zilongwang/ReadingBank huggingface dataset:
a. Purpose of Prestabilization Ratings Under 38 CFR 4.28 Prestabilization ratings under are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient. b. When to Prepare a Prestabilization Rating If a Veteran has an unstable, significantly disabling service-connected (SC) disability at the time of separation that will continue for an indefinite period prepare a prestabilization rating for the unstabilized disability(ies) without waiting for further development or examination on the disability(ies), and defer a decision on any issues that are not ready for a decision. c. Duration of the Award Under 38 CFR 4.28 Prepare prestabilization ratings under as “open ratings.” d. Criteria for Assigning a Prestabilization Rating Assign a prestabilization rating if service treatment records (STRs) show the existence of an unstabilized condition stemming from any disease or injury for which service connection (SC) may be awarded. e. When to Assign 100 and 50 Percent Prestabilization Ratings Use the information below to determine when to assign 100- and 50-percent prestabilization ratings. When … Then assign a … there is an unstabilized condition resulting in severe disability, and substantially gainful employment is not feasible or advisable 100-percent prestabilization rating. there are unhealed or incompletely healed wounds or injuries, and material impairment of employability is likely 50-percent prestabilization rating.
4. General Information on Convalescent Ratings Under 38 CFR 4.30 Introduction This topic contains general information on convalescent ratings under 38 CFR 4.30, including convalescent ratings under 38 CFR 4.30 severe postoperative residuals for ratings under 38 CFR 4.30 work excuses and convalescence ratings scope of convalescence ratings determining the effective date of convalescent ratings extension of convalescent ratings requesting future examinations post-convalescence evaluations and 38 CFR 3.105(e) when the provisions of 38 CFR 4.30 are not applicable. Change Date July 21, 2015 a. Convalescent Ratings under 38 CFR 4.30 provides for a temporary 100-percent evaluation without regard to other provisions of the rating schedule if treatment of an SC disability resulted in surgery necessitating at least one month convalescence surgery with severe postoperative residuals, or immobilization of at least one major joint by cast without surgery, including procedures performed at an outpatient clinic. Note: The provision allowing assignment of a convalescent rating for outpatient surgery necessitating at least one-month of convalescence became effective March 1, 1989. b. Severe Residuals for Ratings Under 38 CFR 4.30 Under , severe postoperative residuals include but are not limited to incompletely healed surgical wounds stumps of recent amputations therapeutic immobilization of one major joint or more application of a body cast the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches (regular prohibited).
a. Provisions of Section 502 of PL 104-275 PL 104-275, Section 502, limits the clothing allowance for Veterans incarcerated for over 60 days if they receive clothing at no cost from the penal institution. Note: In the absence of evidence to the contrary, presume that incarcerated Veterans receive clothing at no cost from the penal institution. b. Payment During the Initial Period of Incarceration General Counsel has held that the restriction on the payment of clothing allowance does not apply for the initial 60 days of any separate period of incarceration. Therefore, the annual clothing allowance amount must be reduced by 1/365th for each day of incarceration after the initial 60 days of incarceration during the 12-month period preceding the August 1st determination of clothing allowance eligibility. c. Payment When the Veteran is Incarcerated for the Entire Clothing Allowance Year If the Veteran is incarcerated for the entire clothing allowance year (August 1st through July 31st), do not pay the Veteran for that year, assuming the Veteran’s incarceration commenced more than 60 days prior to August 1st. d. Payment When the Veteran is Released From Incarceration During the Clothing Allowance Year If the Veteran is initially incarcerated or is released from incarceration during the clothing allowance year, pay the Veteran a partial clothing allowance. Note: Partial clothing allowance payments for years during which the Veteran is incarcerated are not subject to rounding to even dollars. Therefore, partial year payments are made in dollars and cents. Reference: For information on calculating the partial year payment, see M21-1, Part IX, Subpart i, 7.3.b. 4. Processing ACAP NODs or Substantive Appeals
request for application or an intent to file a claim To delete duplicate information in old Block 1.f on information about developing substantially complete applications which is being incorporated into I.1.B.1.c and III.iii.1.C.3.d I.1.B.1.f (old) To add a new Block 1.g regarding notification requirements for claims that are inherently incredible or lack merit. I.1.B.1.g To delete old Block 1.g regarding claimant’s duty to identify and locate records which is being incorporated into I.1.C. I.1.B.1.g (old) To delete and consolidate old Block 1.d into Block 1.h (old 1.e) regarding responding to a request for an earlier effective date. I.1.B.1.h To delete old Block 1.h regarding the definition of relevant records, which is being relocated to I.A.3.a. I.1.B.1.h (old) To delete old Block 1.i regarding the handling of VA Form 21-4142, which is being relocated to III.iii.1.C.3. I.1.B.1.i (old) To add new example of when a Section 5103 notice would not be required I.1.B.1.i (old block k) To add a new Block 1.j regarding Section 5103 notice requirements for subsequent claims I.1.B.1.j To delete old Block 1.j regarding claimants’ duty to authorize release of existing records, which is being relocated into I.1.C and III.iii.1.C. I.1.B.1.j (old) To delete old Block 2.a regarding the definition of a reopened claim, which is being relocated to I.1.A.3.i. I.1.B.2.a (old) To add text indicating that language specific to a previous denial is no longer required to be sent in addition to Section 5103 notice and the obligation is satisfied by EZ forms To add example, and To add references for EZ forms and requests for reconsideration. I.1.B.2.a Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service Distribution LOCAL REPRODUCTION AUTHORIZED
information. To relocate and revise old Block 2.e regarding when to refrain from or discontinue assistance. I.A.3.b To add a new Block c which relocated information from III.iv.2.A regarding claims that are inherently incredible or lack merit I.A.3.c To add a new Block d that defines competent medical evidence. I.A.3.d To add a new Block e that defines competent lay evidence. I.A.3.e To add a new Block f replacing old Block 2.a with a definition of substantially complete applications. I.A.3.f To add a new Block g that defines event. I.A.3.g To add a new Block h that defines information. I.A.3.h To add a new Block i that defines reopened claims. I.A.3.i Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service Distribution LOCAL REPRODUCTION AUTHORIZED
Note: The requirement that payments be continued through the 60-day period does not alter the effective date of the proposed reduction or termination. Reference: For more information on effective dates for reduced benefits, see . Statement advising beneficiary of potential overpayment advises the beneficiary that if the proposed adverse action is implemented, he/she must repay any overpayment resulting from the continuation of payments during the proposed adverse action period, and informs the beneficiary that he/she may minimize any potential overpayment by requesting that the award be adjusted immediately. Basis for proposed decision States the facts and reasons for the proposed action () the evidence under consideration, and the proposed rates and any calculations used to arrive at the proposed rates. Rights of beneficiary Informs the beneficiary of the right to present evidence request a personal hearing, and have representation. Reference: For a list of M21-1 references specific to due process, see M21-1, Part I, 2.B.4. 3. Process for Proposing an Adverse Action Introduction This topic contains information on the process of the proposed adverse action, including process for notices of proposed adverse action, determining where to send the notice of proposed adverse action, and special procedures for hospitalized Veterans. Change Date January 20, 2016
b. Required Elements of the Final Decision Notice Every final decision notice, like a contemporaneous notice, must include the following elements: statement of decision (including new rate(s), if applicable) statement of applicable effective date(s) reasons for decision overpayment information, and appeal rights. Note: There is no need to re-summarize in the final decision notice any evidence referenced in the advance notice. References: For more information on when to provide a summary of evidence in a decision notice, see M21-1, Part III, Subpart v, 2.B.1.e, and notification requirements, see M21-1, Part III, Subpart v, 2.B.1. c. Procedure for Sending a Final Decision Notice Follow the steps in the table below to send the final decision notice. Step Action 1 Compose the final decision notice with all of the required elements and language. References: For more information on the required elements of the final decision notice, see M21-1, Part I, 2.C.4.b, and decision notices, see M21-1, Part III, Subpart v, 2.B. 2 Determine who will receive a notice, and the appropriate address to send the notice. References: For more information on determining who receives a notice, see M21-1, Part I, 2.A.1.c., and the appropriate address to send the notice, see . 3 Send the final decision notice to the beneficiary and representative, if any. 4 Place a copy of the notice in the claims folder.
the representation is unlimited, see M21-1, Part I, 3.A.2.c. Reference: For more information on updating VA electronic systems when a limited declaration of representation is received, see M21-1, Part III, Subpart ii, 3.C.4.b. 3. POA Representation of Incompetent Claimants Introduction This topic contains information on representation of incompetent claimants, including fiduciary appointment for an incompetent Veteran representation for claimants in the process of being declared incompetent, and appointing POA representation to establish competency. Change Date August 17, 2004 a. Fiduciary Appointment for an Incompetent Veteran If the claimant is unable to handle his/her own VA benefit payments, VA appoints a fiduciary to handle the payment of VA funds. b. Representation for Claimants in the Process of Being Declared Incompetent Until a fiduciary is appointed for a claimant in the process of being declared incompetent, accept the appointment of a POA representative from any of the following people in the following order claimant spouse mother or father, or next of kin. Once VA appoints a fiduciary, the fiduciary may appoint a new POA representative. The prior POA is not automatically revoked. c. Appointing POA Representation to Establish Competency An incompetent claimant may appoint a POA representative for the purpose of attempting to establish his/her competency.
a. General Policy on Representation After the Claimant’s Death Representation based on a POA signed by the claimant during his/her lifetime ends with the death of the claimant. In order for the same representative to represent a survivor, the survivor must execute a separate POA. Reference: For more information on the policy expressed in this block, see , 10 Vet.App. 330 (1997).
rating or authorization activity. To remove old Block e as outdated. To update procedures for reviewing evidence received for a remanded appeal. To remove old Block f as outdated. I.5.G.4.f To add a reference to procedures for obtaining a VA Form 646, Statement of Accredited Representative in Appealed Cases. I.5.G.4.g To revise guidance about how to recertify a remanded appeal to BVA. I.5.G.4.h To update the signature block in the sample notification letter to conform to centralized mail standards. I.5.G.5.a Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service Distribution LOCAL REPRODUCTION AUTHORIZED
Department of Veterans Affairs M21-1MR, Part III, Subpart iii Veterans Benefits Administration May 28, 2014 Washington, DC 20420 Transmittal Sheet Changes Included in This Revision The table below describes the changes included in this revision of Veterans Benefits Manual M21-1MR, Part III, “General Claims Process,” Subpart iii, “General Development and Dependency Issues.” Notes: The term regional office (RO) also includes pension management center (PMC), where appropriate. Minor editorial changes have also been made to update incorrect or obsolete hyperlink references make updates that reflect the use of eFolders in lieu of claims folders update the term “veteran” to “Veteran” update obsolete terminology, where appropriate update section and topic titles to more accurately reflect their content clarify block labels and/or block text, and bring the documents into conformance with M21-1MR standards. Reason(s) for the Change Citation Page(s) To reorganize the blocks within (old) topics 10, 11, 12, 13, and 15 into a more logical order. To reduce the information previously contained in these five topics down to three topics and renumber the remaining topics accordingly. M21-1MR, Part III, Subpart iii, Chapter 3, Section B, Topics 3-B-2 through 3-B-16 To rewrite to reflect the replacement of SSA Form Request for Medical Information From Records of the Department of Veterans Affairs, with Form SSA-827, Authorization to Disclose Information to the Social Security Administration (SSA). III.iii.3.B.10 and 11 3-B-2 through 3-B-9 To remove Medal of Honor Pension as a benefit the Social Security Administration (SSA) considers income for SSA purposes. III.iii.3.B.12.c 3-B-12 To create a new block explaining that although SSA is interested in knowing whether a Department of Veterans Affairs (VA) beneficiary receives Medal of Honor Pension or educational benefits, neither are considered VA income for SSA purposes. III.iii.3.B.12.d 3-B-13 To add a block that discusses calculations in III.iii.3.B that result in a negative amount of VA income for SSA purposes. III.iii.3.B.12.i 3-B-16 Continued on next page
mail) located in III.ii.4.H.3 when no return address is found for unidentified mail. To update reference for processing in-process mail to III.ii.E.5.d. III.ii.1.B.2.f To remove topic (old 7) Handling Mail That Could Result in Reduction or Termination of Benefits (moved to III.ii.1.C.6). III.ii.1.B.(old 7) To replace the term “No Record” mail with “Unidentifiable” mail. To remove obsolete terms PTI, PTO and Search mail. III.ii.1.B.3.a To add a note that Miltary File mail does not apply to mail processed in the CM portal. To replace the term “No Record” mail with “Unidentifiable” mail and to add the reference. To remove obsolete terms PTI, PTO and search mail. III.ii.1.B.3.b To update note on unsuccessful attempts to obtain a current address for undeliverable mail. To update the reference for updating the address in the system to III.ii.3.C.1. III.ii.1.B.3.c To remove PTO from Regular/Routine mail description. III.ii.1.B.4.a To update procedures for handling Regular/Routine mail. III.ii.1.B.4.b Rescissions None Authority By Direction of the Under Secretary for Benefits Signature David R. McLenachen, Director Pension and Fiduciary Service Distribution LOCAL REPRODUCTION AUTHORIZED
e. Requests to Revoke or Change POA When a request to revoke POA is received or a new POA is appointed, update all systems as appropriate. Use the table below to annotate a revoked appointment of a claimant’s representative, when a new appointment form is received, or a request for revocation of POA is received without a new appointment. If revocation is being processed in a(n) ... Then ... paper format annotate the revoked form with the reason for revocation, and date the revocation is processed. electronic format add a permanent note in VBMS indicating the revocation of the appointment of representation. Notes: In addition to the permanent note, the word Revoked can be added to the subject line of the POA appointment form in the eFolder, if available. Until the PMCs fully transition to VBMS, substitute adding notes to MAP-D. Reference: For more information on changing the subject line of a document in an eFolder, see the . Reference: For more information on updating POA in VA systems, see Part III, Subpart ii, 3.C.5. f. Handling an Outdated VA Form 21-22 or VA Form If a claimant submits an outdated version of VA Form 21-22 or VA Form send a development letter requesting completion of the current version of the VA Form 21-22 or VA Form 21-22a. With the letter provide the current version of the form for completion, and return the outdated form. Important: If the form is being processed electronically in the centralized mail (CM) portal, print the form so it can be returned to the POA or claimant and upload to VBMS.
g. Handling an Incomplete VA Form 21-22 or VA Form Use the procedure below if VA Form 21-22 or VA Form 21-22a is incomplete. If the VSO is ... Then ... located in the same building as the RO forward the form to the VSO for completion, and check all necessary incomplete items on the form. not located in the same building as the RO, and there is an end product (EP) pending return the form to the claimant with a letter, and check all necessary incomplete items on the form in red ink. not located in the same building as the RO, and there is no EP pending establish an EP 400 Correspondence return the form to the claimant with a letter check all necessary incomplete items on the form in red ink, and clear the EP 400. Important: If the form is being processed electronically in the CM portal, print the form so it can be returned to the POA or claimant and upload to VBMS. Note: The VBMS development action Form incomplete - Items checked in red needed,” can be found under the category GENERAL. Reference: For more information about VBMS development actions, see the . h. Processing Copies of VA Form 21-22 or VA Form With Paper Claims Folders The current versions of VA Form 21-22 or VA Form 21-22a no longer have multiple copies to be acknowledged and sent to the POA or representative. To process these forms with paper claims folders use the below table. If the form is a … Then ... paper VA Form 21-22 enter in the Acknowledged block the current date your initials, and as applicable, complete the Sent to block. paper VA Form 21-22a annotate with the current date, and Acknowledged. an electronic VA Form upload to VBMS.
To clarify that the “records” discussed in this block are records in the Beneficiary Identification and Records Locator Subsystem (BIRLS). To incorporate instructions for consolidating duplicate BIRLS records when one or both of the corresponding claims folders is/are available in an electronic format (eFolder) only. III.ii.4.D.3.b To update the guidelines for reconciling duplicate file numbers. To delete the Note regarding applications for outpatient and domiciliary care, as its meaning/purpose is unclear. III.ii.4.D.3.c To delete (old) III.ii.4.D.3.e, as its content is outdated and no longer relevant. --- Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service Distribution LOCAL REPRODUCTION AUTHORIZED
Department of Veterans Affairs M21-1, Part III, Subpart iv Veterans Benefits Administration March 24, 2015 Washington, DC 20420 Transmittal Sheet Changes Included in This Revision The table below describes the changes included in this revision of Veterans Benefits Manual M21-1, Part III, “General Claims Process,” Subpart iv, “General Rating Process.” Notes: Minor editorial changes have also been made to update incorrect or obsolete hyperlink references update section and topic titles to more accurately reflect their content renumber each topic based on the standard that the first topic in each section is Topic 1, and bring the documents into conformance with M21-1 and Knowledge Management (KM) standards. Reason(s) for the Change Citation To explain that the effective date of a reopened or revised claim based on new and material evidence can be the date of receipt of the intent to file, as well as the date of claim. M21-1, Part III, Subpart iv, Chapter 2, Section B, Topic 1, Block c (III.iv.2.B.1.c) To update the phrase “claim for earlier effective date” to “request for earlier effective date” to be consistent with what constitutes a claim. III.iv.2.B.1.d To clarify that the submission of new and material evidence alone is not sufficient to reopen a claim beginning March 24, 2015. III.iv.2.B.3.a To clarify the definition of clear and unmistakeable error (CUE) III.iv.2.B.4.a To clarify that a CUE is an allegation and not a claim as defined by VA regulations. III.iv.2.B.4.e III.iv.2.B.5.a To clarify that a motion for reconsideration of a Board of Veterans Appeals (BVA) decision is not governed by the Standard Claims and Appeals Forms regulation change. III.iv.2.B.5.c Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service
the future examination cannot be controlled under either situation described above a local diary. Note: Individual ROs may exercise discretion in the manner in which they control these cases. Reference: For more information on establishing future examination control in Share, see the , or VBMS, see the . d. Action When the Control Period for the Future Examination Matures When an 810 series work item 631A Future Physical Examination or 631R Review Need for Reevaluation is generated, a future pending issue matures, or a local diary matures, the claims folder is referred to the rating activity for review. Use the table below to determine the subsequent action. If the rating activity determines that it is necessary to … Then … And … proceed with the examination establish an EP 310 use the date on the 810 series work item, 631A Future Physical Examination, or 631R Review Need for Reevaluation as the date of claim, and ensure the SUPPRESS LETTER checkbox is selected. Note: Do not establish an EP 310 if another EP is already pending for the specific disability under review. Instead, complete all necessary action under the existing EP. request an examination. cancel the examination complete a rating decision to establish permanency. advance the date of the examination cancel the future examination control establish a new future examination
Introduction This topic contains general information about tuberculosis, including , and . Change Date December 13, 2005 a. Using Tuberculosis Classification Standards Become familiar with the following classification standards adopted by the American Lung Association under The Diagnostic Standards and Classification of Tuberculosis in Adults and Children, 1999: Classify an individual as “Tuberculosis Suspect” until diagnostic procedures are complete. (Note: Do not use the classification “Tuberculosis Suspect” for more than three months.) Classify disease caused by other mycobacteria as “Other Mycobacterial Diseases.” (Note: Disease caused by other mycobacteria is indistinguishable clinically, radiologically, and histologically from mycobacterium (M) tuberculosis.) Reference: For more information on the classification standards, see . Continued on next page 17. General Information on Tuberculosis, Continued b. Considering Infection Caused by Other Mycobacteria Other mycobacterium (M) that may commonly be involved as pathogens are M. kansasii M. intracellulare, and M. scrofulaceum. Note: M. bovis is rarely responsible for disease where there is effective control of tuberculosis in cattle and pasteurization of milk and milk products, and indistinguishable from M. tuberculosis except by culture.
Overview 4-F-1 22. Diabetes Mellitus 4-F-2 23. Thyroid Conditions 4-F-6 24. Exhibit 1: Examples of Rating Decisions Involving the Complications of Diabetes Mellitus 4-F-8 Section G: Neurological Conditions and Convulsive Disorders Overview 4-G-1 25. General Information on Neurological and Convulsive Disorders 4-G-2 26. Multiple Sclerosis 4-G-5 Section H: Mental Disorders Overview 4-H-1 27. General Information on Mental Disorders 4-H-2 28. General Information on Posttraumatic Stress Disorder (PTSD) 4-H-5 29. Evaluating Evidence of an In-Service Stressor 4-H-8 30. Evaluating Evidence in Claims Based on Personal Trauma 4-H-18 31. Handling Examinations in Claims for Service Connection for PTSD 4-H-22 32. Deciding a Claim for Service Connection for PTSD 4-H-25 Section I: Conditions of Other Body Systems Overview 4-I-1 33. Digestive System Conditions 4-I-2 34. Genitourinary and Gynecological Conditions 4-I-4 35. Spina Bifida and Other Covered Birth Defects 4-I-6 36. Hemic and Lymphatic System Conditions 4-I-7
mellitus. To add information on rating the level of incomplete paralysis of the peripheral nerves. III.iv.4.F.2.h To add information on the ophthalmological complications of diabetes mellitus. III.iv.4.F.2.i To add information on the genitourinary complications of diabetes mellitus. III.iv.4.F.2.j To add information on the musculoskeletal complications of diabetes mellitus. III.iv.4.F.2.k To add information on immune and other miscellaneous complications of diabetes mellitus. III.iv.4.F.2.l To add information on the skin complications of diabetes mellitus. III.iv.4.F.2.m To add additional guidance and revise existing guidance on rating conditions due to hyperthyroidism. To differentiate between successive and variable rating criteria as provided for by Tatum v. Shinseki. III.iv.4.F.4.b Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service Distribution LOCAL REPRODUCTION AUTHORIZED
d. TBI Residuals The resultant disabling effects of a TBI event beyond those that follow immediately from the acute injury to the brain are known as TBI residuals or TBI sequelae. The signs and symptoms of TBI residuals can be organized into the three main categories of physical, cognitive, and behavioral/emotional residuals for evaluation purposes. Examples of TBI residuals in each of the three categories may include, but are not limited to, those listed below. Physical Cognitive Behavioral/Emotional Apraxia (inability to execute purposeful, previously learned motor tasks, despite physical ability and willingness) Dementias (pre-senile Alzheimer’s type, dementia pugilistica, post traumatic dementia) Depression Aphasia (difficulty communicating orally and/or in writing) Attention and concentration deficits Agitation and irritability Paresis (muscle weakness or incomplete paralysis) Memory, processing, and learning impairment Impulsivity Plegia (paralysis or stroke) Language deficiencies Aggression Dysphagia (difficulty swallowing) Planning difficulties Anxiety Disorders of balance and coordination Judgment and control difficulties Posttraumatic stress disorder Diseases of hormone deficiency Reasoning and abstract thinking limitations Parkinsonism Self-awareness limitations Nausea/vomiting Headaches Dizziness Blurred vision Seizure disorder Sensory loss Weakness Sleep disturbance Note: TBI residuals can resolve in a short period of time or can persist chronically or even permanently. Chronic TBI residuals may include some or all of the clinical signs that developed immediately during the TBI event. Others (such as seizures or spasticity) may have a delayed onset. e. Determining the Issues in TBI Cases A claim for SC for TBI may also be worded as a claim for “head injury,” or “concussion.” A claim document mentioning any of the above must be sympathetically read and understood as a claim for all identifiable TBI residuals that can be attributed to one or more TBI events.
Reference: For more information on evaluating TBI residuals, see M21-1, Part III, Subpart iv, 4.G.2.g. h. Action When Evidence Shows a 38 CFR 3.310(d) Condition Use the table below to determine how to proceed when evidence shows one of the five diagnosable conditions in . If ... Then ... one of the five diagnosable conditions in is identified in the evidence of record while processing a claim unrelated to SC TBI a claim for that secondary condition must be invited. evidence shows one of the five diagnosable conditions while evaluating a claim related to SC TBI develop under normal claim processing procedures and make a determination on the secondary condition under the provisions of (d). i. Determining Effective Dates for Secondary Conditions The rule authorizing VA to establish the five secondary TBI-related conditions in is effective, January 16, 2014. This rule will be applied to all cases pending before VA on or after, January 16, 2014, and does constitute a liberalizing VA regulation under and . Apply
Developing Friendships -- Formative Assessment (Example) Clear Learning Target(s) Criteria for Success Documentation and Analysis of Evidence Descriptive Feedback Change or Adjust Instruction Organizing Play Child demonstrate the ability to organize play with peers Child gets attention of peers appropriately Child gives an idea of what they might do with a toy or material Child gets attention of peers by verbally requesting they join him or her in play (accepting when a child chooses not to join them). Child uses “Let’s” statements to suggest roles or specific activity “You used your words to ask your friends to play with you in blocks. Sarah said no and you were ok with that.” “You are using your words to help everyone understand how to build the block structure.” Model “right” and “wrong” ways to organize play situations. Provide opportunities for them to practice “right” ways within daily interactions. Model by using “Let’s” statements when organizing activities in the classroom. Sharing Child will demonstrate the ability to share toys and materials in daily interactions. Child offers to share materials he or she is using. Child responds to requests from others to share materials. Child says, “You can use my crayons to color your picture.” When asked, the child gives the roller to another child during a play dough activity. “You shared your crayons with Ella. You are a good friend.” “You two are working so well together.” Intentionally set up situations for children to practice sharing n small group activities. Limit the materials available in some centers in order to encourage children to share. Being Helpful/Team Player Child will demonstrate the ability to help or assist others. Child tells or shows someone how to do something. Child assists someone in distress. Child says, “Tia, put your foot here so you can reach the bar.” Child brings a bandage to a child that has fallen. “You are helping Tia be safe on the playground.” “You are so helpful to bring Sam a bandage. That will make him feel better.’ Model showing or telling a child how to do something. Provide a “We care” basket that includes items to help friends feel better (i.e., tissue, bandages, teddy bear, etc.).
Introduction This topic contains information about considering subordinate issues and ancillary benefits, including the definition of subordinate issues, and ancillary benefits types of ancillary benefits, and when to address subordinate issues and ancillary benefits. Change Date August 3, 2011 a. Definition: Subordinate Issues A subordinate issue is derived from the consideration or outcome of related claimed issues. Often the primary and subordinate issues share the same fact pattern. b. Definition: Ancillary Benefits Ancillary benefits are secondary benefits that are considered when evaluating claims for compensation pension, or Dependency and Indemnity Compensation (DIC) entitlement. Eligibility for ancillary benefits is derived from a Veteran’s entitlement to disability benefits or the circumstances of the Veteran’s death. c. Types of Ancillary Benefits Some types of ancillary benefits are Dependents’ Educational Assistance under specially adapted housing under special housing adaptation grants under automotive and adaptive equipment under vocational rehabilitation and employment (VR&E), and loan guaranty for surviving spouses under . Reference: For more information on ancillary benefits, see . d. When to Address Subordinate Issues and Ancillary Benefits The table below contains examples of when to address entitlement to subordinate issues and ancillary benefits at issue in a rating decision. Note: In general, address entitlement to a subordinate issue or ancillary benefit only when entitlement can be granted. Do not put a benefit at issue merely to deny it. Exceptions: Consider the following issues in all applicable ratings,
schedular grades required for the higher rating, or assigning the lower evaluation. individual unemployability whether entitlement was claimed, or there is evidence of disability supporting IU entitlement not specifically claimed. Reference: For more information on a total disability evaluation on the basis of individual unemployability, see , 22 Vet. App. 447 (2009). a death case accrued benefits if VA Form 21-534, Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable), is filed, and a disability claim was pending at the time of death. Reference: For more information on accrued benefits, see . a disability pension claim that was previously denied but is being reopened due to evidence of new disabilities, or a change in the evaluation of any previously evaluated disabilities the issue with a formal coded rating.
2. Introduction Introduction This topic contains information on the Introduction, including , and . Change Date January 20, 2015 a. Purpose of the Introduction The purpose of the Introduction is to identify the claimant, and acknowledge the Veteran’s qualifying service, including any special considerations relevant to the claim, such as former prisoner of war (POW) status. Note: The level of detail in the introduction depends on the complexity of each issue. b. Generating the Introduction The Introduction may be generated using the narrative assistance function in VBMS-R or may be composed manually. Use the guidelines listed below when manually composing the Introduction. Write directly to the claimant. “You” is acceptable usage. Include all periods of service. Use the format “month/day/year to month/day/year.” Note: Service dates must be checked for accuracy. Reference: For more information on using the narrative assistance function, see the . 3. Decision
Rating Decision rating decision to the claimant. Important: the Codesheet of the rating decision is intended for internal processing and should not be routinely distributed to the claimant. copies of draft decisions should not be released to the claimant. Reference: For more information on ADL, see the . 2. Providing Copies of the Rating Decision Introduction This topic contains information about providing copies of the rating decision, including making copies power of attorney (POA) copy of the rating decision copies for Insurance Service copies for 38 U.S.C. Chapter 31 purposes copies for the medical activity, and copies of rating decisions restoring competency. . Change Date April 27, 2015 a. Making Copies Whenever additional copies of the rating decision are required make appropriate entries in the “ COPY TO” field of the Codesheet, and provide and appropriately forward copies of all pages of the rating decision. b. POA Copy of the Rating Decision Provide the VA beneficiary’s power of attorney (POA) representative with a printed copy of the rating decision in the following situations cases involving a paper claims folder Veterans Service Organizations (VSO) who do not have work queues (such as certain county representatives) in VBMS, or VSOs who cannot view the eFolder due to restriction of access to records protected by . For cases with an eFolder
Section C. Protected Ratings Overview In this Section This section contains the following topics: Topic Topic Name See Page Protected Evaluations Under 38 CFR 3.951 and 38 CFR 3.952 8-C-2 Protected Service Connection Under 38 CFR 3.957 8-C-6 Protected Pension Ratings Under 38 CFR 3.951(b) 8-C-7 8. Protected Evaluations Under 38 CFR 3.951 and 38 CFR 3.952 Introduction This topic contains information about protected evaluations, including , and . Change Date September 23, 2014
e. Protected Combined Evaluations Do not reduce benefits when a combined evaluation has been in effect for 20 years or more except in the case of fraud. Both the individual evaluations and the combined evaluation are protected under , even if erroneously assigned. Example: No rating action is warranted to reduce the erroneous 50 percent combined evaluation to the proper 40 percent combined evaluation in a case where two compensable service-connected (SC) disabilities have been evaluated at 30 percent and 20 percent disabling, respectively, and an improperly assigned combined degree of 50 percent has been in effect for 20 or more years. f. Reduction and Discontinuance Under 38 CFR 3.552 Protection under the provisions of either or of a total rating or disability evaluation does not preclude reduction to a hospital rate under . Continued on next page 8. Protected Evaluations Under 38 CFR 3.951 and 38 CFR 3.952, Continued g. Protection Against Rating Schedule Changes Public Law (PL) 102-86 states that a rating evaluation cannot be reduced solely because of a change to the rating schedule subsequent to August 13, 1991. However, protects rating evaluations under the 1925 rating schedule which were the basis of compensation on April 1, 1946. Note: Evaluations in effect when previous changes to the 1945 rating schedule occurred are not protected by PL 102-86. Reference: For more information on the preservation of disability evaluations after rating schedule changes, see , and . h. Reviewing Evaluations After a Rating Schedule Change When reviewing a disability evaluation after a change in the rating schedule, determine whether the current evaluation would be continued or decreased under the prior schedule. Note: The disability evaluation cannot be reduced unless you can show the Veteran’s condition improved enough to have warranted reduction under the prior schedule.
a. Applying 38 CFR 3.105(a) and 38 CFR 3.105(d) Do not take action to sever service connection pursuant to and unless all available relevant evidence, including complete service medical data and autopsy findings (if pertinent in death cases) is of record, and shows that establishment was clearly and unmistakably erroneous. Exception: when VA determines that there is no legal entitlement for a previous award of VA benefits (when service connection is clearly illegal), VA is not required to establish that the original decision was clearly and unmistakably erroneous per in order to sever service connection. , 21 Vet. App. 54, 57 (2007). References: For more information on the ten-year protection even when service connection is erroneous, see , and due process to sever service connection when clearly illegal/without legal entitlement see . Continued on next page , Continued b. Severing Service Connection Due to Diagnosis Change A change in diagnosis may be accepted as a basis for severance if there is certification that the diagnosis on which service connection was based was clearly erroneous under . c. Severing Service Connection for a Psychosis If service connection is severed for a psychosis, make a determination of entitlement under . d. Handling Severance of Service Connection The table below describes how to handle severing service connection. Stage Who is Responsible Description 1 RVSR Refers all ratings proposing severance of service connection to the Veterans Service Center Manager (VSCM) for approval or disapproval under .
Department of Veterans Affairs M21-1, Part III, Subpart v Veterans Benefits Administration March 24, 2015 Washington, DC 20420 Transmittal Sheet Changes Included in This Revision The table below describes the changes included in this revision of Veterans Benefits Manual M21-1, Part III, “General Claims Process,” Subpart v, “General Authorization Issues and Claimant Notifications.” Notes: Minor editorial changes have also been made to update incorrect or obsolete hyperlink references update section and topic titles to more accurately reflect their content renumber each topic based on the standard that the first topic in each section is Topic 1, and bring the documents into conformance with M21-1 and Knowledge Management (KM) standards. Reason(s) for the Change Citation To update instructions for processing hospitalization reports to include removing instructions to establish a future diary date for end product (EP) 320, and adding instruction to establish a diary code 30, “Hospitalization Report.” M21-1, Part III, Subpart v, Chapter 6, Section D, Topic 1 Block b (III.v.6.D.1.b) To remove block containing obsolete instructions for processing an award adjustment without rating board review. III.v.6.D.2.a To update reasons for referring hospital summaries to the rating activity after Standard Claims and Appeals Forms rule implementation. III.v.6.D.4.a To indicate prehospital evaluations will be increased or restored based on adjudication of a claim for increase in service-connected disability after Standard Claims and Appeals Forms rule implementation. III.v.6.D.4.b Rescissions None Authority By Direction of the Under Secretary for Benefits Signature Thomas J. Murphy, Director Compensation Service
Examination. Notes: DoD may have used other forms prior to the issuance of DD Form 2910. For example, the Department of the Navy used the form NAVPERS 1752/1, Sexual Assault Incident Data Collection Report. In restricted reporting cases, DoD stores the evidence, including results from the SAFE, for one year following the date of the victim’s report of sexual assault. If the victim does not claim the evidence or elect an unrestricted report within one year, DoD destroys it. e. Action VA Takes Upon Receipt of Claim Based on MST The table below shows the action VA takes upon receipt of a claim based on MST. Step Action 1 The RO’s Women Veterans Coordinator (WVC) contacts the Veteran via telephone to ask if he/she completed DD Form 2910, DD Form 2911, or a similar form following the incident. Note: If the WVC is unable to contact the Veteran by telephone on the first attempt, a second attempt is not necessary. Continue to develop for the evidence by letter using the restricted report paragraphs as shown in M21-1, Part IV, Subpart ii, 1.D.5.f. 2 Did the Veteran state he/she completed one of the forms? If yes, go to Step 3. If no, follow the normal procedures for developing claims based on personal trauma shown in this topic. 3 Ask the Veteran for the following information the name and location of the military base where the report was filed copies of the DD Form 2910, DD Form 2911, or other evidence, and whether the report was restricted or unrestricted. Notes: Inform the Veteran that he/she will receive a letter documenting this request for information. If the Veteran indicated that the report is unrestricted, develop for the DoD records immediately by sending the development letter shown in M21-1, Part IV, Subpart ii, 1.D.5.i. 4 Document the telephone contact on VA Form 27-0820. Reference: For more information on documenting telephone
b. Establishing Service Connection for a Compensable Qualifying Chronic Disability That Arose During the Presumptive Period Establish service connection if the qualifying chronic disability arose to a compensable degree after the Veteran last served in the Southwest Asia theater of operations during the GW period, regardless of the Veteran’s active duty status at the time. If service connection is established during the presumptive period, include the following statement in the rating decision: Service connection may be presumed for disabilities resulting from undiagnosed illnesses or diagnosed illnesses which arose to a compensable degree after service in the Southwest Asia theater of operations during the Gulf War period. Service connection for [disability] has been awarded on the basis of this presumption. Reference: For more information on documenting a decision see . c. Evaluating the Level of Impairment From an Undiagnosed Disability by Analogy Evaluate the level of impairment of qualifying chronic undiagnosed disabilities by drawing an analogy to an existing DC in the rating schedule per . Precede a discussion of the evaluation criteria in the rating decision with the following statement: Since the disability at issue does not have its own evaluation criteria assigned in VA regulations, a closely related disease or injury was used for this purpose. Reference: For more information on documenting a decision see . Continued on next page , Continued d. Using Hyphenated DCs for Undiagnosed Disabilities Use hyphenated DCs for all undiagnosed disabilities. The table below describes each of the codes that comprise a complete hyphenated DC Reference: For more information on analogous DCs, see , and . Code Description Example Reference First DC Should always be one of the DCs established for the undiagnosed illness 8863, for diseases analogous to systemic diseases For more information on DCs, see , and .
claim for increase. However, if the evidence establishes entitlement to a hospitalization rating, the assignment of a post-hospitalization evaluation is a part of the process of rating the hospitalization issue. An increased evaluation may be warranted and awarded following the period of hospitalization. A reduced evaluation may be warranted by the evidence following the period of hospitalization, and reduction action should be taken in compliance with as warranted. If the medical evidence does not establish that a change in the evaluation is warranted, assign the evaluation in effect prior to hospitalization. If the medical evidence suggests improvement may occur but such improvement is not definitively established, consider scheduling a routine future examination . The assigned evaluation prior to the hospitalization is not subject to review as a part of the hospitalization rating. When a claim for hospitalization for a SC issue must be denied, do not routinely address the evaluation of the SC issue unless a separate claim for increase has been received. c. Awarding Hospitalization Benefits When Admission Is for a NSC Disability Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days. Exception: Treatment for a service-connected disability that is only coincidental in nature and would not require hospitalization by itself does not qualify. Example: Medication management for a condition when treatment could otherwise occur outside of hospitalization does not warrant benefits under . Reference: For more information on hospitalization ratings when admission is for treatment of a NSC disability, see . d. Awarding a Hospitalization Rating for Admission of an Incarcerated Veteran If an incarcerated Veteran is confined to a prison hospital for treatment of an SC disability in excess of 21 days, the Veteran may be eligible for hospitalization benefits. Reference: For information on the effect of imprisonment on benefit payments, see M21-1 Part III, Subpart v, 8.A. e. Awarding a Hospitalization Rating for Multiple SC Conditions In cases in which two or more SC disabilities exist for which the provisions of would apply, increase the evaluation of only one of the disabilities to100 percent.