from sources identified by the claimant. VA also provides 
medical examinations, when appropriate, to diagnose or evaluate 
physical and mental conditions. The claims adjudication process 
inevitably involves some subjective judgment in evaluating the 
evidence in an individualized case. While VA regional offices 
historically requested service medical records and documentary 
evidence in the possession of VA medical facilities on claims, 
the extent to which a claim is developed more fully to include 
a VA examination or requesting private medical records differs 
among VA's regional offices depending on the subjective 
determination of the claims examiner that a particular claim is 
not well-grounded. In such cases, often involving claims filed 
many years after discharge from military service, a claimant 
may be requested to provide additional information before an 
examination is scheduled and full development of the claim is 
undertaken.\2\
---------------------------------------------------------------------------
    \1\ H.R. Rept. No. 105-52, at 2 (1997).
    \2\ Duty to Assist Veterans Act of 1999: Hearings on H.R. 3193 
Before the Subcomm. on Benefits of the House Veterans' Affairs 
Committee, 106th Cong. 1-2 (2000) (statement of Joseph Thompson, Under 
Secretary for Benefits, Department of Veterans Affairs).
---------------------------------------------------------------------------
    As a result of court decisions construing the meaning of 
section 5107 of title 38, United States Code, concerning 
``well-grounded'' claims and the Secretary's ``duty to assist'' 
a veteran in obtaining evidence in support of a claim, the VA 
is no longer able to provide assistance to veterans as it has 
in the past. These decisions have led to substantial 
differences among VA regional offices in the handling of claims 
which lack one or more of the elements needed to ``well-
ground'' a claim as that term has been defined by the United 
States Court of Appeals for Veterans Claims (CAVC). Testimony 
before the Committee and review of files by Committee staff has 
indicated confusion on the part of VA adjudicators concerning 
the meaning and application of the ``well-grounded'' claim 
requirement. An understanding of the CAVC's development of the 
well-grounded claim concept is needed to understand VA's 
current policy on this issue.

Judicial Construction of ``Well-Grounded'' Claim and ``Duty to Assist''

    Soon after its establishment, the CAVC was confronted with 
the necessity to construe the meaning of section 5107, 
particularly the undefined term, ``well-grounded'' claim.\3\ In 
Gilbert v. Derwinski, 1 Vet. App. 49 (1990), the Court 
established a baseline for veterans' claims adjudication. In 
this case, the Court read the language of section 5107 as 
creating a ``chronological'' order for the submission of 
evidence which constitutes a ``well-grounded'' claim and the 
triggering of the Secretary's ``duty to assist.''
---------------------------------------------------------------------------
---------------------------------------------------------------------------
    \3\ Id., at 4.

          Read together, Sec. 3007(a) and (b) [now codified at 
        Sec. 5107(a) and (b)] establish and allocate 
        chronological obligations. Pursuant to Sec. 3007(a) the 
        initial obligation rests with the veteran: ``A person 
        who submits a claim . . . shall have the burden of 
        submitting evidence sufficient to justify a belief by a 
        fair and impartial individual that the claim is well 
        grounded.'' Under Sec. 3007(b) the ``benefit of the 
        doubt'' rule does not shift ``from the claimant to the 
        [Secretary]'' the initial burden to submit a facial 
        valid claim. Thus, the submission of a facially valid 
        claim is necessary; inherently incredible allegations 
---------------------------------------------------------------------------
        of injury would obviously not suffice.

Id. at 55 (citing 38 U.S.C. Sec. 3007 now codified at 
Sec. 5107).
    In that same year, Murphy v. Derwinski, 1 Vet. App. 78 
(1990), refined the Court's definition of a ``well-grounded'' 
claim.\4\ Understanding the infancy of the Court and limited 
precedent case law, the Court pointed to the fact that:
---------------------------------------------------------------------------
---------------------------------------------------------------------------
    \4\ Id.

          [b]ecause a well grounded claim is neither defined by 
        the statute nor the legislative history, it must be 
        given a common sense construction. A well grounded 
        claim is a plausible claim, one which is meritorious on 
        its own or capable of substantiation. Such a claim need 
        not be conclusive but only possible to satisfy the 
        initial burden of Sec. 3007(a) (now codified at 38 
---------------------------------------------------------------------------
        U.S.C. Sec. 5107(a)).

Id. at 81.
    The Court was also confronted with the issue of deciding 
what the Secretary's ``duty to assist'' entailed:

          When a claimant submits a properly filled out and 
        executed VA form 21-526, Veteran's Application for 
        Compensation and Pension, the Secretary has the 
        veteran's biographical, family, medical, and service 
        data. This information will enable the Secretary to 
        fulfill his statutory duty to assist the claimant by 
        securing any relevant VA, military or other 
        governmental records. In addition, if private medical, 
        hospital, employment or other civilian records would 
        assist the development of `the facts pertinent to the 
        claim', the Secretary would be able to request them 
        from the claimant or, upon authorization, obtain them 
        directly.

Murphy at 82 (quoting S. Rept. No. 100-418, at 33-34 (1988)).
    ``The Court has held that while the evidence to make a 
claim well-grounded need not be conclusive, the statutory 
scheme `requires more than just an allegation; a claimant must 
submit supporting evidence' that a claim is plausible.''\5\ The 
meaning of ``supporting evidence,'' in turn, was refined by 
subsequent Court decisions. A 1993 Court decision held that 
``[w]here the determinative issue involves medical causation or 
a medical diagnosis, competent medical evidence to the effect 
that the claim is `plausible' or `possible' is required.'' 
Grottveit v. Brown, 5 Vet. App. 91, 93 (1993).
---------------------------------------------------------------------------
    \5\ Id., at 5, quoting Tirpak v. Derwinski, 2 Vet. App. 609, 610 
(1992).
---------------------------------------------------------------------------
    As a result of these and other Court decisions, the 
understanding of a ``well-grounded'' claim evolved so that it 
included a requirement for the submission of medical evidence 
from a claimant who was seeking benefits for a medical 
condition claimed to be related to service. The lack of such 
medical evidence in the claim led the Grottveit Court to 
conclude that the claim ``was not one on which relief could be 
granted; there was no claim to adjudicate on the merits.''\6\
---------------------------------------------------------------------------
    \6\ Id., at 6.
---------------------------------------------------------------------------
    In Grivois v. Brown, 6 Vet. App. 136 (1994), the CAVC 
stated that it is the duty of VA claims examiners who first 
review a claim to apply the ``well-grounded'' test ``for it is 
their duty to avoid adjudicating implausible claims at the 
expense of delaying well-grounded ones.'' The CAVC noted that 
the statutory scheme recognizes that not all claims filed for 
VA benefits will be meritorious, and that section 5107(a) 
``reflects a policy that implausible claims should not consume 
the limited resources of the VA and force into even greater 
backlog and delay'' those claims which are well grounded.\7\ 
The Court warned that ``while no duty to assist arises absent a 
well-grounded claim, if the Secretary, as a matter of policy, 
volunteers assistance to establish well groundedness, grave 
questions of due process can arise if there is apparent 
disparate treatment between claimants in this regard.''\8\
---------------------------------------------------------------------------
    \7\ Id., at 7.
    \8\ Id., at 7, quoting Grivois at 139-140.
---------------------------------------------------------------------------
    VA's response to this case was to revise its procedure 
manual in January 1994 instructing field offices to fully 
develop claims before deciding whether they are ``well-
grounded,'' including requesting service medical records, VA 
and other government records, and private records identified by 
the claimant as relevant to the claim. VA's policy was based on 
an understanding that although it maynot do less than the 
statute requires, it was not prohibited from doing more than the 
statute requires.\9\
---------------------------------------------------------------------------
    \9\ Id., at 7-8.
---------------------------------------------------------------------------
    In 1995, the CAVC defined the specific requirements which 
would ``well-ground'' a claim for service connection. In Caluza 
v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. 
Cir. 1996), the Court held that ``in order for a claim to be 
well-grounded, there must be competent evidence [1] of current 
disability (a medical diagnosis) . . . ; [2] of incurrence or 
aggravation of a disease or injury in service (lay or medical 
evidence) . . . ; [3] and of a nexus between the in-service 
injury or disease and the current disability (medical 
evidence).'' The United States Court of Appeals for the Federal 
Circuit affirmed that holding in Epps v. Gober, 126 F.3d 1464 
(Fed. Cir. 1997). These three basic elements or requirements 
have become a standard that a claimant must show in order to 
establish entitlement to compensation under 38 U.S.C. 
Sec. 1110.\10\ Nonetheless, believing that the statute did not 
prohibit VA from volunteering assistance, the VA revised 
internal procedure manual provisions and continued to operate 
and adjudicate claims in a manner which delayed a decision on 
``well-groundedness'' until a claim had been fully 
developed.\11\
---------------------------------------------------------------------------
    \10\ Id., at 8.
    \11\ Id.
---------------------------------------------------------------------------
    The VA position of providing assistance to claimants who 
had not filed ``well-grounded'' claims was challenged by the 
CAVC in Morton v. West, 12 Vet. App. 477 (1999), decided on 
July 14, 1999. In Morton, the claimant argued that the VA had 
created a blanket exception to the ``well-grounded'' claim 
requirement of section 5107(a). Citing VA's internal procedures 
manual, the claimant argued that the VA had obligated itself to 
fully develop all claims, regardless of whether they were 
``well-grounded.'' He asserted that those manual provisions 
were valid exercises of the Secretary's authority to create 
exceptions under the ``[e]xcept when otherwise provided'' 
clause in the first sentence of section 5107(a).\12\
---------------------------------------------------------------------------
    \12\ Id., at 10.
---------------------------------------------------------------------------
    The CAVC rejected those assertions for two reasons. First, 
it concluded that the manual provisions at issue were merely 
internal statements of policy or interpretation which could not 
be enforced against VA. Second, CAVC concluded that if the 
manual provisions were interpreted as establishing a blanket 
exception to the statute, such an interpretation would be 
inconsistent with section 5107(a). Additionally, the Court 
reiterated its prior holding that section 5107 reflects a 
Congressional policy that implausible claims should not consume 
VA's limited resources and force ``well-grounded'' claims into 
ever greater backlog and delay. . . . Morton, which is 
currently on appeal to the Federal Circuit, required the 
Compensation and Pension Service to respond with a formal 
change in its policy.\13\
---------------------------------------------------------------------------
    \13\ Id., at 10-11.
---------------------------------------------------------------------------
    In August 1999, the Department of Veterans Affairs issued a 
letter informing each VA regional office that a number of 
provisions in their procedural manual were being rescinded as 
the result of the Morton decision. The August 1999 letter 
instructed regional offices to follow an interim policy 
implementing the Morton decision pending proposed rulemaking, 
specifically directing them to: determine whether or not claims 
are ``well-grounded'' prior to beginning development; give 
notice to claimant if material evidence is necessary; and 
obtain VA medical and service records, but refrain from private 
treatment records or scheduling a VA examination on claims 
which are not ``well-grounded.'' On December 2, 1999, VA 
proposed a new rule setting forth the circumstances in which it 
would obtain relevant records or provide medical examinations 
even if the claimant had not submitted a ``well-grounded'' 
claim.\14\ 64 Fed. Reg. 67528 (1999) (proposed Dec. 2, 1991). 
As noted, witnesses at the March 23, 2000, hearing challenged 
the VA's authority to issue these regulations and criticized 
the proposed rules for failing to provide enough assistance to 
claimants.
---------------------------------------------------------------------------
    \14\ Id., at 11-12.
---------------------------------------------------------------------------
    Historically, the Secretary's ``duty to assist'' has been 
interpreted in varying fashions, but the goal is and has been 
to assist veterans in developing claims and receiving benefits 
for which they are eligible. As questions abound over the 
proper role of veterans and the VA in claim development, the 
Committee finds that it is necessary to clarify claimants' and 
the VA's duties with respect to obtaining evidence in support 
of claims for veterans benefits.

                      Section-by-Section Analysis

    Section 1 would provide that this Act may be cited as the 
``Veterans Claims Assistance Act of 2000''.
    Section 2 would amend chapter 51 of title 38, United States 
Code, to add a new section at the beginning of the chapter. The 
new section would define the term ``claimant'' as that term is 
used in chapter 51. The term ``claimant'' would be defined to 
mean ``any individual applying for, or submitting a claim for, 
any benefit under the laws administered by the Secretary''. The 
purpose of defining this term is to ensure that the Secretary 
will provide applications and assistance to persons whose 
status as a veteran is not yet determined. Similarly, the 
Secretary would be obligated to respond to applications by 
persons who claim eligibility for or entitlement to a VA 
benefit by reason of their relationship to a veteran.
    Section 3 would substantially revise sections 5102 and 5103 
of title 38, United States Code.
    As revised, section 5102 would contain almost all of 
existing sections 5102 and 5103. Subsection (a) of the proposed 
section 5102(a) is identical to existing section 5102. 
Subsections (b), (c), and (d) are, with one exception, 
identical to existing subsections (a) and (b) of existing 
section 5103. Proposed section 5102(b) restates the Secretary's 
obligation to send notices to the claimant and the claimant's 
representative, and to advise the claimant and the claimant's 
representative as to information the claimant must submit to 
complete the application. The Secretary would also be required 
to notify the claimant (and the claimant's representative) of 
any additional information and medical and lay evidence 
necessary to substantiate the claim. It is the Committee's 
understanding that the Secretary currently undertakes to 
provide this notification to a claimant, and that codification 
of this requirement should result ina more uniform practice of 
notifying a claimant of what evidence he or she must provide to the 
Department. For example, the Committee expects that information and 
evidence under the claimant's control such as birth and marriage 
evidence, school attendance and income information should ordinarily be 
provided by the claimant. Information and evidence in the control of 
governmental entities and medical providers should ordinarily be 
obtained directly by the Secretary.
    Proposed subsection (a) of the new section 5103 is a 
revision of language currently found in section 5107(a) of 
title 38, United States Code, which requires the Secretary to 
assist claimants who have filed a ``well-grounded'' claim. As 
revised, the Secretary's duty to assist claimants would not be 
contingent on the claimant filing a claim that is ``well-
grounded.'' That is, the Secretary would be obligated to assist 
a claimant in obtaining evidence that is necessary to establish 
eligibility for the benefit being sought. This language 
recognizes the Secretary's authority to establish differing 
evidentiary requirements for the various benefits administered 
by the Department. It also recognizes that certain claims, 
including those that on their face seek benefits for ineligible 
claimants (such as a veteran who seeks pension benefits but 
lacks wartime service), or claims which have been previously 
decided on the same evidence can be decided without providing 
any assistance or obtaining any additional evidence, and 
authorizes the Secretary to decide those claims without 
providing any assistance under this subsection.
    Proposed subsection (b) of the new section 5103 clarifies 
the Secretary's obligation to assist a claimant in obtaining 
evidence that is relevant to a particular claim. The 
requirement in section 5107 that the claimant has the burden of 
proving entitlement to benefits would not be changed by this 
language. In using the term ``reasonable efforts'' to describe 
the Secretary's obligation to assist in obtaining evidence, the 
Committee expects the Department to use a practical approach to 
assisting a claimant in obtaining evidence. That is, if the 
claimant has adequately identified the source of the evidence 
and has given whatever permission is required for the custodian 
to provide such evidence, the Committee expects the Secretary 
to make repeated, but not necessarily exhaustive, efforts to 
obtain the evidence. In this regard, the Committee notes that 
one effort to obtain evidence would be clearly inadequate and 
that four efforts, except in an unusual case, would be 
exhaustive. Subsection (b) would also require the Secretary to 
provide notice to the claimant if the effort to obtain evidence 
is unsuccessful and briefly explain the Secretary's efforts to 
obtain such evidence, describe any further actions to be taken 
by the Secretary, and allow the claimant a reasonable 
opportunity to obtain the evidence before the claim is decided.
    Proposed subsection (c) of section 5103 would provide 
special rules for obtaining evidence in disability compensation 
claims. For this type of claim, the Secretary would be 
obligated to obtain existing service medical records, records 
of treatment or examination at Department health-care 
facilities, and relevant records in the possession of other 
Federal agencies if relevant to the veteran's claim. The 
limitation of ``reasonableness'' would not apply to the 
Secretary's obligation to obtain these types of records if they 
exist and the claimant has furnished sufficient information to 
locate such records.
    Proposed subsection (d) would require the Secretary to 
provide a medical examination or obtain a medical opinion if 
the Secretary has evidence establishing that (1) the claimant 
has (A) a current disability, (B) current symptoms of a disease 
(such as hepatitis C or post-traumatic arthritis) which may not 
be characterized by symptoms for extended periods of time, or 
(C) persistent or recurrent symptoms of disability following 
discharge from service, and 2) there was an in-service event 
(or series of events) which could have caused or aggravated the 
current disability or symptoms, but 3) the evidence is 
insufficient to establish service-connection. It is the 
Committee's understanding that the Department requests and 
obtains in appropriate cases, as part of the report of a 
medical examination, the examiner's opinion as to whether there 
is a ``nexus'' or linkage between the current disability or 
symptoms and some in-service event or events. This section is 
intended to encourage that practice. However, this provision 
would not require VA to provide an examination where the 
evidence of record establishes service connection on the basis 
of applicable presumptions or other laws. The Committee expects 
the Secretary to continue the current practice of obtaining a 
medical examination, if needed, to establish the rating to be 
assigned to a service-connected disability.
    Proposed subsection (e) would require the Secretary to 
prescribe regulations (1) specifying the evidence needed to 
establish a claimant's eligibility for a benefit, and (2) 
determining what records or evidence are relevant to a claim. 
The Committee notes that this subsection would not require the 
Secretary to prescribe new regulations except to the extent 
that existing regulations are incomplete, impractical, or 
inconsistent with the requirements of this Act.
    Proposed subsection (f) of section 5103 would specify that 
nothing in this legislation would affect the requirement in 
current section 5108 that the Secretary reopen a claim and 
review the former disposition of the claim only if new and 
material evidence is presented by the claimant or is secured 
from a source which previously was unable to produce such 
evidence.
    Proposed subsection (g) of section 5103 would clarify that 
nothing in this revised section should be construed as limiting 
the Secretary's authority to provide assistance to claimants. 
The Committee's intent is to overrule that portion of the 
decision in Morton that found an implied limitation on VA's 
authority to provide assistance to claimants who had not 
submitted ``well-grounded'' claims.
    Proposed section 3(b) of the bill would recodify the 
language presently found at section 5103(c) as a new section 
5126 of title 38, United States Code. Although there is no 
evidence that VA has ever denied a benefit to a person because 
that person lacked a mailing address, the Committee is 
retaining this language because of concern that a repeal of it 
might lead some future VA official to propose such a policy.
    Section 4 would revise section 5107 of title 38, United 
States Code, to eliminate the requirement that a veteran must 
submit a ``well-grounded'' claim. In general, the proposed 
revision to section 5103 discussed above sets out the authority 
for the Secretary to provide assistance to a claimant. Thus, 
the extent to which the Secretary conducts a separate threshold 
examination of the evidence provided in support of a claim is 
now addressed in that section. The revised section 5107 
restates without any substantive change the requirements in 
existing law that the claimant still has the burden of proving 
entitlement to benefits, and that the Secretary must provide 
the benefit of the doubt to the claimant when there is an 
approximate balance of positive and negative evidence regarding 
any material issue.
    Section 5 would add a new sentence to section 5106 of title 
38, United States Code, to provide that Federal departments or 
agencies shall furnish the Department of Veterans Affairs with 
records pertinent to a benefits application without charge.
    Section 6 provides that in general, this Act would apply to 
claims filed after the date of enactment or which have not been 
finally decided as of that date. Subsection (b) would establish 
a special rule providing retroactive relief to claims which 
were finally denied or which were dismissed as not ``well-
grounded'' beginning on July 14, 1999 (the effective date of 
the Morton decision). In such cases, the Secretary could order 
the claim to be readjudicated upon the request of the claimant 
or on the Secretary's own motion. Subsection (b)(3) would 
provide that a motion to readjudicate the claim would have to 
be made within two years from the date of enactment of this 
Act, while subsection (b)(4) would relieve the Secretary of any 
obligation to locate and readjudicate claims which might be 
affected by the change in law described in this subsection.

                           Oversight Findings

    No oversight findings have been submitted to the Committee 
by the Committee on Government Reform.

               Congressional Budget Office Cost Estimate

    The following letter was received from the Congressional 
Budget Office concerning the cost of the reported bill:

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, July 21, 2000.
Hon. Bob Stump,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4864, the Veterans 
Claims Assistance Act of 2000.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Evan 
Christman.
            Sincerely,
                                          Dan L. Crippen, Director.
    Enclosure.

H.R. 4864--Veterans Claims Assistance Act of 2000

    Summary: H.R. 4864 would require the Department of Veterans 
Affairs (VA) to provide assistance to veterans who file claims 
for VA benefits. CBO estimates that implementing the bill would 
cost $4 million in 2001 and $7 million to $8 million annually 
thereafter, assuming appropriation of the necessary funds. 
Because the bill would not affect direct spending or receipts, 
pay-as-you-go procedures would not apply. H.R. 4864 contains no 
intergovernmental or private-sector mandates as defined in the 
Unfunded Mandates Reform Act (UMRA) and would not affect the 
budgets of state, local, or tribal governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of the bill is shown in the following table. 
The costs of this legislation fall within budget function 700 
(veterans benefits and services).
    Basis of estimate: H.R. 4864 would require VA to provide 
more assistance than it does under current law to veterans who 
file claims for benefits. The bill would require VA to pursue 
any records the Secretary identifies as necessary to establish 
a claim, and it would require VA to draft regulations that 
specify what information is necessary for a claim. H.R. 4864 
would direct VA to inform veterans of any information the VA 
needs to adjudicate an incomplete claim, pursue information the 
veteran authorizes or requests the VA to obtain, and inform the 
veteran when the department cannot locate information pertinent 
to a claim.
    If relevant for claims to disability compensation, VA would 
be required to obtain pertinent records, including a veteran's 
medical record from military service, his or her service 
record, any records of treatment provided by the VA, and any 
other relevant materials available from other federal agencies. 
The bill also would require VA to provide medical exams to 
veterans who need them to substantiate their claims. Also, the 
bill would allow any claimant who had a claim denied since July 
14, 1999, to resubmit it if the claim was denied because it 
lacked sufficient evidence.

----------------------------------------------------------------------------------------------------------------
                                                                     By fiscal year, in millions of dollars--
                                                                 -----------------------------------------------
                                                                   2000    2001    2002    2003    2004    2005
----------------------------------------------------------------------------------------------------------------
                                        SPENDING SUBJECT TO APPROPRIATION

Spending under current law for VA's general operating expenses:
    Estimated authorization level \1\...........................     941     941     941     941     941     941
    Estimated outlays...........................................     925     941     941     941     941     941
Proposed changes:
    Estimated authorization level...............................       0       4       7       8       8       8
    Estimated outlays...........................................       0       4       7       7       8       8
Spending under H.R. 4864 for VA's general operating expenses:
    Estimated authorization level \1\...........................     941     945     948     949     949     949
    Estimated outlays...........................................     925     945     948     948     949    949
----------------------------------------------------------------------------------------------------------------
\1\ The 2000 level is the amount appropriated for that year.

Note.--This table assumes that funding under current law will remain at the level appropriated for 2000 without
  adjustment for inflation. If funding over the 2001-2005 period is adjusted for inflation, the base amounts
  would increase by about $35 million a year, but the cost of the proposed changes would remain as shown under
  ``Proposed Changes.''

    CBO expects that, in order to carry out its 
responsibilities under H.R. 4864, VA would have to hire 
additional claims adjudicators. Based on information from the 
VA, CBO assumes that 110 additional claims adjudicators would 
be hired at an estimated cost of $3 million in salary and 
benefits in 2001 and about $7 million annually thereafter. CBO 
estimates that training would cost about $1 million a year and 
that one-time costs associated with expanding the claims 
processing staff would be about $700,000 in 2001. The cost of 
providing medical exams is covered under current law. CBO does 
not expect a significant increase in benefit payments as a 
result of this bill.
    Pay-as-you-go considerations: None.
    Intergovernmental and private-sector impact: H.R. 4864 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would not affect the budgets of state, 
local, or tribal governments.
    Previous CBO estimate: On February 23, 2000, CBO 
transmitted a cost estimate for H.R. 3193, the Duty to Assist 
Veterans Act of 1999. That bill and H.R. 4864 are similar, but 
not identical. The estimated costs are the same, however, 
because CBO believes that VA would implement them substantially 
the same way.
    Estimate prepared by: Federal costs: Evan Christman; impact 
on State, local, and tribal governments: Susan Seig Tompkins; 
impact on the private sector: Rachel Schmidt.
    Estimate approved by: Robert A. Sunshine, Assistant 
Director for Budget Analysis.

                     Inflationary Impact Statement

    The enactment of the reported bill would have no 
inflationary impact.

                  Applicability to Legislative Branch

    The reported bill would not be applicable to the 
legislative branch under the Congressional Accountability Act, 
Public Law 104-1, because the bill would only affect Department 
of Veterans Affairs programs and benefits recipients.

                     Statement of Federal Mandates

    The reported bill would not establish a federal mandate 
under the Unfunded Mandates Reform Act, Public Law 104-4.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, the reported bill is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

TITLE 38, UNITED STATES CODE

           *       *       *       *       *       *       *

PART IV--GENERAL ADMINISTRATIVE PROVISIONS

           *       *       *       *       *       *       *

           CHAPTER 51--CLAIMS, EFFECTIVE DATES, AND PAYMENTS

                          subchapter i--claims

Sec.
5100.    Definition of ``claimant''.
5101.    Claims and forms.
[5102.    Application forms furnished upon request.
[5103.    Incomplete applications.]
5102.    Applications: forms furnished upon request; notice to claimants 
          of incomplete applications.
5103.    Applications: duty to assist claimants.
     * * * * * * *
5126.    Benefits not to be denied based on lack of mailing address.
     * * * * * * *

SUBCHAPTER I--CLAIMS

           *       *       *       *       *       *       *

Sec. 5100. Definition of ``claimant''

  For purposes of this chapter, the term ``claimant'' means any 
individual applying for, or submitting a claim for, any benefit 
under the laws administered by the Secretary.

           *       *       *       *       *       *       *

[Sec. 5102. Application forms furnished upon request

  [Upon request made in person or in writing by any person 
claiming or applying for benefits under the laws administered 
by the Secretary, the Secretary shall furnish such person, free 
of all expense, all such printed instructions and forms as may 
be necessary in establishing such claim.

[Sec. 5103. Incomplete applications

  [(a) If a claimant's application for benefits under the laws 
administered by the Secretary is incomplete, the Secretary 
shall notify the claimant of the evidence necessary to complete 
the application. If such evidence is not received within one 
year from the date of such notification, no benefits may be 
paid or furnished by reason of such application.
  [(b) This section shall not apply to any application or claim 
for Government life insurance benefits.
  [(c) Benefits under laws administered by the Secretary may 
not be denied an applicant on the basis that the applicant does 
not have a mailing address.]

Sec. 5102. Applications: forms furnished upon request; notice to 
                    claimants of incomplete applications

  (a) Furnishing Forms.--Upon request made in person or in 
writing by any person claiming or applying for a benefit under 
the laws administered by the Secretary, the Secretary shall 
furnish such person, free of all expense, all such printed 
instructions and forms as may be necessary in establishing such 
claim.
  (b) Incomplete Applications.--If a claimant's application for 
a benefit under the laws administered by the Secretary is 
incomplete, the Secretary shall notify the claimant and the 
claimant's representative, if any, of the information necessary 
to complete the application. The Secretary shall notify each 
claimant of any additional information and medical and lay 
evidence necessary to substantiate the claim. As part of such 
notice, the Secretary shall indicate which portion of such 
evidence, if any, is to be provided by the claimant and which 
portion of such evidence, if any, the Secretary will attempt to 
obtain on behalf of the claimant.
  (c) Time Limitation.--In the case of evidence that the 
claimant is notified is to be provided by the claimant, if such 
evidence is not received by the Secretary within one year from 
the date of such notification, no benefits may be paid or 
furnished by reason of such application.
  (d) Inapplicability to Certain Benefits.--This section shall 
not apply to any application or claim for Government life 
insurance benefits.

Sec. 5103. Applications: Duty to assist claimants

  (a) Duty To Assist.--The Secretary shall make reasonable 
efforts to assist in obtaining evidence necessary to establish 
a claimant's eligibility for a benefit under a law administered 
by the Secretary. However, the Secretary may decide a claim 
without providing assistance under this subsection when no 
reasonable possibility exists that such assistance will aid in 
the establishment of eligibility for the benefit sought.
  (b) Assistance in Obtaining Records.--(1) As part of the 
assistance provided under subsection (a), the Secretary shall 
make reasonable efforts to obtain relevant records that the 
claimant adequately identifies to the Secretary and authorizes 
the Secretary to obtain.
  (2) Whenever the Secretary, after making such reasonable 
efforts, is unable to obtain all of the records sought, the 
Secretary shall inform the claimant that the Secretary is 
unable to obtain such records. Such a notice shall--
          (A) specifically identify the records the Secretary 
        is unable to obtain;
          (B) briefly explain the efforts that the Secretary 
        made to obtain those records;
          (C) describe any further actions to be taken by the 
        Secretary with respect to the claim; and
          (D) request the claimant, if the claimant intends to 
        attempt to obtain such records independently, to so 
        notify the Secretary within a time period to be 
        specified in the notice.
  (c) Obtaining Records for Compensation Claims.--In the case 
of a claim by a veteran for disability compensation, the 
assistance provided by the Secretary under subsection (a) shall 
include obtaining the following records if relevant to the 
veteran's claim:
          (1) The claimant's existing service medical records 
        and, if the claimant has furnished information 
        sufficient to locate such records, other relevant 
        service records.
          (2) Existing records of relevant medical treatment or 
        examination of the veteran at Department health-care 
        facilities or at the expense of the Department, if the 
        claimant has furnished information sufficient to locate 
        such records.
          (3) Information as described in section 5106 of this 
        title.
  (d) Medical Examinations for Compensation Claims.--In the 
case of a claim by a veteran for disability compensation, the 
assistance provided by the Secretary under subsection (a) shall 
include providing a medical examination, or obtaining a medical 
opinion, when the evidence of record before the Secretary--
          (1) establishes that--
                  (A) the claimant has--
                          (i) a current disability;
                          (ii) current symptoms of a disease 
                        that may not be characterized by 
                        symptoms for extended periods of time; 
                        or
                          (iii) persistent or recurrent 
                        symptoms of disability following 
                        discharge or release from active 
                        military, naval, or air service; and
                  (B) there was an event, injury, or disease 
                (or combination of events, injuries, or 
                diseases) during the claimant's active 
                military, naval, or air service capable of 
                causing or aggravating the claimant's current 
                disability or symptoms, but
          (2) is insufficient to establish service-connection 
        of the current disability or symptoms.
  (e) Regulations.--The Secretary shall prescribe regulations 
to carry out this section. Such regulations shall include 
provisions for--
          (1) specifying the evidence necessary under 
        subsection (a) to establish a claimant's eligibility 
        for a benefit under a law administered by the 
        Secretary; and
          (2) determining under subsections (b) and (c) what 
        records are relevant to a claim.
  (f) Rule With Respect to Disallowed Claims.--Nothing in this 
section shall be construed to require the Secretary to reopen a 
claim that has been disallowed except when new and material 
evidence is presented or secured, as described in section 5108 
of this title.
  (g) Other Assistance Not Precluded.--Nothing in this section 
shall be construed as precluding the Secretary from providing 
such other assistance to a claimant as the Secretary considers 
appropriate.

           *       *       *       *       *       *       *

Sec. 5106. Furnishing of information by other agencies

  The head of any Federal department or agency shall provide 
such information to the Secretary as the Secretary may request 
for purposes of determining eligibility for or amount of 
benefits, or verifying other information with respect thereto. 
No charge may be imposed by the head of any such department or 
agency for providing such information.

[Sec. 5107. Burden of proof; benefit of the doubt

  [(a) Except when otherwise provided by the Secretary in 
accordance with the provisions of this title, a person who 
submits a claim for benefits under a law administered by the 
Secretary shall have the burden of submitting evidence 
sufficient to justify a belief by a fair and impartial 
individual that the claim is well grounded. The Secretary shall 
assist such a claimant in developing the facts pertinent to the 
claim. Such assistance shall include requesting information as 
described in section 5106 of this title.
  [(b) When, after consideration of all evidence and material 
of record in a case before the Department with respect to 
benefits under laws administered by the Secretary, there is an 
approximate balance of positive and negative evidence regarding 
the merits of an issue material to the determination of the 
matter, the benefit of the doubt in resolving each such issue 
shall be given to the claimant. Nothing in this subsection 
shall be construed as shifting from the claimant to the 
Secretary the burden specified in subsection (a) of this 
section.]

Sec. 5107. Burden of proof; benefit of the doubt

  (a) Burden of Proof.--Except when otherwise provided by this 
title or by the Secretary in accordance with the provisions of 
this title, a claimant shall have the burden of proving 
entitlement to benefits.
  (b) Benefit of the Doubt.--The Secretary shall consider all 
evidence and material of record in a case before the Department 
with respect to benefits under laws administered by the 
Secretary and shall give the claimant the benefit of the doubt 
when there is an approximate balance of positive and negative 
evidence regarding any issue material to the determination of 
the matter.

           *       *       *       *       *       *       *

Sec. 5126. Benefits not to be denied based on lack of mailing address

  Benefits under laws administered by the Secretary may not be 
denied a claimant on the basis that the claimant does not have 
a mailing address.

           *       *       *       *       *       *       *

                                
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