Source: https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section5101&num=0&edition=prelim
Timestamp: 2020-06-06 18:26:43
Document Index: 685792321

Matched Legal Cases: ['§ 5101', '§3001', '§4', '§701', '§8053', '§5101', '§402', '§4', '§708', '§502', '§101', '§502', '§402', '§101', '§502', '§3', '§221', '§226', '§227', '§704', '§105', '§809', '§207', '§14', '§106', '§409', '§412', '§109', '§529', '§504', '§241', '§109', '§256', '§702', '§302', '§512', '§707', '§503']

[USC02] 38 USC 5101: Claims and forms
<< Previous TITLE 38 / PART IV / CHAPTER 51 / SUBCHAPTER I / § 5101 Next >>
38 USC 5101: Claims and forms Text contains those laws in effect on June 5, 2020
(1) The term "mentally incompetent" with respect to an individual means that the individual lacks the mental capacity-
( Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1225 , §3001; Pub. L. 97–295, §4(95)(A), Oct. 12, 1982, 96 Stat. 1313 ; Pub. L. 99–576, title VII, §701(61), Oct. 28, 1986, 100 Stat. 3296 ; Pub. L. 101–508, title VIII, §8053(a), Nov. 5, 1990, 104 Stat. 1388–352 ; renumbered §5101 and amended Pub. L. 102–40, title IV, §402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238 , 239; Pub. L. 102–83, §4(a)(1), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 403–405 ; Pub. L. 108–183, title VII, §708(c)(2), Dec. 16, 2003, 117 Stat. 2674 ; Pub. L. 112–154, title V, §502(a), Aug. 6, 2012, 126 Stat. 1190 ; Pub. L. 114–315, title I, §101(a), Dec. 16, 2016, 130 Stat. 1538 .)
2016-Subsec. (a)(1). Pub. L. 114–315 designated existing provisions as subpar. (A), substituted "Except as provided in subparagraph (B), a specific" for "A specific", and added subpar. (B).
2012-Subsec. (a). Pub. L. 112–154, §502(a)(1), designated existing provisions as par. (1) and added par. (2).
2003-Subsec. (a). Pub. L. 108–183 substituted "Commissioner of Social Security" for "Secretary of Health and Human Services".
1991-Pub. L. 102–40, §402(b)(1), renumbered section 3001 of this title as this section.
1986-Subsec. (b)(1). Pub. L. 99–576 substituted "surviving spouse or" for "widow or" in two places.
1982-Subsec. (a). Pub. L. 97–295 substituted "Health and Human Services" for "Health, Education, and Welfare".
Pub. L. 114–315, title I, §101(c), Dec. 16, 2016, 130 Stat. 1540 , provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to claims for benefits based on a death occurring on or after the date of the enactment of this Act [Dec. 16, 2016]."
Pub. L. 112–154, title V, §502(b), Aug. 6, 2012, 126 Stat. 1191 , provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to claims filed on or after the date of the enactment of this Act [Aug. 6, 2012]."
Pub. L. 115–55, §§3–6, Aug. 23, 2017, 131 Stat. 1116–1127 , provided that:
"(a) Plan Required.-Not later than 90 days after the date of the enactment of this Act [Aug. 23, 2017], the Secretary of Veterans Affairs shall submit to the appropriate committees of Congress and the Comptroller General of the United States a comprehensive plan for-
"(3) timely processing, under the new appeals system, of-
"(4) monitoring the implementation of the new appeals system, including metrics and goals-
"(b) Elements.-The plan required by subsection (a) shall include, at a minimum, the following:
"(2) Delineation of the personnel requirements of the Administration and the Board, including staffing levels during the-
"(A) period in which the Administration and the Board are concurrently processing-
"(3) Identification of the legal authorities under which the Administration or the Board may-
"(8) Identification of and a timeline for-
"(11) An estimate of the office space the Administration and the Board will require during each of the periods described in paragraph (2), including-
"(13) An outline of the outreach the Secretary expects to conduct to inform veterans, families of veterans, survivors of veterans, veterans service organizations, military service organizations, congressional caseworkers, advocates for veterans, and such other stakeholders as the Secretary considers appropriate about the new appeals system, including-
"(14) Timelines for updating any policy guidance, Internet websites, and official forms that may be necessary to carry out the new appeals system, including-
"(c) Review by Comptroller General of the United States.-
"(1) In general.-Not later than 90 days after the Comptroller General of the United States receives the plan required by subsection (a), the Comptroller General shall-
"(2) Elements.-The assessment conducted under paragraph (1)(A) shall include the following:
"(d) Periodic Progress Reports.-Not later than 90 days after the date on which the Secretary submits the plan under subsection (a), not less frequently than once every 90 days thereafter until the applicability date set forth in section 2(x)(1) [of Pub. L. 115–55, set out in a note under section 101 of this title], and not less frequently than once every 180 days thereafter for the seven-year period following such applicability date, the Secretary shall submit to the appropriate committees of Congress and the Comptroller General a report on the progress of the Secretary in carrying out the plan and what steps, if any, the Secretary has taken to address any recommendations formulated by the Comptroller General pursuant to subsection (c)(2)(C).
"(e) Publication.-The Secretary shall make available to the public on an Internet website of the Department of Veterans Affairs-
"(f) Appropriate Committees of Congress Defined.-In this section, the term 'appropriate committees of Congress' means-
"(1) In general.-The Secretary of Veterans Affairs may carry out such programs as the Secretary considers appropriate to test any assumptions relied upon in developing the comprehensive plan required by section 3(a) and to test the feasibility and advisability of any facet of the new appeals system.
"(2) Reporting required.-Whenever the Secretary determines, based on the conduct of a program under paragraph (1), that legislative changes to the new appeals system are necessary, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives notice of such determination.
"(b) Department of Veterans Affairs Program on Fully Developed Appeals.-
"(1) In general.-The Secretary of Veterans Affairs may, under subsection (a)(1), carry out a program to provide the option of an alternative appeals process that shall more quickly determine such appeals in accordance with this subsection.
"(2) Election.-
"(A) Filing.-In accordance with subparagraph (B), a claimant may elect to file a fully developed appeal under the program by filing with the Secretary all of the following:
"(B) Timing.-A claimant shall make an election under subparagraph (A) as part of the notice of disagreement filed by the claimant in accordance with subparagraph (A)(i).
"(C) Triage.-The Secretary shall, upon expiration of the period specified in paragraph (3)(C)(iii), ensure that an assessment is undertaken of whether an appeal filed under subparagraph (A) of this paragraph satisfies the requirements for appeal under the program and provide appropriate notification to the claimant of the results of that assessment.
"(D) Reversion.-
"(i) Elected reversion.-At any time, a claimant who makes an election under subparagraph (A) may elect to revert to the standard appeals process. Such a reversion shall be final.
"(ii) Automatic reversion.-A claimant described in clause (i), or a claimant who makes an election under subparagraph (A) but is later determined to be ineligible for the program under paragraph (1), shall revert to the standard appeals process without any penalty to the claimant other than the loss of the docket number associated with the fully developed appeal.
"(E) Outreach.-In providing claimants with notices of the determination of a claim during the period in which the program under paragraph (1) is carried out, the Secretary shall conduct outreach as follows:
"(i) The Secretary shall provide to the claimant (and to the representative of record of the claimant, if any) information regarding-
"(3) Treatment by department and board.-
"(A) Process.-Upon the election of a claimant to file a fully developed appeal pursuant to paragraph (2)(A), the Secretary shall-
"(B) Docket.-
"(i) In general.-The Board of Veterans' Appeals shall-
"(ii) Adjustment.-Beginning one year after the date on which the program commences, the Board may adjust the number of standard appeals decided for each fully developed appeal under clause (i)(III) if the Board determines that such adjustment is fair for both standard appeals and fully developed appeals.
"(C) Limitation on use of new evidence.-
"(i) In general.-Except as provided by clauses (ii) and (iii)-
"(ii) Evidence gathered by board.-Clause (i) shall not apply to evidence developed pursuant to subparagraphs (D) and (E). The Board shall consider such evidence in the first instance without consideration by the Veterans Benefits Administration.
"(iii) Representative of record.-The representative of record of a claimant for appeals purposes, if any, shall be provided an opportunity to review the fully developed appeal of the claimant and submit any additional arguments or evidence that the representative determines necessary during a period specified by the Board for purposes of this subparagraph.
"(D) Prohibition on remand for additional development.-If the Board of Veterans' Appeals determines that a fully developed appeal requires Federal records, independent medical opinions, or new medical examinations, the Board shall-
"(E) Development unit.-
"(i) Establishment.-The Board of Veterans' Appeals shall establish an office to develop Federal records, independent medical opinions, and new medical examinations pursuant to subparagraph (D)(i) that the Board determines necessary to decide a fully developed appeal.
"(ii) Requirements.-The Secretary shall-
"(F) Hearings.-Notwithstanding section 7107 of title 38, United States Code, the Secretary may not provide hearings with respect to fully developed appeals under the program. If a claimant requests to hold a hearing pursuant to such section 7107, such request shall be deemed to be an election to revert to the standard appeals process pursuant to paragraph (2)(D).
"(4) Duration; applicability.-
"(A) Duration.-Subject to subsection (c), the Secretary may carry out the program during such period as the Secretary considers appropriate.
"(B) Applicability.-This section shall apply only to fully developed appeals that are filed during the period in which the program is carried out pursuant to subparagraph (A).
"(A) Compensation.-The term 'compensation' has the meaning given that term in section 101 of title 38, United States Code.
"(B) Fully developed appeal.-The term 'fully developed appeal' means an appeal of a claim for disability compensation that is-
"(C) Standard appeal.-The term 'standard appeal' means an appeal of a claim for disability compensation that is not a fully developed appeal.
"(c) Termination of Authority.-The Secretary of Veterans Affairs may not carry out a program under this section after the applicability date set forth in section 2(x)(1) [of Pub. L. 115–55, set out in a note under section 101 of this title].
"(A) For the Veterans Benefits Administration and, to the extent practicable, each regional office of the Department of Veterans Affairs, the number of-
"(E) The average number of days that appeals are pending on a docket of the Board of Veterans' Appeals maintained pursuant to section 7107 of such title, as amended by section 2(t), disaggregated by-
"(F) With respect to the policy developed and implemented under section 7107(e) of such title, as amended by section 2(t)-
"(M) The average duration, from the filing of an initial claim until the claim is resolved and claimants no longer take any action to protect their effective date under section 5110(a)(2) of such title, as so added-
"(Z) In any case in which the Board decides to screen cases for a purpose described in section 7107(d) of such title, as amended by section 2(t)(1)-
"(ii) a description of the effect such screening has had on-
"(C) The average period such legacy claims were pending before opting in to the new appeals system and the average period required to adjudicate such legacy claims on average after opting in-
"(i) with respect to claims at a regional office of the Department of Veterans Affairs, disaggregated by-
"(1) Claimant.-The term 'claimant' has the meaning given such term in section 5100 of title 38, United States Code.
"(2) Legacy claims.-The term 'legacy claim' means a claim-
"(3) Opt in.-The term 'opt in' means, with respect to a legacy claim of a claimant, that the claimant elects to subject the claim to the new appeals system pursuant to-
"(4) New appeals system.-The term 'new appeals system' means the set of processes and mechanisms by which the Secretary processes, pursuant to the authorities and requirements modified by section 2 [see Tables for classification], claims for benefits under laws administered by the Secretary."
Pub. L. 110–389, title II, §221, Oct. 10, 2008, 122 Stat. 4154 , provided that:
"(a) Pilot Program on Expedited Treatment of Fully Developed Claims.-
"(1) In general.-The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing expeditious treatment of fully developed compensation or pension claims to ensure that such claims are adjudicated not later than 90 days after the date on which such claim is submitted as fully developed.
"(2) Duration of pilot program.-The pilot program under this subsection shall be carried out during the one-year period beginning on the date that is 60 days after the date of the enactment of this Act [Oct. 10, 2008].
"(3) Program locations.-The pilot program under this subsection shall be carried out at 10 regional offices of the Department of Veterans Affairs selected by the Secretary for purposes of such pilot program.
"(4) Fully developed claim defined.-For purposes of this subsection, the term 'fully developed claim' means a claim for a benefit under a law administered by the Secretary-
"(A) for which the claimant-
"(B) for which the claimant-
"(b) Pilot Program on Provision of Checklists to Individuals Submitting Claims.-
"(1) In general.-The Secretary shall carry out a pilot program to assess the feasibility and advisability of providing to a claimant for whom the Secretary is required under section 5103(a) of title 38, United States Code, to provide notice of required information and evidence to such claimant and such claimant's representative, if any, a checklist that includes information or evidence required to be submitted by the claimant to substantiate the claim.
"(2) Duration of pilot program.-The pilot program under this subsection shall be carried out-
"(3) Program locations.-The pilot program under this subsection shall be carried out at four regional offices of the Department selected by the Secretary for purposes of such pilot program.
"(4) Construction.-A checklist provided under the pilot program under this subsection-
"(1) First initial report.-Not later than 335 days after the date of the enactment of this Act [Oct. 10, 2008], the Secretary shall submit to Congress a report on the pilot program under subsection (a) and the pilot program under subsection (b) with respect to claims described in subsection (b)(2)(A).
"(2) Second interim report.-Not later than 1,065 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the pilot program under subsection (b) with respect to claims described in subsection (b)(2)(B).
"(3) Elements of interim reports.-The reports required by paragraphs (1) and (2) shall include the following:
"(4) Final report.-Not later than 180 days after the completion of each pilot program carried out under this section, the Secretary shall submit to Congress a final report on the feasibility and advisability of continuing or expanding the respective pilot program."
Pub. L. 110–389, title II, §226, Oct. 10, 2008, 122 Stat. 4159 , provided that:
"(a) Study of Work Credit System and Work Management System Required.-The Secretary of Veterans Affairs shall conduct a study on the effectiveness of the current employee work credit system and work management system of the Veterans Benefits Administration of the Department of Veterans Affairs, which is used-
"(b) Contents of Study.-In carrying out the study under subsection (a), the Secretary shall consider-
"(8) the elements needed to implement-
"(A) performance standards and accountability measures, intended to ensure that-
"(c) Report to Congress.-Not later than October 31, 2009, the Secretary shall submit to Congress a report on-
"(d) Evaluation of Certain Veterans Benefits Administration Employees Responsible for Processing Claims for Compensation and Pension Benefits.-Not later than 210 days after the date on which the Secretary submits to Congress the report required under subsection (c), the Secretary shall establish an updated system for evaluating the performance and accountability of employees of the Veterans Benefits Administration who are responsible for processing claims for compensation or pension benefits. Such system shall be based on the findings of the study conducted by the Secretary under subsection (a)."
Pub. L. 110–389, title II, §227, Oct. 10, 2008, 122 Stat. 4160 , provided that:
"(a) Review and Comprehensive Plan.-Not later than one year after the date of the enactment of this Act [Oct. 10, 2008], the Secretary of Veterans Affairs shall-
"(b) Information Technology.-The plan developed under subsection (a)(2) shall include the following:
"(3) Development of a technological platform that-
"(B) to the extent practicable-
"(7) The availability, on a secure Internet website of the Department of Veterans Affairs, of a portal that can be used by a claimant to check on the status of any claim submitted by that claimant and that provides information, if applicable, on-
"(B) if no such decision has been reached, notice of-
"(c) Review of Best Practices and Lessons Learned.-In carrying out this section, the Secretary shall review-
"(d) Reduction of Claims Processing Time.-In carrying out this section, the Secretary shall ensure that a plan is developed that, not later than three years after implementation, includes information technology to the extent possible to reduce the processing time for each compensation and pension claim processed by the Veterans Benefits Administration. The performance for claims processing under this plan shall be adjusted for changes to the numbers of claims filed in a given period, the complexity of those claims, and any changes to the basic claims processing rules which occur during the assessment period.
"(e) Consultation.-In carrying out this section, the Secretary of Veterans Affairs shall consult with information technology designers at the Veterans Benefits Administration, the Veterans Health Administration, VistA managers, the Secretary of Defense, appropriate officials of other Government agencies, appropriate individuals in the private and public sectors, veterans service organizations, and other relevant service organizations.
"(f) Report to Congress.-Not later than April 1, 2010, the Secretary shall submit to Congress a report on the review and comprehensive plan required under this section."
Pub. L. 108–183, title VII, §704, Dec. 16, 2003, 117 Stat. 2672 , as amended by Pub. L. 110–389, §105, Oct. 10, 2008, 122 Stat. 4149 ; Pub. L. 111–275, title VIII, §809, Oct. 13, 2010, 124 Stat. 2894 ; Pub. L. 112–191, title II, §207, Oct. 5, 2012, 126 Stat. 1440 ; Pub. L. 113–59, §14, Dec. 20, 2013, 127 Stat. 663 ; Pub. L. 113–175, title I, §106, Sept. 26, 2014, 128 Stat. 1903 ; Pub. L. 114–58, title IV, §409, Sept. 30, 2015, 129 Stat. 535 ; Pub. L. 114–228, title IV, §412, Sept. 29, 2016, 130 Stat. 941 ; Pub. L. 114–315, title I, §109(a)(1), Dec. 16, 2016, 130 Stat. 1544 ; Pub. L. 115–91, div. A, title V, §529, Dec. 12, 2017, 131 Stat. 1383 , provided that:
"(a) Authority.-Using appropriated funds, other than funds available for compensation and pension, the Secretary of Veterans Affairs may provide for the conduct of examinations with respect to the medical disabilities of applicants for benefits under laws administered by the Secretary by persons other than Department of Veterans Affairs employees. The authority under this section is in addition to the authority provided in section 504(b) of the Veterans' Benefits Improvement Act of 1996 (Public Law 104–275; 38 U.S.C. 5101 note).
"(b) Performance by Contract.-Examinations under the authority provided in subsection (a) shall be conducted pursuant to contracts entered into and administered by the Under Secretary for Benefits.
"(c) Expiration.-The authority in subsection (a) shall expire on December 31, 2018. No examination may be carried out under the authority provided in that subsection after that date.
"(d) Licensure of Contract Physicians.-
"(1) In general.-Notwithstanding any law regarding the licensure of physicians, a physician described in paragraph (2) may conduct an examination pursuant to a contract entered into under subsection (b) at any location in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States, so long as the examination is within the scope of the authorized duties under such contract.
"(2) Physician described.-A physician described in this paragraph is a physician who-
"(e) Report.-Not later than four years after the date of the enactment of this Act [Dec. 16, 2003], the Secretary shall submit to Congress a report on the use of the authority provided in subsection (a). The Secretary shall include in the report an assessment of the effect of examinations under that authority on the cost, timeliness, and thoroughness of examinations with respect to the medical disabilities of applicants for benefits under laws administered by the Secretary."
Pub. L. 104–275, title V, §504, Oct. 9, 1996, 110 Stat. 3341 , as amended by Pub. L. 113–235, div. I, title II, §241, Dec. 16, 2014, 128 Stat. 2568 ; Pub. L. 114–315, title I, §109(a)(2), Dec. 16, 2016, 130 Stat. 1544 ; Pub. L. 115–141, div. J, title II, §256, Mar. 23, 2018, 132 Stat. 826 ; Pub. L. 115–407, title VII, §702(b), Dec. 31, 2018, 132 Stat. 5381 , provided that:
"(a) Authority.-The Secretary of Veterans Affairs, acting through the Under Secretary for Benefits, may conduct a pilot program under this section under which examinations with respect to medical disability of applicants for benefits under laws administered by the Secretary that are carried out through the Under Secretary for Benefits may be made by persons other than employees of the Department of Veterans Affairs. Any such examination shall be performed pursuant to contracts entered into by the Under Secretary for Benefits with those persons.
"(b) Limitation.-The Secretary may carry out the pilot program under this section as follows:
"(c) Licensure of Contract Physicians.-
"(1) In general.-Notwithstanding any law regarding the licensure of physicians, a physician described in paragraph (2) may conduct an examination pursuant to a contract entered into under subsection (a) at any location in any State, the District of Columbia, or a Commonwealth, territory, or possession of the United States, so long as the examination is within the scope of the authorized duties under such contract.
"(d) Source of Funds.-Expenses of carrying out the pilot program under this section, including payments for pilot program examination travel and incidental expenses under the terms and conditions set forth by 38 U.S.C. 111, shall be reimbursed to the accounts available for the general operating expenses of the Veterans Benefits Administration and information technology systems from amounts available to the Secretary of Veterans Affairs for payment of compensation and pensions.
"(e) Report to Congress.-Not later than three years after the date of the enactment of this Act [Oct. 9, 1996], the Secretary shall submit to the Congress a report on the effect of the use of the authority provided by subsection (a) on the cost, timeliness, and thoroughness of medical disability examinations."
Pub. L. 103–446, title III, §302, Nov. 2, 1994, 108 Stat. 4658 , as amended by Pub. L. 105–368, title V, §512(c), Nov. 11, 1998, 112 Stat. 3342 , provided that Secretary of Veterans Affairs was to take necessary actions to provide for expeditious treatment, by the Board of Veterans' Appeals and by regional offices of the Veterans Benefits Administration, of any claim that had been remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action, prior to repeal by Pub. L. 108–183, title VII, §707(c), Dec. 16, 2003, 117 Stat. 2673 .
Pub. L. 103–446, title IV, Nov. 2, 1994, 108 Stat. 4659 , as amended by Pub. L. 104–275, title V, §503(a), Oct. 9, 1996, 110 Stat. 3341 , established Veterans' Claims Adjudication Commission which was directed to conduct comprehensive evaluation and assessment of Department of Veterans Affairs system for disposition of claims for veterans benefits and of system for delivery of such benefits, together with any related issues determined to be relevant to study, for purpose of determining means of increasing efficiency of system, means of reducing number of claims under system for which final disposition is pending, and means of enhancing ability of Department of Veterans Affairs to achieve final determination regarding claims under system in prompt and appropriate manner, and further provided for membership and powers of Commission, personnel matters, definitions and funding, and for submission of preliminary report to Secretary of Veterans Affairs and Congress not later than one year after Nov. 2, 1994, submission of final report not later than Dec. 31, 1996, and for termination of Commission 90 days after submission of final report.